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Sample records for extramural clinical placement

  1. The Effect of an Extramural Program on the Perceived Clinical Competence of Dental Hygiene Students.

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    Butters, Janice M.; Vaught, Randall L.

    1999-01-01

    A study investigated the effect of an extramural rotation on dental-hygiene students' self-perceptions of competence in specific clinical areas. Results indicate student perceptions of competence improved significantly on six of 19 dimensions of dental-hygiene practice over the course of the rotation, suggesting that rotation is a valuable…

  2. Factors influencing radiation therapy student clinical placement satisfaction

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    Bridge, Pete; Carmichael, Mary-Ann [School of Clinical Sciences, Queensland University of Technology, Brisbane (Australia)

    2014-02-15

    Introduction: Radiation therapy students at Queensland University of Technology (QUT) attend clinical placements at five different clinical departments with varying resources and support strategies. This study aimed to determine the relative availability and perceived importance of different factors affecting student support while on clinical placement. The purpose of the research was to inform development of future support mechanisms to enhance radiation therapy students’ experience on clinical placement. Methods: This study used anonymous Likert-style surveys to gather data from years 1 and 2 radiation therapy students from QUT and clinical educators from Queensland relating to availability and importance of support mechanisms during clinical placements in a semester. Results: The study findings demonstrated student satisfaction with clinical support and suggested that level of support on placement influenced student employment choices. Staff support was perceived as more important than physical resources; particularly access to a named mentor, a clinical educator and weekly formative feedback. Both students and educators highlighted the impact of time pressures. Conclusions: The support offered to radiation therapy students by clinical staff is more highly valued than physical resources or models of placement support. Protected time and acknowledgement of the importance of clinical education roles are both invaluable. Joint investment in mentor support by both universities and clinical departments is crucial for facilitation of effective clinical learning.

  3. Clinical placements and nursing students' career planning: a qualitative exploration.

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    McKenna, Lisa; McCall, Louise; Wray, Natalie

    2010-04-01

    Many nursing students enter undergraduate programmes with preconceived ideas about their future nursing careers, and intend to practice in particular areas such as midwifery or paediatrics. Through clinical placements, students are exposed to different clinical areas and professional socialization is facilitated. However, little is known about the influence of clinical placements on students' career intentions. This paper reports nursing findings drawn from a large qualitative study conducted in Victoria, Australia that sought to explore the influence of health professional students' clinical placements on their future career intentions. Participants were invited to be involved in either face-to-face or focus group interviews depending upon their own preference. Thematic data analysis revealed three main themes: 're-affirming career choice', 'working in a particular area' and 'work location'. Findings from the study add to our understanding of factors influencing nursing students' planning for their future careers including the impact of clinical placements.

  4. Clinical reasoning of nursing students on clinical placement: Clinical educators' perceptions.

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    Hunter, Sharyn; Arthur, Carol

    2016-05-01

    Graduate nurses may have knowledge and adequate clinical psychomotor skills however they have been identified as lacking the clinical reasoning skills to deliver safe, effective care suggesting contemporary educational approaches do not always facilitate the development of nursing students' clinical reasoning. While nursing literature explicates the concept of clinical reasoning and develops models that demonstrate clinical reasoning, there is very little published about nursing students and clinical reasoning during clinical placements. Semi-structured interviews were conducted with ten clinical educators to gain an understanding of how they recognised, developed and appraised nursing students' clinical reasoning while on clinical placement. This study found variability in the clinical educators' conceptualisation, recognition, and facilitation of students' clinical reasoning. Although most of the clinical educators conceptualised clinical reasoning as a process those who did not demonstrated the greatest variability in the recognition and facilitation of students' clinical reasoning. The clinical educators in this study also described being unable to adequately appraise a student's clinical reasoning during clinical placement with the use of the current performance assessment tool.

  5. Supporting Placement Supervision in Clinical Exercise Physiology

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    Sealey, Rebecca M.; Raymond, Jacqueline; Groeller, Herb; Rooney, Kieron; Crabb, Meagan; Watt, Kerrianne

    2015-01-01

    The continued engagement of the professional workforce as supervisors is critical for the sustainability and growth of work-integrated learning activities in university degrees. This study investigated factors that influence the willingness and ability of clinicians to continue to supervise clinical exercise physiology work-integrated learning…

  6. Clinical placement and case study methodology: a complex affair.

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    Donnelly, Frank; Wiechula, Rick

    2012-11-01

    Clinical placement is a valuable component of nursing education, helping students to authenticate, integrate and develop a range of nursing skills and knowledge. The diversity of nursing curricula throughout the world and the many models of clinical placement make this a difficult subject to research using typical qualitative and quantitative research methodologies. The potential for case study methodology to address the complexity of learning in the clinical environment is significant. This paper argues that Complexity Theory provides an interpretive paradigm that articulates well with case study methodology. This paper also provides an example of the development of a theoretical proposition based on pattern matching. Pattern matching is an approach to data analysis that encourages a consideration of predicted patterns with those that are empirically based. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Every team needs a coach: Training for interprofessional clinical placements.

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    Grymonpre, Ruby; Bowman, Susan; Rippin-Sisler, Cathy; Klaasen, Kathleen; Bapuji, Sunita B; Norrie, Ola; Metge, Colleen

    2016-09-01

    Despite growing awareness of the benefits of interprofessional education and interprofessional collaboration (IPC), understanding how teams successfully transition to IPC is limited. Student exposure to interprofessional teams fosters the learners' integration and application of classroom-based interprofessional theory to practice. A further benefit might be reinforcing the value of IPC to members of the mentoring team and strengthening their IPC. The research question for this study was: Does training in IPC and clinical team facilitation and mentorship of pre-licensure learners during interprofessional clinical placements improve the mentoring teams' collaborative working relationships compared to control teams? Statistical analyses included repeated time analysis multivariate analysis of variance (MANOVA). Teams on four clinical units participated in the project. Impact on intervention teams pre- versus post-interprofessional clinical placement was modest with only the Cost of Team score of the Attitudes Towards Healthcare Team Scale improving relative to controls (p = 0.059) although reflective evaluations by intervention team members noted many perceived benefits of interprofessional clinical placements. The significantly higher group scores for control teams (geriatric and palliative care) on three of four subscales of the Assessment of Interprofessional Team Collaboration Scale underscore our need to better understand the unique features within geriatric and palliative care settings that foster superior IPC and to recognise that the transition to IPC likely requires a more diverse intervention than the interprofessional clinical placement experience implemented in this study. More recently, it is encouraging to see the development of innovative tools that use an evidence-based, multi-dimensional approach to support teams in their transition to IPC.

  8. First impressions count: does FAIRness affect adaptation of clinical clerks in their first clinical placement?

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    Edafe, Ovie; Mistry, Natasha; Chan, Philip

    2013-09-01

    FAIRness (Feedback, Activity, Individualisation, Relevance) teaching is a structured program, comprising series of classes in which student work is anonymised and reviewed by the whole class, as well as students receiving private feedback on their written work. The class work emphasises logic, structure and order in history and examination, with a diagnostic and management focus. The effect of FAIRness teaching methods on the adaptation of medical students entering their first clinical rotations was studied. 18 students in FAIRness placements and 72 students in conventional placements, all in medical/surgical units in the same University teaching hospital were studied. They completed questionnaires relating to effectiveness and quality of clinical teaching. Some students additionally attended focus groups, at the start of placement to discuss their expectations, and after 3 weeks, to discuss their adaptation to the clinical learning environment. All students entering clinical placements had low expectations of their future teaching. Students in standard placements still expressed negative attitudes after 3 weeks, while students on FAIRness placements felt positive. Students in FAIRness placements scored significantly higher on questions related to feedback and review of student work. FAIRness teaching practices help students to adapt to their first clinical placements.

  9. Experience of nursing students with dyslexia on clinical placement.

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    McPheat, Christopher

    2014-06-17

    A review of the literature was conducted to explore the experience of nursing students with dyslexia while on clinical placement. Three main themes emerged, including risk to patient safety, disclosure of dyslexia and support for nursing students. The literature review highlights the lack of dyslexia awareness and understanding in the research and at the trusts at which nursing students are placed, and calls for further research in this area.

  10. Social learning in a longitudinal integrated clinical placement.

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    Roberts, Chris; Daly, Michele; Held, Fabian; Lyle, David

    2016-12-03

    Recent research has demonstrated that longitudinal integrated placements (LICs) are an alternative mode of clinical education to traditional placements. Extended student engagement in community settings provide the advantages of educational continuity as well as increased service provision in underserved areas. Developing and maintaining LICs require a differing approach to student learning than that for traditional placements. There has been little theoretically informed empirical research that has offered explanations of which are the important factors that promote student learning in LICs and the relationships between those factors. We explored the relationship between student learning, student perceptions of preparedness for practice and student engagement, in the context of a rural LIC. We used a sequential qualitative design employing thematic, comparative and relational analysis of data from student interviews (n = 18) to understand possible processes and mechanisms of student learning in the LIC. Through the theoretical lens of social learning systems, we identified two major themes; connectivity and preparedness for practice. Connectivity described engagement and relationship building by students, across formal and informal learning experiences, interprofessional interactions, social interactions with colleagues, interaction with patients outside of the clinical setting, and the extent of integration in the wider community. Preparedness for practice, reflected students' perceptions of having sufficient depth in clinical skills, personal and professional development, cultural awareness and understanding of the health system, to work in that system. A comparative analysis compared the nature and variation of learning across students. In a relational analysis, there was a positive association between connectivity and preparedness for practice. Connectivity is a powerful enabler of students' agentic engagement, collaboration, and learning within an LIC. It

  11. Emotional work and diversity in clinical placements of nursing students.

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    Arieli, Daniella

    2013-06-01

    To learn how students experience clinical placements in a setting of diversity and how they cope with the emotional challenges involved. This study is based on inductive, qualitative research undertaken with Israeli nursing students. In-depth interviews were conducted with 20 students: 10 Arabs (5 men and 5 women), 9 Jews (2 men and 7 women), and 1 Circassian. The interviews were analyzed through coding and categorization. The students' experiences are characterized by emotional strains of various sorts-stress, ambivalence, disgust, frustration, and conflict-that arise in three types of relationships: relationships with patients, with the clinical instructors, and with other students who are on their teams. The data show that diversity has an impact on all these relationships. The data further show that the students cope with the emotional strains by using several strategies of emotional work: distancing, self-strengthening, self-motivation work, and minimizing significance. (a) Nursing students' experiences during their clinical placements should be understood in terms of emotional challenges, and their emotional work and coping strategies call for appropriate forms of support. (b) The diversity of the clinical placement environment should be considered as an important factor, both in understanding students' experiences and learning processes and in designing the support that they need. Culturally diverse settings entail distinct challenges that impact students' emotional reaction to clinical work. Understanding the types of emotional work students do in the process of their clinical experience is critical for educators seeking to promote genuinely caring and effective nursing in culturally diverse settings.  © 2013 Sigma Theta Tau International.

  12. Paramedic instructor perspectives on the quality of clinical and field placements for university educated paramedicine students.

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    O'Meara, Peter; Williams, Brett; Hickson, Helen

    2015-11-01

    To determine the elements of quality clinical and field placements through the eyes of paramedic instructors. Qualitative study. Two large paramedic services in two countries where the entry to practice qualification for paramedics has been set at the Bachelors degree level. Fifteen purposively selected paramedic instructors were invited to voluntarily participate. The criterion for inclusion was that they had supervised at least one university paramedicine student on a field placement. Recruitment ceased when saturation was reached. Face to face semi-structured interviews were conducted with participants who were asked their views and expectations of paramedicine student clinical and field placements. Inductive thematic analysis of the transcripts was completed using Nvivo software. The elements of quality clinical and field placements from the perspective of paramedic instructors were identified. With no agreed clinical and field placement paramedicine standards in the countries studied there is variation in the focus of placements, preferred settings, and expectations. Vocationally trained paramedics favoured paramedic service placements, whilst university educated paramedics see benefits in placements in more diverse settings. Paramedic services and universities need to collaboratively address the variation in paramedicine university student clinical and field placements. Standards need to be developed that address the purpose of placements, expectations of students and instructors, and be scaffolded across the education spectrum from undergraduate student to graduate paramedic to instructor. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Precautions used by occupational health nursing students during clinical placements

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    T.M.M. Maja

    2009-09-01

    Full Text Available Protection of health care workers including students from being infected when caring for high risk patients is a major cause for concern to all promoting occupational health. Safety of every employee is mandatory. Furthermore, universal guidelines for precautions must be used by all interacting with high risk patients and clients to protect themselves and prevent the spread of infection. The aim of this paper was to ascertain the availability of universal guidelines for precautions against the spread of infection in clinical settings and determine the precautions used by OHN students during their clinical placements. To realise these objectives, a quantitative and descriptive design was followed. A purposive sampling method was used to select 45 Occupational health nursing students who participated in the study.Data was collected with the use of a structured questionnaire and the results revealed that: most units where OHN students were placed for clinical experience had guidelines for universal precautions although these were not always accessible to them; regarding compliance to universal precautions, OHN students were reportedly aware of the hazards of failure to comply although in some emergencies and where personal protective material was not available, they had to provide care without using protective equipments. Recommendations made include that employers and staff at all occupational settings must ensure that updated guidelines for universal precautions are available and accessible to every body interacting with high risk patients; health care providers and students must be fully informed about and should always adhere to universal precautions.

  14. Enhancing Learning in Clinical Placements: Reflective Practice, Self-Assessment, Rubrics and Scaffolding

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    Stupans, Ieva; March, Geoff; Owen, Susanne M.

    2013-01-01

    Professional preparatory health programmes generally involve clinical placements with a focus on integration of theory into real life practice. Reflective writing is often included in the assessment requirements for clinical placement courses. However enabling students to engage in deeper levels of reflective writing in action, on action and for…

  15. Impact of Placement Type on the Development of Clinical Competency in Speech-Language Pathology Students

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    Sheepway, Lyndal; Lincoln, Michelle; McAllister, Sue

    2014-01-01

    Background: Speech-language pathology students gain experience and clinical competency through clinical education placements. However, currently little empirical information exists regarding how competency develops. Existing research about the effectiveness of placement types and models in developing competency is generally descriptive and based…

  16. Feedback and assessment for clinical placements: achieving the right balance

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    Burgess A

    2015-05-01

    Full Text Available Annette Burgess, Craig Mellis Central Clinical School, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia Abstract: During clinical placements, the provision of feedback forms an integral part of the learning process and enriches students' learning experiences. The purpose of feedback is to improve the learner's knowledge, skills, or behavior. Receipt of accurate feedback can help to narrow the gap between actual and desired performance. Effective and regular feedback has the potential to reinforce good practice and motivate the learner toward the desired outcome. Despite the obvious role of feedback in effective teaching and learning, a common complaint from students is that they do not receive adequate feedback. Unfortunately, skills in giving and receiving feedback are rarely taught to students or clinicians. This study aims to provide an understanding of the role of feedback within the learning process, consider consequences of inadequate or poorly given feedback, consider the barriers to the feedback process, provide practical guidelines for providing feedback, and consider the need for student and faculty development in feedback skills. Keywords: medical students, formative, summative, assessment

  17. Clinical expectations: what facilitators expect from ESL students on clinical placement.

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    San Miguel, Caroline; Rogan, Fran

    2012-03-01

    Many nursing students for whom English is a second language (ESL) face challenges related to communication on clinical placement and although clinical facilitators are not usually trained language assessors, they are often in a position of needing to assess ESL students' clinical language performance. Little is known, however, about the particular areas of clinical performance facilitators focus on when they are assessing ESL students. This paper discusses the results of a study of facilitators' written assessment comments about the clinical performance of a small group of ESL nursing students over a two and a half year period. These comments were documented on students' clinical assessment forms at the end of each placement. The results provide a more detailed insight into facilitators' expectations of students' language performance and the particular challenges faced by ESL students and indicate that facilitators have clear expectations of ESL students regarding communication, learning styles and professional demeanour. These findings may help both ESL students and their facilitators better prepare for clinical placement.

  18. Nursing students' reflections on the learning experience of a unique mental health clinical placement.

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    Patterson, Christopher; Moxham, Lorna; Brighton, Renee; Taylor, Ellie; Sumskis, Susan; Perlman, Dana; Heffernan, Tim; Hadfield, Louise

    2016-11-01

    There exists a need for innovative thinking to identify new clinical placement opportunities for nursing students. Recovery-based clinical placements for mental health nurse students remain unique and require investigation. To examine the learning experience of Bachelor of Nursing students who undertook an innovative mental health clinical placement known as Recovery Camp. This study incorporated qualitative analysis of written reflections. Using Braun and Clarke's (2006) six phases of thematic analysis the corpus of student reflections were reviewed by three members of the research team independent to each other. Four themes emerged. The theme of Pre-placement Expectations incorporates participant foci on pre-conceptions of Recovery Camp. The theme of Student Learning incorporates the ways in which participants recognised the experience of Recovery Camp influenced learning. Reflections themed under the title Placement Setting include discussion of the Recovery Camp as a clinical placement. The theme of Future Practice incorporates students' reflections on how they plan to practice as nurses as a result the learning experiences of Recovery Camp. An immersive clinical placement such as Recovery Camp can influence students' perceptions of people with mental illness, have a positive impact on student learning and influence students' decisions about future practice. The learning experience of nursing students whom attend unique, recovery-orientated clinical placements can be both positive and educative. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. International students in speech-language pathology clinical education placements: Perceptions of experience and competency development.

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    Attrill, Stacie; Lincoln, Michelle; McAllister, Sue

    2015-06-01

    This study aimed to describe perceptions of clinical placement experiences and competency development for international speech-language pathology students and to determine if these perceptions were different for domestic students. Domestic and international students at two Australian universities participated in nine focus group interviews. Thematic analysis led to the identification of two themes shared by international and domestic students and several separate themes. Shared themes identified the important influence of students' relationships with clinical educators, unique opportunities and learning that occurs on placement. International student themes included concerns about their communication skills and the impact of these skills on client progress. They also explored their adjustment to unfamiliar placement settings and relationships, preferring structured placements to assist this adjustment. Domestic student themes explored the critical nature of competency attainment and assessment on placement, valuing placements that enabled them to achieve their goals. The findings of this study suggest that international students experience additional communication, cultural and contextual demands on clinical placement, which may increase their learning requirements. Clinical education practices must be responsive to the learning needs of diverse student populations. Strategies are suggested to assist all students to adjust to the professional and learning expectations of clinical education placements.

  20. Radiography students' perceptions of clinical placements - A Nigerian perspective

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    Ogbu, S.O.I. [Department of Medical Radiography and Radiological Sciences, University of Nigeria, Enugu Campus, 11 Clement Nnakwe Close, Ugbene, Abakpa-Nike, Enugu State 400001 (Nigeria)], E-mail: sylvogbu_rad@yahoo.com

    2008-05-15

    Purpose: To assess undergraduate radiography student perception of clinical placements and to evaluate their clinical learning experiences. Methods: To evaluate student perception of clinical placements, a Likert-scale questionnaire was used to assess clinical practice, the practice-learning environment. One hundred and seventy-eight undergraduate [student] radiographers participated in the study. Results: The students indicated they had adequate and enjoyed their time on the clinical placement. They also indicated the qualified staff was supportive, friendly and approachable. The students were able to achieve their learning outcomes during the placement. However placement venues, according to the students, had inadequate learning resources. No radiographic/medical imaging research findings, whether locally generated or otherwise, were used in clinical practice. Conclusions: Clinical placements had adequate student support. It provided a pleasant learning experience for the students and it enhanced their skills. Staff was willing and available to assist learning. Nevertheless, the training institutions, professional body and clinical placement providers need to make an effort to address inadequate learning resources (e.g. IT, library, study rooms) as well as the non-utilization of radiographic/medical imaging research findings.

  1. International clinical placements for Australian undergraduate nursing students: A systematic thematic synthesis of the literature.

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    Browne, Caroline A; Fetherston, Catherine M; Medigovich, Kristina

    2015-10-01

    International clinical placements provide undergraduate nursing students with the opportunity to experience or practice nursing care in diverse countries, settings, and cultures. This systematic review aims to ascertain the current knowledge on international clinical placements offered by undergraduate nursing programs in Australia. It seeks to explore three questions: (1) How have previous experiences of nursing students' international clinical placements been described? (2) How have participants and stakeholders determined if the placement has been successful? And (3) What benefits or challenges have been identified by stakeholders as a result of participating in international clinical placements? A systematic thematic synthesis was undertaken. A search of electronic databases including CINAHL, Proquest Central, Scopus, PubMed, and Health Collection was undertaken between September and October 2014. Key terms including 'international clinical placement', 'study abroad', 'international exchange', 'nursing', and 'Australia' were used to identify articles that appeared in peer-reviewed English language journals and that explored international clinical placements offered to undergraduate nursing students by Australian universities. Eight studies were identified that meet the inclusion criteria, and through thematic analysis, five key themes were identified including developing cultural awareness and competence, providing a global perspective on health care, translation of theory to practice, growing personally through reflection, and overcoming apprehension to successfully meet the challenge. A comparison search of literature from Canada and the United Kingdom revealed that similar themes occurred internationally. Although personal successes were identified by students undertaking international clinical placement, further research is required to identify all stakeholder experiences including those of the educators, the educational institutions, and travel providers

  2. Optimal markers' placement on the thorax for clinical gait analysis.

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    Armand, Stéphane; Sangeux, Morgan; Baker, Richard

    2014-01-01

    Although, several thorax models have been proposed for clinical gait analysis, none has received widespread acceptance nor been subject to any extensive validation work, especially for the marker set to use. The aim of this study was thus to determine the optimal and minimal makers' placement on the thorax for clinical gait analysis. Ten healthy subjects have performed a series of movements (arm, head, trunk) with large amplitude during walking. Reflective markers were taped on the thorax (C7, T2, T4, T6, T8, T10, T12, sternum, clavicles and ribs) and their 3D positions were captured with an opto-electronic system. Each combination of 3 markers has been tested. The global error of each model was computed with the estimated position of the markers considering the thorax segment as a solid segment. Two families of marker sets were identified with the lowest error. The first family was composed by two anterior and one posterior marker on the thorax (incisura jugularis (IJ), xiphoid process, and T8). The second family was composed by two posterior and one anterior maker (IJ, T2 and T8 or T10). Even, if these two families of marker sets presented a similar error for marker position, the angles obtained from these marker sets showed large differences especially for the axial rotation movement of the trunk (up to 40.1°). The optimal and minimal maker set identified with a variety of large movements of the trunk, head and arms was IJ, T2 and T8 or T10. Copyright © 2013 Elsevier B.V. All rights reserved.

  3. Supervising international students in clinical placements: perceptions of experiences and factors influencing competency development.

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    Attrill, Stacie; Lincoln, Michelle; McAllister, Sue

    2016-07-16

    Health professional education programs attract students from around the world and clinical supervisors frequently report that international students find learning in clinical placement contexts particularly challenging. In existing literature clinical supervisors, who support international students on placement have identified concerns about their communication and interactions within clinical environments. However, clinical supervisors' perspectives about their experiences with international students on placement and the strategies they utilise to facilitate international student learning have not been described. As a result we have little insight into the nature of these concerns and what clinical supervisors do to support international students' competency development. Five focus group interviews were conducted with twenty Speech-Language Pathology clinical supervisors, recruited from 2 Australian universities. Interview data were analysed thematically. Themes identified were interpreted using cognitive load and sociocultural learning theories to enhance understanding of the findings. Four themes were identified: 'Complex teaching and learning relationships', 'Conceptions of students as learners'; Student communication skills for professional practice', and 'Positive mutual learning relationships'. Findings indicated that clinical supervisors felt positive about supporting international students in clinical placements and experienced mutual learning benefits. However, they also identified factors inherent to international students and the placement environment that added to workload, and made facilitating student learning complex. Clinical supervisors described strategies they used to support international students' cultural adjustment and learning, but communication skills were reported to be difficult to facilitate within the constraints of placements. Future research should address the urgent need to develop and test strategies for improving international

  4. Satisfaction with clinical placement--The perspective of nursing students from multiple universities.

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    Lamont, Scott; Brunero, Scott; Woods, Karen P

    2015-01-01

    Projected nursing shortfalls in Australia have identified the need for organisational planning and strategies around recruitment and retention in healthcare facilities. Strategies include but are not limited to alliances with university faculty and the quality of undergraduate clinical placement experience. This cross-sectional study explored undergraduate nursing students' satisfaction with clinical placement experience from the perspective of multiple university faculties, and the relationship this has with future employment intention at a metropolitan hospital in Sydney, New South Wales. Findings from respondents demonstrated satisfaction with the clinical placement on the following criteria: expectations being met; welcoming of unit staff and attitudes of thereafter; clinical and university facilitator support; and participation in patient care. Three quarters of respondents also indicated that they would consider the hospital as a future employer. Satisfaction with clinical placement experience may aid organisational recruitment strategies.

  5. Preparation for high-acuity clinical placement: confidence levels of final-year nursing students

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    Porter J

    2013-04-01

    Full Text Available Joanne Porter, Julia Morphet, Karen Missen, Anita Raymond School of Nursing and Midwifery, Monash University, Churchill, VIC, Australia Aim: To measure final-year nursing students’ preparation for high-acuity placement with emphasis on clinical skill performance confidence. Background: Self-confidence has been reported as being a key component for effective clinical performance, and confident students are more likely to be more effective nurses. Clinical skill performance is reported to be the most influential source of self-confidence. Student preparation and skill acquisition are therefore important aspects in ensuring students have successful clinical placements, especially in areas of high acuity. Curriculum development should aim to assist students with their theoretical and clinical preparedness for the clinical environment. Method: A modified pretest/posttest survey design was used to measure the confidence of third-year undergraduate nursing students (n = 318 for placement into a high-acuity clinical setting. The survey comprised four questions related to clinical placement and prospect of participating in a cardiac arrest scenario, and confidence rating levels of skills related to practice in a high-acuity setting. Content and face validity were established by an expert panel (α = 0.90 and reliability was established by the pilot study in 2009. Comparisons were made between confidence levels at the beginning and end of semester. Results: Student confidence to perform individual clinical skills increased over the semester; however their feelings of preparedness for high-acuity clinical placement decreased over the same time period. Reported confidence levels improved with further exposure to clinical placement. Conclusion: There may be many external factors that influence students’ perceptions of confidence and preparedness for practice. Further research is recommended to identify causes of poor self-confidence in final-year nursing

  6. PSYCHIATRIC CLINICAL PLACEMENT UPON NURSING STUDENTS PERCEIVED KNOWLEDGE IN CARING FOR MENTALLY ILL

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    Herry Prasetyo

    2012-08-01

    Full Text Available Background: The implementation of a psychiatric clinical placement has been an integral component in Indonesia Nursing Academies. Purpose: The research was to investigate how nursing students’ perceived knowledge in caring for mentally ill patients as a result of their psychiatric clinical placement. Method: A descriptive survey design commonly called non-experimental design was used in this research. Students, who had completed two weeks in a psychiatric clinical placement as a component of mental health nursing subject, were invited to participate. Then, a questionnaire was distributed to nursing students (N=40, giving an overall responses rate of 85 %. Result: The finding revealed that as a result of clinical placement, the majority of nursing students had better perceived knowledge regarding the concept of mental health and mental illness, nursing care plan, medication and providing education towards patient and people in community about mental health. Conclusion: The findings provide evidence for the benefits of such a clinical placement in relation to students’ perceived knowledge in caring for psychiatric patients. Key words: Clinical placement, nursing students, knowledge, mentally ill

  7. Supporting culturally and linguistically diverse students during clinical placement: strategies from both sides of the table.

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    O'Reilly, Sharleen L; Milner, Julia

    2015-10-15

    Increasing proportions of Culturally and Linguistically Diverse (CALD) students within health professional courses at universities creates challenges in delivering inclusive training and education. Clinical placements are a core component of most health care degrees as they allow for applied learning opportunities. A research gap has been identified in regard to understanding challenges and strategies for CALD students in health professional placements. A key stakeholder approach was used to examine barriers and enablers experienced by CALD students in clinical placement. Semi-structured focus groups with healthcare students (n = 13) and clinical placement supervisors (n = 12) were employed. The focus groups were analysed using open coding and thematic analysis. Three main barrier areas were identified: placement planning and preparation; teaching, assessment and feedback; and cultural and language issues. Potential solutions included addressing placement planning and preparation barriers, appropriate student placement preparation, pre-placement identification of higher risk CALD students, and diversity training for supervisors. For the barrier of teaching, assessment & feedback, addressing strategies were to: adapt student caseloads, encourage regular casual supervisor-student conversations, develop supportive placement delivery modes and structures, set expectations early, model the constructive feedback process, use visual aids, and tailor the learning environment to individual student needs. The enablers for cultural & language issues were to: build language and practical approaches for communication, raise awareness of the healthcare system (how it interacts with healthcare professions and how patients access it), and initiate mentoring programs. The findings suggest that teaching and learning strategies should be student-centred, aiming to promote awareness of difference and its impacts then develop appropriate responses by both student and teacher

  8. Assessment of student competency in a simulated speech-language pathology clinical placement.

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    Hill, Anne E; Davidson, Bronwyn J; McAllister, Sue; Wright, Judith; Theodoros, Deborah G

    2014-10-01

    Clinical education programs in speech-language pathology enable the transition of students' knowledge and skills from the classroom to the workplace. Simulated clinical learning experiences provide an opportunity to address the competency development of novice students. This study reports on the validation of an assessment tool designed to evaluate speech-language pathology students' performance in a simulated clinical placement. The Assessment of Foundation Clinical Skills (AFCS) was designed to link to concepts and content of COMPASS(®): Competency Assessment in Speech Pathology, a validated assessment of performance in the workplace. It incorporates units and elements of competency relevant to the placement. The validity of the AFCS was statistically investigated using Rasch analysis. Participants were 18 clinical educators and 130 speech-language pathology students undertaking the placement. Preliminary results support the validity of the AFCS as an assessment of foundation clinical skills of students in this simulated clinical placement. All units of competency and the majority of elements were relevant and representative of these skills. The use of a visual analogue scale which included a pre-Novice level to rate students' performance on units of competency was supported. This research provides guidance for development of quality assessments of performance in simulated placements.

  9. Something has shifted: Nursing students' global perspective following international clinical placements.

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    Gower, Shelley; Duggan, Ravani; Dantas, Jaya A R; Boldy, Duncan

    2017-10-01

    To examine understandings of global health issues among nursing students following participation in an international clinical placement during their pre-registration university education. Universities use international clinical placements, especially in developing countries, to develop cultural awareness in students; however, little is known about the longer term influences on students' understandings of global nursing. A retrospective cross-sectional design was used, using an exploratory, descriptive qualitative approach. Individual semi-structured interviews were conducted in 2014 with a purposive sample of 25 pre-registration nursing students from four Western Australian universities who undertook clinical placements across five countries. Data were analysed using inductive thematic analysis. Findings highlight that students developed new understandings around health systems including fragility of resource access, differences in clinical practice and variances in nursing roles between settings. Students also experienced challenges but were able to appreciate alternative world viewpoints. International clinical placements can develop greater awareness and help students form realistic strategies for using their nursing skills globally. Pre-placement training in cultural awareness and health system realities, along with strong supervisory support, is critical to success. © 2017 John Wiley & Sons Ltd.

  10. How Clinical Instructors Can Enhance the Learning Experience of Physical Therapy Students in an Introductory Clinical Placement

    Science.gov (United States)

    Cole, Beverley; Wessel, Jean

    2008-01-01

    Purpose: There is little understanding of how physical therapy students are influenced by clinical instructors (CIs) particularly at the outset of their clinical learning. The purpose of this study was to evaluate physical therapy students' perceptions of their learning experiences during an introductory clinical placement. Methods: Subjects were…

  11. A sense of belonging and perceived stress among baccalaureate nursing students in clinical placements.

    Science.gov (United States)

    Grobecker, Patricia A

    2016-01-01

    The rigorous efforts students put into baccalaureate nursing programs to become a professional nurse is compounded by their need to have a sense of belonging in their clinical placements. In addition, the students' perceived stress may contribute to their physiological and psychological wellbeing undermining academic achievements and confidence. A sense of belonging and perceived stress have research history in psychological and sociological realms; but not used together in the nursing profession as applied in clinical placements. The Perceived Stress Scale is a psychological instrument used globally; however, the Belongingness Scale-Clinical Placement Experience (BES-CPE) measurement tool has not been used in published research in the United States. A descriptive correlational research design examining the relationship between a sense of belonging and perceived stress among baccalaureate nursing students in clinical placements. Three measurement tools were used for data collection: BES-CPE, Perceived Stress Scale (PSS-10) and demographic questionnaire. Students were able to access the online survey through SurveyMonkey®. A national study was conducted using 1296 volunteer nursing students from the National Student Nurses Association (NSNA) database. These nursing students were currently enrolled in a baccalaureate nursing program, 18years of age and completed at least one clinical experience. The findings from this study revealed a statistically significant low inverse relationship (r=-.277) between a sense of belonging and perceived stress among baccalaureate nursing students in their clinical placements. The findings also supported the use of BES-CPE as a reliable and valid measurement tool for nursing students in clinical placements. The results of this study supported the concept of a sense of belonging as a fundamental human need, having a positive influence and impact on students' learning, motivation and confidence. In contrast, perceived stress has

  12. [Extramural research funds and penal law--status of legislation].

    Science.gov (United States)

    Ulsenheimer, Klaus

    2005-04-01

    After decades of smooth functioning, the cooperation of physicians and hospitals with the industry (much desired from the side of the government in the interest of clinical research) has fallen in legal discredit due to increasingly frequent criminal inquires and proceedings for unduly privileges, corruption, and embezzlement. The discredit is so severe that the industry funding for clinical research is diverted abroad to an increasing extent. The legal elements of embezzlement assume the intentional violation of the entrusted funds against the interest of the customer. Undue privileges occur when an official requests an advantage in exchange for a service (or is promised one or takes one) in his or somebody else's interest. The elements of corruption are then given when the receiver of the undue privilege provides an illegal service or takes a discretionary decision under the influence of the gratuity. The tension between the prohibition of undue privileges (as regulated by the penal law) and the granting of extramural funds (as regulated by the administrative law in academic institutions) can be reduced through a high degree of transparency and the start of control possibilities--public announcement and authorization by the officials--as well as through exact documentation and observance of the principles of separation of interests and moderation. With the anti-corruption law of 1997, it is possible to charge of corruption also physicians employed in private institutions. In contrast, physicians in private practice are not considered in the above criminal facts. They can only be charged of misdemeanor, or called to respond to the professional board, on the basis of the law that regulates advertising for medicinal products (Heilmittelwerbegesetz).

  13. Communication Barrier during Clinical Placement: Challenges and Experiences of International Nursing students

    OpenAIRE

    Awe, Omobolape

    2014-01-01

    ABSTRACT Effective communication in a clinical environment is vital. It plays an important role in patient care, just as language proficiency has been noted to be related to satisfactory learning experiences. This study aimed to understand the experiences of the students in respect to communication barriers during clinical practice and to answer three main re-search questions; 1: Do international student experience communication barrier during clinical placement? 2: What kind of language b...

  14. University Extra-Mural Studies and Extension Outreach: Incompatibilities

    Science.gov (United States)

    Rogers, Alan

    2014-01-01

    The argument of this paper is that--within a wide range of university responses to the challenge of outreach--there grew up in the extra-mural or adult education departments of many UK universities an alternative epistemological paradigm to the older and more traditional extension programmes. This paradigm threatened the extension approach and has…

  15. Academic training and clinical placement problems to achieve nursing competency

    Directory of Open Access Journals (Sweden)

    NARJES RAHMATI SHARGHI

    2015-01-01

    Full Text Available Introduction: High quality of care is one of the requirements of nursing which depends on the nursing competency. In this connection, the aim of this research was to determine the problems related to the academic training (nursing’ educational program and clinical practice to achieve competency from the viewpoint of nurses, faculty members, and nursing students. Methods: The study was an analytical cross-sectional one. The sample consisted of the academic staff, the third and the fourth year nursing students and nurses in practice. The instrument of the study was a two-part researcher-made questionnaire with 22 questions in the theoretical- clinical realm to assess problems related to the theoretical and clinical teaching in nursing, and 23 questions to assess the clinical functions. The questionnaire was validated in terms of both face and content validity. Its reliability, using Cronbach’s Alpha coefficient, was 0.72 in the theoretical-clinical and 0.73 in the clinical realm. Both descriptive and analytical statistics were used to analyze the data, using SPSS software. Results: The results of this study indicated that from the participants’ viewpoints, the most important problems in the academic education for nurses to acquire competency were as follows: lack of academic research during the clinical period (88.9%, no application of theoretical aspects of the nursing process in practice (85.6%, insufficient knowledgeable and professional educators (81.1%, the use of traditional routine-oriented methods on the wards (75.6%; also insufficient time for performance based on knowledge in relation to the nurse’s workload (86.5%, weakness and usefulness of scientific function encouragement systems in clinic (85.2%, and learnt theoretical subjects not coming into practice in clinical fields after graduation (75.6%. Conclusion: Efforts to reduce the gap between the theoretical and practical (clinical function knowledge in educational and work

  16. Academic training and clinical placement problems to achieve nursing competency

    Science.gov (United States)

    RAHMATI SHARGHI, NARJES; ALAMI, ALI; KHOSRAVAN, SHAHLA; MANSOORIAN, MOHAMMAD REZA; EKRAMI, ALI

    2015-01-01

    Introduction: High quality of care is one of the requirements of nursing which depends on the nursing competency. In this connection, the aim of this research was to determine the problems related to the academic training (nursing' educational program) and clinical practice to achieve competency from the viewpoint of nurses, faculty members, and nursing students. Methods: the study was an analytical cross-sectional one. The sample consisted of the academic staff, the third and the fourth year nursing students and nurses in practice. The instrument of the study was a two-part researcher-made questionnaire with 22 questions in the theoretical- clinical realm to assess  problems related to the theoretical and clinical teaching in nursing, and 23 questions to assess the clinical functions. The questionnaire was validated in terms of both face and content validity. Its reliability, using Cronbach's Alpha coefficient, was 0.72 in the theoretical-clinical and 0.73 in the clinical realm. Both descriptive and analytical statistics were used to analyze the data, using SPSS software. Results: The results of this study indicated that from the participants’ viewpoints, the most important problems in the academic education for nursea to acquire competency were as follows: lack of academic research the clinical period (88.9%), no application of theoretical aspects of the nursing process in practice (85.6%), insufficient knowledgeable and professional educators (81.1%), the use of traditional routine-oriented methods on the wards (75.6%); also insufficient time for performance based on knowledge in relation to  the nurse's workload (86.5%), weakness and usefulness of scientific function encouragement systems in clinic (85.2%), and learnt theoretical subjects not coming into practice in clinical fields after graduation (75.6%). Conclusion: Efforts to reduce the gap between the theoretical and practical (clinical function) knowledge in educational and work environment are

  17. Critical action research applied in clinical placement development in aged care facilities.

    Science.gov (United States)

    Xiao, Lily D; Kelton, Moira; Paterson, Jan

    2012-12-01

    The aim of this study was to develop quality clinical placements in residential aged care facilities for undergraduate nursing students undertaking their nursing practicum topics. The proportion of people aged over 65 years is expected to increase steadily from 13% in 2006 to 26% of the total population in Australia in 2051. However, when demand is increasing for a nursing workforce competent in the care of older people, studies have shown that nursing students generally lack interest in working with older people. The lack of exposure of nursing students to quality clinical placements is one of the key factors contributing to this situation. Critical action research built on a partnership between an Australian university and five aged care organisations was utilised. A theoretical framework informed by Habermas' communicative action theory was utilised to guide the action research. Multiple research activities were used to support collaborative critical reflection and inform actions throughout the action research. Clinical placements in eight residential aged care facilities were developed to support 179 nursing students across three year-levels to complete their practicum topics. Findings were presented in three categories described as structures developed to govern clinical placement, learning and teaching in residential aged care facilities.

  18. A descriptive survey investigating pre-registration student nurses' perceptions of clinical skill development in clinical placements.

    Science.gov (United States)

    Stayt, Louise C; Merriman, Clair

    2013-04-01

    Clinical skill development is essential to nurse education. Clinical skills are frequently taught in higher education institutions using clinical simulation. It is unclear if clinical skills are subsequently consolidated and developed in clinical placements. The aim of this survey was to evaluate pre-registration student nurses perceptions of the frequency of opportunities to practise, the level of supervision and assessment of, clinical skills in their clinical placements. This was a cross-sectional survey design using an online, self-report questionnaire including a Likert-type scale and open ended comments. Four hundred and twenty one students, from all year groups, from a university in the south of England on a wide variety of clinical placements participated. Participants evaluated the frequency of opportunity to practise, level of supervision and assessment of and feedback on performance of specific clinical skills. Clinical skills evaluated were measurement of vital signs, aseptic non-touch technique, assisting with eating and drinking, and assisting with comfort and hygiene. Data were analysed utilising Statistical Package for the Social Sciences Version 19. The frequency of opportunities to practise skills in clinical placement was variable with some participants reporting that they never had opportunity to practise essential skills. Similarly the level of supervision and assessment was also inconsistent suggesting that participants frequently practised clinical skills unsupervised without being assessed as competent. Inconsistencies in clinical skill development may lead to graduates who are not work ready and as a result, insufficient clinical competence potentially leads to unsafe practice and poor patient care. This calls for stronger partnerships between educators and clinical areas and the prioritisation of mentor preparation and education as well as organisational support in terms of mentor workload planning. Copyright © 2012 Elsevier Ltd. All

  19. Clinical evaluation of Xive implants 3-year after placement

    Institute of Scientific and Technical Information of China (English)

    Ruixia Wang; Hua Yuan; Ning Chen; Guoping Wang; Zhaoping Fang; Guoxing Zhou

    2008-01-01

    Objective: The main purpose of this retrospective study is to evaluate clinical outcomes of Xive implants 3-year after insertion. Methods: 219 Xive implants were placed in 139 patients and their clinical effects were evaluated using the Albrektsson Standard. Results:The 3-year survival rate of the Xive implants is 97.26%(213/219). Eleven cases of immediate implants and 15 cases of implant insertion after maxillary sinus lifting all succeeded. The failure ratio is 6/219(2.74%) with failures resulting from excess bone loss in the implant region, peal-implant mucosal inflammation or continuous pain caused by some unknown reasons. Conclusion: Xive implants are clinically effective for the restoration of missing teeth. Immediate implant and implant following maxillary sinus lifting were also successful.

  20. The significance of communities of practice: Norwegian nursing students' experience of clinical placement in Bangladesh.

    Science.gov (United States)

    Jørgensen, Wanja; Hadders, Hans

    2015-04-01

    The purpose of this study was to gain understanding of Norwegian students' experience of learning in clinical placement in Bangladesh without formal one-to-one supervision, by a personal mentor in the ward. Using focus group interviews with bachelor nursing students we explored the significance of 'communities of practice' in nursing practicum abroad, socialization and knowledge transfer. Seven third year bachelor nursing students enrolled in a clinical placement programme in Bangladesh participated in focus group interviews prior to their departure to Bangladesh, during their stay in Bangladesh and after their return to Norway. The Students' marginality and 'peripheral participation' triggered insight and reflection. The challenging but advantageous position of the peripheral students was heightened further due to the lack of one-to-one supervision in the clinic. Their previous experience with problem based learning and group learning was an asset that made them more resilient and helped them to cope.

  1. One-step surgical placement of Brånemark implants: a prospective multicenter clinical study.

    Science.gov (United States)

    Becker, W; Becker, B E; Israelson, H; Lucchini, J P; Handelsman, M; Ammons, W; Rosenberg, E; Rose, L; Tucker, L M; Lekholm, U

    1997-01-01

    This prospective longitudinal multicenter study evaluated the clinical outcomes after placement and restoration of one-step Brånemark implants into the maxillae and mandibles of completely and partially edentulous patients. Six surgical treatment centers participated in this study, in which 135 implants were placed into 63 adult patients. All implants were stable after placement. The majority of implants were placed into type B bone with minimal jaw resorption and type 2 bone quality. After implant placement, standard transmucosal healing abutments were firmly placed. The average amount of time between implant placement and prosthetic abutment connection was 170 days in the maxillae and 147 days in the mandibles. To evaluate crestal bone changes caused by implant placement, a periodontal probe was used to measure midbuccally from the top of the implant cylinder to the alveolar crest; in 29 patients, 54 midbuccal bone crest sites were remeasured following prosthetic abutment connection. Crestal bone changes in mandibles and maxillae were statistically and clinically insignificant. Six implants were lost prior to loading and one implant has not been restored. No implants or restorations were lost after loading. At 1 year, the implant success rate was 95.6%. Mesiodistal radiographic measurements from 34 patients were averaged, and changes from prosthetic abutment connection to, on average, 12 months follow-up were compared. The radiographs, which were digitalized, measured from the bottom of the implant cylinder to the most coronal bone in contact with implant thread. For mandibular implants, the mean radiographic bone level at prosthetic abutment connection was 1.07 mm; after loading, it was 1.35 mm. For maxillary implants, the mean radiographic bone height at prosthetic abutment connection was 1.16 mm; after loading, it was 1.36 mm. These changes were not statistically significant. The 1-year outcomes from this patient series indicate that one-step Br

  2. Identifying Opportunities for Peer Learning: An Observational Study of Medical Students on Clinical Placements.

    Science.gov (United States)

    Tai, Joanna H; Canny, Benedict J; Haines, Terry P; Molloy, Elizabeth K

    2017-01-01

    Phenomenon: Peer assisted learning (PAL) is frequently employed and researched in preclinical medical education. Fewer studies have examined PAL in the clinical context: These have focused mainly on the accuracy of peer assessment and potential benefits to learner communication and teamwork skills. Research has also examined the positive and negative effects of formal, structured PAL activities in the clinical setting. Given the prevalence of PAL activities during preclinical years, and the unstructured nature of clinical placements, it is likely that nonformal PAL activities are also undertaken. How PAL happens formally and informally and why students find PAL useful in this clinical setting remain poorly understood.

  3. Psychometric testing of the Persian version of the Belongingness Scale-Clinical Placement Experience.

    Science.gov (United States)

    Ashktorab, Tahereh; Hasanvand, Shirin; Seyedfatemi, Naemeh; Zayeri, Farid; Levett-Jones, Tracy; Pournia, Yadollah

    2015-03-01

    Belongingness has been identified both as a fundamental human need and as a prerequisite for nursing students' clinical learning. Belongingness has also been associated with students' academic achievement, retention, self-esteem, self-directed learning, and self-efficacy. The Belongingness Scale-Clinical Placement Experience is a valid and reliable measure of nursing students' belongingness scores; however, a Persian version of this scale is not currently available. This study aimed to translate the Belongingness Scale-Clinical Placement Experience into Persian, to evaluate its psychometric properties, and to measure the belongingness experiences of Iranian nursing students. Following translation and initial validity and reliability testing of the scale, 300 nursing students from three universities in Iran completed the survey. Further psychometric testing was undertaken followed by analysis of descriptive statistics. Based on the results of confirmatory factor analysis two items were removed from the scale. The mean score of Persian version of the Belongingness Scale-Clinical Placement Experience was 3.21 (0.57). The whole scale had a high internal consistency (Cronbach's alpha=0.92). The alpha coefficients of the subscales of "self-esteem", "connectedness", and "efficacy" were 0.85, 0.86, and 0.80 respectively. Similar to previous versions of the Belongingness Scale-Clinical Placement Experience, the Persian version demonstrated strong psychometric properties with strong validity and reliability, indicating its utility and appropriateness when measuring Iranian nursing students' belongingness experiences. Further testing with other cohorts would strengthen these results. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Building workplace social capital: A longitudinal study of student nurses' clinical placement experiences.

    Science.gov (United States)

    Materne, Michelle; Henderson, Amanda; Eaton, Emma

    2017-09-01

    Quality clinical placement experiences have been associated with nurses' workplace social capital. Social capital is broadly understood as the social organisation of trust, norms and networks that benefit society. Building social capital in the workplace may benefit experiences of staff and students. The aim of this study was to assess the impact of building workplace social capital on student nurse perceptions of clinical learning experiences. A quality improvement process was measured through repeated student surveys. First, second, third year students (n = 1176) from three universities completed a validated Student Clinical Learning Culture Survey (SCLCS) following their placement, at the commencement of quality improvement initiatives and five years later. The SCLCS measured students' perceptions of social affiliation, their motivation, satisfaction and dissatisfaction with clinical contexts. The first year of systematic changes focused on increasing student numbers along with improving communication, trust and knowledge sharing, antecedents to workplace social capital. No change was evident after the first year. Six years after commencement of building workplace social capital differences across all subscales, except dissatisfaction, were significant (p social capital that enhances student placement experiences. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Free gingival grafting and vestibuloplasty with endosseous implant placement: clinical report.

    Science.gov (United States)

    Simons, A M; Baima, R F

    1994-01-01

    Soft-tissue complications may occur adjacent to endosseous implants and their associated transepithelial abutments. Vestibuloplasty and connective tissue grafting techniques can be used to obtain attached keratinized tissue in the anterior endentulous mandible before implant placement in an effort to improve the long-term prognosis. A clinical case is presented that was restored with a mandibular implant-supported, bar-retained overdenture opposing a maxillary complete denture after grafting and vestibuloplasty procedures.

  6. The impact of short term clinical placement in a developing country on nursing students: A qualitative descriptive study.

    Science.gov (United States)

    Ulvund, Ingeborg; Mordal, Elin

    2017-08-01

    Offering nursing students' international clinical placement during the educational program is one response to meet the need of cultural competence among nurses. This paper provides insight into the impact of clinical placement, in a developing country, on third year nursing students. In the study we investigated how short term international clinical placement impacted Norwegian nursing students' development of cultural competency. In this study we utilised a qualitative descriptive design and used individual interviews with eighteen Norwegian nursing students who had all participated in an international clinical placement. The data were analysed using the principles of systematic text condensation. In spite the international clinical placement only was four weeks, the findings suggested that real life experience culturally awakened the students and forced an ongoing process developing cultural competence. However, it is important to give students time to reflection. Although increased cultural awareness and a growing cultural competence was identified by the students undertaking international clinical placement, further research is required. It is important to investigate the best methods to support the students' reflection such that the experiences lead to learning. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Fluctuations in the emotional intelligence of therapy students during clinical placements: Implication for educators, supervisors, and students.

    Science.gov (United States)

    Gribble, Nigel; Ladyshewsky, Richard K; Parsons, Richard

    2017-01-01

    This study investigated the changes in emotional intelligence (EI) of occupational therapy, physiotherapy, and speech pathology students (therapy students). Clinical placements have multiple benefits including the development of interprofessional skills, enhancing practice skills and interpersonal skills. Higher EI competencies have been shown to have a positive impact on patient outcomes, teamwork skills, dealing with stress, and patient satisfaction. Data for this study were collected at two time points: before third-year therapy students commenced extended clinical placements (T1 with 261 students) and approximately 7 months later after students had completed one or more clinical placements (T2 with 109 students). EI was measured using the Emotional Quotient Inventory 2.0 (EQ-i(2.0)). Only one EI score, assertiveness, demonstrated a significant decline. No EI score showed a significant increase. A third or more of the students showed increases of five points or more in self-actualisation, emotional expression, independence, reality testing and optimism. However, of concern were the five EI scores where therapy students' EI scores decreased by more than five points: assertiveness (where 38% of students declined), problem solving (37%), impulse control (35%), self-actualisation (35%), and stress tolerance (33%). With EI scores declining for some students during clinical placements, there are implications for clinical supervisors and interprofessional facilitators as clinical performance may decline concurrently. There is a range of potential reasons that clinical placements could negatively influence the EI competencies of a therapy student, including poor clinical supervision, conflict between a student, and supervisor and failing a clinical placement. The research suggests that interprofessional facilitators and university educators might consider students undertaking EI tests before clinical placements.

  8. Impact of myocardial bridge on clinical outcome after coronary stent placement.

    Science.gov (United States)

    Tsujita, Kenichi; Maehara, Akiko; Mintz, Gary S; Doi, Hiroshi; Kubo, Takashi; Castellanos, Celia; Liu, Jian; Yang, Junqing; Oviedo, Carlos; Franklin-Bond, Theresa; Sugirtharaj, Dorcas Deborah; Dangas, George D; Lansky, Alexandra J; Stone, Gregg W; Moses, Jeffrey W; Leon, Martin B; Mehran, Roxana

    2009-05-15

    Most intravascular ultrasound (IVUS)-identifiable myocardial bridges (MBs) were not appreciated angiographically, especially when they occurred adjacent to fixed proximal obstructive disease. The impact of MB stent placement on clinical outcome was determined in 317 consecutive patients with obstructive left anterior descending coronary artery lesions undergoing coronary stent placement. In these patients, IVUS identified 70 MBs, defined as a segment of coronary artery with both systolic compression and perivascular echolucent muscle. IVUS showed that the stent extended into the MB segment beyond the obstructive lesion in 24 patients (34%; MB stent group), although significant plaque was not observed within any MB segment. In the remaining 46 patients, the left anterior descending artery stent was implanted in only the obstructive lesion, avoiding the distal MB segment (non-MB stent group). Minimum stent area was significantly smaller in the MB stent group than non-MB stent group (4.8 +/- 1.1 vs 5.8 +/- 1.8 mm(2); p = 0.02). Rates of target-lesion revascularization, target-vessel revascularization, and composite end point (death/myocardial infarction/target-lesion revascularization/target-vessel revascularization, evaluated at a mean follow-up of 358 +/- 252 days) were more common in patients with versus without MB stent placement. Specifically, target-lesion revascularization rates were 24% versus 3%, respectively (log-rank p = 0.003). In-stent restenosis occurred within the stented MB segment in 3 of 5 MB stent group patients who required target-lesion revascularization (60%). In conclusion, inadvertent MB stent placement in left anterior descending artery lesions occurred commonly and may have been associated with an increased incidence of late events.

  9. Computed tomography of intra - and extramural ethmoid cells: iconographic essay

    Energy Technology Data Exchange (ETDEWEB)

    Goncalves, Fabricio Guimaraes [McGill University Health Centre (MUHC), Montreal, QC (Canada). Montreal General Hospital; Jovem, Cassio Lemos [Med Imagem, Teresina, PI (Brazil); Moura, Leonardo de Oliveira [Centro de Treinamento em Imagenologia (CETRIM), Joao Pessoa, PB (Brazil)

    2011-09-15

    The development of the paranasal sinuses is an intricate process that begins in the intrauterine life and terminates in early adulthood. Among the paranasal sinuses, the ethmoid cells or labyrinth are probably the most complex structures, being associated with the highest number of normal variants. Variations in the pattern of pneumatization of the ethmoid cells can be divided into intra - and extramural cells. Intramural cells are those which develop within the ethmoid labyrinth. Extramural cells are those that develop isolatedly. Computed tomography is the most useful tool in the evaluation of inflammatory processes of the paranasal sinuses. Computed tomography also plays a relevant role in the preoperative planning as well as in the postoperative follow-up, since it demonstrates exact anatomical details of normal structures with accuracy in the detection of variants. In the present pictorial essay, the authors describe the most common anatomical variants of the ethmoid labyrinth and their relationship with adjacent structures. Endoscopic sinonasal surgery has become increasingly less invasive, requiring more detailed anatomical imaging of this region. (author)

  10. Experiences by student nurses during clinical placement in psychiatric units in a hospital

    Directory of Open Access Journals (Sweden)

    W.J.C. Van Rhyn

    2004-09-01

    Full Text Available An exploratory study was conducted with the aim of discovering and describing experiences of psychiatric nursing students during clinical placement in a psychiatric unit. For the purpose of the study an unstructured interview was conducted with each participant during their first placement in a psychiatric unit to identify the factors experienced as stressful. The results indicated that all eight participants experienced average to high stress. Sources of stress identified included, among others, ineffective teaching and learning programmes, poor managerial governance of the service, detachment of professional nurses from their teaching role, poor relationships among staff, overreliance on the medical model of care and patient neglect. Psychiatric nursing students sampled indicated universal support for in-service education and training for professional nurses, attitude change of professional nurses towards students, support for student initiatives, student involvement in patient care and adequate allocation of resources for patient care and nurse training. The exploration and description of experiences of the psychiatric nursing students will help nurse educators plan clinical learning opportunities in such a way that they are less stressful, thus ensuring that psychiatric nursing students are equipped to utilise themselves as therapeutic instruments.

  11. [The Cracow modification of the Calotte method of teeth placement in clinical evaluation].

    Science.gov (United States)

    Majewski, S; Wiśniewska, G

    1990-01-01

    The purpose of the paper was checking of theoretical principles and assessment of the clinical usefulness of the calotte method of teeth placement in Cracow modification. In 110 patients this study was carried out according to the following schema: prosthetic treatment using complete prostheses with teeth placed by the modified method or by the Gysi-Fischer method, for comparison, and periodically repeated clinical examinations considering such elements as: articulation and occlusion, fixation and statics of prostheses, masticatory function and speech, and aesthetic result and adaptation process. In all these parameters good results were obtained by the modified method. It is concluded that the modification is particularly useful in therapeutically difficult cases, with unfavourable anatomic-physiological conditions of the denture bearing area.

  12. Reflections of physiotherapy students in the United Arab Emirates during their clinical placements: A qualitative study

    Directory of Open Access Journals (Sweden)

    Al-Shamlan Amal

    2005-01-01

    Full Text Available Abstract Background Although Western models of education are being used to establish health professional programs in non-Western countries, little is known about how students in these countries perceive their learning experiences. The purpose of this qualitative study was to describe the reflections of physiotherapy students from a Middle East culture during their clinical placements and to compare them to reflections of physiotherapy students from a Western culture. Methods Subjects were six senior students (3 females, 3 males, mean age 22.6 years and 15 junior, female students (mean age 20.1 years in the baccalaureate physiotherapy program at a university in the United Arab Emirates (UAE. They wrote weekly entries in a journal while in their clinical placements. They described an event, their reaction to it, and how it might affect their future behavior. Two evaluators independently read and coded the content of all the journals, and then worked together to categorize the data and develop themes. A third evaluator, an UAE national, independently read the journals to validate the content analysis. A feedback session with students was used to further validate the data interpretation. The themes were compared to those derived from a similar study of Canadian physiotherapy students. Results The content of the students' reflections were grouped into 4 themes: professional behavior, awareness of learning, self-development and shift to a patient orientation, and identification and analysis of ethical issues. Although the events were different, students from the UAE considered many of the same issues reflected on by Canadian students. Conclusion Physiotherapy students from a Middle East culture consider many of the same issues as students from a Western culture when asked to reflect on their clinical experience. They reflect on their personal growth, on how they learn in a clinical setting, and on the ethical and professional behaviors of themselves

  13. Learning pathways during clinical placement of physiotherapy students: a Malaysian experience of using learning contracts and reflective diaries

    Directory of Open Access Journals (Sweden)

    Ayiesah Ramli

    2013-07-01

    These learning themes reflected the views of the students about what they have considered to be important learning pathways during their clinical placements. They give valuable insights into the experiences and opinions of students during their clinical education process, which should be useful for enhancing teaching and learning methods in physiotherapy education.

  14. Key influences identified by first year undergraduate nursing students as impacting on the quality of clinical placement: A qualitative study.

    Science.gov (United States)

    Cooper, John; Courtney-Pratt, Helen; Fitzgerald, Mary

    2015-09-01

    Despite the fact that high quality clinical placement is an integral component of pre-registration nursing education for the development of the future nursing workforce, the literature identifies an ongoing struggle to 'get it right'. To examine qualitative data gathered through the Quality Clinical Placements Evaluation project to identify what pre-registration nursing students deemed helpful and not helpful influences on their first year Professional Experience Placement. A total of 553 first year undergraduate nursing students from 2010 to 2012 were enrolled in the programme and all were invited to complete a validated survey to measure the quality of their first clinical placement. A total of 361 completed surveys were returned. This paper examines the data provided through open-ended questions within the survey related to most helpful and least helpful aspects of their clinical experience. An inductive analysis approach using NVIVO allowed inherent areas to emerge from the raw data forming three key themes that influenced the experience of students. Feeling welcomed, individual versus team attitudes, and student expectations of supervising ward nurses were the themes identified that were perceived by the student as important to the success of learning and the quality of the experience overall. The findings echo previous research into the student experience of clinical placement; however the focus regarding the need for students to have a quality relationship with the supervising nurse is an area that warrants further exploration. Furthermore, we argue that students should be purposely engaged in the tertiary sector and provided guidance and strategies related to forming and maintaining relationships with those that supervise their clinical placement, in order to ensure consistent positive experiences. The outcomes from this study suggest that a missing component is teaching undergraduates how to manage relationships in clinical settings. Copyright © 2015

  15. Studying abroad: Exploring factors influencing nursing students' decisions to apply for clinical placements in international settings.

    Science.gov (United States)

    Kent-Wilkinson, Arlene; Dietrich Leurer, Marie; Luimes, Janet; Ferguson, Linda; Murray, Lee

    2015-08-01

    For over 15 years the College of Nursing at the University of Saskatchewan has facilitated study abroad clinical placements in a number of countries to enhance student learning. Nursing students often find their study abroad experience to be a defining moment in their educational program, and in their personal and professional growth. The main objective of this research was to explore factors influencing nursing students' decisions to study abroad. A descriptive longitudinal design study was conducted using an online survey. The Study Abroad Survey was distributed to all undergraduate and graduate nursing students, in all years of all programs, at all sites of the College of Nursing, University of Saskatchewan in Saskatchewan, Canada. A total of 1058 nursing students registered in the 2013-2014 academic year were surveyed. The data were collected using an online survey administered by Campus Labs™ (2014). Students indicated that their interest in study abroad international experiences was high (84%), with many perceived benefits, but barriers to participation were also high for these students. Financial barriers topped the list (71%), followed by family responsibilities (30%) and job obligations (23%). The research highlights the factors behind student decision making related to international placements, and provides the basis for improvements to the College of Nursing's International Study Abroad Program (ISAP). Previous travel and international service learning, resulting in increased perceived value of a study abroad experience may prove to be the more significant factor influencing decision making, rather than financial barrier. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Appropriate electrode placement site of electric pulp tester for the premolars: A clinical study

    Directory of Open Access Journals (Sweden)

    Seema Dinesh Bargale

    2015-01-01

    Full Text Available Context: Electric pulp testers (EPTs are widely used as diagnostic aid in dentistry for dental pulp. This delivers enough current to overcome enamel and dentin resistance and to stimulate the myelinated sensory fibers at the junction of pulp and dentin. Such testing requires the electrode to be in contact with the surface of the tooth, with optimal positions identified for anterior teeth, premolars, and molars. Aims: To determine the best site position of EPT on premolars. The objective of electric pulp testing was to determine the sensibility of each premolar at the lowest sensory response threshold. Settings and Design: Clinical study Materials and Methods: The premolars of 20 patients between 13 and 15 years accompanied with parents, free of restorations, and caries were selected. Five sites on the crown were tested with EPT for minimum of four times. Statistical analysis used: One-way analysis of variance test and the Tukey′s honestly significant difference test. Results: The lowest threshold response was noted at the incisal edge of the tooth; the middle third had a higher threshold among all the different placement of electrode. Statistically significant difference was observed for occlusal surface in terms of region of placement of electrode. Conclusions: This experiment found the best electrode site for pulp testing in premolars. The appropriate EPT site was on the occlusal surface of maxillary and mandibular premolars.

  17. Belongingness: a montage of nursing students' stories of their clinical placement experiences.

    Science.gov (United States)

    Levett-Jones, Tracy; Lathlean, Judith; McMillan, Margaret; Higgins, Isabel

    2007-04-01

    The psychological and social sciences literature is replete with assertions that human beings are fundamentally and pervasively motivated by the need to belong. This paper reports on some of the findings from the qualitative phase of a mixed-method, multi-site study that explored nursing students' experience of belongingness while on clinical placements. Students from Australia and the United Kingdom were interviewed to identify factors that impact upon and are consequences of belongingness. A montage of participants' stories is used to illustrate some of the key features of clinical workplaces that are conducive to the development of belongingness. Contextual factors and interpersonal dynamics were seen to have a significant bearing on students' experiences. Clinical leaders/managers who were welcoming, accepting and supportive, and nursing staff who were inclusive and encouraging, facilitated students' perception of being valued and respected as members of the nursing team. Additionally, the provision of consistent, quality mentorship was identified as important to students' feelings of connectedness and fit. The experience of belongingness, in turn, enhanced students' potential for learning and influenced their future career decisions. Alternatively, alienation resulted from unreceptive and unwelcoming clinical environments and from the dissonance created when students' personal and professional values did not articulate with those evident in practice environments. Consequently, distress, detachment and disengagement occurred and students' capacity and motivation for learning was negatively impacted.

  18. Learning from clinical placement experience: Analysing nursing students' final reflections in a digital storytelling activity.

    Science.gov (United States)

    Paliadelis, Penny; Wood, Pamela

    2016-09-01

    This paper reports on the learning potential of a reflective activity undertaken by final year nursing students, in which they were asked to recount two meaningful events that occurred during their clinical placements over the duration of their 3-year nursing degree program and reflect on how these events contributed to their learning to become beginning level Registered Nurses (RNs). This descriptive qualitative study gathered narratives from 92 students as individual postings in an online forum created within the University's learning management system. An analysis of the students' reflections are the focus of this paper particularly in relation to the value of reflecting on the identified events. Four themes emerged that clearly highlight the way in which these students interpreted and learned from both positive and negative clinical experiences, their strong desire to fit into their new role and their ability to re-imagine how they might respond to clinical events when they become Registered Nurses. The findings of this study may contribute to developing nursing curricula that better prepares final year students for the realities of practice.

  19. University-Pharmaceutical Industry Cooperation: Creation of a New Administrative Position to Broker the Placement of Clinical Trials.

    Science.gov (United States)

    Mishler, John M.

    1989-01-01

    A pilot program at the University of Missouri-Kansas City included creation of a part-time administrative position to enhance cooperative ventures between the university and the pharmaceutical industry through placement of clinical trials among academic units with interdisciplinary research programs in the health sciences. Sponsored funding levels…

  20. University-Pharmaceutical Industry Cooperation: Creation of a New Administrative Position to Broker the Placement of Clinical Trials.

    Science.gov (United States)

    Mishler, John M.

    1989-01-01

    A pilot program at the University of Missouri-Kansas City included creation of a part-time administrative position to enhance cooperative ventures between the university and the pharmaceutical industry through placement of clinical trials among academic units with interdisciplinary research programs in the health sciences. Sponsored funding levels…

  1. Does ethnicity, gender or age of physiotherapy students affect performance in the final clinical placements? An exploratory study.

    Science.gov (United States)

    Naylor, Sandra; Norris, Meriel; Williams, Annabel

    2014-03-01

    To explore demographic differences in awarded marks of the final clinical placement in a physiotherapy undergraduate programme. Retrospective analysis of clinical placement assessment marks. A London university offering clinical placements throughout South East England. 333 physiotherapy students entering physiotherapy training between 2005 to 2009. Marks awarded following assessment using a clinical placement assessment form. The mean mark (SD) for age were standard entry 71 (7.4) vs. mature entry 72 (7.99) (ns); for gender male 72 (8.45) vs. female 71 (7.21) (ns); and ethnicity White British 72 (7.71) vs. ethnic minority 70 (7.01) (p=0.023). No interaction effects were observed between the independent variables and only ethnicity demonstrated a statistically significant effect (mean difference (MD) 2.4% 95%CI 0.5 to 4.3, F=5.24, p=0.023). This difference was maintained in most subcategories. Significant differences were observed for the interpersonal section (MD 2.21% 95%CI 0.14 to 4.28, F=4.409, p=0.03), the clinical reasoning section (MD 2.39% 95%CI 0.53 to 4.25, F=6.37, p=0.012) and the treatment section (MD 2.93 95%CI 1.10 to 4.83, F=9.198, p=0.003). Physiotherapy students from minority ethnic backgrounds were awarded a significantly lower mark than their white majority peers in final clinical placements, although the difference was small. Potential reasons are considered, with the strongest recommendation being for further enquiry into the potential relationship between ethnicity and success in undergraduate physiotherapy education. Copyright © 2013 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  2. Impact of Carcinomatosis on Clinical Outcomes after Self-Expandable Metallic Stent Placement for Malignant Gastric Outlet Obstruction.

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    Ji Eun Lee

    Full Text Available It is still unclear whether the peritoneal carcinomatosis had a negative effect on the clinical outcomes of patients who underwent self-expandable metallic stent (SEMS placement for malignant gastric outlet obstruction (GOO. Although carcinomatosis may be associated with the development of multifocal gastrointestinal (GI tract obstruction or decreased bowel movement, previous studies investigated the occurrence of stent failure only and thus had limitation in evaluating clinical outcomes of patients with carcinomatosis.Between 2009 and 2013, 155 patients (88 patients without carcinomatosis and 67 patients with carcinomatosis underwent endoscopic SEMS placement for malignant GOO. Factors affecting clinical success and obstructive symptom-free survival (time period between SEMS placement and the recurrence of obstructive symptoms due to multifocal GI tract obstruction or decreased bowel movement as well as stent failure were assessed.Patients with carcinomatosis showed higher Eastern Cooperative Oncology Group (ECOG scale than those without carcinomatosis. Clinical success rates were 88.1% in patients with carcinomatosis and 97.7% in patients without carcinomatosis. In multivariate analysis, only ECOG scale was identified as an independent predictor of clinical success. During follow-up period, patients with carcinomatosis showed significantly shorter obstructive symptom-free survival than those without carcinomatosis. In multivariate analysis, the presence of carcinomatosis, chemotherapy or radiation therapy after SEMS placement, and obstruction site were identified as independent predictors of obstructive symptom-free survival. For patient without carcinomatosis, stent failure accounted for the recurrence of obstructive symptoms in 84.6% of cases. For patients with carcinomatosis, multifocal GI tract obstruction or decreased bowel movement accounted for 37.9% of cases with obstructive symptom recurrence and stent failure accounted for 44.8% of

  3. Ultrasound-guided central venous catheter placement : a structured review and recommendations for clinical practice

    NARCIS (Netherlands)

    Saugel, Bernd; Scheeren, Thomas W L; Teboul, Jean-Louis

    2017-01-01

    The use of ultrasound (US) has been proposed to reduce the number of complications and to increase the safety and quality of central venous catheter (CVC) placement. In this review, we describe the rationale for the use of US during CVC placement, the basic principles of this technique, and the curr

  4. Factors influencing choice of site for rural clinical placements by final year medical students in a South African university

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    Nontsikelelo O. Mapukata

    2017-01-01

    Full Text Available Background: Most of South Africa’s citizens who live in rural or underserved communities rely on the public health care sector to access quality health care. The value of rural exposure through clinical placements is well documented. Medical schools in South Africa have a responsibility to provide solutions that address the prevailing human resources challenges. Despite this commitment, medical students do not necessarily appreciate their role in resolving South Africa’s human resources challenges. This study aimed to assess the factors that influenced the choice of clinical learning sites in a self-selection process undertaken by Wits final year medical students for the compulsory 6-week integrated primary care block rotation.Methods: Qualitative data related to reasons for choice of service learning site were gathered from 524 pre-placement questionnaires completed by final year medical students entering the rotation over a 3-year period (2012–2014. Thematic analysis was performed using the MAXQDA software.Results: Eight themes emerged from the study indicating that the majority of participants were in favour of local urban underserved placement. Contextual factors, such as work commitments or family responsibilities, being compromised socially and losing academic standing were the main reasons for seeking urban placement. Good supervision, opportunistic learning, skills development and moral support were reasons for seeking rural placements. Previous voluntary exposure to rural practice or being of rural origin was a strong indicator for uptake of rural placement.Conclusion: This study has demonstrated the challenges faced by coordinators in balancing personal and institutional needs with country needs and the contextual factors that must be considered when implementing medical education programmes that respond to social challenges.

  5. Clinical incidents involving students on placement: an analysis of incident reports to identify potential risk factors.

    Science.gov (United States)

    Gaida, J E; Maloney, S; Lo, K; Morgan, P

    2015-06-01

    Students are sometimes involved in incidents during clinical training. To the authors' knowledge, no quantitative studies of incidents specifically involving physiotherapy students on clinical placement are available in the literature. A retrospective audit (2008 to 2011) of incident reports involving physiotherapy students was conducted to identify the nature and features of incidents. The study aimed to determine if injuries to a student or patient were more or less likely when the supervisor was in close proximity, and whether students with lower academic performance in their preclinical semester were more likely to be involved in an incident. There were 19 care-delivery-related and three equipment-related incidents. There were no incidents of violent, aggressive or demeaning behaviour towards students. The incident rate was 9.0/100,000 student-hours for third-year students and 6.8/100,000 student-hours for fourth-year students. The majority of incidents (55%) occurred from 11 am to 12-noon and from 3 pm to 3.30 pm. Incidents more often resulted in patient or student injury when the supervisor was not in close proximity (approximately 50% vs approximately 20%), although the difference was not significant (P=0.336). The academic results of students involved in incidents were equivalent to the whole cohort in their preclinical semester {mean 75 [standard deviation (SD) 6] vs 76 (SD 7); P=0.488}. The unexpected temporal clustering of incidents warrants further investigation. Student fatigue may warrant attention as a potential contributor; however, contextual factors, such as staff workload, along with organisational systems, structures and procedures may be more relevant. The potential relationship between supervisor proximity and injury also warrants further exploration. The findings of the present study should be integrated into clinical education curricula and communicated to clinical educators. Copyright © 2014 Chartered Society of Physiotherapy. Published by

  6. Primary care clinical placements: The views of Australian registered nurse mentors and pre-registration nursing students (part 2).

    Science.gov (United States)

    McInnes, Susan; Peters, Kath; Hardy, Jennifer; Halcomb, Elizabeth

    2015-11-01

    An increased burden of chronic and complex conditions treated in the community and an aging population have exacerbated the primary care workload. Predicted nursing shortages will place further stressors on this workforce. High quality clinical placements may provide a strategic pathway to introduce and recruit new nurses to this speciality. This paper is Part 2 of a two part series reporting the findings of a mixed methods project. Part 1 reported on the qualitative study and Part 2 reports on the quantitative study. Forty-five pre-registration nursing students from a single Australian tertiary institution and 22 primary care Registered Nurse (RN) mentors who supervised student learning completed an online survey. Students largely regarded their primary care placement positively and felt this to be an appropriate learning opportunity. Most RNs were satisfied with mentoring pre-registration nursing students in their setting. Furthermore, the RNs desire to mentor students and the support of general practitioners (GPs) and consumers were seen as key enablers of pre-registration nursing placements. Findings from this study provide a preliminary impression of primary care clinical placements from the perspective of pre-registration nursing students and registered nurse mentors. Further research should examine whether a broader scope of non-traditional health settings such as non-government organisations, charities, pharmacies, welfare and social services can also provide appropriate learning environments for pre-registration nursing students.

  7. A Comprehensive Study of Extramural Venous Invasion in Colorectal Cancer

    Science.gov (United States)

    McClelland, David; Murray, Graeme I

    2015-01-01

    Colorectal cancer is a common malignancy and a leading cause of cancer related death. Cancer staging following resection is key to determining any adjuvant therapy in those patients with high risk disease. In colorectal cancer, tumour stage and lymph node stage are the main pathological factors which have been considered to influence outcome. Increasing emphasis is now being placed on other factors, especially the presence of extramural venous invasion (EMVI). It is important to understand the relationship of EMVI with other pathological factors and to confirm that in an individual centre that EMVI is being detected at an appropriate rate and is of prognostic significance. This comprehensive study assesses the reporting and prognostic significance of EMVI in a single centre, using prospectively collected data from histopathology reports of a cohort of 2405 patients who underwent surgery for colorectal cancer over a nine year period. Overall, EMVI was reported in 27.9% of colorectal cancer excision specimens. In tumours (n = 1928) that had not received neoadjuvant therapy, the presence of EMVI varied significantly depending on tumour site (χ2 = 12.03, p<0.005), tumour stage (χ2 = 268.188, p<0.001), lymph node stage (χ2 = 294.368, p<0.001) and Dukes’ stage (χ2 = 253.753, p<0.001). Multivariate analysis confirmed EMVI as a significant independent prognostic indicator (p<0.001). In conclusion, the presence of EMVI as an independent prognostic indicator is shown and is related to other pathological and prognostic factors. This study emphasises the requirement for the accurate identification of EMVI in colorectal cancer excision specimens and also understanding the relationship of EMVI with other prognostic factors. PMID:26671331

  8. A Comprehensive Study of Extramural Venous Invasion in Colorectal Cancer.

    Directory of Open Access Journals (Sweden)

    David McClelland

    Full Text Available Colorectal cancer is a common malignancy and a leading cause of cancer related death. Cancer staging following resection is key to determining any adjuvant therapy in those patients with high risk disease. In colorectal cancer, tumour stage and lymph node stage are the main pathological factors which have been considered to influence outcome. Increasing emphasis is now being placed on other factors, especially the presence of extramural venous invasion (EMVI. It is important to understand the relationship of EMVI with other pathological factors and to confirm that in an individual centre that EMVI is being detected at an appropriate rate and is of prognostic significance. This comprehensive study assesses the reporting and prognostic significance of EMVI in a single centre, using prospectively collected data from histopathology reports of a cohort of 2405 patients who underwent surgery for colorectal cancer over a nine year period. Overall, EMVI was reported in 27.9% of colorectal cancer excision specimens. In tumours (n = 1928 that had not received neoadjuvant therapy, the presence of EMVI varied significantly depending on tumour site (χ2 = 12.03, p<0.005, tumour stage (χ2 = 268.188, p<0.001, lymph node stage (χ2 = 294.368, p<0.001 and Dukes' stage (χ2 = 253.753, p<0.001. Multivariate analysis confirmed EMVI as a significant independent prognostic indicator (p<0.001. In conclusion, the presence of EMVI as an independent prognostic indicator is shown and is related to other pathological and prognostic factors. This study emphasises the requirement for the accurate identification of EMVI in colorectal cancer excision specimens and also understanding the relationship of EMVI with other prognostic factors.

  9. [NIC as a tool for assessing competences of nursing students in clinical placement at surgical units].

    Science.gov (United States)

    Celma Vicente, Matilde; Ajuria-Imaz, Eloisa; Lopez-Morales, Manuel; Fernandez-Marín, Pilar; Menor-Castro, Alicia; Cano-Caballero Galvez, Maria Dolores

    2015-01-01

    This paper shows the utility of a NIC standardized language to assess the extent of nursing student skills at Practicum in surgical units To identify the nursing interventions classification (NIC) that students can learn to perform in surgical units. To determine the level of difficulty in learning interventions, depending on which week of rotation in clinical placement the student is. Qualitative study using Delphi consensus technique, involving nurses with teaching experience who work in hospital surgical units, where students undertake the Practicum. The results were triangulated through a questionnaire to tutors about the degree of conformity. A consensus was reached about the interventions that students can achieve in surgical units and the frequency in which they can be performed. The level of difficulty of each intervention, and the amount of weeks of practice that students need to reach the expected level of competence was also determined. The results should enable us to design better rotations matched to student needs. Knowing the frequency of each intervention that is performed in each unit determines the chances of learning it, as well as the indicators for its assessment. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  10. Diversity characteristics and the experiences of nursing students' during clinical placements: A qualitative study of students and supervisors views.

    Science.gov (United States)

    Koch, Jane; Everett, Bronwyn; Phillips, Jane; Davidson, Patricia M

    2014-11-10

    Abstract Background: Little is known about which diversity characteristics if any, impact on nursing students' clinical placements or how these may affect the quality of their learning experiences. There is therefore a need to better understand these effects not only from the student's perspective but also from the perspective of the staff who supervise them, in order to ensure students obtain maximal benefit from their placements. Aim: To describe the clinical experiences of nursing students and the diversity characteristics that affect this learning experience. Methods: Data were collected from a series of open-ended questions embedded within a larger anonymous web-based survey, from August 2011 to March 2012. Participants included first, second and third year undergraduate Bachelor of Nursing students (N=704) and faculty members involved in the clinical learning environment (N = 165) from seven Australian universities. Findings: Qualitative findings were clustered into three main themes, differences, difficulty and discrimination, each with three subthemes. Conclusion: Findings suggest a need to offer appropriate support for nursing students who feel different because of diversity characteristics. Whilst some of the participant perceptions are confronting they provide valuable insights for universities developing curricula and the clinical placement facilities where students obtain their experience.

  11. Diversity characteristics and the experiences of nursing students during clinical placements: A qualitative study of student, faculty and supervisors' views.

    Science.gov (United States)

    Koch, Jane; Everett, Bronwyn; Phillips, Jane; Davidson, Patricia M

    2014-01-01

    Abstract Background: Little is known about which diversity characteristics if any, impact on nursing students' clinical placements or how these may affect the quality of their learning experiences. There is therefore a need to better understand these effects not only from the student's perspective but also from the perspective of the staff who supervise them, in order to ensure students obtain maximal benefit from their placements. To describe the clinical experiences of nursing students and the diversity characteristics that affect this learning experience. Data were collected from a series of open-ended questions embedded within a larger anonymous web-based survey, from August 2011 to March 2012. Participants included first, second and third year undergraduate Bachelor of Nursing students (N = 704) and faculty members involved in the clinical learning environment (N = 165) from seven Australian universities. Qualitative findings were clustered into three main themes: differences, difficulty and discrimination, each with three sub-themes. FINDINGS suggest a need to offer appropriate support for nursing students who feel different because of diversity characteristics. Whilst some of the participant perceptions are confronting they provide valuable insights for universities developing curricula and the clinical placement facilities where students obtain their experience.

  12. Uncovering degrees of workplace bullying: A comparison of baccalaureate nursing students' experiences during clinical placement in Australia and the UK.

    Science.gov (United States)

    Birks, Melanie; Cant, Robyn P; Budden, Lea M; Russell-Westhead, Michele; Sinem Üzar Özçetin, Yeter; Tee, Stephen

    2017-07-01

    Bullying in health workplaces has a negative impact on nurses, their families, multidisciplinary teams, patient care and the profession. This paper compares the experiences of Australian and UK baccalaureate nursing students in relation to bullying and harassment during clinical placement. A secondary analysis was conducted on two primary cross-sectional studies of bullying experiences of Australian and UK nursing students. Data were collected using the Student Experience of Bullying during Clinical Placement (SEBDCP) questionnaire and analysed using descriptive and inferential statistics. The total sample was 833 Australian and 561 UK students. Australian nursing students experienced a higher rate of bullying (50.1%) than UK students (35.5%). Students identified other nurses as the main perpetrators (Aust 53%, UK 68%), although patients were the main source of physical acts of bullying. Few bullied students chose to report the episode/s. The main reason for non-reporting was fear of being victimised. Sadly, some students felt bullying and harassment was 'part of the job'. A culture of bullying in nursing persists internationally. Nursing students are vulnerable and can question their future in the 'caring' profession of nursing after experiencing and/or witnessing bullying during clinical placement. Bullying requires a zero tolerance approach. Education providers must develop clearer policies and implement procedures to protect students - the future nursing workforce. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Clinical evaluation of radiotherapy for advanced esophageal cancer after metallic stent placement

    Institute of Scientific and Technical Information of China (English)

    You-Tao Yu; Guang Yang; Yan Liu; Bao-Zhong Shen

    2004-01-01

    AIM: To evaluate the therapeutic effect of radiotherapy for esophageal cancer after expandable metallic stent placement.METHODS: Ten cases of advanced esophageal cancer were evaluated, 7 having complete obstruction and 3 with digestive-respiratory fistula. Ten nitinol stents were placed at the site of stenosis. Patients were treated with a total dose of 1 200 cGy divided into 3 fractions of 400 cGy 4-7 d after stents placement.RESULTS: All the 10 stents were placed successfully at one time. After radiotherapy for advanced esophageal cancer, the survival period of the cases ranged from 14 to 22 mo, with a mean survival of 17 mo. No re-stenosis occurred among all the 10 cases.CONCLUSION: Stent placement combined with radiotherapy for esophageal cancer is helpful to prolong patients' survival and reduce occurrence of re-stenosis.

  14. Physiotherapy students find guided journals useful to develop reflective thinking and practice during their first clinical placement: a qualitative study.

    Science.gov (United States)

    Constantinou, Maria; Kuys, Suzanne S

    2013-03-01

    This study evaluated physiotherapy students' perception of a reflective journal in developing reflective thinking and practice and identified the main concepts recorded by students in the journal. A mixed methods study with qualitative content analysis of student journals and quantitative analysis of questionnaire responses. 131 (74 female, 57 male) physiotherapy students undergoing their first clinical placement. On completion of their placement, students submitted a reflective journal electronically and completed a questionnaire of closed and open ended questions. Questionnaires were analysed using frequencies for the responses of the closed questions and thematic analysis of the open ended questions. Journals were de-indentified and underwent a content analysis using Leximancer software to obtain a concept map and frequencies of the main concepts identified in the journals, with specific examples. The majority (88%, 79/90) of respondents found the journal useful in assisting them to learn from their experiences, and to develop reflective thinking and practice. 54% (49/90) indicated they would continue to use the journals. The most frequently identified concepts were residents, time and exercises; representing more than 5000 of the total concepts identified in the journals. Analysis of the reflective journals indicated that students demonstrated improvements in the three stages of reflective practice: awareness of thoughts and feelings, critical analysis of situation, and development of new perspectives. Guided journal writing may be a useful tool in facilitating reflective thinking and practice during clinical placements of physiotherapy students. Copyright © 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  15. Protocol for Bone Augmentation with Simultaneous Early Implant Placement: A Retrospective Multicenter Clinical Study

    Directory of Open Access Journals (Sweden)

    Peter Fairbairn

    2015-01-01

    Full Text Available Purpose. To present a novel protocol for alveolar bone regeneration in parallel to early implant placement. Methods. 497 patients in need of extraction and early implant placement with simultaneous bone augmentation were treated in a period of 10 years. In all patients the same specific method was followed and grafting was performed utilizing in situ hardening fully resorbable alloplastic grafting materials consisting of β-tricalcium phosphate and calcium sulfate. The protocol involved atraumatic extraction, implant placement after 4 weeks with simultaneous bone augmentation, and loading of the implant 12 weeks after placement and grafting. Follow-up periods ranged from 6 months to 10 years (mean of 4 years. Results. A total of 601 postextraction sites were rehabilitated in 497 patients utilizing the novel protocol. Three implants failed before loading and three implants failed one year after loading, leaving an overall survival rate of 99.0%. Conclusions. This standardized protocol allows successful long-term functional results regarding alveolar bone regeneration and implant rehabilitation. The concept of placing the implant 4 weeks after extraction, augmenting the bone around the implant utilizing fully resorbable, biomechanically stable, alloplastic materials, and loading the implant at 12 weeks seems to offer advantages when compared with traditional treatment modalities.

  16. Midwifery students׳ experiences of an innovative clinical placement model embedded within midwifery continuity of care in Australia.

    Science.gov (United States)

    Carter, Amanda G; Wilkes, Elizabeth; Gamble, Jenny; Sidebotham, Mary; Creedy, Debra K

    2015-08-01

    midwifery continuity of care experiences can provide high quality clinical learning for students but can be challenging to implement. The Rural and Private Midwifery Education Project (RPMEP) is a strategic government funded initiative to (1) grow the midwifery workforce within private midwifery practice and rural midwifery, by (2) better preparing new graduates to work in private midwifery and rural continuity of care models. this study evaluated midwifery students׳ experience of an innovative continuity of care clinical placement model in partnership with private midwifery practice and rural midwifery group practices. a descriptive cohort design was used. All students in the RPMEP were invited to complete an online survey about their experiences of clinical placement within midwifery continuity models of care. Responses were analysed using descriptive statistics. Correlations between total scale scores were examined. Open-ended responses were analysed using content analysis. Internal reliability of the scales was assessed using Cronbach׳s alpha. sixteen out of 17 completed surveys were received (94% response rate). Scales included in the survey demonstrated good internal reliability. The majority of students felt inspired by caseload approaches to care, expressed overall satisfaction with the mentoring received and reported a positive learning environment at their placement site. Some students reported stress related to course expectations and demands in the clinical environment (e.g. skill acquisition and hours required for continuity of care). There were significant correlations between scales on perceptions of caseload care and learning culture (r=.87 pflexible academic programme enabled students to access learning at any time and prioritise continuity of care experiences. Strategies are needed to better support students achieve a satisfactory work-life balance. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  17. Factors Associated With Nursing Students' Resilience: Communication Skills Course, Use of Social Media and Satisfaction With Clinical Placement.

    Science.gov (United States)

    Sigalit, Warshawski; Sivia, Barnoy; Michal, Itzhaki

    The purpose of this study was to explore the (a) associations between students' personal and group resilience to their utilization of social networking platforms and formally taught communication skills, (b) students' personal and clinical characteristics that are related to personal and group resilience and the perceived helpfulness of communication course, and (c) factors that contribute to students' satisfaction with their clinical placement. Data were collected from 149 second year nursing students learning in a major university in the country of Israel with the use of a self-administered structured questionnaire. Students' satisfaction from their clinical placement was measured using 1 open-ended question, analyzed through qualitative methods. Results demonstrated positive correlations between students' use of social networking to their personal and group resilience (Pcommunication course (Pnetworking can and should be used as a learning tool to promote resilience among nursing students. Faculty and nurse managers should be aware of the central role of the clinical instructor and initiate collaborative and supporting initiatives. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Accuracy of targeted wire guided tube thoracostomy in comparison to classical surgical chest tube placement - A clinical study.

    Science.gov (United States)

    Protic, Alen; Barkovic, Igor; Ivancic, Aldo; Kricka, Ozren; Zuvic-Butorac, Marta; Sustic, Alan

    2015-11-01

    Chest tube malfunction, after the tube thoracostomy, is often the result of an inappropriate chest tube tip position. The aim of this study was to analyse the precision of chest tube placement using the targeted wire guide technique (TWG technique) with curve dilator and to compare it to the classical surgical technique (CS technique). In this clinical study 80 patients with an indication for thoracic drainage, due to pneumothorax or pleural effusion were included. Experimental group contained 39 patients whose chest tube was placed using the TWG technique. The control group contained 41 patients whose chest tube was placed using the CS technique. The comparison of the outcomes of the two techniques applied suggests that the TWG technique was significantly more successful in achieving adequate (precise) chest tube placement, irrespective of patient diagnosis (TWG vs. CS in all patients, 78.4% vs. 36.6%, p<0.001). In the pleural effusion group, TWG and CS had success rates of 78.2% and 37.5% (p=0.005), respectively, while in pneumothorax group, TWG and CS had success rates of 78.6% and 35.3% (p=0.029), respectively. Using a curved dilator and the TWG technique for the thoracic drainage procedure we found statistically significant advantage to the TWG technique in comparison to the CS technique (78% vs. 37%) regarding precise chest tube placement within the pleural cavity. Introducing the materials and technique used in this clinical trial into clinical practice may improve the quality of thoracic drainage, including residual volume of air and/or fluid, poor functioning of the chest tube, and, as a consequence of both, prolonged hospitalisation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Encouraging Free Play: Extramural Digital Game-Based Language Learning as a Complex Adaptive System

    Science.gov (United States)

    Scholz, Kyle

    2017-01-01

    Massively multiplayer online role-playing games like World of Warcraft are ideally suited to encourage and facilitate second language development (SLD) in the extramural setting, but to what extent do the language learners' actual trajectories of gameplay contribute to SLD? With the current propensity to focus research in digital game-based…

  20. Early Lessons Learned from Extramural School Programs That Offer HPV Vaccine

    Science.gov (United States)

    Hayes, Kim A.; Entzel, Pamela; Berger, Wendy; Caskey, Rachel N.; Shlay, Judith C.; Stubbs, Brenda W.; Smith, Jennifer S.; Brewer, Noel T.

    2013-01-01

    Background: There has been little evaluation of school-located vaccination programs that offer human papillomavirus (HPV) vaccine in US schools without health centers (ie, extramural programs). This article summarizes lessons learned from such programs. Methods: In July to August 2010, 5 programs were identi?ed. Semistructured, in-depth telephone…

  1. Early Lessons Learned from Extramural School Programs That Offer HPV Vaccine

    Science.gov (United States)

    Hayes, Kim A.; Entzel, Pamela; Berger, Wendy; Caskey, Rachel N.; Shlay, Judith C.; Stubbs, Brenda W.; Smith, Jennifer S.; Brewer, Noel T.

    2013-01-01

    Background: There has been little evaluation of school-located vaccination programs that offer human papillomavirus (HPV) vaccine in US schools without health centers (ie, extramural programs). This article summarizes lessons learned from such programs. Methods: In July to August 2010, 5 programs were identi?ed. Semistructured, in-depth telephone…

  2. Strategies of persuasion in offers to participate in cancer clinical trials I: Topic placement and topic framing.

    Science.gov (United States)

    Barton, Ellen; Eggly, Susan; Winckles, Andrew; Albrecht, Terrance L

    2014-01-01

    Clinical trials are the gold standard in medical research evaluating new treatments in cancer care; however, in the United States, too few patients enroll in trials, especially patients from minority groups. Offering patients the option of a clinical trial is an ethically-charged communicative event for oncologists. One particularly vexed ethical issue is the use of persuasion in trial offers. Based on a corpus of 22 oncology encounters with Caucasian-American (n = 11) and African-American (n = 11) patients, this discourse analysis describes oncologists' use of two persuasive strategies related to the linguistic structure of trial offers: topic placement and topic framing. Findings are presented in total and by patient race, and discussed in terms of whether these strategies may constitute ethical or unethical persuasion, particularly with respect to the ethical issue of undue influence and the social issue of underrepresentation of minorities in cancer clinical trials.

  3. Physiotherapy students and clinical educators perceive several ways in which incorporating peer-assisted learning could improve clinical placements: a qualitative study.

    Science.gov (United States)

    Sevenhuysen, Samantha; Farlie, Melanie K; Keating, Jennifer L; Haines, Terry P; Molloy, Elizabeth

    2015-04-01

    What are the experiences of students and clinical educators in a paired student placement model incorporating facilitated peer-assisted learning (PAL) activities, compared to a traditional paired teaching approach? Qualitative study utilising focus groups. Twenty-four physiotherapy students and 12 clinical educators. Participants in this study had experienced two models of physiotherapy clinical undergraduate education: a traditional paired model (usual clinical supervision and learning activities led by clinical educators supervising pairs of students) and a PAL model (a standardised series of learning activities undertaken by student pairs and clinical educators to facilitate peer interaction using guided strategies). Peer-assisted learning appears to reduce the students' anxiety, enhance their sense of safety in the learning environment, reduce educator burden, maximise the use of downtime, and build professional skills including collaboration and feedback. While PAL adds to the clinical learning experience, it is not considered to be a substitute for observation of the clinical educator, expert feedback and guidance, or hands-on immersive learning activities. Cohesion of the student-student relationship was seen as an enabler of successful PAL. Students and educators perceive that PAL can help to position students as active learners through reduced dependence on the clinical educator, heightened roles in observing practice, and making and communicating evaluative judgments about quality of practice. The role of the clinical educator is not diminished with PAL, but rather is central in designing flexible and meaningful peer-based experiences and in balancing PAL with independent learning opportunities. ACTRN12610000859088. [Sevenhuysen S, Farlie MK, Keating JL, Haines TP, Molloy E (2015) Physiotherapy students and clinical educators perceive several ways in which incorporating peer-assisted learning could improve clinical placements: a qualitative study

  4. Physiotherapy students and clinical educators perceive several ways in which incorporating peer-assisted learning could improve clinical placements: a qualitative study

    Directory of Open Access Journals (Sweden)

    Samantha Sevenhuysen

    2015-04-01

    Full Text Available Question: What are the experiences of students and clinical educators in a paired student placement model incorporating facilitated peer-assisted learning (PAL activities, compared to a traditional paired teaching approach? Design: Qualitative study utilising focus groups. Participants: Twenty-four physiotherapy students and 12 clinical educators. Intervention: Participants in this study had experienced two models of physiotherapy clinical undergraduate education: a traditional paired model (usual clinical supervision and learning activities led by clinical educators supervising pairs of students and a PAL model (a standardised series of learning activities undertaken by student pairs and clinical educators to facilitate peer interaction using guided strategies. Results: Peer-assisted learning appears to reduce the students’ anxiety, enhance their sense of safety in the learning environment, reduce educator burden, maximise the use of downtime, and build professional skills including collaboration and feedback. While PAL adds to the clinical learning experience, it is not considered to be a substitute for observation of the clinical educator, expert feedback and guidance, or hands-on immersive learning activities. Cohesion of the student-student relationship was seen as an enabler of successful PAL. Conclusion: Students and educators perceive that PAL can help to position students as active learners through reduced dependence on the clinical educator, heightened roles in observing practice, and making and communicating evaluative judgments about quality of practice. The role of the clinical educator is not diminished with PAL, but rather is central in designing flexible and meaningful peer-based experiences and in balancing PAL with independent learning opportunities. Registration: ACTRN12610000859088. [Sevenhuysen S, Farlie MK, Keating JL, Haines TP, Molloy E (2015 Physiotherapy students and clinical educators perceive several ways in which

  5. Clinical safety of cardiac magnetic resonance imaging at 3 T early after stent placement for acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Jehl, Jerome; Comte, Alexandre; Aubry, Sebastien; Kastler, Bruno [Hopital Jean Minjoz, Service de Radiologie A and C, Centre Hospitalier Universitaire de Besancon, Besancon (France); Meneveau, Nicolas; Schiele, Francois [Hopital Jean Minjoz, Service de Cardiologie, Centre Hospitalier Universitaire de Besancon, Besancon (France)

    2009-12-15

    The purpose of this study was to prospectively evaluate the safety of cardiac magnetic resonance (CMR) imaging at 3 T performed early (less than 14 days) after bare metal or drug-eluting coronary stent implantation in patients with acute myocardial infarction (AMI). Seventy-two consecutive patients with AMI treated by percutaneous revascularisation with a stent underwent CMR examination with a median delay of 6 days. Patients were followed-up for major adverse cardiac events, during hospitalisation and at 6 months. After CMR imaging, no acute stent thrombosis, death or repeated AMI were recorded at 6-month follow-up. Two symptomatic in-stent restenoses and two silent in-stent restenoses were recorded, at a mean delay of 106 days. In our population, we found a target revascularisation rate of 5.6%. This is consistent with the 6-month event rates after coronary artery stent (CAS) placement for AMI, evaluated by several studies. This preliminary clinical study supports the safety of 3-T CMR imaging performed early after coronary stent placement. (orig.)

  6. Paramedic and midwifery student exposure to workplace violence during clinical placements in Australia – A pilot study

    Science.gov (United States)

    McKenna, Lisa

    2016-01-01

    Objectives The objective of this pilot study was to identify the type of workplace violence experienced by undergraduate paramedic and midwifery students. Methods The study used a cross-sectional methodology with the self-administered paper-based Paramedic Workplace Violence Exposure Questionnaire to elicit undergraduate paramedic and midwife responses to workplace violence whilst on clinical placements. There were 393 students eligible for inclusion in the study. A convenience sample was used. The anonymous questionnaire took 10 to 20 minutes to complete. Descriptive statistics are used to summarise the data with a two-tailed t-test used to compare groups. Results The main form of workplace violence was verbal abuse 18% and intimidation 17%. There was a statistically significant difference between midwifery and paramedic students for intimidation (t(134)=-3.143, CI: -0.367 to -0.082, p=0.002) and between females and males for sexual harassment (t(134)=2.029, CI: 0.001 to 0.074, p=0.045), all other results were not statistically different. Conclusions This pilot study is the first of its kind in Australia and internationally to identify exposure rates of workplace violence by undergraduate paramedic students during clinical placements and one of very few to identify midwifery students’ exposure rates of workplace violence. The study identified that students were exposed to a range of workplace violence acts from verbal abuse through to sexual harassment. These findings highlight a need for investigation of workplace violence exposure of medical, nursing and allied health students during the clinical phase of their studies. PMID:27941182

  7. Product placement

    OpenAIRE

    Šafaříková, Kateřina

    2008-01-01

    The bachelor thesis deals with the product placement and its application in television production. The aim is to assess application of product placement in area European Union and United States of America on particular TV programmes and to enter the question which companies most frequently use product placement in TV production. The theoretical part of the thesis is focused on defining and determination of particular instruments of communication mix. In the practical part is compared legislat...

  8. The prognostic significance of extramural deposits and extracapsular lymph node invasion in colon cancer.

    LENUS (Irish Health Repository)

    Al Sahaf, Osama

    2011-08-01

    The status of resected lymph nodes in colon cancer determines prognosis and further treatment. The American Joint Committee on Cancer staging system has designated extramural nodules as nonnodal disease and classified them as extensions of the T category in the sixth edition and as site-specific tumor deposits in the seventh edition. Extracapsular lymph node extension is an established poor prognostic indicator in many cancers. Its significance in colon cancer has not been extensively investigated.

  9. Right Ventricular Function and Left Ventricular Assist Device Placement: Clinical Considerations and Outcomes

    Science.gov (United States)

    Lainez, Romeo; Parrino, Gene; Bates, Michael

    2010-01-01

    The HeartMate II is an axial-flow left ventricular assist device that is approved for the treatment of advanced heart failure as a bridge to transplant or destination therapy. Despite the success of this device, right ventricular failure remains a persistent problem in most studies. Right ventricular dysfunction is usually defined as the need for right heart mechanical support or the persistent requirement for inotropes to support right heart function beyond 14 days. Over 21 months, 45 patients with end-stage heart disease underwent placement of the HeartMate II at our institution. This continuous cohort of patients underwent a retrospective review to evaluate the incidence of right heart failure. The perioperative survival was 91% with no incidents of mechanical support for the right ventricle and no requirements for inotropes beyond 14 days. This survival was consistent to beyond 1 year at the time of the study, and 18% of patients underwent heart transplant with 100% survival. PMID:21603391

  10. Systematic review of prognostic importance of extramural venous invasion in rectal cancer

    Science.gov (United States)

    Chand, Manish; Siddiqui, Muhammed RS; Swift, Ian; Brown, Gina

    2016-01-01

    AIM: To systematically review the survival outcomes relating to extramural venous invasion in rectal cancer. METHODS: A systematic review was conducted using PRISMA guidelines. An electronic search was carried out using MEDLINE, EMBASE, CINAHL, Cochrane library databases, Google scholar and PubMed until October 2014. Search terms were used in combination to yield articles on extramural venous invasion in rectal cancer. Outcome measures included prevalence and 5-year survival rates. These were graphically displayed using Forest plots. Statistical analysis of the data was carried out. RESULTS: Fourteen studies reported the prevalence of extramural venous invasion (EMVI) positive patients. Prevalence ranged from 9%-61%. The pooled prevalence of EMVI positivity was 26% [Random effects: Event rate 0.26 (0.18, 0.36)]. Most studies showed that EMVI related to worse oncological outcomes. The pooled overall survival was 39.5% [Random effects: Event rate 0.395 (0.29, 0.51)]. CONCLUSION: Historically, there has been huge variation in the prevalence of EMVI through inconsistent reporting. However the presence of EMVI clearly leads to worse survival outcomes. As detection rates become more consistent, EMVI may be considered as part of risk-stratification in rectal cancer. Standardised histopathological definitions and the use of magnetic resonance imaging to identify EMVI will improve detection rates in the future. PMID:26819536

  11. Integrating Course Work With Field Work Placements in Undergraduate Clinical Biofeedback.

    Science.gov (United States)

    Motiff, James P.

    The three major aspects of the clinical biofeedback experience for undergraduates at Hope College, Holland, Michigan are presented in terms of the academic program, the actual clinical experience, and the procedures for becoming certified as a "biofeedback assistant." The academic program is detailed, including the requirements for…

  12. Integrating Course Work With Field Work Placements in Undergraduate Clinical Biofeedback.

    Science.gov (United States)

    Motiff, James P.

    The three major aspects of the clinical biofeedback experience for undergraduates at Hope College, Holland, Michigan are presented in terms of the academic program, the actual clinical experience, and the procedures for becoming certified as a "biofeedback assistant." The academic program is detailed, including the requirements for…

  13. Challenges to the clinical placement and evaluation of adhesively-bonded, cervical composite restorations.

    Science.gov (United States)

    Kubo, Shisei; Yokota, Hiroaki; Yokota, Haruka; Hayashi, Yoshihiko

    2013-01-01

    The incidence of non-carious cervical lesions (NCCLs) has been increasing. The clinical performance of resin composites in NCCLS was previously unsatisfactory due to their non-retentive forms and margins lying on dentin. In order to address this problem, a lot of effort has been put into developing new dentin adhesives and restorative techniques. This article discusses these challenges and the criteria used for evaluating clinical performance as they relate to clinical studies, especially long-term clinical trials. Polymerization contraction, thermal changes and occlusal forces generate debonding stresses at adhesive interfaces. In laboratory studies, we have investigated how these stresses can be relieved by various restorative techniques and how bond strength and durability can be enhanced. Lesion forms, restorative techniques, adhesives (adhesive strategies, bond strengths, bond durability, and the relationship between enamel and dentin bond strengths) were found to have a complex relationship with microleakage. With regard to some restorative techniques, only several short-term clinical studies were available. Although in laboratory tests marginal sealing improved with a low-viscosity resin liner, an enamel bevel or prior enamel etching with phosphoric acid, clinical studies failed to detect significant effects associated with these techniques. Long-term clinical trials demonstrated that adhesive bonds continuously degraded in various ways, regardless of the adhesion strategy used. Early loss of restoration may no longer be the main clinical problem when reliable adhesives are properly used. Marginal discoloration increased over time and may become a more prominent reason for repair or replacement. Reliable and standardized criteria for the clinical evaluation of marginal discoloration should be established as soon as possible and they should be based on evidence and a policy of minimal intervention. Copyright © 2012 Academy of Dental Materials. Published by

  14. A survey on air bubble detector placement in the CPB circuit: a 2011 cross-sectional analysis of the practice of Certified Clinical Perfusionists.

    Science.gov (United States)

    Kelting, T; Searles, B; Darling, E

    2012-07-01

    The ideal location of air bubble detector (ABD) placement on the cardiopulmonary bypass (CPB) circuit is debatable. There is, however, very little data characterizing the prevalence of specific ABD placement preferences by perfusionists. Therefore, the purpose of this study was to survey the perfusion community to collect data describing the primary locations of air bubble detector placement on the CPB circuit. In June 2011, an 18-question on-line survey was conducted. Completed surveys were received from 627 participants. Of these, analysis of the responses from the 559 certified clinical perfusionists (CCP) was performed. The routine use of ABD during CPB was reported by 96.8% of CCPs. Of this group, specific placement of the bubble detector is as follows: distal to the venous reservoir outlet (35.6%), between the arterial pump and oxygenator (3.8%), between the oxygenator and arterial line filter (35.1%), distal to the arterial line filter (ALF) (23.6%), and other (1.8%). Those placing the ABD distal to the venous reservoir predominately argued that an emptied venous reservoir was the most likely place to introduce air into the circuit. Those who placed the ABD between the oxygenator and the arterial line filter commonly reasoned that this placement protects against air exiting the membrane. Those placing the ABD distal to the ALF (23.6%) cited that this location protects from all possible entry points of air. A recent false alarm event from an ABD during a case was reported by 36.1% of CCPs. This study demonstrates that the majority of CCPs use an ABD during the conduct of CPB. The placement of the ABD on the circuit, however, is highly variable across the perfusion community. A strong rationale for the various ABD placements suggests that the adoption of multiple ABD may offer the greatest comprehensive protection against air emboli.

  15. Assessing students' English language proficiency during clinical placement: A qualitative evaluation of a language framework.

    Science.gov (United States)

    San Miguel, Caroline; Rogan, Fran

    2015-06-01

    The increase in nursing students for whom English is an additional language requires clinical facilitators to assess students' performance regarding clinical skills, nursing communication and English language. However, assessing language proficiency is a complex process that is often conflated with cultural norms and clinical skills, and facilitators may lack confidence in assessing English language. This paper discusses an evaluation of a set of guidelines developed in a large metropolitan Australian university to help clinical facilitators make decisions about students' English language proficiency. The study found that the guidelines were useful in helping facilitators assess English language. However, strategies to address identified language problems needed to be incorporated to enable the guidelines to also be used as a teaching tool. The study concludes that to be effective, such guidelines need embedding within a systematic approach that identifies and responds to students who may be underperforming due to a low level of English language proficiency.

  16. VLSI placement

    Energy Technology Data Exchange (ETDEWEB)

    Hojat, S.

    1986-01-01

    The placement problem of assigning modules to module sites in a regular array must be addressed in VLSI and WSI. The placement problem of assigning heterogeneous modules to module sites in a regular array is NP-complete. The placement problem could be simplified if one could find a footprint with the property that all modules of the optimum placement occupy locations in the footprint, with no vacancies within the footprint region. If such footprints were known, they could be precomputed for each system size and the optimization problem would be reduced to a search of placements meeting the footprint constraint. The author shows that the placement problem could not be simplified by finding footprints. As result, several heuristic algorithms for the placement problem were developed and compared to each other and other established algorithms with respect to time complexity and performance measured, by the expected distance traversed by an intermodule message. Compared to previous algorithms, one new heuristic algorithm gave better performance in a shorter execution time on all test examples.

  17. Replacing stressful challenges with positive coping strategies: a resilience program for clinical placement learning.

    Science.gov (United States)

    Delany, C; Miller, K J; El-Ansary, D; Remedios, L; Hosseini, A; McLeod, S

    2015-12-01

    Clinical education is foundational to health professional training. However, it is also a time of increased stress for students. A student's perception of stressors and their capacity to effectively manage them is a legitimate concern for educators, because anxiety and decreased coping strategies can interfere with effective learning, clinical performance and capacity to care for patients. Resilience is emerging as a valuable construct to underpin positive coping strategies for learning and professional practice. We report the development and evaluation of a psycho-education resilience program designed to build practical skills-based resilience capacities in health science (physiotherapy) students. Six final year undergraduate physiotherapy students attended four action research sessions led by a clinical health psychologist. Resilience strategies drawn from cognitive behavioural therapy, and positive and performance psychology were introduced. Students identified personal learning stressors and their beliefs and responses. They chose specific resilience-based strategies to address them, and then reported their impact on learning performance and experiences. Thematic analysis of the audio-recorded and transcribed action research sessions, and students' de identified notes was conducted. Students' initial descriptions of stressors as 'problems' outside their control resulting in poor thinking and communication, low confidence and frustration, changed to a focus on how they managed and recognized learning challenges as normal or at least expected elements of the clinical learning environment. The research suggests that replacing stressful challenges with positive coping strategies offers a potentially powerful tool to build self-efficacy and cognitive control as well as greater self-awareness as a learner and future health practitioner.

  18. Over-the-balloon placement of the Gore Hybrid Vascular Graft in challenging clinical conditions

    Directory of Open Access Journals (Sweden)

    Scott S. Berman, MD, MHA, FACS

    2016-09-01

    Full Text Available This report describes a useful technique for deployment of the Gore Hybrid Vascular Graft (W. L. Gore and Associates, Flagstaff, Ariz in difficult clinical situations that create challenges in obtaining vascular control before introducing the nitinol-reinforced section of the graft. In both arterial and venous applications, introducing the Gore Hybrid Vascular Graft over a balloon allows concurrent vascular control by inflation of the balloon and easier introduction of the device into the recipient vessel by creating a smoother transition between the leading edge of the graft and the guidewire. Examples of both arterial and venous applications of this novel technique are presented.

  19. Reinforcement of thin-walled root canal structures for placement of esthetic dowels: a clinical report.

    Science.gov (United States)

    Ayad, Mohamed F; Bahannan, Salma A; Rosenstiel, Stephen F

    2011-01-01

    Thin-walled root canals always present a challenge to dentists to select a restorative treatment that does not further weaken the thin tooth structure. The prognosis of dowel and core restorations can be unpredictable. This clinical report describes the treatment of a patient with extensive caries extending into the root canal of an endodontically treated maxillary central incisor. The use of a flowable composite resin in combination with a quartz fiber reinforced post is described, resulting in the rehabilitation of a structurally compromised root canal with satisfactory esthetic and functional outcomes.

  20. CLINICAL STUDY OF POSTERIOR CHAMBER PHAKIC IOL PLACEMENT IN MYOPIC PATIENTS

    Directory of Open Access Journals (Sweden)

    Ashok Kumar P

    2017-02-01

    Full Text Available BACKGROUND The aim of this study was to determine the safety and efficacy of posterior chamber phakic IOL in Myopic patients. MATERIALS AND METHODS This prospective interventional study included 50 eyes of 50 patients with myopia. Patients of age more than 18 yrs. Stable refraction, Myopia, Mild to Moderate keratoconus and absence of any ocular pathology and any history of ocular surgeries were included in this study. Prior to starting treatment certain parameters like visual acuity, AC depth, Iridocorneal Angle Aperture, Endothelial cell count, Central corneal thickness and IOP were considered. Intervention- Implantation of the phakic IOL. Main outcome Measures- Uncorrected Visual Acuity (UCVA, best spectacle corrected visual acuity (BSCVA, AS OCT AC depthbetween endothelium and phakic IOL, IOP and Endothelial cell count were recorded. RESULTS Postoperative examinations conducted at day 1, day 3, after 1 week, 1 month and after 3 months .out of 50 patients, 4 patients had striate keratopathy, 2 patients had shallow ac during immediate post-operative period. During the postoperative follow up 10 patients had BCVA of 6/9-6/6 (20%, 14 patients had 6/9-6/12 (28%, 24 patients had 6/12-6/24(48% and remaining 2 patients had <6/24 which was better than their preoperative uncorrected visual acuity. CONCLUSION Based on this prospective clinical study and on comparison with other clinical studies posterior chamber phakic IOL corrective procedures are safe and effective for treatment of myopia. It also shows that it can provide sharp and clear vision in 96% of our study population. It does not induce dry eye syndrome as in other refractive surgeries. Short term complications like endothelial damage, angle closure glaucoma, iritis, anterior capsule injury/lens changes were not encountered during our study. But still long term follow up is required to confirm long term safety of the implant.

  1. Surgical Protocol and Short-Term Clinical Outcome of Immediate Placement in Molar Extraction Sockets Using a Wide Body Implant

    Directory of Open Access Journals (Sweden)

    Stefan Vandeweghe

    2011-08-01

    Full Text Available Objectives: Implant placement in molar extraction sockets can be difficult due to complex multi-root anatomy and the lack of predictable primary stability. The aim of this study was to evaluate the outcome of an 8 - 9 mm diameter tapered implant, designed to be placed in molar extraction sockets.Material and methods: Patients treated at least 1 year before with a Max® implant (Southern Implants, Irene, South Africa were invited for a clinical examination. Variables collected were surgical and prosthetic protocol, implant dimension and smoking habits. Peri-implant bone level was determined on peri-apical radiographs and compared to baseline, being implant insertion.Results: 98 implants had been placed in 89 patients. One implant had failed. Thirty eight patients representing 47 implants (maxilla 26, mandible 21 were available for clinical examination. Mean bone loss was 0.38 mm (SD 0.48; range - 0.50 – 1.95 after a mean follow-up of 20 months (range 12 - 35. Implant success was 97.9%. Around 30 implants, a bone substitute was used to fill the residual space, but this did not affect the bone loss outcome. Bone loss was only significantly different between maxilla and mandible (0.48 mm vs. 0.27 mm and between the 8 and 9 mm diameter implants (0.23 mm vs. 0.55 mm. A full papilla was present at 71% of the interproximal sites and irrespective of bone loss.Conclusions: The Max® implant demonstrated good primary stability, when placed in molar extraction sockets, with limited bone loss over time.

  2. A retrospective analysis of patients referred for implant placement to a specialty clinic: indications, surgical procedures, and early failures.

    Science.gov (United States)

    Bornstein, Michael M; Halbritter, Sandro; Harnisch, Hendrik; Weber, Hans-Peter; Buser, Daniel

    2008-01-01

    This retrospective study analyzed the pool of patients referred for treatment with dental implants over a 3-year period in a referral specialty clinic. All patients receiving dental implants between 2002 and 2004 in the Department of Oral Surgery and Stomatology, University of Bern, were included in this retrospective study. Patients were analyzed according to age, gender, indications for implant therapy, location of implants, and type and length of implants placed. A cumulative logistic regression analysis was performed to identify and analyze potential risk factors for complications or failures. A total of 1,206 patients received 1,817 dental implants. The group comprised 573 men and 633 women with a mean age of 55.2 years. Almost 60% of patients were age 50 or older. The most frequent indication for implant therapy was single-tooth replacement in the maxilla (522 implants or 28.7%). A total of 726 implants (40%) were inserted in the esthetically demanding region of the anterior maxilla. For 939 implants (51.7%), additional bone-augmentation procedures were required. Of these, ridge augmentation with guided bone regeneration was performed more frequently than sinus grafting. Thirteen complications leading to early failures were recorded, resulting in an early failure rate of 0.7%. The regression analysis failed to identify statistically significant failure etiologies for the variables assessed. From this study it can be concluded that patients referred to a specialty clinic for implant placement were more likely to be partially edentulous and over 50 years old. Single-tooth replacement was the most frequent indication (> 50%). Similarly, additional bone augmentation was indicated in more than 50% of cases. Adhering to strict patient selection criteria and a standardized surgical protocol, an early failure rate of 0.7% was experienced in this study population.

  3. [Nursing students' satisfaction and perception of their first clinical placement: observational study].

    Science.gov (United States)

    Comparcini, Dania; Simonetti, Valentina; Tomietto, Marco; Galli, Francesco; Fiorani, Catia; Di Labio, Luisa; Cicolini, Giancarlo

    2014-01-01

    Background. Gli ambienti di apprendimento clinico sono definiti come una rete di fattori interagenti nel contesto, in grado di influenzare gli esiti dell’apprendimento degli studenti. La soddisfazione degli studenti è considerata un indicatore del raggiungimento degli esiti dell’apprendimento ed è determinante a partire dalla prima esperienza di tirocinio. Scopo. Analizzare l’esperienza di apprendimento clinico degli studenti infermieri del primo anno di corso dopo il primo tirocinio clinico ed identificare i principali determinanti della soddisfazione degli studenti. Metodo. Lo studio osservazionale è stato realizzato in cinque sedi universitarie italiane del Corso di Laurea in Infermieristica. 420 studenti hanno compilato la versione italiana della “Clinical Learning Environment, Supervision and plus Nurse Teacher (CLES+T) scale” al termine del primo tirocinio clinico. Risultati. I punteggi medi assegnati alle dimensioni della scala variano da 4.02 (clima di apprendimento) a 3.30 (relazione di tutorato). La maggior parte degli studenti è soddisfatto della propria esperienza di tirocinio (75.6%), ma sono emerse differenze in relazione alle diverse sedi di tirocinio clinico. Discussione. I principali determinanti della soddisfazione sono lo stile di leadership del coordinatore infermieristico e l’integrazione teoria-pratica nella relazione fra tutor clinico, universitario e studente. Conclusioni. I risultati dello studio contribuiscono alla comprensione della prima esperienza di tirocinio degli studenti. Tuttavia, sono necessarie ulteriori ricerche per determinare le variabili organizzative specifiche e i modelli tutoriali in grado di aumentare la soddisfazione degli studenti, per sviluppare strategie formative basate sull’integrazione tra tutor universitari e guide di tirocinio.

  4. Prospective randomized clinical trial of hydrophilic tapered implant placement at maxillary posterior area: 6 weeks and 12 weeks loading

    Science.gov (United States)

    2016-01-01

    PURPOSE Early loading of implant can be determined by excellent primary stability and characteristic of implant surface. The implant system with recently improved surface can have load application 4-6 weeks after installing in maxilla and mandible. This study evaluated the effect of healing period to the stability of hydrophilic tapered-type implant at maxillary posterior area. MATERIALS AND METHODS This study included 30 patients treated by hydrophilic tapered-type implants (total 41 implants at maxilla) and classified by two groups depending on healing period. Group 1 (11 patients, 15 implants) was a control group and the healing period was 12 weeks, and Group 2 (19 patients, 26 implants) was test group and the healing period was 6 weeks. Immediately after implant placement, at the first impression taking, implant stability was measured using Osstell Mentor. The patients also took periapical radiographs after restoration delivery, 12 months after restoration and final followup period. The marginal bone loss around the implants was measured using the periapical radiographs. RESULTS All implants were survived and success rate was 97.56%. The marginal bone loss was less than 1mm after 1 year postoperatively except the one implant. The stabilities of the implants were not correlated with age, healing period until loading, insertion torque (IT), the diameter of fixture and the location of implant. Only the quality of bone in group 2 (6 week) was correlated with the stability of implant. CONCLUSION Healing period of 6 weeks can make the similar clinical prognosis of implants to that of healing period of 12 weeks if bone quality is carefully considered in case of early loading. PMID:27826390

  5. Efectividad de un programa de ejercicio físico extramural sobre la funcionalidad en varones con osteoartrosis de rodilla

    OpenAIRE

    Roberto Eduardo Parra Ortega

    2014-01-01

    Objetivo: Evaluar los resultados funcionales de un programa de ejercicio físico extramural comparado con la terapia física usual en varones con diagnóstico de Osteoartrosis de rodilla (OAR) grado I y II de Bucaramanga. Metodología: Ensayo Clínico controlado. La muestra estuvo conformada por 34 varones asignados sistemáticamente, pares para el grupo experimental e impares para el control. El grupo experimental recibió un programa de ejercicios extramural durante 4 meses y medio, de lunes a vie...

  6. CCCT - NCTN Steering Committees - Clinical Imaging

    Science.gov (United States)

    The Clinical Imaging Steering Committee serves as a forum for the extramural imaging and oncology communities to provide strategic input to the NCI regarding its significant investment in imaging activities in clinical trials.

  7. The efficacy of different pre- and post-operative analgesics in the management of pain after orthodontic separator placement: A randomized clinical trial

    Directory of Open Access Journals (Sweden)

    V Sudhakar

    2014-01-01

    Full Text Available Introduction: Pain-free treatment to the patients is considered as an important treatment objective for orthodontic health care providers. However, many orthodontists underestimate the degree of pain experienced by the patients. Hence, this study was conducted as a randomized, double-blinded clinical trial with the following objectives. Objective: To study the pain characteristics after separator placement; to compare the efficacy of various commonly used analgesics in pain management and to determine the efficacy of pre- and post-operative analgesics in pain management. Subjects and Methods: Data were collected from 154 patients (77 males and 77 females, age group of 14-21 years, with mean age of 18.8 years who reported to Department of Orthodontics. Patients were randomly divided in to four groups. Group 1: Paracetamol 650 mg, Group 2: Ibuprofen 400 mg, Group 3: Aspirin 300 mg, Group 4: Placebo and the study were conducted as a randomized, double-blinded clinical trial. The patients were instructed to take two tablets, one tablet 1 h before separator placement, and the other one after 6 h. The pain evaluations were made by the patients, when teeth not touching (TNT, biting back teeth together, chewing food (CF using a 100-mm visual analogue scale for 7 days after separator placement. Patients were advised to record the severity of pain. Results: Group 3 (Aspirin 300 mg showed lowest pain values, followed by Group 2 (ibuprofen 400 mg, and Group 1 (paracetamol 650 mg. All NSAID′s achieved good pain control compared to Group 4 (placebo, where the intensity pain was maximum. Conclusion: Pre- and post-operative analgesics were found to be more effective in controlling orthodontic pain, after separator placement at all-time intervals.

  8. Challenges of Implementing the NIH Extramural Associate Research Development Award (EARDA) at a Minority-Serving University

    Science.gov (United States)

    Pickens, Jeffrey

    2010-01-01

    The impacts and challenges of implementing an NIH/NICHD Extramural Associate Research Development Award (EARDA) at a private Minority-Serving-Institution (MSI) are examined. This article outlines efforts to gain institutional buy-in and challenges encountered in creating a functioning Office of Sponsored Research and implementing research policies…

  9. Technical and clinical outcome of percutaneous CT fluoroscopy-guided screw placement in unstable injuries of the posterior pelvic ring

    Energy Technology Data Exchange (ETDEWEB)

    Strobl, Frederik F.; Haeussler, Sophia M.; Paprottka, Philipp M.; Hoffmann, Ralf-Thorsten; Reiser, Maximilian F.; Trumm, Christoph G. [Institute for Clinical Radiology, Munich (Germany); Pieske, Oliver [Ludwig-Maximilians-University Hospital Munich, Department of Trauma Surgery, Munich (Germany)

    2014-08-15

    To evaluate technical success, complications, and effective dose in patients undergoing CT fluoroscopy-guided iliosacral screw placement for the fixation of unstable posterior pelvic ring injuries. Our retrospective analysis includes all consecutive patients with vertical sacral fractures and/or injury of the iliosacral joint treated with CT fluoroscopy-guided screw placement in our department from 11/2005 to 03/2013. Interventions were carried out under general anesthesia and CT fluoroscopy (10-20 mAs; 120 kV; 16- or 128-row scanner, Siemens Healthcare, Erlangen, Germany). Technical outcome, major and minor complications, and effective patient dose were analyzed. We treated 99 consecutive patients (mean age 53.1 ± 21.7 years, 50 male, 49 female) with posterior pelvic ring instability with CT fluoroscopy-guided screw placement. Intervention was technically successful in all patients (n = 99). No major and one minor local complication occurred (1 %, secondary screw dislocation). General complications included three cases of death (3 %) due to pulmonary embolism (n = 1), hemorrhagic shock (n = 1), or cardiac event (n = 1) during a follow-up period of 30 days. General complications were not related to the intervention. Mean effective patient radiation dose per intervention was 12.28 mSv ± 7.25 mSv. Mean procedural time was 72.1 ± 37.4 min. CT fluoroscopy-guided screw placement for the treatment of posterior pelvic ring instabilities can be performed with high technical success and a low complication rate. This method provides excellent intrainterventional visualization of iliac and sacral bones, as well as the sacral neuroforamina for precise screw placement by applying an acceptable effective patient dose. (orig.)

  10. Randomized clinical trial comparing ultrasound-guided procedure with the Seldinger's technique for placement of implantable venous ports.

    Science.gov (United States)

    Miao, Jianzhong; Ji, Lijun; Lu, Jianjun; Chen, Jianqing

    2014-09-01

    The aim of this randomized controlled study was to compare ultrasound-guided procedure with the Seldinger's technique for placement of implantable venous ports. A total of 214 patients were randomized to receive TIAP placement by either ultrasound-guided procedure or the Seldinger's technique. Complications and pain perception were compared between these two groups. No severe perioperative or periinterventional complication occurred. Significantly (P venous thrombosis, fever of unknown origin, skin necrosis, and sepsis. In conclusion, both techniques, the TIAP implantation via ultrasound-guided jugular vein puncture and via Seldinger's technique subclavian vein puncture, are feasible and safe. Regarding intrainterventional pain perception and implantation-related complications, the jugular vein puncture under ultrasound guidance seems to be advantageous.

  11. Single-blind randomized clinical trial to evaluate clinical and radiological outcomes after one year of immediate versus delayed implant placement supporting full-arch prostheses.

    Science.gov (United States)

    Pellicer-Chover, Hilario; Peñarrocha-Oltra, David; Bagán, Leticia; Fichy-Fernandez, Antonio-J; Canullo, Luigi; Peñarrocha-Diago, Miguel

    2014-05-01

    To evaluate and compare peri-implant health, marginal bone loss and success of immediate and delayed implant placement for rehabilitation with full-arch fixed prostheses. The present study was a prospective, randomized, single-blind, clinical preliminary trial. Patients were randomized into two treatment groups. In Group A implants were placed immediately post-extraction and in Group B six months after extraction. The following control time-points were established: one week, six months and twelve months after loading. Measurements were taken of peri-implant crevicular fluid volume, plaque index, gingival retraction, keratinized mucosa, probing depth, modified gingival index and presence of mucositis. Implant success rates were evaluated for the two groups. The study sample included fifteen patients (nine women and six men) with a mean average age of 63.7 years. One hundred and forty-four implants were placed: 76 placed in healed sites and 68 placed immediately. At the moment of prosthetic loading, keratinized mucosa width and probing depth were higher in immediate implants than delayed implants, with statistically significant differences. However, after six and twelve months, differences between groups had disappeared. Bone loss was 0.54 ± 0.39 mm for immediate implants and 0.66 ± 0.25 mm for delayed implants (p=0.201). No implants failed in either group. The present study with a short follow-up and a small sample yielded no statistically significant differences in implant success and peri-implant marginal bone loss between immediate and delayed implants with fixed full-arch prostheses. Peri-implant health showed no statistically significant differences for any of the studied parameters (crevicular fluid volume, plaque index, gingival retraction, keratinized mucosa, probing depth, modified gingival index and presence of mucositis) at the twelve-month follow-up.

  12. [Interspinous spacers and disc herniation. Geomorphometric and clinical study of 71 cases treated by L4-L5 microdiscectomy associated to spacer placement].

    Science.gov (United States)

    Aso Escario, José; Aso Vizán, Alberto; Martínez Quiñones, José Vicente; Consolini, Fabian; Martín Gallego, Álvaro; Arregui Calvo, Ricardo

    2015-01-01

    A controversial indication of interspinous spacers is their use as a complement to discectomy. At the present time, there is no solid clinical evidence of effectiveness of that association, which might result from variability in spacer positioning, restricting its correct biomechanical actions. In this study our goal was to identify and analyse the variability in the placement of an interspinous spacer, and to investigate its relationship with the clinical results. We performed a retrospective study on X-ray films from 71 patients suffering from disc herniation in L4-L5 who underwent surgery in our hospital, consisting of: microdiscectomy and biomed interspinous spacer implantation. The geomorphometric techniques used to analyse the data were procrustes superimposition and principal components analysis. We compared the clinical results (using the Herron and Turner scale), segmental lordosis and surgical distraction with the geomorphometric parameters. Significant morphological variability was found in the implant position showing cephalo-caudal translation and clockwise-counterclockwise rotations. This variability did not correlate with clinical results. A relationship with anatomical features (lordosis) and additional surgical distraction was identified. A different morphology of implant-segment configuration was identified in cases with recurrence of disc herniation. Geometric morphometrics allowed identifying high variability in the final placement of interspinous spacers. Nevertheless, it seems not to be related to the clinical outcome, depending rather on the degree of lordosis and distraction. Some differences in segment-implant morphology were identified in cases with recurrences. To assess the effectiveness of spacers, larger studies including morphological and clinical variables are required. Copyright © 2013 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  13. Alveolar Ridge Contouring with Free Connective Tissue Graft at Implant Placement: A 5-Year Consecutive Clinical Study.

    Science.gov (United States)

    Hanser, Thomas; Khoury, Fouad

    2016-01-01

    This study evaluated volume stability after alveolar ridge contouring with free connective tissue grafts at implant placement in single-tooth gaps. A total of 52 single-tooth gaps with labial volume deficiencies in the maxilla (incisors, canines, and premolars) were consecutively treated with implants and concomitant free palatal connective tissue grafts in 46 patients between 2006 and 2009. Implants had to be covered with at least 2 mm peri-implant local bone after insertion. At implant placement, a free connective tissue graft from the palate was fixed inside a labial split-thickness flap to form an existing concave buccal alveolar ridge contour due to tissue volume deficiency into a convex shape. Standardized volumetric measurements of the labial alveolar contour using a template were evaluated before connective tissue grafting and at 2 weeks, 1 year, and 5 years after implantprosthetic incorporation. Tissue volume had increased significantly (P tissue contour of the implant before connective tissue grafting to baseline (2 weeks after implant-prosthetic incorporation). Statistically, 50% of the reference points (P > .05) kept their volume from baseline to 1 year after prosthetic incorporation and from baseline to 5 years after prosthetic incorporation, respectively, whereas reference points located within the area of the implant sulcus showed a significant (P connective tissue grafting appears to be an appropriate long-term means to contour preexisting buccal alveolar volume deficiencies in single implants.

  14. Sediment Placement Areas 2012

    Data.gov (United States)

    California Department of Resources — Dredge material placement sites (DMPS), including active, inactive, proposed and historical placement sites. Dataset covers US Army Corps of Engineers San Francisco...

  15. Clinical analysis of biliary stent placement combined with gamma-knife for the treatment of complex hilar cholangiocarcinoma

    Directory of Open Access Journals (Sweden)

    Zhi-qiang FENG

    2011-05-01

    Full Text Available Objective To evaluate the therapeutic effect of biliary stent placement combined with gamma-knife for the treatment of complex hilar cholangiocarcinoma.Methods Five patients with type IV hilar cholangiocarcinoma,according to Bismuth classification,combined with stenosis of distant common bile duct were treated with biliary stent placement and gamma-knife.The left intrahepatic bile duct was catheterized under the guidance of ultrasound,followed by catheterization of right intrahepatic bile duct aided by percutaneous transhepatic cholangiography for drainage(PTCD.Three biliary stents were inserted to relieve obstruction.Patients then underwent gamma-knife treatment after subsidence of jaundice,and bilirubin,followed by determination of transaminase and observation of the condition of the tumor.Results Total bilrubin,direct bilrubin and alanine transaminase of patients were 289.38±101.43μmol/L,180.42±72.50μmol/L and 148.80±82.65 U/L respectively before PTCD,and 94.2±20.43μmol/L,62.37±30.41μmol/L and 109.27±45.52 U/L,respectively,7 days after PTCD,and they declined to 27.20±14.60μmol/L,20.58±9.33μmol/L and 59.80±35.18 U/L,respectively,one month after PTCD.Five patients survived for 10,13,14,17 and 24 months,respectively.The median survival time was 15 months.Conclusion The combination of insertion of metallic stents and gamma-knife therapy is a safe and effective treatment for complex hilar cholangiocarcinoma,and this therapeutic strategy may improve survival rate and control the rate of grouth of carcinoma.

  16. Spinal Anesthesia and Minimal Invasive Laminotomy for Paddle Electrode Placement in Spinal Cord Stimulation: Technical Report and Clinical Results at Long-Term Followup

    Directory of Open Access Journals (Sweden)

    S. Sarubbo

    2012-01-01

    Full Text Available Object. We arranged a mini-invasive surgical approach for implantation of paddle electrodes for SCS under spinal anesthesia obtaining the best paddle electrode placement and minimizing patients’ discomfort. We describe our technique supported by neurophysiological intraoperative monitoring and clinical results. Methods. 16 patients, affected by neuropathic pain underwent the implantation of paddle electrodes for spinal cord stimulation in lateral decubitus under spinal anesthesia. The paddle was introduced after flavectomy and each patient confirmed the correct distribution of paresthesias induced by intraoperative test stimulation. VAS and patients’ satisfaction rate were recorded during the followup and compared to preoperative values. Results. No patients reported discomfort during the procedure. In all cases, paresthesias coverage of the total painful region was achieved, allowing the best final electrode positioning. At the last followup (mean 36.7 months, 87.5% of the implanted patients had a good rate of satisfaction with a mean VAS score improvement of 70.5%. Conclusions. Spinal cord stimulation under spinal anesthesia allows an optimal positioning of the paddle electrodes without any discomfort for patients or neurosurgeons. The best intraoperative positioning allows a better postoperative control of pain, avoiding the risk of blind placements of the paddle or further surgery for their replacement.

  17. Spinal anesthesia and minimal invasive laminotomy for paddle electrode placement in spinal cord stimulation: technical report and clinical results at long-term followup.

    Science.gov (United States)

    Sarubbo, S; Latini, F; Tugnoli, V; Quatrale, R; Granieri, E; Cavallo, M A

    2012-01-01

    We arranged a mini-invasive surgical approach for implantation of paddle electrodes for SCS under spinal anesthesia obtaining the best paddle electrode placement and minimizing patients' discomfort. We describe our technique supported by neurophysiological intraoperative monitoring and clinical results. 16 patients, affected by neuropathic pain underwent the implantation of paddle electrodes for spinal cord stimulation in lateral decubitus under spinal anesthesia. The paddle was introduced after flavectomy and each patient confirmed the correct distribution of paresthesias induced by intraoperative test stimulation. VAS and patients' satisfaction rate were recorded during the followup and compared to preoperative values. No patients reported discomfort during the procedure. In all cases, paresthesias coverage of the total painful region was achieved, allowing the best final electrode positioning. At the last followup (mean 36.7 months), 87.5% of the implanted patients had a good rate of satisfaction with a mean VAS score improvement of 70.5%. Spinal cord stimulation under spinal anesthesia allows an optimal positioning of the paddle electrodes without any discomfort for patients or neurosurgeons. The best intraoperative positioning allows a better postoperative control of pain, avoiding the risk of blind placements of the paddle or further surgery for their replacement.

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

    Institute of Scientific and Technical Information of China (English)

    孔娟; 贾春怡; 陈艳霞

    2016-01-01

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

  19. Efectividad de un programa de ejercicio físico extramural sobre la funcionalidad en varones con osteoartrosis de rodilla

    Directory of Open Access Journals (Sweden)

    Roberto Eduardo Parra Ortega

    2016-08-01

    Full Text Available Objetivo: Evaluar los resultados funcionales de un programa de ejercicio físico extramural comparado con la terapia física usual en varones con diagnóstico de Osteoartrosis de rodilla (OAR grado I y II de Bucaramanga. Metodología: Ensayo Clínico controlado. La muestra estuvo conformada por 34 varones asignados sistemáticamente, pares para el grupo experimental e impares para el control. El grupo experimental recibió un programa de ejercicios extramural durante 4 meses y medio, de lunes a viernes, una hora diaria de sesión. El grupo control  cumplió con las indicaciones y protocolos de ejercicio terapéutico que normalmente se aplican en Santander para el tratamiento de la OAR. Se utilizó un análisis de covarianzas para establecer la efectividad de la intervención. Resultados: Se encontró que el promedio del aumento entre el grupo que recibió programa de ejercicio físico extramural comparado con el grupo control fue de 40,2 seg. (p=0,000 en el tiempo máximo de duración en posición de pie sobre la pierna afectada y 58,9 seg.  (p=0,000 en  el tiempo máximo de duración en posición bípeda con flexión de rodillas a 90 grados. Así mismo se disminuyeron 9,2 seg. (p=0,000 al realizar 20 flexiones de pierna a 90°, 4,6 seg. (p=0,000 para recorrer 50 metros planos, 138,4 seg. (p=0,000 para recorrer 1600 metros planos y 29,8 seg. (p=0,000 para ascender 100 escalones de 25 cm. Conclusiones: Los adultos jóvenes con OAR en Santander-Colombia que desarrollaron el programa de ejercicio físico extramural mostraron mayor mejoría funcional que los que se rehabilitaron cumpliendo el protocolo tradicional.

  20. Two-year clinical outcomes after coronary drug-eluting stent placement in Chinese men and women: a multicenter, prospective registry study

    Directory of Open Access Journals (Sweden)

    Shrestha R

    2013-07-01

    Full Text Available Rajiv Shrestha,1 Sandeep Gami,1 Jing Xu,2 Du-Jiang Xie,2 Zhi-Zhong Liu,2 Tian Xu,1 Fei Ye,2 Shi-Qing Din,3 Xue-Song Qian,4 Song Yang,5 Yue-Qiang Liu,6 Feng Li,7 Ai-Ping Zhang,8 Shao-Liang Chen2 1Nanjing Medical University, Nanjing, 2Nanjing First Hospital, Nanjing Medical University, Nanjing, 3Huainan Xinhua Hospital, Huainan, 4Zhangjiagang People's Hospital, Zhangjiagang, 5Yixin People's Hospital, Yixin, 6Jintan People's Hospital, Jintan, 7Huainan Oriental General Hospital, Huainan, 8Huainan People's Hospital, Huainan, People's Republic of China Background: Previous studies have reported a discrepancy in baseline characteristics and outcomes after percutaneous coronary intervention between men and women. However, this finding has never been verified in the Chinese population. The present study analyzed two-year clinical outcomes after placement of coronary drug-eluting stents in Chinese men and women. Methods: From January 2005 to December 2010, a total of 3804 Chinese patients (2776 men, 1028 women who underwent drug-eluting stent implantation were studied prospectively. The primary endpoint was the composite major adverse cardiac event (MACE rate, including myocardial infarction, cardiac death, and target vessel revascularization at two years. Stent thrombosis served as the safety endpoint. Propensity score matching was used to compare the adjusted MACE rate between the two groups. Results: At two-year follow-up, unadjusted rates of myocardial infarction, non-ST segment elevation myocardial infarction, target vessel revascularization, and MACE were significantly different between men (6.84%, 4.6%, 13.1%, and 21.7%, respectively and women (3.8% [P = 0.001], 2.0% [P < 0.001] 10.3% [P = 0.025], and 16.3% [P < 0.001], respectively. After propensity score matching, there were no significant differences in composite MACE and individual endpoints at two years between the genders. Conclusion: Despite all the unfavorable risk factor clustering in

  1. Size and characteristics of the biomedical research workforce associated with U.S. National Institutes of Health extramural grants.

    Science.gov (United States)

    Pool, Lindsay R; Wagner, Robin M; Scott, Lindsey L; RoyChowdhury, Deepshikha; Berhane, Rediet; Wu, Charles; Pearson, Katrina; Sutton, Jennifer A; Schaffer, Walter T

    2016-03-01

    The U.S. National Institutes of Health (NIH) annually invests approximately $22 billion in biomedical research through its extramural grant programs. Since fiscal year (FY) 2010, all persons involved in research during the previous project year have been required to be listed on the annual grant progress report. These new data have enabled the production of the first-ever census of the NIH-funded extramural research workforce. Data were extracted from All Personnel Reports submitted for NIH grants funded in FY 2009, including position title, months of effort, academic degrees obtained, and personal identifiers. Data were de-duplicated to determine a unique person count. Person-years of effort (PYE) on NIH grants were computed. In FY 2009, NIH funded 50,885 grant projects, which created 313,049 full- and part-time positions spanning all job functions involved in biomedical research. These positions were staffed by 247,457 people at 2,604 institutions. These persons devoted 121,465 PYE to NIH grant-supported research. Research project grants each supported 6 full- or part-time positions, on average. Over 20% of positions were occupied by postdoctoral researchers and graduate and undergraduate students. These baseline data were used to project workforce estimates for FYs 2010-2014 and will serve as a foundation for future research.

  2. Supporting student mental health nurses in clinical placement through virtual in-practice support (VIPS): Innovation uptake and the 'VIPS' project.

    Science.gov (United States)

    Hardy, Sally; Mushore, Manyara; Goddard, Linda

    2016-11-01

    The integration of technology in nurse education has become an essential element of academic practice. Yet innovation uptake between academic institutions across the four countries of the UK and their clinical practice partners has proved problematic, leading to a slow introduction of digitally enhanced teaching and learning innovations, particularly in the area of clinical decision making and leadership. The Virtual in Practice Support (VIPS) project involved two academic institutions working with the same mental health care service partner aiming to maximise student clinical placement learning. Student nurses in their final year of training were invited to take part in testing the viability of distance e-tutoring (via computer access to academic nurse lecturers) for facilitated critical reflection. An evaluation of the use of video linked conference sessions, set up for students to undertake a group based online (i.e. virtual) group tutorial is presented. All participants completed an evaluation data sheet using a five point Likert scale and free text evaluation feedback form completed at the end of each online tutorial session. Students were also invited to a focus group and all tutors were interviewed at the completion of the project. The VIPS project findings highlight; i) the importance of a clear project vision for innovation uptake ii) consequences of working with innovation champions and iii) how technology can be used to maximise student learning across geographical distance through online facilitated group critical discussion. VIPS' participants were able to articulate positive outcomes as a result of engaging in a multi-institutional project that capitalised on the richness of nursing clinical practice learning experience for both the students and the academics involved as innovation champions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. 前牙区早期种植的临床效果观察%Clinical Treatment Effects of Early Implant Placement in Esthetic Zone

    Institute of Scientific and Technical Information of China (English)

    杜燚; 丘仿松; 谢远鸿

    2013-01-01

      Objective To evaluate the Clinical treatment effects of earrly implant placement in the esthetic zone. Methods 21 Straumann implants were placed in the anterior region of mandible or maxilla of 18 patients with 21 teeth missing 2~8 weeks, including 17 cases of guided bone regeneration, complete final restorations 4-6 months later. Patients were followed up for 6~24 months, through clinical and radiologic examination to observe the clinical effect. Results All of the implants functioned well, except gingival recession of 2 implants. Conclusion Early planting can Shorten implant restoration time, and achieved good clinical results.%  目的评价前牙区美学区早期种植的临床效果。方法18例患者21颗牙缺失2~8周后,植入21颗 Straumann 种植体,其中17颗行引导骨组织再生术。术后4~6个月后行永久性修复。随访6~24个月,通过临床和放射学检查观察临床效果。结果21颗种植体修复均成功,2颗种植体随访期内出现软组织退缩。结论早期种植可以缩短种植修复时间,并取得较好的临床效果。

  4. The degree of extramural spread of T3 rectal cancer: a plea to the UICC and AJCC.

    Science.gov (United States)

    Zinicola, R; Pedrazzi, G; Haboubi, N; Nicholls, R J

    2017-03-01

    The above article, published online on 15 July 2016 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the authors, the journal Editor-in-Chief, Neil Mortensen, and John Wiley & Sons Limited. After acceptance the authors were made aware of a contribution to a prior publication of the UICC, TNM Supplement: A commentary on uniform use, 4th Edition, ed. C. Wittekind (Wiley, 2012), p. 195, which renders the central argument of their article invalid. They have therefore asked for it to be withdrawn. A modified version of the paper was published in the January 2017 issue (volume 19; issue 1) with the title "The degree of extramural spread of T3 rectal cancer: an appeal to the American Joint Committee on Cancer".

  5. Clinical results of autologous bone augmentation harvested from the mandibular ramus prior to implant placement. An analysis of 104 cases

    Science.gov (United States)

    Sakkas, Andreas; Ioannis, Konstantinidis; Winter, Karsten; Schramm, Alexander; Wilde, Frank

    2016-01-01

    Background: The aim of this study was the evaluation of the clinical success and complication rates associated with autologous bone grafts harvested from the mandibular ramus for alveolar ridge augmentation and the identification of possible risk factors for graft failure. Methods: In a consecutive retrospective study 86 patients could be included. In these patients a total of 104 bone grafts from the mandibular ramus were harvested for alveolar ridge augmentation. Medical history, age of patient, smoking status, periodontal status and complications were recorded. The need for bone grafting was defined by the impossibility of installing dental implants of adequate length or diameter to fulfill prosthetic requirements, or for aesthetic reasons. The surgical outcome was evaluated concerning complications at the donor or at the recipient site, risk factors associated with the complications and graft survival. All patients were treated using a two-stage technique. In the first operation bone blocks harvested from the retromolar region were placed as lateral or vertical onlay grafts using augmentation templates and were fixed with titanium osteosynthesis screws after exposure of the deficient alveolar ridge. After a healing period of 3–5 months computed tomography scans were performed followed by virtual implant planning and the implants were inserted using guided dental implantation. Results: 97 of the 104 onlay bone grafts were successful. In only 7 patients a graft failure occurred after a postsurgical complication. No long-term nerve damage occurred. Postoperative nerve disturbances were reported by 11 patients and had temporary character only. After the healing period between 4 to 5 months, 155 implants were placed (39 in the maxilla, 116 in the mandible). A final rehabilitation with dental implants was possible in 82 of the 86 patients. Except the 7 graft failures, all recorded complications were minor complications which could be easily treated successfully

  6. Evaluating students' perception of their clinical placements - testing the clinical learning environment and supervision and nurse teacher scale (CLES + T scale) in Germany.

    Science.gov (United States)

    Bergjan, Manuela; Hertel, Frank

    2013-11-01

    Clinical nursing education in Germany has not received attention in nursing science and practice for a long time, as it often seems to be a more or less "formalized appendix" of nursing education. Several development projects of clinical education taking place are mainly focused on the qualification of clinical preceptors. However, the clinical context and its influence on learning processes have still not been sufficiently investigated. The aim of this study was the testing of a German version of the clinical learning environment and supervision and nurse teacher scale (CLES + T scale). The sample of the pilot study consists of first-, second- and third-year student nurses (n=240) of a university nursing school from January to March 2011. Psychometric testing of the instrument is carried out by selected methods of classical testing theories using SPPS 19. The results show transferability of all subcategories of the CLES + T scale in the non-academic nursing education system of a university hospital in Germany, without the teacher scale. The strongest factor is "supervisory relationship". The German version of the CLES + T scale may help to evaluate and compare traditional and new models in clinical nursing education.

  7. Tools to reduce first year nursing students' anxiety levels prior to undergoing objective structured clinical assessment (OSCA) and how this impacts on the student's experience of their first clinical placement.

    Science.gov (United States)

    Stunden, Annette; Halcomb, Elizabeth; Jefferies, Diana

    2015-09-01

    One form of assessment that tests students' theoretical skills and confidence in their clinical practice is known as the Objective Structured Clinical Assessment (OSCA). Traditionally it was first launched from medical education, and is now being incorporated by other disciplines, such as nursing. This review seeks to present the best available evidence into strategies that help reduce first year nursing students' anxiety levels prior to undergoing OSCA and clinical placement. A systematic literature search was performed using Medline and CINAHL. This review considered any English language original research published between 2005 and 2013. A literature search located 117 articles. Eight articles were identified as meeting the inclusion in criteria. Majority of studies reported simulation session prior to the OSCA increased students confidence and reduced their anxiety levels. This resulted in students' reporting that they valued the OSCA as a worthwhile assessment. However there were four major themes: that students were anxious about attending the OSCA; that adequate preparation was seen as a coping strategy; that simulation was a further cause for anxiety; and that the simulation experience could also be used as an OSCA tool. Students who have been exposed to simulation scenarios before the OSCA are able to cope much better during the OSCA. Therefore, it is highly recommended to incorporate simulation scenarios into the nursing curricula for first year nursing students' clinical units to help reduce their anxiety levels prior to OCSA. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Best evidence: nasogastric tube placement verification.

    Science.gov (United States)

    Longo, M Anne

    2011-08-01

    Further research on cost-effective techniques to verify enteral tube placement is warranted using a variety of pediatric populations with differing conditions that may impact gastric pH. It is imperative that clinical facilities review current policies and procedures to ensure that evidence-based findings are guiding nursing practice. Many nurses continue to rely on auscultation to verify NGT placement. Education and competency validation can assist with current practices for NGT placement being consistently incorporated by all personnel in the health care setting. Continuing to search for evidence related to nursing care will guide the direct care RN in providing best practice.

  9. Nearshore Placement Webinar: Nearshore Placement Research & Development

    Science.gov (United States)

    2012-11-29

    Huntington Beach (SANDAG) Shark River Inlet (NAN) Assateague Island, MD (NAB) Positive Recreational Feature Small Dispersive Placements Innovative...Coordination Act  Endangered Species Act  Coastal Zone Management Act – Sec. 307(c)  Marine Protection, Research, and Sanctuaries Act

  10. Nursing students' experience of practice placements.

    Science.gov (United States)

    MacDonald, Kathleen; Paterson, Kirstie; Wallar, Jessica

    2016-11-02

    Clinical practice placements are an essential component of pre-registration nursing programmes. Integration into a new team in an unfamiliar setting, which has its own values, practices, culture and language, can be stressful for nursing students. This article presents and discusses students' reflections on preparing for, entering and leaving practice placements. Ten students who participated in fortnightly group reflective sessions, discussed and analysed their learning experiences while on practice placements in an acute hospital. The challenges the students encountered were deconstructed using a group narrative approach. The students experienced ethical dilemmas around patient dignity, consent and advocacy as well as factors external to the practice setting, such as navigating systems and processes to access information before starting practice placements, managing household duties and academic workloads while working long shifts, and managing fatigue and loneliness. The students devised recommendations for other students to enable them to navigate their practice placements effectively and enhance their learning experience. Raising awareness among academic and practice placement staff of the challenges students encounter before and during their practice placement is essential to assist students to succeed and maximise their learning potential.

  11. Persistent left superior vena cava: review of the literature, clinical implications, and relevance of alterations in thoracic central venous anatomy as pertaining to the general principles of central venous access device placement and venography in cancer patients.

    Science.gov (United States)

    Povoski, Stephen P; Khabiri, Hooman

    2011-12-28

    Persistent left superior vena cava (PLSVC) represents the most common congenital venous anomaly of the thoracic systemic venous return, occurring in 0.3% to 0.5% of individuals in the general population, and in up to 12% of individuals with other documented congential heart abnormalities. In this regard, there is very little in the literature that specifically addresses the potential importance of the incidental finding of PLSVC to surgeons, interventional radiologists, and other physicians actively involved in central venous access device placement in cancer patients. In the current review, we have attempted to comprehensively evaluate the available literature regarding PLSVC. Additionally, we have discussed the clinical implications and relevance of such congenital aberrancies, as well as of treatment-induced or disease-induced alterations in the anatomy of the thoracic central venous system, as they pertain to the general principles of successful placement of central venous access devices in cancer patients. Specifically regarding PLSVC, it is critical to recognize its presence during attempted central venous access device placement and to fully characterize the pattern of cardiac venous return (i.e., to the right atrium or to the left atrium) in any patient suspected of PLSVC prior to initiation of use of their central venous access device.

  12. MRI-detected extramural vascular invasion is an independent prognostic factor for synchronous metastasis in patients with rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Beomseok; Lim, Joon-seok; Kim, Honsoul; Kim, Myeong-Jin [Yonsei University, College of Medicine, Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Seoul (Korea, Republic of); Myoung, Sungmin [Jungwon University, Department of Medical Information, Goesan (Korea, Republic of); Choi, Junjeong [Yonsei University Wonju College of Medicine, Department of Pathology, Wonju (Korea, Republic of); Kim, Nam Kyu [Yonsei University, College of Medicine, Department of Surgery, Severance Hospital, Seoul (Korea, Republic of)

    2015-05-01

    To determine whether magnetic resonance imaging (MRI)-detected extramural vascular invasion (EMVI) could predict synchronous distant metastases in rectal cancer. Patients who underwent rectal MRI between July 2011 and December 2012 were screened. This study included 447 patients with pathologically confirmed rectal adenocarcinoma who had undergone MRI without previous treatment. Distant metastases were recorded at the initial work-up and over a 6-month follow-up. Univariate/multivariate logistic regression models were used to determine the risk of metastasis. The diagnostic performance was calculated using pathologic lymphovascular invasion (LVI) as a gold standard. Among 447 patients, 79 patients (17.7 %) were confirmed to have distant metastases. Three MRI features are significantly associated with a high risk of distant metastasis: positive EMVI (odds ratio 3.02), high T stage (odds ratio 2.10) and positive regional lymph node metastasis (odds ratio 6.01). EMVI in a large vessel (≥3 mm) had a higher risk for metastasis than EMVI in a small vessel (<3 mm). Sensitivity, specificity and accuracy of MRI-detected EMVI were 28.2 %, 94.0 % and 80.3 %, respectively. MRI-detected EMVI is an independent risk factor for synchronous metastasis in rectal cancer. EMVI in large vessels is a stronger risk factor for distant metastasis than EMVI in small vessels. (orig.)

  13. The origin of the medical research grant in the United States: the Rockefeller Foundation and the NIH Extramural Funding Program.

    Science.gov (United States)

    Schneider, William H

    2015-04-01

    The establishment of National Institutes of Health (NIH) extramural grants in the second half of the twentieth century marked a signal shift in support for medical research in the United States and created an influential model for the rest of the world. A similar landmark development occurred in the first half of the twentieth century with the creation of the Rockefeller Foundation and its funding programs for medical research. The programs and support of the foundation had a dramatic impact on medical research in the United States and globally. This paper examines early connections between these two developments. The NIH grants have usually been seen as having their roots primarily in the government programs of the Second World War. This article finds direct and indirect influence by the Rockefeller Foundation, as well as parallel developments in these two monumental programs of support for medical research. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Fiducial Marker Placement

    Science.gov (United States)

    ... Media Computed Tomography (CT) - Body General Ultrasound Ultrasound - Prostate Introduction to Cancer Therapy (Radiation Oncology) Proton Therapy Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiotherapy (SBRT) Images related to Fiducial Marker Placement Sponsored by ...

  15. Product Placement in Cartoons

    Directory of Open Access Journals (Sweden)

    Irena Oroz Štancl

    2014-06-01

    Full Text Available Product placement is a marketing approach for integrating products or services into selected media content. Studies have shown that the impact of advertising on children and youth are large, and that it can affect their preferences and attitudes. The aim of this article is to determine the existing level of product placement in cartoons that are broadcast on Croatian television stations. Content analysis of cartoons in a period of one month gave the following results: in 30% of cartoons product placement was found; most product placement were visual ads, in 89%, however, auditory product placement and plot connection was also found. Most ads were related to toys and it is significant that even 65% of cartoons are accompanied by a large amount of products available on the Croatian market. This is the result of two sales strategies: brand licensing (selling popular cartoon characters to toys, food or clothing companies and cartoon production based on existing line of toys with the sole aim of making their sales more effective.

  16. Suboccipital neuropathy after bone conduction device placement

    NARCIS (Netherlands)

    Faber, H.T.; Ru, J.A. de

    2013-01-01

    OBJECTIVE: To describe the clinical characteristics of a 70-year-old female with occipital neuropathy following bone conduction device surgery. DESCRIPTION: A 65-year-old woman underwent bone conduction device placement surgery on the left temporal bone. Postoperatively she progressively developed c

  17. Simple, quick, and efficient implant placement jig

    Directory of Open Access Journals (Sweden)

    Nikhil Narayan Pai

    2015-01-01

    Full Text Available Implants have become an inherent part of everyday orthodontic practice, but unlike prosthodontic implants, their placement and insertion into narrow interradicular spaces for orthodontic purposes remain a tricky and challenging part to most clinicians. An innovative and clinically useful method has been described here for safe and easy insertion of mini-implants.

  18. Osseointegrated fixture placement with simultaneous tooth extraction.

    Science.gov (United States)

    Schabes, G A; Sacks, H G; Kaufman, P S

    1992-03-01

    Three cases are presented that illustrate the potential for accelerating the healing phase with fixture-based treatment. Depending on the clinical circumstances, techniques may include radical alveolectomy, the use of fresh extraction sockets, and fixture placement in inter-radicular bone.

  19. Course Placement Study.

    Science.gov (United States)

    Fredericksen, Marlene; Slark, Julie

    Following the implementation of a matriculation plan at Rancho Santiago College (RSC), a study was conducted to examine the appropriateness of student course placement as assessed by faculty and students and to investigate faculty's perceptions of changes in students' skill level preparation over the past few years. Questionnaires were completed…

  20. Digital placement and clinical application of lumbar pedicle screws based on 3D printing%基于3D打印的腰椎椎弓根螺钉数字化置入及临床应用

    Institute of Scientific and Technical Information of China (English)

    陈宣煌; 许卫红; 黄文华; 林海滨; 张国栋; 吴长福; 陈旭; 余正希

    2015-01-01

    BACKGROUND:3D printing to prepare individualized navigation template-assisted screw placement can elevate screw placement accuracy of spinal pedicle screw,and have good prospects for clinical application.OBJECTIVE:To investigate the method of lumbar pedicle screw navigation placement using digital design of Mimics software combined with 3D printing module,and to explore its feasibility and accuracy.METHODS:From February 2012 to August 2013,a total of 60 patients with lumbar diseases underwent 3D printing module-assisted lumbar pedicle screw navigation placement.Al patients received continuous thin slice CT scan.We colected Dicom format images.Mimics software was used for 3D reconstruction to design screw channel and the supporting column of lumbar pedicle screw placement and to divide strippable bone surface,to design navigation module with screw channel,and then to carry out 3D printing.Navigation module was utilized for navigation screw placement during the surgery.The position and replacement of screw were observed.X-ray and CT scan were applied to assess the outcomes of screw placement.The patients were folowed up for (12.17±3.21) months.Oswestry Disability Index was employed to evaluate the improvement of lumbar function.Japanese Orthopaedic Association (low back pain) scoring system was used to assess the therapeutic effects.RESULTS AND CONCLUSION:253 navigation modules were made and 253 screws were implanted.Screw channel and postoperative bone surrounding the vertebral body were observed,and no breakage was found.Postoperative X-ray and CT scan revealed that the direction of eight pedicle screws was migrated compared with preoperative design,but their positions were stil satisfactory.The placement site,direction and length of 245 pedicle screws were consistent with the desired site,direction and length in Mimics software,with an accuracy of 96.84%.The navigation module was tightly connected to bone structure in front of the corresponding vertebral body

  1. Product placement in the Skyfall

    OpenAIRE

    Arustamyan, Mikayel

    2013-01-01

    The bachelor's thesis deals with product placement in the latest James Bond movie called Skyfall. The goal of this thesis is to analyse the product placement in this movie and suggest possible improvements of promotion for companies' products and brands in the next James Bond movies. In the theoretical part I write about marketing mix and marketing communication, I define the product placement and describe the history of product placement. In the practical part I analyse the effectiveness of ...

  2. Dental hygiene student experiences in external placements in Australia.

    Science.gov (United States)

    Taylor, Jane A; Hayes, Melanie J; Wallace, Linda

    2012-05-01

    While placements in external locations are being increasingly used in dental education globally, few studies have explored the student learning experience at such placements. The purpose of this study was to investigate student experiences while on external placement in a baccalaureate dental hygiene program. A self-reporting questionnaire was distributed to final-year dental hygiene students (n=77) at the University of Newcastle, Australia, in 2010. The questionnaire included questions regarding the type of placement, experiences offered, supervision, resources available, and lasting impressions. Responding students were generally positive about their external placement experience and indicated that the majority of facilities provided them with the opportunity to provide direct patient care and perform clinical tasks typical of a practicing hygienist. However, there was a statistically significant difference in their opinions about discipline-focused and community placements. Students indicated that their external placement experience provided opportunities to learn more about time and patient management, including hands-on experience with specific clinical tasks. Ongoing evaluations are necessary to ensure that external placements meet both student needs and intended learning outcomes within dental hygiene programs.

  3. Port placement in thoracoscopy

    Directory of Open Access Journals (Sweden)

    KB Galketiya

    2014-03-01

    Full Text Available Background: Thoracoscopy reduces the morbidity of open thoracotomy. The placement of camera and working ports is crucial for successful completion of the procedure. Methods: A retrospective review of video assisted thoracoscopic surgeries performed during January 2011 to June 2013 at the university surgical unit, Peradeniya, Sri Lanka was done. Port placement of each surgery was identified and the adequacy of space for dissection, use of additional ports for retractors, successful, comfortable and safe completion of the surgery with regard to average operative time, mean blood loss and conversions to open surgery were noted. Results: 9 different thoracoscopic procedures were performed on 67 patients. All procedures allowed comfortable dissection, adequate space for dissection and required no additional ports for retractors except for thymectomy and excision of retrosternal goiter. Time taken was acceptable with minimum blood loss and no conversions. Conclusion: For anterior and posterior mediastinal procedures the camera port was placed in the mid and the posterior axillary lines respectively and provided a clear display of the anatomy. The thirty degree camera was preferred as it provided a wider visual field. Working ports for anterior and posterior mediastinal procedures were placed in the anterior and mid axillary line respectively. Most effective placement for working ports were found to be two intercostal spaces above and below the camera port.

  4. Assessing and predicting successful tube placement outcomes in ALS patients.

    Science.gov (United States)

    Beggs, Kathleen; Choi, Marcia; Travlos, Andrew

    2010-01-01

    This study reviews feeding tube placement outcomes in 69 ALS outpatients seen at an outpatient interdisciplinary ALS clinic in British Columbia, Canada. The objective was to determine at which point the risks outweigh the benefits of tube placement by reviewing outcomes against parameters of respiratory function, nutritional status and speech and swallowing deterioration. The study was a retrospective review of tube placements between January 2000 and 2005, analysing data on respiratory function (forced vital capacity and respiratory status), weight change from usual body weight (UBW) and speech/swallowing deterioration using ALS Severity Score ratings (Hillel et al., 1989) at time of tube placement. Results show a statistically significant association between nutritional status and successful tube placement outcomes (p=0.003), and none between respiratory status, speech/swallowing variables, or number of deteriorated variables in each patient. Study findings were impacted by lack of available respiratory data. The only study variable that predicted successful tube placement outcome was a body weight greater than or equal to 74% UBW at time of tube placement. In the absence of access to respiratory testing, the relatively simple assessment of weight may assist patients and caregivers in appropriate decisions around tube placement.

  5. Fluoroscopy-guided percutaneous gastrostomy and nasogastric feeding tube placement: comparison of the clinical effect%X线引导下经皮胃造瘘术和鼻-胃营养管置入术的疗效比较

    Institute of Scientific and Technical Information of China (English)

    姚全军; 胡鸿涛; 黎海亮; 郭晨阳; 孟艳莉; 骆俊朋; 李亚楠

    2012-01-01

    目的 探讨X线引导下经皮胃造瘘术和鼻-胃营养管置入术的临床疗效和安全性.方法 回顾性分析67例吞咽困难患者,其中喉癌14例,食管-纵隔瘘18例,颈段食管癌35例.22例行X线引导下经皮胃造瘘术,45例行X线引导下鼻-胃营养管置入术.结果 所有患者均成功实施介入治疗,技术成功率为100%.术后8d、1个月两组患者的血清白蛋白、前白蛋白和淋巴细胞计数较术前明显升高(P<0.05).术后1、3个月两组患者的体重及生活质量较术前明显提升(P<0.05).术后1个月胃造瘘组的血清白蛋白和生活质量明显高于鼻-胃营养管置入组(P<0.05).术后两组的总并发症发生率差异无统计学意义(P>0.05).胃造瘘组的治疗费用为鼻-胃营养管置入组的2.6倍.结论 X线引导下经皮胃造瘘术和营养管置入术均可改善患者的营养状况,且安全、有效,胃造瘘术的临床疗效优于营养管置入术,但费用较昂贵.%Objective To investigate the clinical effect and safety of fluoroscopy - guided percutaneous gastrostomy and nasogastric feeding tube placement. Methods The clinical data of sixty-seven patients with dysphagia were retrospectively analyzed. The primary diseases included laryngocarcinoma (n = 14), esophagomediastinal fistul a (n = 18) and cervical esophageal carcinoma (n = 35). Twenty-two patients underwent fluoroscopy - guided percutaneous gastrostomy (group G) and forty - five patients received fluoroscopy-guided nasogastric feeding tube placement (group N). The results were analyzed and compared between the two methods. Results The interventional therapy was successfully accomplished in all patients with a technical success rate of 100%. In both groups, the levels of the serum albumin (ALB), prealbumin (PA) and total lymphocyte count (TLC) determined at 8 days and one month after the procedure were significantly higher than those determined before the therapy (P < 0.05). One and three

  6. Early evaluation of cerebral metabolic rate of glucose (CMRglu) with {sup 18}F-FDG PET/CT and clinical assessment in idiopathic normal pressure hydrocephalus (INPH) patients before and after ventricular shunt placement: preliminary experience

    Energy Technology Data Exchange (ETDEWEB)

    Calcagni, Maria Lucia; Lavalle, Mariadea; Leccisotti, Lucia; Giordano, Alessandro [Universita Cattolica del Sacro Cuore, Institute of Nuclear Medicine, Rome (Italy); Mangiola, Annunziato; De Bonis, Pasquale; Anile, Carmelo [Universita Cattolica del Sacro Cuore, Institute of Neurosurgery, Rome (Italy); Indovina, Luca [Universita Cattolica del Sacro Cuore, Institute of Physics, Rome (Italy); Marra, Camillo [Universita Cattolica del Sacro Cuore, Institute of Neurology, Rome (Italy); Pelliccioni, Armando [Istituto Nazionale per l' Assicurazione contro gli Infortuni sul Lavoro (INAIL), Rome (Italy)

    2012-02-15

    We evaluated the relationships between the cerebral metabolic rate of glucose (CMRglu) measured by dynamic {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) and the clinical and neuropsychological assessment before and after the surgical procedure in idiopathic normal pressure hydrocephalus (INPH) patients. Eleven selected INPH patients underwent clinical assessment (modified Rankin scale, Krauss scale, Larsson categorization system and Stein-Langfitt scale), cognitive evaluation (Mini-Mental State Examination, MMSE) and dynamic {sup 18}F-FDG PET/CT scan 3 days before and 1 week after ventricular shunt placement. After shunting, the global CMRglu significantly increased (2.95 {+-} 0.44 vs 4.38 {+-} 0.68, p = 10{sup -7}) in all INPH patients with a mean percentage value of 48.7%. After shunting, no significant change was found in the Evans ratio whereas a significant decrease in all clinical scale scores was observed. Only a slight reduction in the MMSE was found. After shunting, a significant correlation between the global CMRglu value and clinical assessment was found (R {sup 2} = 0.75, p = 0.024); indeed all clinical scale scores varied (decreasing) and the CMRglu value also varied (increasing) in all INPH patients. Our preliminary data show that changes in the CMRglu are promptly reversible after surgery and that there is a relationship between the early metabolic changes and clinical symptoms, independently from the simultaneous changes in the ventricular size. The remarkable and prompt improvement in the global CMRglu and in symptoms may also have important implications for the current concept of ''neuronal plasticity'' and for the cells' reactivity in order to recover their metabolic function. (orig.)

  7. Advances in Pediatric Gastrostomy Placement.

    Science.gov (United States)

    McSweeney, Maireade E; Smithers, C Jason

    2016-01-01

    Placement of gastrostomy tubes in infants and children has become increasingly commonplace. A historical emphasis on use of open gastrostomy has been replaced by less invasive methods of placement, including percutaneous endoscopic gastrostomy and laparoscopically assisted gastrostomy procedures. Various complications, ranging from minor to the more severe, have been reported with all methods of placement. Many pediatric patients who undergo gastrostomy tube placement will require long-term enteral therapy. Given the prolonged time pediatric patients may remain enterally dependent, further quality improvement and education initiatives are needed to improve long-term care and outcomes of these patients.

  8. Experiences of Supervision at Practice Placement Sites

    Directory of Open Access Journals (Sweden)

    Lesley Diack

    2014-01-01

    Full Text Available Background. Whilst placement supervision and clinical education programmes are of significant value in shaping the behaviours of undergraduate healthcare students, appropriate provisions which are efficacious to the learner are somewhat lacking, particularly for students studying on UK MPharm programmes. Objectives. To explore and explain the value of placement supervision to the personal development and employability of undergraduate pharmacy students. Methods. Students participated in a week long community pharmacy pilot programme, a result of a collaborative effort between the School of Pharmacy and Life Sciences and a small consortium of community pharmacies. Students and stakeholders were asked to evaluate their experiences via separate questionnaires which had been developed to elicit views and attitudes. Key Findings. Feedback from students and stakeholders towards the experience was overwhelmingly positive with multiple benefits being reported. Of particular prominence was the emphasis in student feedback on the value of placement supervision to their professional and personal development. Findings were indicative of a development in clinical practice proficiencies, core skills, and improvement in decision-making practice. Conclusions. The benefits of clinical supervision to the professional and personal development of MPharm students are well documented, although attracting professional pharmacy supervisors is proving a problematic task for educational providers in the UK.

  9. Effect of tunnel placements on clinical and magnetic resonance imaging findings 2 years after anterior cruciate ligament reconstruction using the double-bundle technique

    Directory of Open Access Journals (Sweden)

    Suomalainen P

    2014-08-01

    Full Text Available Piia Suomalainen,1 Tommi Kiekara,2 Anna-Stina Moisala,1 Antti Paakkala,2 Pekka Kannus,3 Timo Järvelä4 1Division of Orthopaedics and Traumatology, Department of Trauma, Musculoskeletal Surgery and Rehabilitation, Tampere University Hospital, Tampere, 2Medical Imaging Centre, Tampere University Hospital, Tampere, 3Injury and Osteoporosis Research Center, UKK Institute, Tampere, 4Arthroscopic and Sports Medicine Center Omasairaala, Helsinki, Finland Purpose: The purpose of the study reported here was to find out if the clinical and magnetic resonance imaging (MRI findings of a reconstructed anterior cruciate ligament (ACL have an association. Our hypothesis, which was based on the different functions of the ACL bundles, was that the visibility of the anteromedial graft would have an impact on anteroposterior stability, and the visibility of the posterolateral graft on rotational stability of the knee. Methods: This study is a level II, prospective clinical and MRI study (NCT02000258. The study involved 75 patients. One experienced orthopedic surgeon performed all double-bundle ACL reconstructions. Two independent examiners made the clinical examinations at 2-year follow-up: clinical examination of the knee; KT-1000, International Knee Documentation Committee and Lysholm knee evaluation scores; and International Knee Documentation Committee functional score. The MRI evaluations were made by two musculoskeletal radiologists separately, and the means of these measurements were used. Results: We found that the location of the graft in the tibia had an impact on the MRI visibility of the graft at 2-year follow-up. There were significantly more partially or totally invisible grafts if the insertion of the graft was more anterior in the tibia. No association was found between the clinical results and the graft locations. Conclusion: Anterior graft location in the tibia can cause graft invisibility in the MRI 2 years after ACL reconstruction, but this

  10. [Developmental Placement.] Collected Research References.

    Science.gov (United States)

    Bjorklund, Gail

    Drawing on information and references in the ERIC system, this literature review describes research related to a child's developmental placement. The issues examined include school entrance age; predictive validity, reliability, and features of Gesell School Readiness Assessment; retention; and the effectiveness of developmental placement. A…

  11. A piezo surgery with corticotomies and implant placement as part of a multidisciplinary approach to treat malocclusion disorder in an adult patient: clinical report

    OpenAIRE

    Gelpi, Federico; De Santis, Daniele; Marconcini, Simone; Briguglio, Francesco; Finotti, Marco

    2015-01-01

    This clinical report illustrates a multidisciplinary approach for the rehabilitation of a young adult patient affected by a bilateral edentulous space and an anterior deep bite. The patient required orthodontics and surgical corticotomy and implantology (both performed with a piezo device). A multidisciplinary planning approach, including orthodontics, oral and periodontic surgery, and restorative dentistry, has an important role in the final outcome of treatment. In fact a dental class I occ...

  12. Clinical application of platelet-rich fibrin by the application of the Double J technique during implant placement in alveolar bone defect areas: case reports.

    Science.gov (United States)

    Kim, Jin-Son; Jeong, Moon-Hwan; Jo, Ji-Ho; Kim, Su-Gwan; Oh, Ji-Su

    2013-06-01

    Platelet-rich fibrin (PRF) belongs to a new generation of platelet concentrates, with simplified processing and without biochemical blood handling. PRF releases growth factors and matrix glycoproteins. In this study, the Double J technique was used. The Double J technique, which uses centrifuged venous blood that is sampled using 2 different types of DB vacutainers, is a procedure that covers the PRF matrix obtained from 1 of the DB vacutainers on transplanted osseous coagulum, which is obtained using the plasma layer and buffering layer from the second DB vacutainer. Two cases were reported because clinically valid results were obtained. Additional studies are definitely warranted.

  13. A piezo surgery with corticotomies and implant placement as part of a multidisciplinary approach to treat malocclusion disorder in an adult patient: clinical report.

    Science.gov (United States)

    Gelpi, Federico; De Santis, Daniele; Marconcini, Simone; Briguglio, Francesco; Finotti, Marco

    2015-12-01

    This clinical report illustrates a multidisciplinary approach for the rehabilitation of a young adult patient affected by a bilateral edentulous space and an anterior deep bite. The patient required orthodontics and surgical corticotomy and implantology (both performed with a piezo device). A multidisciplinary planning approach, including orthodontics, oral and periodontic surgery, and restorative dentistry, has an important role in the final outcome of treatment. In fact a dental class I occlusion has been established only on the right side. The left side could not be restored to an ideal class I relationship due to the pontic prosthesis. The original collapsed right posterior occlusion was corrected. A stable posterior occlusion was established, and the balancing interference was eliminated. Centric relation and centric occlusion were established at the same vertical dimension of occlusion. The cephalometric analysis and clinical aspect at the end of treatment showed that the patient had improvements in overbite and overjet.Multidisciplinary management, including endodontic and restorative dentistry, periodontics, corticotomy-assisted orthodontics, implants, and prosthetics, was used for a young female patient with multiple missing teeth, anterior deep bite, and a malocclusion with cant of the occlusal plane. The interaction of interdisciplinary specialties and careful treatment planning were required. The patient also benefited esthetically from our effort.

  14. Using the Social Enterprise Intervention (SEI) and Individual Placement and Support (IPS) models to improve employment and clinical outcomes of homeless youth with mental illness1

    Science.gov (United States)

    Ferguson, Kristin M.

    2013-01-01

    Prior research reveals high unemployment rates among homeless youth. The literature offers many examples of using evidence-informed and evidence-based supported employment models with vulnerable populations to assist them in obtaining and maintaining employment and concurrently addressing mental health challenges. However, there are few examples to date of these models with homeless youth with mental illness. The purpose of this article was thus to describe a methodology for establishing a university-agency research partnership to design, implement, evaluate, and replicate evidence-informed and evidence-based interventions with homeless youth with mental illness to enhance their employment, mental health, and functional outcomes. Data from two studies are used to illustrate the relationship between vocational skill-building/employment and mental health among homeless youth. The article concludes with a discussion of the implications of conducting community-based participatory employment and clinical intervention research. The author highlights the opportunities and tensions associated with this approach. PMID:24294127

  15. Using the Social Enterprise Intervention (SEI) and Individual Placement and Support (IPS) models to improve employment and clinical outcomes of homeless youth with mental illness.

    Science.gov (United States)

    Ferguson, Kristin M

    2013-09-01

    Prior research reveals high unemployment rates among homeless youth. The literature offers many examples of using evidence-informed and evidence-based supported employment models with vulnerable populations to assist them in obtaining and maintaining employment and concurrently addressing mental health challenges. However, there are few examples to date of these models with homeless youth with mental illness. The purpose of this article was thus to describe a methodology for establishing a university-agency research partnership to design, implement, evaluate, and replicate evidence-informed and evidence-based interventions with homeless youth with mental illness to enhance their employment, mental health, and functional outcomes. Data from two studies are used to illustrate the relationship between vocational skill-building/employment and mental health among homeless youth. The article concludes with a discussion of the implications of conducting community-based participatory employment and clinical intervention research. The author highlights the opportunities and tensions associated with this approach.

  16. Clinical application of the ureteroscope assistant placement of peritoneal dialysis catheters%输尿管镜辅助下腹膜透析管置入技术的应用

    Institute of Scientific and Technical Information of China (English)

    朱微; 燕翔; 蒋春明; 张苗

    2012-01-01

    To evaluate the clinical feasibility,safety and effect of the ureteroscope assistant placement of peritoneal dialysis catheters in patients with end stage renal disease (ESRD). Methodology: Thirty two consecutive ESRD patients underwent ureteroscope assistant placement of peritoneal dialysis catheters. Informed consent form was signed by patients under principle of voluntary. All patients were eligible to receive local infiltration anesthesia. Ureteroscopic monitoring was performed via a peer-away sheath through an incision near the umbilicus. A catheter was passed through the peer-away sheath into the true pelvis. A subcutaneous tunnel was created and a point in left lower quadrant was selected as the exit site of the catheter. Results; All the catheters were successfully placed and the mean time of operation was (42 ±15) minutes. The dose of additional local anesthetics during procedure is 20% lidocaine (13 ±5) milliliter. Blood loss was very little in operation. Only 4 cases presented the ascites with little red blood cells which lasted (16 ±5) hours. During mean follow-up period of 12 months, there were no catheter-related complications, such as catheter migration, obstruction,and dialysate leakage. Conclusion:The ureteroscope assistant placement of peritoneal dialysis catheters is worthy to be popularized for it's safty and effectiveness in end stage renal disease ( ESRD) patients.%目的:探讨输尿管镜辅助下腹膜透析管置人技术的临床应用安全性和疗效. 方法:自愿选择腹膜透析替代治疗的终末期肾病患者32例,局麻下采用经皮微创穿刺技术,使用Peer-Away鞘建立腹腔通道,以输尿管镜进入腹腔内定位,并引导腹膜透析管置于膀胱直肠窝或子宫直肠窝,近端建立皮下隧道并经左下腹戳洞引出.结果:全部患者腹膜透析管均放置成功,手术时间(42±15) min,术中用20%盐酸利多卡因(13±5)ml,出血极少,仅4例术后出现淡血

  17. Three-dimensional SPACE fluid-attenuated inversion recovery at 3 T to improve subthalamic nucleus lead placement for deep brain stimulation in Parkinson's disease: from preclinical to clinical studies.

    Science.gov (United States)

    Senova, Suhan; Hosomi, Koichi; Gurruchaga, Jean-Marc; Gouello, Gaëtane; Ouerchefani, Naoufel; Beaugendre, Yara; Lepetit, Hélène; Lefaucheur, Jean-Pascal; Badin, Romina Aron; Dauguet, Julien; Jan, Caroline; Hantraye, Philippe; Brugières, Pierre; Palfi, Stéphane

    2016-08-01

    OBJECTIVE Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a well-established therapy for motor symptoms in patients with pharmacoresistant Parkinson's disease (PD). However, the procedure, which requires multimodal perioperative exploration such as imaging, electrophysiology, or clinical examination during macrostimulation to secure lead positioning, remains challenging because the STN cannot be reliably visualized using the gold standard, T2-weighted imaging (T2WI) at 1.5 T. Thus, there is a need to improve imaging tools to better visualize the STN, optimize DBS lead implantation, and enlarge DBS diffusion. METHODS Gradient-echo sequences such as those used in T2WI suffer from higher distortions at higher magnetic fields than spin-echo sequences. First, a spin-echo 3D SPACE (sampling perfection with application-optimized contrasts using different flip angle evolutions) FLAIR sequence at 3 T was designed, validated histologically in 2 nonhuman primates, and applied to 10 patients with PD; their data were clinically compared in a double-blind manner with those of a control group of 10 other patients with PD in whom STN targeting was performed using T2WI. RESULTS Overlap between the nonhuman primate STNs segmented on 3D-histological and on 3D-SPACE-FLAIR volumes was high for the 3 most anterior quarters (mean [± SD] Dice scores 0.73 ± 0.11, 0.74 ± 0.06, and 0.60 ± 0.09). STN limits determined by the 3D-SPACE-FLAIR sequence were more consistent with electrophysiological edges than those determined by T2WI (0.9 vs 1.4 mm, respectively). The imaging contrast of the STN on the 3D-SPACE-FLAIR sequence was 4 times higher (p SPACE-FLAIR-guided implantation than for those in whom T2WI was used (62.2% vs 43.6%, respectively; p SPACE-FLAIR sequence (p SPACE-FLAIR sequences at 3 T improved STN lead placement under stereotactic conditions, improved the clinical outcome of patients with PD, and increased the benefit/risk ratio of STN-DBS surgery.

  18. Clinical Applications of the Placement of Blind Nasal Jejunal Tube in Critically Ill Patients%盲视放置鼻空肠管在重症患者中的临床应用

    Institute of Scientific and Technical Information of China (English)

    魏威; 唐元旭; 杨聪

    2011-01-01

    Objective: The placement of blind nasal jejunal tube which is a treatment for critically ill patients could solve the problem of enteral nutrition,protect the food from regurgitation and aspiration,reduce aspiration pneumonia,as well as the corrosive esophageal stricture caused by toxic poisoning.Methods: Blind insertion technique of spiral nasal jejunal tube,together with early enteral nutrition therapy,was applied to various patients.Results: Blind insertion technique of spiral nasal jejunal tube had higher concordant and less injury.Conclusion: Blind insertion technique of spiral nasal jejunal tube,which was a clinical research with practical significance,could be used to all kinds of critically ill patients support nutrition,improve prognosis,cure rate and survival rate.%目的:探讨放置鼻空肠管在临床上抢救危重病人时解决肠内营养问题,防止食物返流、误吸,减少吸入性肺炎发生,减轻腐蚀性毒物中毒所致食道狭窄的临床应用效果。方法:对各种危重病人进行手法盲插留置螺旋型鼻空肠管,实施早期肠内营养支持治疗。结果:通过手法盲插留置螺旋型鼻空肠管,成功率较高,对病人损伤小。结论:通过留置鼻空肠管对各种重症患者进行营养支持治疗,可改善重症患者的预后,提高治愈率和存活率,是临床具有实用性意义的研究。

  19. Does rectal indomethacin eliminate the need for prophylactic pancreatic stent placement in patients undergoing high-risk ERCP? Post hoc efficacy and cost-benefit analyses using prospective clinical trial data.

    Science.gov (United States)

    Elmunzer, B Joseph; Higgins, Peter D R; Saini, Sameer D; Scheiman, James M; Parker, Robert A; Chak, Amitabh; Romagnuolo, Joseph; Mosler, Patrick; Hayward, Rodney A; Elta, Grace H; Korsnes, Sheryl J; Schmidt, Suzette E; Sherman, Stuart; Lehman, Glen A; Fogel, Evan L

    2013-03-01

    A recent large-scale randomized controlled trial (RCT) demonstrated that rectal indomethacin administration is effective in addition to pancreatic stent placement (PSP) for preventing post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) in high-risk cases. We performed a post hoc analysis of this RCT to explore whether rectal indomethacin can replace PSP in the prevention of PEP and to estimate the potential cost savings of such an approach. We retrospectively classified RCT subjects into four prevention groups: (1) no prophylaxis, (2) PSP alone, (3) rectal indomethacin alone, and (4) the combination of PSP and indomethacin. Multivariable logistic regression was used to adjust for imbalances in the prevalence of risk factors for PEP between the groups. Based on these adjusted PEP rates, we conducted an economic analysis comparing the costs associated with PEP prevention strategies employing rectal indomethacin alone, PSP alone, or the combination of both. After adjusting for risk using two different logistic regression models, rectal indomethacin alone appeared to be more effective for preventing PEP than no prophylaxis, PSP alone, and the combination of indomethacin and PSP. Economic analysis revealed that indomethacin alone was a cost-saving strategy in 96% of Monte Carlo trials. A prevention strategy employing rectal indomethacin alone could save approximately $150 million annually in the United States compared with a strategy of PSP alone, and $85 million compared with a strategy of indomethacin and PSP. This hypothesis-generating study suggests that prophylactic rectal indomethacin could replace PSP in patients undergoing high-risk ERCP, potentially improving clinical outcomes and reducing healthcare costs. A RCT comparing rectal indomethacin alone vs. indomethacin plus PSP is needed.

  20. Recent progress in pedicle screw placement in the subaxial cervical spine and clinical applications%下颈椎椎弓根螺钉的置钉技术及临床应用进展

    Institute of Scientific and Technical Information of China (English)

    陈长宝; 张晓林; 马信龙

    2015-01-01

    下颈椎椎弓根螺钉是颈椎生物力学上最稳定的内固定,能有效恢复颈椎矢状序列、提供坚强内固定及更高融合率。由于下颈椎椎弓根、椎动脉及神经根等结构存在较大的个体差异,术前评估应个体化。下颈椎椎弓根螺钉的置钉技术包括徒手置钉和近年来发展的计算机导航辅助置钉技术。尽管与椎弓根螺钉相关的神经血管并发症不能完全避免,但只要进行充分的术前个性化评估和术中精准的置钉技术,就可将神经血管并发症降至最低。下颈椎椎弓根螺钉内固定技术已经应用于治疗各种颈椎疾患,并发症少,临床疗效良好,具有广泛的临床应用价值。%Pedicle screw fixation is biomechanically most reliable for reconstruction of the cervical spine, which can ef⁃fectively restore cervical sagittal profiles, provide rigid fixation and higher fusion rate. Because of the large individual differ⁃ences in cervical pedicle, vertebral artery and nerve root, preoperative evaluation should be individualized. Cervical pedicle screw techniques include freehand technique and the computer-assisted navigation technology developed recently. Although complications associated with cervical pedicle screw fixation cannot be completely obviated, they can be minimized by com⁃bination of sufficient preoperative imaging studies of the pedicles and meticulous surgical techniques of screw placement. Cervical pedicle screw fixation techniques have been used in the treatment of various cervical disorders, with fewer complica⁃tions and good clinical efficacy, and a wide range of clinical applications.

  1. Sensor placement optimization in buildings

    Science.gov (United States)

    Bianco, Simone; Tisato, Francesco

    2012-01-01

    In this work we address the problem of optimal sensor placement for a given region and task. An important issue in designing sensor arrays is the appropriate placement of the sensors such that they achieve a predefined goal. There are many problems that could be considered in the placement of multiple sensors. In this work we focus on the four problems identified by Hörster and Lienhart. To solve these problems, we propose an algorithm based on Direct Search, which is able to approach the global optimal solution within reasonable time and memory consumption. The algorithm is experimentally evaluated and the results are presented on two real floorplans. The experimental results show that our DS algorithm is able to improve the results given by the most performing heuristic introduced in. The algorithm is then extended to work also on continuous solution spaces, and 3D problems.

  2. Optimal Obstacle Placement with Disambiguations.

    OpenAIRE

    Ceyhan, Elvan; Aksakalli, Vural

    2012-01-01

    arXiv:1201.5076v3 [stat.AP] 14 Jan 2013 The Annals of Applied Statistics 2012, Vol. 6, No. 4, 1730–1774 DOI: 10.1214/12-AOAS556 c Institute of Mathematical Statistics, 2012 OPTIMAL OBSTACLE PLACEMENT WITH DISAMBIGUATIONS By Vural Aksakalli and Elvan Ceyhan Istanbul S¸ehir University and Ko¸c University We introduce the optimal obstacle placement with disambigua-tions problem wherein the goal is to place true obstacles in an en-vironment cluttered with false obst...

  3. Out-of-Home Placement of Children Exposed to Violence

    Science.gov (United States)

    Harpaz-Rotem, Ilan; Berkowitz, Steven; Marans, Steven; Murphy, Robert A.; Rosenheck, Robert A.

    2008-01-01

    There is growing concern about the increasing number of children in the USA who are exposed to community violence and the need to remove some of them from their families. This study examines risk factors for out-of-home placement among a large pool of children and adolescents who were referred for general clinical assessment following exposure to…

  4. Placement Development Teams and interprofessional education with healthcare students.

    Science.gov (United States)

    Williamson, Graham R; Callaghan, Lynne; Whittlesea, Emma; Mutton, Lauren; Heath, Val

    2011-08-01

    The aim was to investigate the impact of a new structure for supporting students and mentors in practice placements (Placement Development Teams) in fostering interprofessional education from the perspective of non-medical health care students and staff. Interprofessional education is an important international issue which received significant impetus in the UK as a result of many high-profile cases where uni-professional boundaries and cultures have contributed to adverse patient and client outcomes. This study was part of a longitudinal qualitative evaluation of Placement Development Teams. The design for this stage was cross-sectional. Data were collected using telephone interviews with key educational stakeholders in trusts and Strategic Health Authorities and focus groups with third-year non-medical health care students working in the south-west peninsula of England. Students' focus group data indicated that interprofessional support and learning was key. Students had mixed views on how much they valued support gained from staff and students from other professions. Staff data indicated that they facilitated communication. Staff discussed their practical activities which made a difference and helped change the organisational culture in favour of interprofessional education. If interprofessional education in clinical practice is to be effective, it needs local facilitation and structures that support it. Placement Development Teams can provide this. The 'best' means of 'doing interprofessional education' in clinical practice and its impact on patient outcomes requires further large-scale research work with rigorous methodologies at a national level. To embed interprofessional education in practice-based professions' curricula and clinical placements requires active, supportive structures and local facilitation. Structures such as Placement Development Teams can help to achieve this where organisational cultures are influenced by committed staff. Students require

  5. The Placement Professional as Marketeer.

    Science.gov (United States)

    Walz, Garry R.

    1988-01-01

    Discusses resistance of helping professions to marketing. Defines human services marketing. Describes forces that are placing human services in an increasingly competitive position. Makes recommendations to enhance the image of career planning and placement services and increase their usage. Concludes that by adopting a marketeer orientation,…

  6. STRUCTURAL CHALLENGES OF HOLIDAY PLACEMENT ...

    African Journals Online (AJOL)

    User

    not be separated from parents unless it is in their best interests. In an effort to .... enjoyment and pleasure over holiday placements. It was noted that ... community life. Networking was cited as a great benefit as they were able to make some friends. ... treatment between the guardian's biological children and the respondents.

  7. CLINICAL APPLICATION OF IMMEDIATE IMPLANT PLACEMENT OF ZIMMER DENTAL IMPLANT SYSTEM IN THE MOLAR REGIONS%Zimmer种植系统在后牙即刻种植的临床应用研究

    Institute of Scientific and Technical Information of China (English)

    容明灯; 张雪洋; 刘卫平; 卢海宾; 李少冰; 罗维; 苏媛; 黄雁红; 金爱琼

    2014-01-01

    Objective To observe the clinical effects of the immediate implant placement of Zimmer dental implant system in the molar regions.Methods 14 cases with a total of 19 molar teeth to be scheduled for immediate implant were se-lected to be treated with Zimmer dental implant system .17 of the 19 molar teeth were simultaneously operated with GBR tech-nique.The upper structure was repaired with Palladium PFM porcelain crown after the postoperative phase I of 4~6 months and postoperative phase II of 2 weeks.Results All the 19 dental implants were well combined and were stable in the follow-ing 12 months.Conclusion A good osseointegration is obtained in the molar teeth with Zimmer dental implant system .Cor-rectly dealing with the soft and hard tissues in the process of immediate implant of molar teeth shortens the period of treat-ment, and repairs the bone tissue defects around the original lost teeth and the surrounding gingival tissue form.The immedi-ate implant should be applied properly in the molar teeth .%目的:观察Zimmer种植体在后牙区即刻种植的临床效果。方法选择14例19颗后牙区即刻种植病例,采用Zimmer种植系统,其中17颗同时行GBR 技术,Ⅰ期术后4~6个月,Ⅱ期术后2周,上部结构采用钯金烤瓷冠修复。结果19颗种植体骨结合良好,追踪12个月,种植体稳存。结论 Zimmer 在后牙区采用即刻种植可以取得良好的骨结合。在后牙区即刻种植手术过程中,正确的软硬组织处理可以在缩短疗程的同时,良好的恢复了原缺失牙周围的骨组织缺损及周围牙龈组织形态。在后牙区即刻种植时,应选择恰当的适应症,避免盲目即刻种植。

  8. Ask a Scientist: What is Color Blindness?

    Medline Plus

    Full Text Available ... Clinical Studies Publications Catalog Photos and Images Spanish Language Information Dilated Exam Grants and Funding Extramural Research Division of Extramural Science Programs Division of Extramural ...

  9. The Visual System

    Medline Plus

    Full Text Available ... Clinical Studies Publications Catalog Photos and Images Spanish Language Information Dilated Exam Grants and Funding Extramural Research Division of Extramural Science Programs Division of Extramural ...

  10. A virtual reality based simulator for learning nasogastric tube placement.

    Science.gov (United States)

    Choi, Kup-Sze; He, Xuejian; Chiang, Vico Chung-Lim; Deng, Zhaohong

    2015-02-01

    Nasogastric tube (NGT) placement is a common clinical procedure where a plastic tube is inserted into the stomach through the nostril for feeding or drainage. However, the placement is a blind process in which the tube may be mistakenly inserted into other locations, leading to unexpected complications or fatal incidents. The placement techniques are conventionally acquired by practising on unrealistic rubber mannequins or on humans. In this paper, a virtual reality based training simulation system is proposed to facilitate the training of NGT placement. It focuses on the simulation of tube insertion and the rendering of the feedback forces with a haptic device. A hybrid force model is developed to compute the forces analytically or numerically under different conditions, including the situations when the patient is swallowing or when the tube is buckled at the nostril. To ensure real-time interactive simulations, an offline simulation approach is adopted to obtain the relationship between the insertion depth and insertion force using a non-linear finite element method. The offline dataset is then used to generate real-time feedback forces by interpolation. The virtual training process is logged quantitatively with metrics that can be used for assessing objective performance and tracking progress. The system has been evaluated by nursing professionals. They found that the haptic feeling produced by the simulated forces is similar to their experience during real NGT insertion. The proposed system provides a new educational tool to enhance conventional training in NGT placement.

  11. A Cognitive Model of College Mathematics Placement

    Science.gov (United States)

    1989-08-01

    study focused on the precalculus -- calculus placement decision. The Cognitive model uses novel, or analysis level, placement test items in an attempt to...relative to the requirements of a precalculus course. Placement test scores may be partitioned to give analysis and non-analysis subtest scores which can...67 5.1.1 1989 Intercorrelations ....................................................................... 67 5.1.2 1989 Precalculus -Calculus

  12. Mathematics Placement at the University of Illinois

    Science.gov (United States)

    Ahlgren Reddy, Alison; Harper, Marc

    2013-01-01

    Data from the ALEKS-based placement program at the University of Illinois is presented visually in several ways. The placement exam (an ALEKS assessment) contains precise item-specific information and the data show many interesting properties of the student populations of the placement courses, which include Precalculus, Calculus, and Business…

  13. Mathematics Placement at the University of Illinois

    Science.gov (United States)

    Ahlgren Reddy, Alison; Harper, Marc

    2013-01-01

    Data from the ALEKS-based placement program at the University of Illinois is presented visually in several ways. The placement exam (an ALEKS assessment) contains precise item-specific information and the data show many interesting properties of the student populations of the placement courses, which include Precalculus, Calculus, and Business…

  14. Community placement: auditing the quality.

    Science.gov (United States)

    Bell, G; Bennett, J

    The second article in this two-part series analyses the development of an educational audit tool to examine the quality of the learning environment for student nurses undergoing community placement. Deficits in existing tools are identified and rationales suggested to overcome perceived problems. The article also discusses the issues which emerged during the piloting of the tool and its value as an audit instrument.

  15. What Are Clinical Trial Phases?

    Medline Plus

    Full Text Available ... Adult Cancers Metastatic Cancer Recurrent Cancer Research NCI’s Role in Cancer Research Intramural Research Extramural Research Bioinformatics ... Terminology Resources NCI Data Catalog Cryo-EM NCI's Role in Cancer Research Intramural Research Extramural Research Bioinformatics ...

  16. The Forms and Analysis of Product Placement

    OpenAIRE

    Hlaváček, Josef

    2014-01-01

    The aim of this thesis is to describe marketing communication and product placement in the theoretical part, consequently analyze examples of product placement from the practice and last but not least also analyze the perception and examples of product placement based on the survey research. Therefore the thesis is divided into three main parts. The first, theoretical part, describes the marketing mix, concept of communication, communication mix, new forms of communication, integrated marketi...

  17. Service placement in ad hoc networks

    CERN Document Server

    Wittenburg, Georg

    2012-01-01

    Service provisioning in ad hoc networks is challenging given the difficulties of communicating over a wireless channel and the potential heterogeneity and mobility of the devices that form the network. Service placement is the process of selecting an optimal set of nodes to host the implementation of a service in light of a given service demand and network topology. The key advantage of active service placement in ad hoc networks is that it allows for the service configuration to be adapted continuously at run time. ""Service Placement in Ad Hoc Networks"" proposes the SPi service placement fr

  18. Product placement of computer games in cyberspace.

    Science.gov (United States)

    Yang, Heng-Li; Wang, Cheng-Shu

    2008-08-01

    Computer games are considered an emerging media and are even regarded as an advertising channel. By a three-phase experiment, this study investigated the advertising effectiveness of computer games for different product placement forms, product types, and their combinations. As the statistical results revealed, computer games are appropriate for placement advertising. Additionally, different product types and placement forms produced different advertising effectiveness. Optimum combinations of product types and placement forms existed. An advertisement design model is proposed for use in game design environments. Some suggestions are given for advertisers and game companies respectively.

  19. Improving student support in professional placement learning: findings from the South west peninsula pilot of a new english national placement quality assurance and enhancement process.

    Science.gov (United States)

    Williamson, Graham R; Heath, Val; Ballantyne, Liz; Callaghan, Lynne; Webster, Daniel; Hunter, Claire

    2008-01-01

    English stakeholder collaboration has resulted in a new quality assurance process for non-medical health and social care placement providers and higher education institutions. This study aimed to discover the impact on student support that taking part in a pilot had on participating placement areas. Using a questionnaire survey with longitudinal follow-up one year later, we found that placement staff valued the opportunity to review and improve student support practices. This was still in evidence a year later where the pilot was described as giving the opportunity to provide evidence of aspects of student support practice; communicating and changing or developing aspects of that practice. Benefits accrued from interdisciplinary working in sharing and collaborating with other professions and organisations. Such activity could enhance clinical support staff activities and facilitate strategic partnerships between placement providers and higher education institutions.

  20. The Visual System

    Medline Plus

    Full Text Available ... 5248 Health Information Frequently asked questions Clinical Studies Publications Catalog Photos and Images Spanish Language Information Grants and Funding Extramural Research Division of Extramural Science Programs Division of Extramural Activities Extramural Contacts NEI ...

  1. NEI You Tube Videos: Amblyopia

    Medline Plus

    Full Text Available ... 5248 Health Information Frequently asked questions Clinical Studies Publications Catalog Photos and Images Spanish Language Information Grants and Funding Extramural Research Division of Extramural Science Programs Division of Extramural Activities Extramural Contacts NEI ...

  2. Glaucoma

    Medline Plus

    Full Text Available ... 5248 Health Information Frequently asked questions Clinical Studies Publications Catalog Photos and Images Spanish Language Information Grants and Funding Extramural Research Division of Extramural Science Programs Division of Extramural Activities Extramural Contacts NEI ...

  3. About the Eye

    Medline Plus

    Full Text Available ... 5248 Health Information Frequently asked questions Clinical Studies Publications Catalog Photos and Images Spanish Language Information Grants and Funding Extramural Research Division of Extramural Science Programs Division of Extramural Activities Extramural Contacts NEI ...

  4. Ask a Scientist: What is Color Blindness?

    Medline Plus

    Full Text Available ... 5248 Health Information Frequently asked questions Clinical Studies Publications Catalog Photos and Images Spanish Language Information Grants and Funding Extramural Research Division of Extramural Science Programs Division of Extramural Activities Extramural Contacts NEI ...

  5. Social Work Program. Field Placement Manual for Social Work Field Placement I, Social Work Field Placement II.

    Science.gov (United States)

    Miller, Howard J.; And Others

    This document is a manual for a social work field placement program. The social work field placement is described as a learning experience designed to translate the students' interests, interpersonal abilities, and academic knowledge and theory into the capability of enabling others to solve problems. Expectations of skills to be learned in the…

  6. New pole placement algorithm - Polynomial matrix approach

    Science.gov (United States)

    Shafai, B.; Keel, L. H.

    1990-01-01

    A simple and direct pole-placement algorithm is introduced for dynamical systems having a block companion matrix A. The algorithm utilizes well-established properties of matrix polynomials. Pole placement is achieved by appropriately assigning coefficient matrices of the corresponding matrix polynomial. This involves only matrix additions and multiplications without requiring matrix inversion. A numerical example is given for the purpose of illustration.

  7. Internship guide : Work placements step by step

    NARCIS (Netherlands)

    Haag, Esther

    2013-01-01

    Internship Guide: Work Placements Step by Step has been written from the practical perspective of a placement coordinator. This book addresses the following questions : what problems do students encounter when they start thinking about the jobs their degree programme prepares them for? How do you

  8. Internship guide : Work placements step by step

    NARCIS (Netherlands)

    Haag, Esther

    2013-01-01

    Internship Guide: Work Placements Step by Step has been written from the practical perspective of a placement coordinator. This book addresses the following questions : what problems do students encounter when they start thinking about the jobs their degree programme prepares them for? How do you fi

  9. Private Placement Debt Financing for Public Entities

    Science.gov (United States)

    Holman, Lance S.

    2010-01-01

    Private placement financing is a debt or capital lease obligation arranged between a municipality or a 501(c) (3) not-for-profit organization and a single sophisticated institutional investor. The investor can be a bank, insurance company, finance company, hedge fund, or high-net worth individual. Private placement financing is similar to…

  10. 32 CFR 1656.10 - Job placement.

    Science.gov (United States)

    2010-07-01

    ... will be reassigned in accordance with § 1656.12. (c) In making job interview referrals and in making... 32 National Defense 6 2010-07-01 2010-07-01 false Job placement. 1656.10 Section 1656.10 National....10 Job placement. (a) Selective Service will maintain a job bank for the exclusive purpose of...

  11. Clitoral Pain Following Retropubic Midurethral Sling Placement

    Directory of Open Access Journals (Sweden)

    Melanie Christofferson, DO

    2015-12-01

    Conclusion: Clitoral pain symptoms following placement of a retropubic midurethral sling should be evaluated and promptly addressed, given the potential negative impact on the patient's sexual function. Christofferson M, Barnard J, and Montoya TI. Clitoral pain following retropubic midurethral sling placement. Sex Med 2015;3:346–348.

  12. 20 CFR 801.103 - Organizational placement.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Organizational placement. 801.103 Section 801... BOARD Establishment and Authority of the Board § 801.103 Organizational placement. As prescribed by the... Administration in the Department of Labor. It is accordingly found appropriate for organizational purposes to...

  13. Hepatocellular Carcinoma Complicated by Gastroduodenal Obstruction: Palliative Treatment with Metallic Stent Placement

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ye Jin; Kim, Jin Hyoung, E-mail: m1fenew@daum.net; Song, Ho-Young; Park, Jung-Hoon; Na, Han Kyu; Kim, Pyeong Hwa; Fan, Yong [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center (Korea, Republic of)

    2012-10-15

    Purpose: To evaluate the clinical effectiveness of self-expandable metallic stents in seven patients with malignant gastroduodenal obstruction caused by inoperable hepatocellular carcinoma (HCC). Methods: Seven patients with gastroduodenal obstruction caused by advanced HCC underwent metallic stent placement from 2003 to 2010. These patients had total dysphagia (n = 5) or were able to eat only liquids (n = 2) before stent placement. Patients had Eastern Cooperative Oncology Group performance scores of 2 or 3, and Child-Pugh classification B or C. Results: Stent placement was technically successful in all seven patients (100%) and clinically successful in six (86%). Five patients could eat a soft diet, and one patient tolerated regular diet after stent placement. Stent-related obstructive jaundice occurred in one patient. One patient had hematemesis 11 days after stent placement. Overall mean survival was 51 days (range, 10-119 days). Stent patency was preserved in six patients with clinical success until death. Conclusion: Placement of a covered self-expandable metallic stent may offer good palliation in patients with gastroduodenal obstruction due to advanced HCC.

  14. Artificial Intelligence based technique for BTS placement

    Science.gov (United States)

    Alenoghena, C. O.; Emagbetere, J. O.; Aibinu, A. M.

    2013-12-01

    The increase of the base transceiver station (BTS) in most urban areas can be traced to the drive by network providers to meet demand for coverage and capacity. In traditional network planning, the final decision of BTS placement is taken by a team of radio planners, this decision is not fool proof against regulatory requirements. In this paper, an intelligent based algorithm for optimal BTS site placement has been proposed. The proposed technique takes into consideration neighbour and regulation considerations objectively while determining cell site. The application will lead to a quantitatively unbiased evaluated decision making process in BTS placement. An experimental data of a 2km by 3km territory was simulated for testing the new algorithm, results obtained show a 100% performance of the neighbour constrained algorithm in BTS placement optimization. Results on the application of GA with neighbourhood constraint indicate that the choices of location can be unbiased and optimization of facility placement for network design can be carried out.

  15. Genetic Algorithm Approaches for Actuator Placement

    Science.gov (United States)

    Crossley, William A.

    2000-01-01

    This research investigated genetic algorithm approaches for smart actuator placement to provide aircraft maneuverability without requiring hinged flaps or other control surfaces. The effort supported goals of the Multidisciplinary Design Optimization focus efforts in NASA's Aircraft au program. This work helped to properly identify various aspects of the genetic algorithm operators and parameters that allow for placement of discrete control actuators/effectors. An improved problem definition, including better definition of the objective function and constraints, resulted from this research effort. The work conducted for this research used a geometrically simple wing model; however, an increasing number of potential actuator placement locations were incorporated to illustrate the ability of the GA to determine promising actuator placement arrangements. This effort's major result is a useful genetic algorithm-based approach to assist in the discrete actuator/effector placement problem.

  16. A method to locate electrode placement.

    Science.gov (United States)

    Brodnick, D

    2000-01-01

    A new method uses redundancy in the 12-lead electrocardiogram (ECG) to determine the angles to all of the electrodes used to record the ECG. No other transducers or signals are needed. The method, a matrix manipulation of the standard 12-lead, would be applicable to all existing ECGs already stored on hospital systems. The invention of this method was originally motivated by the slight differences seen between ECGs acquired by the standard resting electrode placement versus those acquired in a monitoring or exercise placement. An ECG signal is acquired in multiple channels. A covariance matrix is formed. From the eigenvector solution of the matrix, the angles between the eigenvectors and the original signal vectors are determined. The angles calculated for any ECG test are compared to reference angles to determine whether the electrodes are placed in the standard ECG electrode placement, an alternative electrode placement, or an incorrect electrode placement.

  17. Rapid prototyping drill guide template for lumbar pedicle screw placement

    Institute of Scientific and Technical Information of China (English)

    LU Sheng; XU Yong-qing; ZHANG Yuan-zhi; LI Yan-bing; SHI Ji-hong; CHEN Guo-ping; CHEN Yu-bing

    2009-01-01

    To develop a novel method of spinal pedical stereotaxy by reverse engineering and rapid prototyping techniques, and to validate its accuracy by experimental and clinical studies. Methods: A 3D reconstruction model for the desired lumbar vertebra was generated by using the Mimics 10.11 software, and the optimal screw size and orientation were determined using the reverse engineering software. Afterwards, a drill template was created by reverse engi-neering principle, whose surface was the antitemplate of the vertebral surface. The drill template and its correspond-ing vertebra were manufactured using the rapid prototyping technique. Results: The accuracy of the drill template was con-firmed by drilling screw trajectory into the vertebral biomodel preoperatively. This method also showed its ability to cus-tomize the placement and size of each screw based on the unique morphology of the lumbar vertebra.The drill tem-plate fits the postural surface of the vertebra very well in the cadaver experiment. Postoperative CT scans for controlling the pedicle bore showed that the personalized template had a high precision in cadaver experiment and clinical application. No misplacement occurred by using the per-sonalized template. During surgery, no additional computer assistance was needed.Conclusions: The authors have developed a novel drill template for lumbar pedicle screw placement with good applicability and high accuracy. The potential use of drill templates to place lumbar pedicle screws is promising. Our methodology appears to provide an accurate technique and trajectory for pedicle screw placement in the lumbar spine.

  18. Evaluation of the safety of latrogenic lntestinal perforation during placement of percutaneous drainage catheter in rabbit

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Choon Hyeong; Oh, Joo Hyung; Park, Ga Young; Shin, Hong Sub; Kim, In Sub; Yoon, Yup; Lee, Dong Ho; Ko, Young Tae; Choi, Woo Suk; Lim, Joo Won [Kyunghee Univ. Hospital, Seoul (Korea, Republic of)

    1996-10-01

    To evaluate the safety of transgression of the bowel during intraperitoneal percutaneous catheter placement in an animal model. Eight 8-F straight catheters were percutaneously inserted into the small and large bowel of eight rabbits. In four animals, the catheters were left in place until autopsy, whereas in the remaining four, the catheters were withdrawn five days after insertion. Autopsy was performed in all animals ten days after catheter placement, and gross and microscopic examination was carried out. Transgressing the bowel during intraperitoneal percutaneous catheter placement did not contribute to any clinically significant complications. At autopsy, there was no bowel leakage, peritonitis, or abscess, although peritoneal adhesions were found around the catheter tract. Although further study is warranted, our study with an animal model indicated that transgression of the intestine during percutaneous placement of an intraabdominal catheter did not produce significant complications.

  19. Brachytherapy for the prevention of neointimal hyperplasia in the canine inferior vena cava after stent placement

    Energy Technology Data Exchange (ETDEWEB)

    Isota, Masayuki; Kaminou, Toshio; Sakai, Yukimasa; Nakamura, Kenji; Yamada, Ryusaku [Osaka City Univ. (Japan). Medical School

    2002-06-01

    The aim of this study was to evaluate the efficacy of brachytherapy for preventing neointimal hyperplasia in the inferior vena cava (IVC) after stent placement. Sixteen beagles underwent Z-stent placement in the IVC and the aorta. For 8 of 16 beagles, irradiation (15 Gy) was delivered endoluminally to the stented segments of each vessel immediately after stent placement using the {sup 192}Ir. All animals were sacrificed after 6 weeks for morphometric and histopathologic examination. Morphometrically, neointimal thickness in the IVC of the radiation group was significantly decreased compared with the control group as well as that in the aorta (p<0.05). Histopathologic findings showed the neointima in the IVC of the control group contained markedly organization of thrombus and neovascularization though that in the IVC of the radiation group consisted mainly of smooth muscle cells without organization of thrombus and neovascularization. From these data intravenous irradiation may prevent clinical restenosis after stent placement. (author)

  20. Educational Placement of Children with Spina Bifida.

    Science.gov (United States)

    Lauder, Calvin E.; And Others

    1979-01-01

    Procedures of school placement for 38 children (ages 5 to 18 years) with spina bifida in 23 school districts in western New York State were studied 5 years after a mandated process was enacted. (Author)

  1. Realistic Approach for Phasor Measurement Unit Placement

    DEFF Research Database (Denmark)

    Rather, Zakir Hussain; Chen, Zhe; Thøgersen, Paul

    2015-01-01

    This paper presents a realistic cost-effectivemodel for optimal placement of phasor measurement units (PMUs) for complete observability of a power system considering practical cost implications. The proposed model considers hidden or otherwise unaccounted practical costs involved in PMU...

  2. Selective Placement Program Coordinator (SPPC) Directory

    Data.gov (United States)

    Office of Personnel Management — List of the Selective Placement Program Coordinators (SPPC) in Federal agencies, updated as needed. Users can filter the list by choosing a state and/or agency name.

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

    Institute of Scientific and Technical Information of China (English)

    张云; 吴志娟; 徐文藻

    2014-01-01

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

  4. Empowerment of physiotherapy students on placement: The interplay between autonomy, risk, and responsibility.

    Science.gov (United States)

    Clouder, Lynn; Adefila, Arinola

    2017-11-01

    Knowledge of the effects on students of clinical educators' giving or withholding responsibility on placement is limited. The associated empowering, or disempowering impact indicates the need for research on what grounds such decisions are made. The study aimed to explore clinical educators' perspectives on the importance of giving student physiotherapists increasing levels of responsibility on clinical placement, and the factors considered when giving or withholding responsibility. A grounded theory methodology underpins this United Kingdom (UK) based study. The phase of the study reported in this article involved 26, semi-structured interviews with clinical educators, each followed by the completion of a diamond ranking exercise. Three themes emerged: 1) the ubiquity of risk; 2) the relationship between trust and trustworthiness; and 3) graduated supervision. The first theme, acknowledged that risk is ever-present and that clinical educators are used to managing it, balancing risk and responsibility given to students. The second theme highlighted the importance of developing trust/trustworthiness as a foundation for a sound working relationship between student and clinical educator. The third theme focusing on graduated supervision as a means of empowering students to take on increasingly demanding responsibilities on placement. The study illustrates the complex relationship between risk, trust, responsibility, and developing student autonomy. A strategy is proposed to provide an empowering alternative to the tendency to increase surveillance and/or limit the responsibility for students who lack confidence or capability in taking responsibility on clinical placement. Future research could aim to test the strategy more widely.

  5. The influence student placement experience can have on the employment choices of graduates: A paediatric nursing context.

    Science.gov (United States)

    Boyd-Turner, Danni; Bell, Elaine; Russell, Alison

    2016-01-01

    This paper explores how the student placement experience may influence employment choices in the context of paediatric nursing. A qualitative research methodology was used. Data was collected using semi structured interviews at a tertiary teaching hospital. The sample group comprised of six newly qualified nurses who had completed their Bachelor of Nursing less than 12 months before the interview. They had completed at least one clinical placement at the site of data collection in their 2nd or 3rd year of undergraduate nursing studies. The main themes contributing to the student nurse experience within the context of paediatric nursing included the wish to work with children, a job being available, support during clinical placements and assistance with future career planning while on placement. The support experienced by student nurses during their clinical placement was seen to have a very positive influence on their future employment choices. Group de-briefing to support mutual understanding and sharing was seen to be a highly positive aspect of a clinical placement. Also how students were treated by clinical staff was a key factor that influenced future employment choices.

  6. Percutaneous needle placement using laser guidance: a practical solution

    Science.gov (United States)

    Xu, Sheng; Kapoor, Ankur; Abi-Jaoudeh, Nadine; Imbesi, Kimberly; Hong, Cheng William; Mazilu, Dumitru; Sharma, Karun; Venkatesan, Aradhana M.; Levy, Elliot; Wood, Bradford J.

    2013-03-01

    In interventional radiology, various navigation technologies have emerged aiming to improve the accuracy of device deployment and potentially the clinical outcomes of minimally invasive procedures. While these technologies' performance has been explored extensively, their impact on daily clinical practice remains undetermined due to the additional cost and complexity, modification of standard devices (e.g. electromagnetic tracking), and different levels of experience among physicians. Taking these factors into consideration, a robotic laser guidance system for percutaneous needle placement is developed. The laser guidance system projects a laser guide line onto the skin entry point of the patient, helping the physician to align the needle with the planned path of the preoperative CT scan. To minimize changes to the standard workflow, the robot is integrated with the CT scanner via optical tracking. As a result, no registration between the robot and CT is needed. The robot can compensate for the motion of the equipment and keep the laser guide line aligned with the biopsy path in real-time. Phantom experiments showed that the guidance system can benefit physicians at different skill levels, while clinical studies showed improved accuracy over conventional freehand needle insertion. The technology is safe, easy to use, and does not involve additional disposable costs. It is our expectation that this technology can be accepted by interventional radiologists for CT guided needle placement procedures.

  7. “双管法”镍钛记忆合金支架置入术治疗气管狭窄和气管瘘的临床应用%Clinical use of "double-barreled" nickel-titanium memory alloy stent placement for treatment of tracheal stenosis and fistula

    Institute of Scientific and Technical Information of China (English)

    魏宁; 顾玉明; 徐浩; 祖茂衡; 张庆桥; 许伟; 崔艳峰; 刘洪涛; 王文亮

    2012-01-01

    Objective To assess the efficacy of "double-barreled" nickel-titanium memory alloy stent placement for treatment of benign or malignant tracheal stenosis and tracheal fistula under local anesthesia and digital subtraction angiography(DSA) monitoring.Methods A retrospective analysis was performed on the profiles of 25 typical cases who received intubation via the nasal cavity or tracheal fistula (O2:2-4 L/min) followed by endotracheal placement of various n ickel-titanium memory alloy stents under DSA monitoring and laryngopharyngeal or tracheal local anesthesia between 2003 and 2011.Results Nickel-titanium stents,including 2 integrated inverted Y-shaped stents,a bullet-like membrane-coated stent,5 tubular membrane-coated stents and 20 tubular common stents,were successflly implanted in 25 patients.Stent placement was associated with marked improvement in dyspnea,and the grading reduced from Ⅲ-Ⅳ to 0- Ⅰ.Furthermore,pulse oxygen saturation (SPO2) was improved to (92.55±3.08)% during spontaneous breathing as compared with (73.24± 3.07)% previously during high-flow oxygen therapy (P< 0.05).Conclusion The "double-barreled" nickel-titanium memory alloy stent placement under local anesthesia and DSA monitoring is worthwhile for clinical application due to its safety,effectiveness and simplicity.%目的 探讨在局麻和数字减影血管造影机(DSA)监视下应用“双管法”置入镍钛记忆合金支架急诊治疗气管良恶性狭窄和气管瘘的疗效.方法 回顾性分析2003-2011年间,在DSA监视和咽喉、气管局麻下,先经鼻或气管瘘口留置通气导管,予以2~4 L/min流量供氧,再经气管置入不同类型镍钛记忆合金气管支架的25个典型病例.结果 25例患者行镍钛记忆合金支架均成功,共置入一体式倒Y型支架2枚,“子弹头”覆膜支架1枚,管状覆膜支架5枚,管状裸支架20枚.所有患者术后呼吸困难明显改善,气促评级由Ⅲ~Ⅳ级改善为0~Ⅰ级,氧饱

  8. Immediate Dental Implant Placements Using Osteotome Technique: A Case Report and Literature Review.

    Science.gov (United States)

    Al-Almaie, Saad

    2016-01-01

    This clinical case describes the effect of the osteotome technique on the osseointegration of a mandibular dental implant in a 42-year-old female patient with dento-alveolar bony defects and to review the literature regarding immediate implant placement using osteotome technique. The amount of bone expansion at the alveolar ridge and the marginal bone resorption from the time of implant placement to one year after the implant's functional loading were recorded clinically. The esthetic outcome for the restored implant (the gingival margin) was achieved one years after the implant's functional loading. The surgical and prosthetic sites for the implant showed no postoperative complications, and no infection or wound dehiscence was recorded during the follow-up period. The osteotome technique is good for the purpose for which it was introduced, and its advantages with immediate implant placement include reduced surgical trauma and a shorter treatment time.

  9. Ultraflex precision colonic stent placement as a bridge to surgery in patients with malignant colon obstruction

    DEFF Research Database (Denmark)

    Fregonese, D.; Naspetti, R.; Ferrer, S.;

    2008-01-01

    Background: Emergency surgery for malignant colon obstruction entails relatively high morbidity and mortality rates and typically necessitates a 2-step resection. These problems might be potentially mitigated by placement of a self-expanding metal stent (SEMS) as a bridge to surgery. A nitinol...... colorectal SEMS may offer several advantages, but available evidence on the utility of this SEMS type remains highly limited. Objective: Our purpose was to evaluate the effectiveness and safety as a bridge to surgery of a nitinol SEMS designed for colorectal use. Design: Prospective and retrospective...... multicenter clinical study. Setting: Sixteen European study centers. Patients: Thirty-six patients with malignant colonic obstruction. Interventions: Nitinol colorectal SEMS placement. Main Outcome Measures: Technical success in accurate SEMS placement with coverage of the entire stricture length, clinical...

  10. Reducing CSF shunt placement in patients with spinal myelomeningocele

    Directory of Open Access Journals (Sweden)

    Suresh Sankhla

    2009-01-01

    Full Text Available Object: The incidence of hydrocephalus requiring shunts in children with myelomeningocele (MMC is reported to be very high. Shunt-related complications are a significant cause of morbidity and mortality in this population. In order to minimize shunt placements, we used very rigid clinical selection criteria and followed them in all patients who had myelomeningocele and enlarged ventricles. The follow-up outcome of this retrospective study is reported. Methods: From 2000 to 2007, 23 patients with myelomeningocele and variable degree of hydrocephalus were treated at our institute with primary surgical closure of their myelomeningoceles without a CSF diversion procedure. Patients with severe hydrocephalus who required immediate shunt insertion, and those with no significant associated hydrocephalus were not included in this study. Data regarding the surgical results and complications, postoperative management, and the outcome at follow-up were obtained from their hospital records. Results: Initially increased size of the ventricular system was found to have decreased or stabilized in 17 (81% patients postoperatively. However, ventriculomegaly continued to progress further in 4 (19% out of 21 patients. Of 11 patients who presented with enlarged head, eight (73% patients showed reduction or stabilization in their head circumference. Three (27% children continued to have progressive head enlargement in the postoperative period and required shunt placement. Signs of raised intracranial pressure observed in six patients on admission, improved in two (33% and persisted or worsened in four (67% patients who eventually improved after the insertion of a shunt. Eight (35% patients experienced wound-related complications following closure of the MMC, including CSF leak in four, wound infection in three, wound breakdown in three, and pseudomeningocele in two patients. Shunt placement was required in the postoperative period in 13 (56.5% patients to treat

  11. Tunnel placement in anterior cruciate ligament reconstruction: MRI analysis as an important factor in the radiological report

    Energy Technology Data Exchange (ETDEWEB)

    Tomczak, R.J. [Department of Radiology, University of Ulm, Robert-Koch-Strasse 9, D-89075 Ulm (Germany)]|[Department of Radiology, Division of Body Imaging and MRI, University of Florida, College of Medicine, 1600 Archer Road, Gainesville, FL 32610 (United States); Hehl, Gerhard [Department of Trauma Surgery, University of Ulm, Robert-Koch-Strasse 9, D-89075 Ulm (Germany); Mergo, Patricia J. [Department of Radiology, Division of Body Imaging and MRI, University of Florida, College of Medicine, 1600 Archer Road, Gainesville, FL 32610 (United States); Merkle, E. [Department of Radiology, University of Ulm, Robert-Koch-Strasse 9, D-89075 Ulm (Germany); Rieber, Andrea [Department of Radiology, University of Ulm, Robert-Koch-Strasse 9, D-89075 Ulm (Germany); Brambs, Hans-Joachim [Department of Radiology, University of Ulm, Robert-Koch-Strasse 9, D-89075 Ulm (Germany)

    1997-07-07

    Objective. Correct placement of tunnels for anterior cruciate ligament (ACL) reconstruction is of prime importance for the clinical outcome of the patient. In this study, the possibility of using MRI to document tunnel placement and provide a more comprehensive report following ACL reconstruction was explored at no additional cost in patients scheduled for routine knee MRI. Design and patients. One year after ACL reconstruction, 45 patients underwent clinical examination (IKCD score), radiographic examination, and MRI using a 1.5-T unit. Results. Twenty patients with good tibial and femoral attachment results were found at clinical examination to have a stable knee joint with a full range of motion. In 25 patients with suboptimal placements, examination showed either a stable knee with a decreased range of motion or instability with a normal range of motion. Conclusion. Patients` clinical outcome, and the radiographic and MRI findings, correlated closely with the quality of operative tunnel placement. A record of this finding is important for completeness of the radiological report. Furthermore the MRI findings can be used to improve the surgical quality of tunnel placement. Because tunnel placement can be shown adequately with radiography, however, MRI cannot be justified for this reason alone, so such assessment is advised only when MRI is needed to show all postoperative features. (orig.). With 5 figs., 4 tabs.

  12. Pheochromocytoma-induced atrial tachycardia leading to cardiogenic shock and cardiac arrest: resolution with atrioventricular node ablation and pacemaker placement.

    Science.gov (United States)

    Shawa, Hassan; Bajaj, Mandeep; Cunningham, Glenn R

    2014-12-01

    Pheochromocytoma should be considered in young patients who have acute cardiac decompensation, even if they have no history of hypertension. Atrioventricular node ablation and pacemaker placement should be considered for stabilizing pheochromocytoma patients with cardiogenic shock due to atrial tachyarrhythmias. A 38-year-old black woman presented with cardiogenic shock (left ventricular ejection fraction, cardiogenic shock and cardiac arrest unresolved by the placement of 2 different ventricular assist devices, but that was completely reversed by radiofrequency ablation of the atrioventricular node and the placement of a temporary pacemaker. We present the patient's clinical, laboratory, and imaging findings, and we review the relevant literature.

  13. Analog Module Placement Design Using Genetic Algorithm

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    This paper presents a novel genetic algorithm for analog module placement based on ageneralization of the two-dimensional bin packing problem. The genetic encoding and operators assure that allproblem constraints are always satisfied. Thus the potential problems of adding penalty terms to the costfunction are eliminated so that the search configuration space is drastically decreased. The dedicated costfunction is based on the special requirements of analog integrated circuits. A fractional factorial experimentwas conducted using an orthogonal array to study the algorithm parameters. A meta GA was applied todetermine the optimal parameter values. The algorithm was tested with several local benchmark circuits. Theexperimental results show that the algorithm has better performance than the simulated annealing approachwith satisfactory results comparable to manual placement. This study demonstrates the effectiveness of thegenetic algorithm in the analog module placement problem. The algorithm has been successfully used in alayout synthesis tool.

  14. Where Should We Go With Advanced Placement?

    Science.gov (United States)

    Lichten, William

    2001-04-01

    This is a review of the Advanced Placement (AP)Program. In disagreement with claims of the College Board, there is firm evidence that the average test performance level has dropped. The College Board's scale and claims for AP qualification disagree seriously with college standards. A majority of tests taken do not qualify. It appears that "advanced placement" is coming closer to "placement." This paper recommends that the College Board's policy, which previously has concentrated on the numbers of participants, should include an emphasis on student performance and program quality. AP could accomplish its goal of reaching a wider range of students by changing along the lines followed in college introductory physics courses: multiple tracks.

  15. Trajectory surgical guide stent for implant placement.

    Science.gov (United States)

    Adrian, E D; Ivanhoe, J R; Krantz, W A

    1992-05-01

    This article describes a new implant placement surgical guide that gives both implant location and trajectory to the surgeon. Radiopaque markers are placed on diagnostic dentures and a lateral cephalometric radiograph is made that shows the osseous anatomy at the symphysis and the anterior tooth location. The ideal implant location and trajectory data are transferred to a surgical stent that programs the angle and location of the fixtures at time of surgery. The stent has the additional benefit of acting as an occlusion rim, a mouth prop, and tongue retractor. Use of this stent has resulted in consistently programming the placement of implant fixtures that are prosthodontically ideal.

  16. Product Placement: La publicidad del s. XXI

    OpenAIRE

    Martin Soler, Anna

    2015-01-01

    Les característiques i la versatilitat del product placement el converteixen en una opció interessant per als anunciants que desitgen una publicitat original i creativa, alhora que per als productors aquesta pràctica els permet obtenir finançament per als seus continguts. Avui en dia, aquesta tècnica no tan sols es troba en el cinema i la televisió ja que la seva presència en els videojocs, el teatre o la literatura fa que el product placement s'instauri com la publicitat del s.XXI. Las ca...

  17. Clinical observation of the middle-late patients with esophageal cancer to perform esophageal stent placement and radiation therapy%覆膜支架置入联合放射治疗在中晚期食管癌治疗中的临床观察

    Institute of Scientific and Technical Information of China (English)

    胥雄阳; 赵平宗; 蒋丽琳; 杨兴平; 郭凤英; 贾碧慧

    2015-01-01

    Objective To study the clinical value of esophageal stent placement with radiation therapy for the middle-late pa-tients with esophageal cancer.Methods To perform esophageal stent placement and radiation therapy for the middle-late 35 pa-tients,and to perform radiation therapy for the middle-late 37 patients,then observe the clinical curative effects.Results The treat-ment group were significantly alleviated with dysphagia symptom after operation,which 32 cases sticked the entire radiation,ac-counting for 91.4%,no one can′t complete the treatment because of nutritional status reason.Survival time of one month after ra-diotherapy was up to 100.0%,and survival time of six months was 85.7% (30/35).But the contrast group with dysphagia symp-tom were aggravated or no relief,and needed parenteral nutrition.There were 23 cases to complete the entire radiation,accounting for 62.2%,and 5 cases happened esophageal tracheal fistula.Survival time of one month after radiotherapy was 83.8%(31/37),and survival time of six months was 62.2% (23/37).Two groups of cases in radiotherapy resistance difference was statistically signifi-cant,one month and six months of survival time were statistically significant (all P <0.05 ).Conclusion Esophageal stent place-ment with radiotherapy is more efficient than only radiation therapy to the middle-late patients with esophageal cancer.%目的:探讨食管覆膜支架置入联合放射治疗对中晚期食管癌治疗的临床价值。方法对35例中晚期食管癌患者进行覆膜支架置入术并放射治疗(治疗组),对37例中晚期食管癌患者进行单纯放射治疗(对照组),并进行临床疗效对比观察。结果治疗组术后患者吞咽困难症状均明显缓解,坚持完成全程放射治疗32例(91.4%),无因营养状况原因导致治疗情况不能完成;放射治疗后1个月以上生存期达100.0%,6个月生存期为85.7%(30/35)。对照组放射治疗开始1周内吞咽困难症状加重或无缓解,需

  18. Gastrostomy placement improves height and weight gain in girls with Rett syndrome

    Science.gov (United States)

    Growth failure and undernutrition complicate the clinical course of girls with Rett syndrome (RTT). These abnormalities are, in part, the consequence of oral motor dysfunction and inadequate dietary intake. We hypothesized that gastrostomy placement for nutritional therapy reverses the decline in he...

  19. Gastrostomy placement favorably alters the natural history of growth failure and undernutrition in Rett syndrome

    Science.gov (United States)

    Growth failure and undernutrition complicate the clinical course of girls with Rett syndrome (RTT). These abnormalities are, in part, the consequence of oral motor dysfunction and inadequate dietary intake. Our objective was to determine if gastrostomy placement for nutritional therapy alters the na...

  20. Cross-racial foster home placement among native American psychiatric patients.

    Science.gov (United States)

    Westermeyer, J

    1977-04-01

    In Minnesota, about 0.5 percent of the general population are raised outside of their biologic homes. However, it has been estimated that 25 to 30 percent of all Indian children under the age of 18 years are currently living outside of their biologic homes. Clinical experience with adolescent and adult Indian psychiatric patients bears this out: about half of them have been raised in foster or adoptive homes.Seventeen American Indian patients who had been raised in non-Indian foster and adoptive homes were interviewed for five to ten hours each. Data were collected from the patients and social agencies regarding demographic characteristics, social coping, and current clinical problems. In addition, information obtained regarding their out-of-family placement included: age at placement, reason for placement, number of subsequent placements, and interracial and intraracial relationships during placement and subsequently during adulthood.This clinical sample shows a low rate of psychosis and neurosis, but a high rate of alcohol-related disorders, suicide attempts, and behavioral problems. While their education is average, their employment and marital status shows marked social disability. Most have had numerous childhood placements over a long period, all in white homes, and none have subsequently returned to their family-of-origin.These unfortunate human beings have been described by both whites and Indians in Minnesota as "apples": racially "red" or Indian on the outside, but culturally white on the inside. White groups do not accept them as whites because they are distinctively racial Indians, but they do not feel at ease in Indian communities since they were raised with white values and attitudes. While some of these people do indeed make successful adjustments in Indian or white society (or both) the results of this study show that many apparently do not.

  1. Flapless implant placement with crown lengthening procedure to correct crown height: a case report.

    Science.gov (United States)

    Jacobson, Nancy; Starr, Cliff

    2009-10-01

    Bone loss and soft tissue loss are common problems after tooth extraction and that can lead to excessive length of clinical crowns. This problem can be exacerbated by delaying implant placement after tooth extraction. In this case the opposite occurred. After flapless placement of a NobelDirect implant with immediate loading there was not enough vertical space for an esthetic restoration. Surgical crown lengthening was performed to create vertical space to place an esthetically pleasing restoration in harmony with the patient's existing dentition.

  2. Augmentation of residual alveolar bone height with tissue engineering for dental implant placement

    Directory of Open Access Journals (Sweden)

    S M Balaji

    2014-01-01

    Full Text Available The challenge of correcting deficient vertical alveolar height for dental implant placement has been there since dental implants came in to regular clinical placement. The ability of various methods to increase the residual alveolar height has met with varying results. The primary reason is that the techniques were not quite successful in maintaining the required residual alveolar height. Use of Bone Morphogentic Protein, especially rhBMP-2 has been met with high degree of success in deficient vertical alveolar height in a mandibular ridge. The demonstration of this using a case has been presented here.

  3. Repair of pectus excavatum during HeartMate II left ventricular assist device placement.

    Science.gov (United States)

    Tchantchaleishvili, Vakhtang; Massey, Howard Todd

    2016-01-01

    Pectus excavatum deformity often remains clinically asymptomatic even in cases of a severely diminished thoracic volume and frequently remains uncorrected. In the patient population that requires left ventricular assist device (LVAD) placement, a diminished thoracic volume can be problematic and lead to significant challenges in pump and outflow cannula positioning. Here we present a case of pectus excavatum correction during LVAD placement to show that this deformity can be successfully addressed with minimal, if any, additional operative risk at the time of LVAD implant.

  4. Photoelectron Spectroscopy in Advanced Placement Chemistry

    Science.gov (United States)

    Benigna, James

    2014-01-01

    Photoelectron spectroscopy (PES) is a new addition to the Advanced Placement (AP) Chemistry curriculum. This article explains the rationale for its inclusion, an overview of how the PES instrument records data, how the data can be analyzed, and how to include PES data in the course. Sample assessment items and analysis are included, as well as…

  5. Photoelectron Spectroscopy in Advanced Placement Chemistry

    Science.gov (United States)

    Benigna, James

    2014-01-01

    Photoelectron spectroscopy (PES) is a new addition to the Advanced Placement (AP) Chemistry curriculum. This article explains the rationale for its inclusion, an overview of how the PES instrument records data, how the data can be analyzed, and how to include PES data in the course. Sample assessment items and analysis are included, as well as…

  6. Situated learning in the practice placement.

    Science.gov (United States)

    Cope, P; Cuthbertson, P; Stoddart, B

    2000-04-01

    Nurses who had just completed their training in Scotland were interviewed with regard to their experiences on placements. The nurses had either completed a traditional training course or came from the first cohort of the Project 2000 diploma level course. The interviews focused on the way in which the student nurses had learned in their practice placements. The results suggest that the placement is a complex social and cognitive experience in which there are elements of situated learning. Acceptance into the community of practice is important but this can be separated, conceptually at least, into a social acceptance which might be extended to any student and a professional acceptance which relies on the display of appropriate competence. The nurses described the way in which their mentors had interacted with them in terms which suggested that cognitive apprenticeship strategies had been used to further their learning in practice. It is concluded that, in view of the central importance of the placement for training nurses, explicit use of mentoring techniques derived from situated learning and cognitive apprenticeship might be beneficial.

  7. Source placement for equalization in small enclosures

    DEFF Research Database (Denmark)

    Stefanakis, Nick; Sarris, J.; Cambourakis, G.

    2008-01-01

    ) but not with those that will deteriorate it (the "undesired" modes). Simulation results in rectangular rooms and in a car cavity show the benefits of source placement in terms of reduced overall error and increased spatial robustness in the equalization process. Additional benefits, which can be derived by proper...

  8. Radiologic placement of tunneled central venous catheter

    Energy Technology Data Exchange (ETDEWEB)

    Hahn, Seong Tae; Yang, Po Song; Yang, Dong Hunn; Kim, Ki Tae; Kim, Choon Yul; Shinn, Kyung Sub [The Catholic Univ. College of Medicine, Seoul (Korea, Republic of); Yun, Eun Joo [Korea Veterans Hospital, Seoul (Korea, Republic of)

    1996-01-01

    To evaluate the efficacy and safety of fluoroscopy-guided, radiologic placement of a tunneled central venous catheter into the superior vena cava (SVC). Thirty five patients underwent tunneled central venous catheter placement to facilitate long-term chemotherapy. They included 33 leukemic patients, one colon cancer patient, and one multiple myeloma patient. After confirming central venous patency with a injection of contrast media via the peripheral cephalic or basilic vein in the wrist joint, the subclavian vein was punctured under fluoroscopic guidance. A 7F double lumen TPN catheter was placed into the SVC through a subcutaneous tunnel in the anterior chest wall. Catheter placements were successful in all patients. The mean procedure time was 17.2minutes, mean fluooscopy time was 1.3minutes, mean number of punctures was 1.4, and mean volume of injhected contrast media was 43.5cc. Only two of all leukemic patients developed mild hematomas at the puncture site, but these soon resolved themselves. None of the patients developed pneumothorax or hemothorax. But late complications included local infection in two patients (6%) and thrombotic occlusion of the catheter in one (3%). The occluded catheter was successfully recanalized with Urokinase infusion. Fluoroscopy-guided, radiologic placement of a tunneled central venous catheter is an easy and safe method, and useful for patients requiring long-term venous access.

  9. 34 CFR 300.327 - Educational placements.

    Science.gov (United States)

    2010-07-01

    ... public agency must ensure that the parents of each child with a disability are members of any group that makes decisions on the educational placement of their child. (Authority: 20 U.S.C. 1414(e)) ... CHILDREN WITH DISABILITIES Evaluations, Eligibility Determinations, Individualized Education Programs,...

  10. Delayed bracket placement in orthodontic treatment

    Directory of Open Access Journals (Sweden)

    Chandra Wigati

    2008-12-01

    Full Text Available Background: Beside bracket position, the timing of bracket placement is one of the most essential in orthodontic treatment with fixed appliances. Even it seems simple the timing of bracket placement can be crucial and significantly influence the result of orthodontic treatment. However it is often found brackets are placed without complete understanding of its purpose and effects, which could be useless and even detrimental for the case. Purpose: The aim of this case report is to show that the timing of bracket placement could be different depending on the cases. Case: Five different cases are presented here with different timing of bracket placement. Case management: On these cases, brackets were placed on the upper arch first, on the lower arch first, or even only on some teeth first. Good and efficient orthodontic treatment results were achieved. Conclusion: For every orthodontic case, from the very beginning of treatment, bracket should be placed with the end result in mind. If brackets are correctly placed at a correct time, better treatment result could be achieved without unnecessary round tripping tooth movement.

  11. Expanding the Scope of Advanced Placement Classes

    Science.gov (United States)

    Lim, Victoria

    2008-01-01

    Dr. Paul Dosal of the University of South Florida is not impressed with the way most high school students learn about Latin American history. Dosal believes an advanced placement course in the subject will change that. He's the executive director of ENLACE Florida, a statewide network funded by the W.K. Kellogg Foundation, designed to increase the…

  12. Stabilization, Pole Placement, and Regular Implementability

    NARCIS (Netherlands)

    Belur, Madhu N.; Trentelman, H.L.

    2002-01-01

    In this paper, we study control by interconnection of linear differential systems. We give necessary and sufficient conditions for regular implementability of a given linear differential system. We formulate the problems of stabilization and pole placement as problems of finding a suitable, regularl

  13. Advanced Placement: Model Policy Components. Policy Analysis

    Science.gov (United States)

    Zinth, Jennifer

    2016-01-01

    Advanced Placement (AP), launched in 1955 by the College Board as a program to offer gifted high school students the opportunity to complete entry-level college coursework, has since expanded to encourage a broader array of students to tackle challenging content. This Education Commission of the State's Policy Analysis identifies key components of…

  14. Sensor Placement for Modal Parameter Subset Estimation

    DEFF Research Database (Denmark)

    Ulriksen, Martin Dalgaard; Bernal, Dionisio; Damkilde, Lars

    2016-01-01

    The present paper proposes an approach for deciding on sensor placements in the context of modal parameter estimation from vibration measurements. The approach is based on placing sensors, of which the amount is determined a priori, such that the minimum Fisher information that the frequency resp...

  15. 5 CFR 359.702 - Placement rights.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Placement rights. 359.702 Section 359.702 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS REMOVAL FROM THE SENIOR... rights. (a) An appointee covered by this subpart is entitled to be placed in a vacant civil...

  16. Wavelength converter placement in optical networks with dynamic traffic

    DEFF Research Database (Denmark)

    Buron, Jakob Due; Ruepp, Sarah Renée; Wessing, Henrik;

    2008-01-01

    We evaluate the connection provisioning performance of GMPLS-controlled wavelength routed networks under dynamic traffic load and using three different wavelength converter placement heuristics. Results show that a simple uniform placement heuristic matches the performance of complex heuristics u...

  17. Lumbar total disc arthroplasty: coronal midline definition and optimal TDA placement.

    Science.gov (United States)

    Marshman, Laurence A G; Friesem, Tai; Rampersaud, Y Raja; Le Huec, Jean-Charles; Krishna, Manoj; Reddy, Guru R

    2008-01-01

    It is a general principle with arthroplasty insertion that precise implant centering is critical for long term function and outcome. Whilst some authors have proclaimed that lumbar total disc arthroplasty (TDA) may be different, and that off -centre placement may be functionally well tolerated, these claims are premature: significantly worse clinical results have already been reported with poorly placed TDA at 2 years. Accurate TDA placement requires a precise and consistent definition of the desired coronal midline target (which is currently lacking), as well as a procedural mechanism to optimize placement at that target. We summarize our experience, as well as others', in achieving these two requirements. Long-term outcomes after lumbar TDA insertion should only be compared with results from fusion where TDAs have been implanted accurately.

  18. Subintimal stent placement in patients with long segment occlusion of the iliac artery

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Ho Jung; Kim, Young Hwan; Kim, Si Hyung; Ko, Sung Min; Choi, Jin Soo; Lee, Hyun Jin; Kim, Hyung Tae; Jo, Won Hyun [Dongsan Medical Center, Keimyung University College of Medicine, Daegu (Korea, Republic of); Kim, Yong Joo [Andong General Hospital, Andong (Korea, Republic of)

    2008-01-15

    We evaluated the technical feasibility and clinical efficacy of subintimal stent placement for long segment occlusion of the iliac artery. From March 2003 to February 2007, subintimal stent placement for long segment occlusion of the iliac artery of 24 limbs in 22 patients was analyzed retrospectively. Endovascular access was performed via the ipsilateral femoral artery in 7 cases, via the contralateral femoral artery in 6 cases, via both femoral arteries in 10 cases and via the brachial artery in one case. The SAFARI (subintimal arterial flossing with antegrade-retrograde intervention) technique using a microcatheter was performed to recannalize iliac artery occlusion in three cases. Medical records were reviewed for the collection of follow-up data. The stent patency rate was analyzed by use of the Kaplan-Meier method. Subintimal stent placement was technically successful in 23 of 24 procedures (95.8%). The mean ankle-brachial index (ABI) increased form 0.26 to 0.82. The Fontaine classification was improved after stent placement in all patients. Major complications occurred in four procedures: three distal embolizations and one arterial rupture. All of the complications were successfully treated by endovascular intervention. The primary stent patency rates at 6-months, 1-, 2-and 3-years were 95%, 88%, 88% and 88%, respectively. Subintimal stent placement is a safe and effective treatment for long segment occlusion of the iliac artery.

  19. Target Tracking, Approach, and Camera Handoff for Automated Instrument Placement

    Science.gov (United States)

    Bajracharya, Max; Diaz-Calderon, Antonio; Robinson, Matthew; Powell, Mark

    2005-01-01

    This paper describes the target designation, tracking, approach, and camera handoff technologies required to achieve accurate, single-command autonomous instrument placement for a planetary rover. It focuses on robust tracking integrated with obstacle avoidance during the approach phase, and image-based camera handoff to allow vision-based instrument placement. It also provides initial results from a complete system combining these technologies with rover base placement to maximize arm manipulability and image-based instrument placement.

  20. Brand placement prominence: good for memory! Bad for attitudes?

    NARCIS (Netherlands)

    E. van Reijmersdal

    2009-01-01

    This paper presents two laws about the effects of brand placement on audience reactions. This article presents two laws about the effects of brand placement on audience reactions. Brand placement is the compensated inclusion of brands or brand identifiers within media programming. The first law stat

  1. Dit programma bevat product placement: Effecten van sponsorvermeldingen in televisieprogramma's

    NARCIS (Netherlands)

    Boerman, S.C.; van Reijmersdal, E.A.; Neijens, P.C.; Bronner, A. E.; Dekker, P.; de Leeuw, E.; Paas, L.J.; de Ruyter, K.; Smidts, A.; Wieringa, J.E.

    2015-01-01

    Europese richtlijnen vereisen dat brand placement in televisieprogramma’s wordt kenbaar gemaakt door een tekst zoals "Dit programma bevat product placement" of door een PP (product placement) logo. Deze sponsorvermeldingen hebben als doel de televisiekijker te informeren over merken of producten die

  2. BRAND PLACEMENT AND CONSUMER CHOICE: AN IN-STORE EXPERIMENT

    Science.gov (United States)

    Sigurdsson, Valdimar; Saevarsson, Hugi; Foxall, Gordon

    2009-01-01

    An in-store experiment was performed to investigate the effects of shelf placement (high, middle, low) on consumers' purchases of potato chips. Placement of potato chips on the middle shelf was associated with the highest percentage of purchases. The results confirm the importance of item placement as a factor in consumers' buying behavior. PMID:20190939

  3. How media factors affect audience responses to brand placement

    NARCIS (Netherlands)

    E. van Reijmersdal; E. Smit; P. Neijens

    2010-01-01

    This study investigates the influence of media factors on brand placement effects in a real-life setting. Although many studies on brand placement have been conducted, insights into context effects on brand placement reactions are scarce. The impact of objective and subjective media context factors

  4. Brand Placement and Consumer Choice: An in-Store Experiment

    Science.gov (United States)

    Sigurdsson, Valdimar; Saevarsson, Hugi; Foxall, Gordon

    2009-01-01

    An in-store experiment was performed to investigate the effects of shelf placement (high, middle, low) on consumers' purchases of potato chips. Placement of potato chips on the middle shelf was associated with the highest percentage of purchases. The results confirm the importance of item placement as a factor in consumers' buying behavior.…

  5. Parental Status Characteristics and Self-Placement of Young Adults.

    Science.gov (United States)

    McBroom, William H.; Hammer, Gail

    1983-01-01

    Examines status self-placement literature. Tests Talcott Parsons's inferences that, in predicting young adults' self-placement, (1) father's occupation is more important than other status variables of the father, (2) mother's employment makes the process of self-placement less predictable, and (3) "emancipation" from family of…

  6. Parental Status Characteristics and Self-Placement of Young Adults.

    Science.gov (United States)

    McBroom, William H.; Hammer, Gail

    1983-01-01

    Examines status self-placement literature. Tests Talcott Parsons's inferences that, in predicting young adults' self-placement, (1) father's occupation is more important than other status variables of the father, (2) mother's employment makes the process of self-placement less predictable, and (3) "emancipation" from family of…

  7. Impact of cytochrome P450 3A4-metabolized statins on the antiplatelet effect of a 600-mg loading dose clopidogrel and on clinical outcome in patients undergoing elective coronary stent placement.

    Science.gov (United States)

    Trenk, Dietmar; Hochholzer, Willibald; Frundi, Devine; Stratz, Christian; Valina, Christian M; Bestehorn, Hans-Peter; Büttner, Heinz Joachim; Neumann, Franz-Josef

    2008-01-01

    Early studies suggested interactions between statins and clopidogrel. Based on the outcome and platelet data, there is now huge evidence of no interactions between statins and 75 to 300 mg clopidogrel; however, data with 600-mg loading are lacking. In a pre-specified analysis of the EXCELSIOR cohort, we investigated the interaction between statins, especially cytochrome P4503A4-metabolized atorvastatin and simvastatin, and the antiplatelet effects of a 600-mg loading dose of clopidogrel. We analyzed 1,395 patients scheduled for coronary angiography (CA). Patients received clopidogrel 600 mg at least two hours before CA and 75 mg daily thereafter in case of percutaneous coronary intervention (PCI). Statin medication on admission was continued unaltered until discharge. Platelet function was assessed by optical aggregometry and flow cytometry of adenosine diphosphate (ADP)-stimulated surface expression of CD62P, CD63 and PAC-1 before clopidogrel and immediately before CA. Residual platelet aggregation (RPA) after addition of ADP 5 muM was similar irrespective of statin treatment at baseline (p = 0.968). RPA at CA was 46.2 +/- 16.8% in patients without statin (n = 682), 45.5 +/- 17.0% in patients with atorvastatin (n = 255), 45.8 +/- 16.3% with simvastatin (n = 335), 47.3 +/- 14.9% with fluvastatin (n = 42) and 45.9 +/- 16.2% with pravastatin (n = 81; p = 0.962). Consistent results were obtained by flow cytometry. In patients with PCI (n = 553), the one-year incidence of death, myocardial infarction and target lesion reintervention did not differ between cohorts stratified according to statin co-medication (p = 0.645). Thus, peri-interventional atorvastatin and simvastatin had no effect on the antiplatelet activity of a loading dose of clopidogrel 600 mg and did not affect clinical outcome after PCI.

  8. Low recurrence rate and low chronic pain associated with inguinal hernia repair by laparoscopic placement of Parietex ProGrip™ mesh: clinical outcomes of 220 hernias with mean follow-up at 23 months.

    Science.gov (United States)

    Birk, D; Hess, S; Garcia-Pardo, C

    2013-06-01

    The aim of this study was to demonstrate the safety and the efficacy of the self-gripping Parietex ProGrip™ mesh (Sofradim Production, Trévoux, France) used with the laparoscopic approach for inguinal hernia repair. The incidence of chronic pain, post-operative complications, patient satisfaction and hernia recurrence at follow-up after 12 months was evaluated. Data were collected retrospectively from patient files and were analyzed for 169 male and female patients with 220 primary inguinal hernias. All patients included had undergone surgical repair for inguinal hernia by the laparoscopic transabdominal preperitoneal approach using Parietex ProGrip™ meshes performed in the same clinical center in Germany. Pre-, per- and post-operative data were collected, and a follow-up after 12 months was performed prospectively. Complications, pain scored on a 0-10 numeric rating scale (NRS), patient satisfaction and hernia recurrence were assessed. The only complications were minor and were post-operative: hematoma/seroma (3 cases), secondary hemorrhage through the trocar's site (2 cases), hematuria, emphysema in the inguinal regions (both sides) and swelling above the genital organs (1 case for each). At mean follow-up at 22.8 months, there were only 3 reports of hernia recurrence: 1.4 % of the hernias. Most patients (95.9 %) were satisfied or very satisfied with their hernia repair with only 1.2 % reporting severe pain (NRS score 7-10) and 3.6 % reported mild pain. This study demonstrates that in experienced hands, inguinal hernia repair surgery performed by laparoscopic transabdominal preperitoneal hernioplasty using Parietex ProGrip™ self-gripping meshes is rapid, efficient and safe with low pain and low hernia recurrence rate.

  9. Planned and unplanned terminations of foster care placements in the Netherlands: Relationships with characteristics of foster children and foster placements

    NARCIS (Netherlands)

    van Rooij, F.; Maaskant, A.; Weijers, I.; Weijers, D.; Hermanns, J.

    2015-01-01

    This study examined the role of placement and child characteristics in the unplanned termination of foster placements. Data were used from 169 foster children aged 0 to 20. Results showed that 35% of all foster placement terminations were unplanned. Outcomes of logistic regression analyses

  10. Stent graft placement for dysfunctional arteriovenous grafts

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Gyeong Sik [Dept. of Radiology, CHA Bundang Medical Center, College of Medicine, CHA University, Seongnam (Korea, Republic of); Shin, Byung Seok; Ohm, Joon Young; Ahn, Moon Sang [Chungnam National University Hospital, Daejeon (Korea, Republic of)

    2015-07-15

    This study aimed to evaluate the usefulness and outcomes of stent graft use in dysfunctional arteriovenous grafts. Eleven patients who underwent stent graft placement for a dysfunctional hemodialysis graft were included in this retrospective study. Expanded polytetrafluoroethylene covered stent grafts were placed at the venous anastomosis site in case of pseudoaneurysm, venous laceration, elastic recoil or residual restenosis despite the repeated angioplasty. The patency of the arteriovenous graft was evaluated using Kaplan-Meier analysis. Primary and secondary mean patency was 363 days and 741 days. Primary patency at 3, 6, and 12 months was 82%, 73%, and 32%, respectively. Secondary patency at the 3, 6, 12, 24, and 36 months was improved to 91%, 82%, 82%, 50%, and 25%, respectively. Fractures of the stent graft were observed in 2 patients, but had no effect on the patency. Stent graft placement in dysfunctional arteriovenous graft is useful and effective in prolonging graft patency.

  11. Customized ATP towpreg. [Automated Tow Placement

    Science.gov (United States)

    Sandusky, Donald A.; Marchello, Joseph M.; Baucom, Robert M.; Johnston, Norman J.

    1992-01-01

    Automated tow placement (ATP) utilizes robotic technology to lay down adjacent polymer-matrix-impregnated carbon fiber tows on a tool surface. Consolidation and cure during ATP requires that void elimination and polymer matrix adhesion be accomplished in the short period of heating and pressure rolling that follows towpreg ribbon placement from the robot head to the tool. This study examined the key towpreg ribbon properties and dimensions which play a significant role in ATP. Analysis of the heat transfer process window indicates that adequate heating can be achieved at lay down rates as high as 1 m/sec. While heat transfer did not appear to be the limiting factor, resin flow and fiber movement into tow lap gaps could be. Accordingly, consideration was given to towpreg ribbon having uniform yet non-rectangular cross sections. Dimensional integrity of the towpreg ribbon combined with customized ribbon architecture offer great promise for processing advances in ATP of high performance composites.

  12. Pole Placement with Fields of Positive Characteristic

    CERN Document Server

    Gorla, Elisa

    2009-01-01

    The pole placement problem belongs to the classical problems of linear systems theory. It is often assumed that the ground field is the real numbers R or the complex numbers C. The major result over the complex numbers derived in 1981 by Brockett and Byrnes states that arbitrary static pole placement is possible for a generic set of m-inputs, p-outputs and McMillan degree n system as soon as mp>=n. Moreover the number of solutions in the situation mp=n is an intersection number first computed by Hermann Schubert in the 19th century. In this paper we show that the same result with slightly different proofs holds over any algebraically closed field.

  13. Optimal sensor placement using machine learning

    CERN Document Server

    Semaan, Richard

    2016-01-01

    A new method for optimal sensor placement based on variable importance of machine learned models is proposed. With its simplicity, adaptivity, and low computational cost, the method offers many advantages over existing approaches. The new method is implemented on an airfoil equipped with a Coanda actuator. The analysis is based on flow field data obtained from 2D unsteady Reynolds averaged Navier-Stokes (URANS) simulations with different actuation conditions. The optimal sensor locations is compared against the current de-facto standard of maximum POD modal amplitude location, and against a brute force approach that scans all possible sensor combinations. The results show that both the flow conditions and the type of sensor have an effect on the optimal sensor placement, whereas the choice of the response function appears to have limited influence.

  14. Efficient iterative adaptive pole placement algorithm

    Institute of Scientific and Technical Information of China (English)

    李俊民; 李靖; 杨磊

    2004-01-01

    An iterative adaptive pole placement algorithm is presented. The stability and the convergence of the algorithm are respectively established. Since one-step iterative formulation in computing controller's parameters is used, the on-line computation cost is greatly reduced with respected to the traditional algorithm. The algorithm with the feed-forward can follow arbitrarily bounded output. The algorithm is also extended to multivariate case. Simulation examples show the efficiency and robustness of the algorithm.

  15. Automated Placement of Multiple Stereo Cameras

    OpenAIRE

    Malik, Rahul; Bajcsy, Peter

    2008-01-01

    International audience; This paper presents a simulation framework for multiple stereo camera placement. Multiple stereo camera systems are becoming increasingly popular these days. Applications of multiple stereo camera systems such as tele-immersive systems enable cloning of dynamic scenes in real-time and delivering 3D information from multiple geographic locations to everyone for viewing it in virtual (immersive) 3D spaces. In order to make such multi stereo camera systems ubiquitous, sol...

  16. Balanced Placement Of Vibration Sensors And Actuators

    Science.gov (United States)

    Gawronski, Wodek

    1996-01-01

    Mathematical approach that involves Hankel singular values leads to method for estimation of optimal placement of relatively few vibration sensors and actuators in multivariable flexible structure. Approach extends and complements previous developments regarding approximate decomposition, to Hankel singular values, of singular values of controllability and observability grammian matrices of multivariable flexible structure. Mathematical constructs also described in "Designing An Approximately Balanced LQG Compensator" (NPO-19000).

  17. Can donated media placements reach intended audiences?

    Science.gov (United States)

    Cooper, Crystale Purvis; Gelb, Cynthia A; Chu, Jennifer; Polonec, Lindsey

    2013-09-01

    Donated media placements for public service announcements (PSAs) can be difficult to secure, and may not always reach intended audiences. Strategies used by the Centers for Disease Control and Prevention's (CDC) Screen for Life: National Colorectal Cancer Action Campaign (SFL) to obtain donated media placements include producing a diverse mix of high-quality PSAs, co-branding with state and tribal health agencies, securing celebrity involvement, monitoring media trends to identify new distribution opportunities, and strategically timing the release of PSAs. To investigate open-ended recall of PSAs promoting colorectal cancer screening, CDC conducted 12 focus groups in three U.S. cities with men and women either nearing age 50 years, when screening is recommended to begin, or aged 50-75 years who were not in compliance with screening guidelines. In most focus groups, multiple participants recalled exposure to PSAs promoting colorectal cancer screening, and most of these individuals reported having seen SFL PSAs on television, in transit stations, or on the sides of public buses. Some participants reported exposure to SFL PSAs without prompting from the moderator, as they explained how they learned about the disease. Several participants reported learning key campaign messages from PSAs, including that colorectal cancer screening should begin at age 50 years and screening can find polyps so they can be removed before becoming cancerous. Donated media placements can reach and educate mass audiences, including millions of U.S. adults who have not been screened appropriately for colorectal cancer.

  18. FPGA Congestion-Driven Placement Refinement

    Energy Technology Data Exchange (ETDEWEB)

    Vicente de, J.

    2005-07-01

    The routing congestion usually limits the complete proficiency of the FPGA logic resources. A key question can be formulated regarding the benefits of estimating the congestion at placement stage. In the last years, it is gaining acceptance the idea of a detailed placement taking into account congestion. In this paper, we resort to the Thermodynamic Simulated Annealing (TSA) algorithm to perform a congestion-driven placement refinement on the top of the common Bounding-Box pre optimized solution. The adaptive properties of TSA allow the search to preserve the solution quality of the pre optimized solution while improving other fine-grain objectives. Regarding the cost function two approaches have been considered. In the first one Expected Occupation (EO), a detailed probabilistic model to account for channel congestion is evaluated. We show that in spite of the minute detail of EO, the inherent uncertainty of this probabilistic model impedes to relieve congestion beyond the sole application of the Bounding-Box cost function. In the second approach we resort to the fast Rectilinear Steiner Regions algorithm to perform not an estimation but a measurement of the global routing congestion. This second strategy allows us to successfully reduce the requested channel width for a set of benchmark circuits with respect to the widespread Versatile Place and Route (VPR) tool. (Author) 31 refs.

  19. USAGE OF PASTE FOR TEMPORARY PLACEMENT IN THE TREATMENT OF CHRONIC APICAL PERIODONTITIS

    Directory of Open Access Journals (Sweden)

    A.V. Borysenko

    2012-03-01

    Full Text Available Summary: The aim of the present investigation was usage of medicamental paste with antibacterial and regeneration action for temporary placement in the treatment of chronic apical periodontitis. Materials and method: The medicamental paste for temporary placement of root canals consists of a mixture of metronidazole, Enterosgel (Silm and Alflutop (Biotehnos S.A., Romania. Thë paste was used for the treatment of 30 teeth with chronic apical periodontitis. Final obturation of the root canals was performed with gutta percha cones and sealer. The efficiency of the treatment was appreciated after examination on the basis of clinical and radiographic findings. Results: During the treatment of the 30 teeth, no exacerbations of the pathological process were recorded. Pain after obturation of the root canals was revealed in only 6 (20% of the treated teeth. No pain, pathologic changes of gingiva, good mastication efficiency in all teeth after treatment were revealed. Conclusions: The high clinical efficiency of the medicamental paste with antibacterial and regeneration action at the level of temporary root canals placement in the treatment of chronic apical periodontitis was shown. Keywords: chronic apical periodontitis, medicamental paste for temporary root canals placement, metronidazole, Enterosgel (Silm and Alflutop (Biotehnos S.A., Romania

  20. Portal vein stent placement with or without varix embolization of jejunal variceal bleeding after hepatopancreatobiliary surgery.

    Science.gov (United States)

    Shim, Dong Jae; Shin, Ji Hoon; Ko, Gi-Young; Kim, Yook; Han, Kichang; Gwon, Dong-Il; Ko, Heung-Kyu

    2017-04-01

    Background Extrahepatic portal hypertension after surgery involving the duodenum or jejunum might result in massive ectopic variceal bleeding. Purpose To report the results of portal vein stent placement with the addition of variceal embolization. Material and Methods Between January 2000 and June 2015, portal vein stent placement was attempted in 477 patients. Of these, 22 patients (age, 63 ± 10 years) with jejunal variceal bleeding caused by portal vein obstruction after surgery were included in this study. Computed tomography (CT) findings before and after treatment and the rates of technical and clinical success, complications, and clinical outcomes were retrospectively evaluated. Results Stent placement was successful in 19 of 22 patients. Additional variceal embolization was performed in five cases. Clinical success, defined as the cessation of bleeding without recurrence within 1 month, was achieved in 18 of 19 patients with technical success. One patient developed recurrent bleeding 4 days after stent placement and was successfully treated with additional variceal embolization. There were no procedure-related complications. A regression of the jejunal varices was noted in 14 of 19 patients on follow-up CT scans. During the follow-up period (258 days; range, 7-1196 days), stent occlusion and recurrent bleeding occurred in six and four patients, respectively, of the 19 patients who achieved technical success. Statistical analyses revealed no significant differences regarding stent patency between benign and malignant strictures. Conclusion Percutaneous, transhepatic, portal vein stent placement with or without jejunal variceal embolization appears to be a safe and effective treatment for jejunal variceal bleeding after surgery.

  1. Risk of infection after placement of an extraventricular drainage catheter

    Directory of Open Access Journals (Sweden)

    Novak Vesna

    2012-01-01

    Full Text Available Introduction. The occurrence of infection after the placement of an extraventricular drainage (EVD catheter can be a very serious problem in neurosurgery. Objective. The aim of this study was to confirm that the use of special catheters with impregnated antibiotics decreased the percentage of infection. Methods. The prospective study conducted at the Clinic of Neurosurgery in Niš in the period 2006-2009 is presented. Group 1 comprised of 43 patients in whom a commonly used system for EVD was applied. Group 2 comprised of 39 patients in whom the Rifampycin and Clindamycin impregnated EVD catheters were applied (Bactiseal catheters. Results. In Group 1 infection occurred in nine patients, mainly caused by bacteria of Staphylococcus genus. In Group 2 only two patients developed infections caused by Acinetobacter. Conclusion. The use of Bactiseal EVD catheters considerably decreased the percentage of infection occurrence with prolonged EVD catheter drainage period.

  2. Bone grafting simultaneous to implant placement. Presentation of a case.

    Science.gov (United States)

    Peñarrocha-Diago, Miguel; Gómez-Adrián, Maria Dolores; García-Mira, Berta; Ivorra-Sais, Mariola

    2005-01-01

    Bone defects at mandibular alveolar crest level complicate the placement of dental implants in the ideal location. Surgical reconstruction using autologous bone grafts allows implant fixation in an esthetic and functional manner. We describe a patient with large mandibular bone loss secondary to periodontal inflammatory processes. Reconstruction of the mandibular alveolar process was carried out using onlay block bone grafts harvested from the mandible. The grafts were stabilized by positioning the dental implants through them--a procedure that moreover afforded good primary implant fixation. After two years of follow-up the clinical and radiological outcome is good. In the lower jaw, where bone regeneration is complicated, we were able to achieve good results in this patient--minimizing the corresponding waiting time by grafting and placing the implants in the same surgical step.

  3. Factors affecting the placement or replacement of direct restorations in a dental school

    Directory of Open Access Journals (Sweden)

    Samara Silvani

    2014-01-01

    Full Text Available Context: The knowledge of the reasons for the placement of direct restorations makes possible to trace an epidemiological profile of a specific population and to direct the teaching of dentistry to techniques that are commonly used today and will be continued performed in the future. Purpose: The aim of this study was to verify the reasons for placement and replacement of direct restorations in patients treated in the Dental Clinic of the Uberaba University - Brazil. Materials and Methods: This study evaluated 306 restorative procedures carried out on 60 patients. During the treatment planning, a form that contained information about the patient′s gender, tooth number, the classification of restorations, the reasons for placement and replacement of amalgam and tooth-colored restorations, the material that had to be removed and the new material used to fill the cavities was filled for each patient. Statistical analysis was carried out using Chi-square test (α = 0.05. Results: The data showed that most of the patients were female (66.7%. Of all the restorations placed, 60.45% were 1 st -time placements, while 39.55% were replacements. For 1 st -time restorations, the main reason for placement was primary caries (76.76%, followed by non-carious cervical lesions (15.14%. The amalgam restorations were replaced more frequently (67.77%. The primary reason for replacements was the presence of secondary caries (for both previous amalgam (42.68% and composite (66.67% restorations (P < 0.05. The resin composite was the most indicated material for the new restorations (98.04% (P < 0.05. Conclusions: The main reason for placement of direct restorations was primary caries, while secondary caries was the main reason for replacements. In almost all cases, the material used to fill the cavities was the resin composite.

  4. Impact of multidisciplinary, early renal education on vascular access placement.

    Science.gov (United States)

    Lindberg, Jill S; Husserl, Fred E; Ross, Jamie L; Jackson, Dina; Scarlata, Debra; Nussbaum, Joyce; Cohen, Andrew; Elzein, Hafez

    2005-02-01

    The Ochsner Clinic Foundation initiated the Healthy Start Clinic to identify, educate, and refer chronic kidney disease patients to nephrologists earlier in the course of their disease. This study investigated the impact of a structured educational session on the type and timing of permanent vascular access placement in patients receiving hemodialysis. Before initiating dialysis, the HSC patient group received a general overview of the kidney and kidney disease, plus one-on-one instruction from a registered nurse, a dietitian, and a social worker. The HSC group was compared with a concurrent, conventionally prepared group of CKD patients who initiated dialysis during the same study period. Of the 147 patients initiating hemodialysis at OCF between April 1997 and December 2000, 61 had received structured HSC education, and 86 had received conventional care. In HSC-educated patients, the incidence of PVAs placed before hemodialysis initiation was twofold greater than in patients who received conventional care (77% HSC; 36% non-HSC, p < 0.001), and more HSC-educated patients initiated hemodialysis using their PVA (49% HSC; 23% non-HSC, p < 0.01). In addition, five times more patients who received HSC education received arteriovenous fistulas (52% HSC; 10% non-HSC, p < 0.001). Finally, significantly fewer HSC-educated patients initiated dialysis on a temporary catheter (51% HSC; 77% non-HSC, p < 0.001). Education programs for CKD patients help increase the number of patients receiving early PVA placement, as well as the proportion of patients receiving AVFs as opposed to grafts or temporary catheters.

  5. FROM BRAND PLACEMENT TO TOURISM PRODUCT PLACEMENT. FICTION SERIES AS PROMOTIONAL SUPPORT OF SPANISH TOURISM DESTINATIONS

    Directory of Open Access Journals (Sweden)

    Noelia Araújo-Vila

    2011-12-01

    Full Text Available Every day more consumers spend much of their free time to the consumption of audiovisual series, which is reflected in the notable increase in downloads and audiences. Therefore, many sectors have decided to use audiovisual series as advertising (brand placement, being one of them the tourism sector (tourism product placement. There are many worldwide destinations that have decided to set in a fiction series, thus being viewed by thousands of spectators, which has resulted in increases in visitors. In the Spanish case is not so clear the use of this strategy, as it is analysed in this article.

  6. Covered self-expandable metallic stent placement for a post-operative malignant anastomotic stricture secondary to recurrent gastric cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Woon Ha; Jung, Gyoo Sik; Kim, Kyu Jong; Lee, Sang Ho [Gospel Hospital, College of Medicine, Kosin University, Busan (Korea, Republic of); Ko, Ji Ho [Masan Samsung Medical Center, Sungkyunkwan University School of University, Masan (Korea, Republic of); Jeong, Kyung Soon [University of Ulsan Colleg of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2007-09-15

    To evaluate the technical feasibility and clinical effectiveness of stent placement for the treatment of a post-operative malignant anastomotic stricture secondary to recurrent gastric cancer. Under fluoroscopic guidance, one or two covered stents were placed in 20 consecutive patients (age range, 44-75 years) with an anastomotic stricture due to a recurrent gastric malignancy. Before stent placement, all patients had severe nausea and recurrent vomiting after ingestion. Stent placement was technically successful for all patients, and no procedural complications occurred. After stent placement, 18 of 20 (90.0%) patients were able to ingest at least a liquid diet and had a markedly decreased incidence of vomiting. During the follow-up of 2-116 weeks (mean, 25.5 weeks), stent migration occurred in two patients (10.0%) on one day after the procedure. All patients with stent migration were treated successfully by means of placing a second stent. Three patients showed a recurrence of the stricture due to tumor overgrowth; two of the patients were treated with coaxial placement of a second stent. Another patient refused additional management. Covered self-expandable metallic stent placement seems to be technically feasible and effective for palliative treatment of a post-operative malignant anastomotic stricture secondary to recurrent gastric cancer.

  7. Extramural Research Grants and Scientists’ Funding Strategies

    DEFF Research Database (Denmark)

    Grimpe, Christoph

    2012-01-01

    Although competitive funding of public research has been characterised as providing output incentives that raise efficiency and productivity, we know very little about whether the quality of a scientist’s research is in fact the primary award criterion on which funding bodies base their grant......), government, foundation, and industry grants. Based on a sample of more than 800 scientists at universities and public research institutes in Germany, the results indicate that scientist productivity measured in terms of publication and patent stock is a statistically significant determinant only...... and innovation policy about potential discrepancies between policy rhetoric, stipulated award criteria, and actual funding outcomes which makes it possible to fine-tune the debate on how public research should be financed....

  8. Injury of the Inferior Alveolar Nerve during Implant Placement: a Literature Review

    Directory of Open Access Journals (Sweden)

    Gintaras Juodzbalys

    2011-01-01

    Full Text Available Objectives: The purpose of present article was to review aetiological factors, mechanism, clinical symptoms, and diagnostic methods as well as to create treatment guidelines for the management of inferior alveolar nerve injury during dental implant placement.Material and Methods: Literature was selected through a search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were inferior alveolar nerve injury, inferior alveolar nerve injuries, inferior alveolar nerve injury implant, inferior alveolar nerve damage, inferior alveolar nerve paresthesia and inferior alveolar nerve repair. The search was restricted to English language articles, published from 1972 to November 2010. Additionally, a manual search in the major anatomy, dental implant, periodontal and oral surgery journals and books were performed. The publications there selected by including clinical, human anatomy and physiology studies.Results: In total 136 literature sources were obtained and reviewed. Aetiological factors of inferior alveolar nerve injury, risk factors, mechanism, clinical sensory nerve examination methods, clinical symptoms and treatment were discussed. Guidelines were created to illustrate the methods used to prevent and manage inferior alveolar nerve injury before or after dental implant placement.Conclusions: The damage of inferior alveolar nerve during the dental implant placement can be a serious complication. Clinician should recognise and exclude aetiological factors leading to nerve injury. Proper presurgery planning, timely diagnosis and treatment are the key to avoid nerve sensory disturbances management.

  9. Treatment planning for prostate focal laser ablation in the face of needle placement uncertainty.

    Science.gov (United States)

    Cepek, Jeremy; Lindner, Uri; Davidson, Sean R H; Haider, Masoom A; Ghai, Sangeet; Trachtenberg, John; Fenster, Aaron

    2014-01-01

    To study the effect of needle placement uncertainty on the expected probability of achieving complete focal target destruction in focal laser ablation (FLA) of prostate cancer. Using a simplified model of prostate cancer focal target, and focal laser ablation region shapes, Monte Carlo simulations of needle placement error were performed to estimate the probability of completely ablating a region of target tissue. Graphs of the probability of complete focal target ablation are presented over clinically relevant ranges of focal target sizes and shapes, ablation region sizes, and levels of needle placement uncertainty. In addition, a table is provided for estimating the maximum target size that is treatable. The results predict that targets whose length is at least 5 mm smaller than the diameter of each ablation region can be confidently ablated using, at most, four laser fibers if the standard deviation in each component of needle placement error is less than 3 mm. However, targets larger than this (i.e., near to or exceeding the diameter of each ablation region) require more careful planning. This process is facilitated by using the table provided. The probability of completely ablating a focal target using FLA is sensitive to the level of needle placement uncertainty, especially as the target length approaches and becomes greater than the diameter of ablated tissue that each individual laser fiber can achieve. The results of this work can be used to help determine individual patient eligibility for prostate FLA, to guide the planning of prostate FLA, and to quantify the clinical benefit of using advanced systems for accurate needle delivery for this treatment modality.

  10. Treatment planning for prostate focal laser ablation in the face of needle placement uncertainty

    Energy Technology Data Exchange (ETDEWEB)

    Cepek, Jeremy, E-mail: jcepek@robarts.ca; Fenster, Aaron [Robarts Research Institute, London, Ontario N6A 5K8, Canada and Biomedical Engineering, The University of Western Ontario, London, Ontario N6A 5B9 (Canada); Lindner, Uri; Trachtenberg, John [Department of Surgical Oncology, Division of Urology, University Health Network, Toronto, Ontario M5G 2C4 (Canada); Davidson, Sean R. H. [Ontario Cancer Institute, University Health Network, Toronto, Ontario M5G 2M9 (Canada); Haider, Masoom A. [Department of Medical Imaging, Sunnybrook Health Sciences Center, Toronto, Ontario M4N 3M5, Canada and Department of Medical Imaging, University of Toronto, Toronto, Ontario M5S 2J7 (Canada); Ghai, Sangeet [Department of Medical Imaging, University Health Network, Toronto, Ontario M5G 2M9 (Canada)

    2014-01-15

    Purpose: To study the effect of needle placement uncertainty on the expected probability of achieving complete focal target destruction in focal laser ablation (FLA) of prostate cancer. Methods: Using a simplified model of prostate cancer focal target, and focal laser ablation region shapes, Monte Carlo simulations of needle placement error were performed to estimate the probability of completely ablating a region of target tissue. Results: Graphs of the probability of complete focal target ablation are presented over clinically relevant ranges of focal target sizes and shapes, ablation region sizes, and levels of needle placement uncertainty. In addition, a table is provided for estimating the maximum target size that is treatable. The results predict that targets whose length is at least 5 mm smaller than the diameter of each ablation region can be confidently ablated using, at most, four laser fibers if the standard deviation in each component of needle placement error is less than 3 mm. However, targets larger than this (i.e., near to or exceeding the diameter of each ablation region) require more careful planning. This process is facilitated by using the table provided. Conclusions: The probability of completely ablating a focal target using FLA is sensitive to the level of needle placement uncertainty, especially as the target length approaches and becomes greater than the diameter of ablated tissue that each individual laser fiber can achieve. The results of this work can be used to help determine individual patient eligibility for prostate FLA, to guide the planning of prostate FLA, and to quantify the clinical benefit of using advanced systems for accurate needle delivery for this treatment modality.

  11. Immediate Implants: Clinical Guidelines for Esthetic Outcomes

    Directory of Open Access Journals (Sweden)

    Mohammad A. Javaid

    2016-06-01

    Full Text Available Research has shown that tooth loss results in morphological changes in alveolar ridge that may influence the subsequent implant placement. Immediate implant placement was introduced as a possible means to limit bone resorption and reduce the number of surgical procedures following tooth extraction. Histological and clinical evidence from human clinical studies showing efficacy of immediate implants has come to light over the last decade or so. However, immediate implant placement is a challenging surgical procedure and requires proper case selection and surgical technique. Furthermore, there appears to be a lack of clinical guidelines for immediate implant placement case selection. Therefore, the aim of this mini-review is to analyze critical evidence from human studies in order to establish clinical guidelines which may help clinicians in case selection when considering immediate implant placement protocol.

  12. Optimal Placement of Wavelength Converting Nodes

    DEFF Research Database (Denmark)

    Belotti, Pietro; Stidsen, Thomas K.

    2001-01-01

    The all optical network using WDM and optical nodes (OXC's) seems to be a possibility in a near future. The consensus to day seems to be that optical wavelength conversions is un-realistic for several decades, hence wavelength blocking will happen in the all optical networks. A possible solution ...... to this problem could be to include digital nodes (DXC's) in the network at the right places. In this article we present a linear programming model which optimizes the placement of these more expensive DXC's in the network....

  13. Modifying Orthogonal Drawings for Label Placement

    Directory of Open Access Journals (Sweden)

    Konstantinos G. Kakoulis

    2016-03-01

    Full Text Available In this paper, we investigate how one can modify an orthogonal graph drawing to accommodate the placement of overlap-free labels with the minimum cost (i.e., minimum increase of the area and preservation of the quality of the drawing. We investigate computational complexity issues of variations of that problem, and we present polynomial time algorithms that find the minimum increase of space in one direction, needed to resolve overlaps, while preserving the orthogonal representation of the orthogonal drawing when objects have a predefined partial order.

  14. Wind Farm Turbine Type and Placement Optimization

    Energy Technology Data Exchange (ETDEWEB)

    Graf, Peter; Dykes, Katherine; Scott, George; Fields, Jason; Lunacek, Monte; Quick, Julian; Rethore, Pierre-Elouan

    2016-10-03

    The layout of turbines in a wind farm is already a challenging nonlinear, nonconvex, nonlinearly constrained continuous global optimization problem. Here we begin to address the next generation of wind farm optimization problems by adding the complexity that there is more than one turbine type to choose from. The optimization becomes a nonlinear constrained mixed integer problem, which is a very difficult class of problems to solve. This document briefly summarizes the algorithm and code we have developed, the code validation steps we have performed, and the initial results for multi-turbine type and placement optimization (TTP_OPT) we have run.

  15. Product placement as a form of advertainment

    Directory of Open Access Journals (Sweden)

    Chiţu, I. B.

    2010-12-01

    Full Text Available Nowadays, one of the big issues advertisers on television face is the consumer’s (viewer’s ability to “zap” advertisements, as the public is increasingly tired of commercials. Advertainment is a form of communication that combines the elements of advertising and entertainment and is designed to overcome the tendency, especially among television viewers, to change channels or mute the audio during standard advertising commercials. This paper tries to give a brief overview of a method that belongs to advertainment, product placement, and how it is used by companies.

  16. Post-placement temperature reduction techniques

    DEFF Research Database (Denmark)

    Liu, Wei; Nannarelli, Alberto

    2010-01-01

    With technology scaled to deep submicron era, temperature and temperature gradient have emerged as important design criteria. We propose two post-placement techniques to reduce peak temperature by intelligently allocating whitespace in the hotspots. Both methods are fully compliant with commercial...... technologies, and can be easily integrated with state-of-the-art thermal-aware design flow. Experiments in a set of tests on circuits implemented in STM 65nm technologies show that our methods achieve better peak temperature reduction than directly increasing circuit's area....

  17. Immediate placement of endosseous implants into the extraction sockets

    Directory of Open Access Journals (Sweden)

    Vijay Ebenezer

    2015-01-01

    Full Text Available Implant by definition "means any object or material, such as an alloplastic substance or other tissue, which is partial or completely inserted into the body for therapeutic, diagnostic, prosthetic, or experimental purpose." The placement of a dental implant in an extraction socket at the time of extraction or explantation is known as immediate implant placement whereas delayed placement of implant signifies the implant placement in edentulous areas where healing has completed with new bone formation after the loss of tooth/teeth. Recent idea goes by "why late when it can be done immediately." There are several advantages of immediate placement of implants, and lots of studies have been done. In this article, the advantages and disadvantages of immediate versus delayed placement of implants have been reviewed.

  18. The "Strengthening Nursing Culture Project" - an exploratory evaluation study of nursing students' placements within Aboriginal Medical Services.

    Science.gov (United States)

    Hart, Bethne; Cavanagh, Miriam; Douglas, Denise

    2015-01-01

    Cultural awareness and cultural competence have been the focus of the transcultural nursing literature that has explored the roles and responsibilities of nurses in their care of Aboriginal and Torres Strait Islander Peoples. Cultural immersion programs, upholding cultural safety and cultural humility, offer valuable guidance to the education of nursing students regarding Aboriginal and Torres Strait Islander health and cultures. This study seeks to explore nursing students' experiences of a cultural immersion program within Aboriginal Medical Services (AMSs) in New South Wales, Australia. Eight nursing students participated in a mixed methods design exploratory study of their clinical placement within AMSs. A survey gathered data regarding levels of preparation and confidence, learning barriers, placement stressors and personal reflections. Nursing students reported positive and transformative experiences of intercultural learning. Cultural immersion programs provide a valuable framework for the design and evaluation of clinical placement programs for nursing students within intercultural learning spaces.

  19. Consumer responses to product placements in Thai television sitcoms

    OpenAIRE

    Ketrattanakul, Chalinee; Pongpatranon, Pimmanee

    2009-01-01

    Date: May 28, 2009 Program: MIMA – International Marketing Course name: Master Thesis (EFO705) Title: Consumer responses to product placements in Thai television sitcoms Authors: Chalinee Ketrattanakul           Pimmanee Pongpatranon        Tutor: Tobias Eltebrandt Problem: How Thai consumers identify the advertising strategy of product placements in Thai sitcoms? Purpose: To examine the responses of Thai customers toward product placements in T...

  20. Two-Phase Algorithm for Optimal Camera Placement

    OpenAIRE

    Jun-Woo Ahn; Tai-Woo Chang; Sung-Hee Lee; Yong Won Seo

    2016-01-01

    As markers for visual sensor networks have become larger, interest in the optimal camera placement problem has continued to increase. The most featured solution for the optimal camera placement problem is based on binary integer programming (BIP). Due to the NP-hard characteristic of the optimal camera placement problem, however, it is difficult to find a solution for a complex, real-world problem using BIP. Many approximation algorithms have been developed to solve this problem. In this pape...

  1. Placement of a Hemodialysis Catheter using the Dilated Right External Jugular Vein as a Primary Route

    Energy Technology Data Exchange (ETDEWEB)

    Park, Mi Hyun [Dankook University Hospital, Cheonan (Korea, Republic of); Shin, Byung Seok [Chungnam National University Hospital, Daejeon (Korea, Republic of)

    2010-08-15

    To evaluate the feasibility that a dilated right external jugular vein (EJV) could be a primary venous access site for large bore hemodialysis catheter placement. Between January 2008 and April 2009, a total of 173 hemodialysis catheters (14.5 F) were placed. Among them, we evaluated the clinical data of 42 patients who underwent placement through a dilated right EJV. We evaluated technical success, duration of catheterization in days, and the presence of complications. Technical success was achieved for 41 patients (98%). Catheter placement was unsuccessful in one patient due to narrowing of the EJV. The catheter dwell time ranged between 14 and 305 days (mean; 76 days, total catheter days: 3,111 days). A total of 26 hemodialysis catheters were removed due to complications (n=2) and termination of hemodialysis via the hemodialysis catheter (n=24). There was air embolization (n=1) and catheter kinking (n=3) during procedures and catheter related infections (n=2) during the follow-up period. The incidence of catheter related infection was 0.06 per 100 catheter days. No cases of catheter malfunction or symptomatic venous thrombosis were observed. We suggest that a dilated right EJV could be considered as a preferred primary route for hemodialysis catheter placement with easy access

  2. An accuracy study of computer-planned implant placement in the augmented maxilla using osteosynthesis screws.

    Science.gov (United States)

    Verhamme, L M; Meijer, G J; Soehardi, A; Bergé, S J; Xi, T; Maal, T J J

    2017-04-01

    Previous research on the accuracy of flapless implant placement of virtually planned implants in the augmented maxilla revealed unfavourable discrepancies between implant planning and placement. By using the osteosynthesis screws placed during the augmentation procedure, the surgical template could be optimally stabilized. The purpose of this study was to validate this method by evaluating its clinically relevant accuracy. Twelve consecutive fully edentulous patients with extreme resorption of the maxilla were treated with a bone augmentation procedure. Virtual implant planning was performed and a surgical template was manufactured. Subsequently, six implants were installed using the surgical template, which was only supported by the osteosynthesis screws. Implant deviations between planning and placement were calculated. A total of 72 implants were installed. Mean deviations found in the mesiodistal direction were 0.817mm at the implant tip and 0.528mm at the implant shoulder. The angular deviation was 2.924°. In the buccolingual direction, a deviation of 1.038mm was registered at the implant tip and 0.633mm at the implant shoulder. The angular deviation was 3.440°. This study showed that implant placement in the augmented maxilla using a surgical template supported by osteosynthesis screws is accurate.

  3. An innovation in Australian dental education: rural, remote and Indigenous pre-graduation placements.

    Science.gov (United States)

    Bazen, Jennifer J; Kruger, Estie; Dyson, Kate; Tennant, Marc

    2007-01-01

    Anticipating the looming crisis in access to dental services in rural and remote areas, the Western Australian Centre for Rural and Remote Oral Health developed an undergraduate rural placement program to provide dental students of The University of Western Australia opportunities for direct experience of rural and remote practice during the final year of the undergraduate curriculum. The Rural, Remote and Indigenous Placement program started in 2002 and, to the end of 2005, had placed 78 final year dental students in supervised clinical practice in rural, remote or Indigenous practice. In this study, the evolution of the program (2002-2005) is described and student evaluation of the program is reported. While involved in the rural placement program, students were assessed by experienced dental practitioners and provided program evaluation. This structured feedback allowed continuous improvement of the program. Data from each year's graduates was also analysed to examine the question of influence of placements on practice location during the first 6 months after graduation. Although it will be many years before the effects of outplacement programs can be specifically attained, the evidence to date indicates that the program may be a valuable tool among the plethora of strategies being investigated to augment Australia's rural oral health workforce.

  4. Low-dose acetylsalicylic acid and bleeding risks with ventriculoperitoneal shunt placement.

    Science.gov (United States)

    Kamenova, Maria; Croci, Davide; Guzman, Raphael; Mariani, Luigi; Soleman, Jehuda

    2016-09-01

    OBJECTIVE Ventriculoperitoneal (VP) shunt placement is a common procedure for the treatment of hydrocephalus following diverse neurosurgical conditions. Most of the patients present with other comorbidities and receive antiplatelet therapy, usually acetylsalicylic acid (ASA). Despite its clinical relevance, the perioperative management of these patients has not been sufficiently investigated. The aim of this study was to compare the peri- and postoperative bleeding complication rates associated with ASA intake in patients undergoing VP shunt placement. METHODS Of 172 consecutive patients undergoing VP shunt placement between June 2009 and December 2015, 40 (23.3%) patients were receiving low-dose ASA treatment. The primary outcome measure was bleeding events in ASA users versus nonusers, whereas secondary outcome measures were postoperative cardiovascular events, hematological findings, morbidity, and mortality. A subgroup analysis was conducted in patients who discontinued ASA treatment for < 7 days (n = 4, ASA Group 1) and for ≥ 7 days (n = 36, ASA Group 2). RESULTS No statistically significant difference for bleeding events was observed between ASA users and nonusers (p = 0.30). Cardiovascular complications, surgical morbidity, and mortality did not differ significantly between the groups either. Moreover, there was no association between ASA discontinuation regimens (< 7 days and ≥ 7 days) and hemorrhagic events. CONCLUSIONS Given the lack of guidelines regarding perioperative management of neurosurgical patients with antiplatelet therapy, these findings elucidate one issue, showing comparable bleeding rates in ASA users and nonusers undergoing VP shunt placement.

  5. The Re-Placement Test: Using TOEFL for Purposes of Placement

    Science.gov (United States)

    Moglen, Daniel

    2015-01-01

    This article will consider using TOEFL scores for purposes of placement and advising for international graduate students at a northern California research university. As the number of international students is on the rise and the funds for the graduate ESL program are diminishing, the way in which the university is handling the influx of…

  6. Placement suitability criteria of composite tape for mould surface in automated tape placement

    Directory of Open Access Journals (Sweden)

    Zhang Peng

    2015-10-01

    Full Text Available Automated tape placement is an important automated process used for fabrication of large composite structures in aeronautical industry. The carbon fiber composite parts realized with this process tend to replace the aluminum parts produced by high-speed machining. It is difficult to determine the appropriate width of the composite tape in automated tape placement. Wrinkling will appear in the tape if it does not suit for the mould surface. Thus, this paper deals with establishing placement suitability criteria of the composite tape for the mould surface. With the assumptions for ideal mapping and by applying some principles and theorems of differential geometry, the centerline trajectory of the composite tape is identified to follow the geodesic. The placement suitability of the composite tape is examined on three different types of non-developable mould surfaces and four criteria are derived. The developed criteria have been used to test the deposition process over several mould surfaces and the appropriate width for each mould surface is obtained by referring to these criteria.

  7. Identity and Placement Learning: Student Accounts of the Transition Back to University Following a Placement Year

    Science.gov (United States)

    Auburn, Timothy

    2007-01-01

    There has been an increasing emphasis on employability within the higher education curriculum. Supervised work experience, particularly in the form of a placement year, has been an established means of providing experiences which are intended to enhance employability. This study examines a relatively neglected but important aspect of supervised…

  8. Placement suitability criteria of composite tape for mould surface in automated tape placement

    Institute of Scientific and Technical Information of China (English)

    Zhang Peng; Sun Ronglei; Zhao Xueying; Hu Lingjin

    2015-01-01

    Automated tape placement is an important automated process used for fabrication of large composite structures in aeronautical industry. The carbon fiber composite parts realized with this process tend to replace the aluminum parts produced by high-speed machining. It is difficult to determine the appropriate width of the composite tape in automated tape placement. Wrinkling will appear in the tape if it does not suit for the mould surface. Thus, this paper deals with establishing placement suitability criteria of the composite tape for the mould surface. With the assumptions for ideal mapping and by applying some principles and theorems of differential geometry, the centerline trajectory of the composite tape is identified to follow the geodesic. The placement suitability of the composite tape is examined on three different types of non-developable mould surfaces and four criteria are derived. The developed criteria have been used to test the deposition process over several mould surfaces and the appropriate width for each mould surface is obtained by referring to these criteria.

  9. Retained Urethral Catheter Secondary to Placement in Proximal Ureter

    Directory of Open Access Journals (Sweden)

    Thomas B. McGregor

    2016-01-01

    Full Text Available We present an unusual complication secondary to indwelling urethral catheter placement. Routine catheter placement by the obstetrics team in a postpartum female leads to retention of the catheter and inability of its removal by both the obstetrics and urology teams. Although a retained urinary catheter is relatively common, inability to remove a catheter secondary to placement inadvertently into a ureter is extremely rare. In this paper we will discuss the options in removing a retained catheter and present our case of a retained catheter secondary to placement within the right proximal ureter.

  10. Retained Urethral Catheter Secondary to Placement in Proximal Ureter.

    Science.gov (United States)

    McGregor, Thomas B; Sharda, Rajan

    2016-01-01

    We present an unusual complication secondary to indwelling urethral catheter placement. Routine catheter placement by the obstetrics team in a postpartum female leads to retention of the catheter and inability of its removal by both the obstetrics and urology teams. Although a retained urinary catheter is relatively common, inability to remove a catheter secondary to placement inadvertently into a ureter is extremely rare. In this paper we will discuss the options in removing a retained catheter and present our case of a retained catheter secondary to placement within the right proximal ureter.

  11. Upper eyelid postseptal weight placement for treatment of paralytic lagophthalmos.

    Science.gov (United States)

    Rozen, Shai; Lehrman, Craig

    2013-06-01

    Left untreated, paralytic lagophthalmos may result in corneal dryness, ulcerations, and subsequent blindness. The most common nondynamic surgical solution is upper eyelid weight placement in a superficial, pretarsal pocket, carrying the risk of visibility, extrusion, and entropion. The authors present a technique useful in patients presenting with either primary symptoms of corneal exposure or complications of previous implants that is equally efficacious, with a potentially decreased risk of complications, in which the weight is inserted into a deeper, postseptal position but requires use of a heavier weight. Nineteen patients, 15 primary and four secondary, treated between the years 2008 and 2012 with the postseptal approach, were evaluated for demographics, cause, resolution of primary symptoms, and complications. The average weight difference between that measured in the clinic versus weight used in surgery in the primary group and the average weight difference between that inserted in previous surgery versus weight placed in corrective surgery were calculated. The average weight difference was 0.213 g (range, 0 to 0.4 g) in the primary group and 0.2 g (range, 0 to 0.4 g) in the revision group. Symptoms resolved in all but one patient, neither revisions nor complications were noted, and the longest follow-up was 4 years. The retroseptal technique has proven to be safe, reproducible, and very useful in both primary and secondary upper eyelid surgery for paralytic lagophthalmos. It successfully addresses several common problems encountered with more superficial weight placement, including visibility, exposure, and entropion, but often necessitates use of a heavier weight. Therapeutic, IV.

  12. Delayed diagnosis of shunt overdrainage following functional hemispherotomy and ventriculoperitoneal shunt placement in a hemimegalencephaly patient

    Directory of Open Access Journals (Sweden)

    Yasunori Nagahama

    2017-01-01

    Full Text Available Shunt overdrainage represents a nebulous condition of variable clinical and imaging presentations, where the diagnosis is primarily clinical. The condition presents a diagnostic challenge particularly in patients with cognitive impairment and developmental delays. Here we present a 3-year-old boy with drug-resistant focal onset seizures due to hemimegalencephaly who previously underwent functional hemispherotomy followed by ventriculoperitoneal shunt placement for postoperative hydrocephalus. The subsequent clinical course was complicated by delayed diagnosis of shunt overdrainage in the absence of significant image findings. Maintaining a high index of suspicion for the possibility of shunt overdrainage is critical even in the face of unremarkable imaging findings.

  13. Delayed diagnosis of shunt overdrainage following functional hemispherotomy and ventriculoperitoneal shunt placement in a hemimegalencephaly patient.

    Science.gov (United States)

    Nagahama, Yasunori; Peters, David; Kumonda, Sho; Vesole, Adam; Joshi, Charuta; J Dlouhy, Brian; Kawasaki, Hiroto

    2017-01-01

    Shunt overdrainage represents a nebulous condition of variable clinical and imaging presentations, where the diagnosis is primarily clinical. The condition presents a diagnostic challenge particularly in patients with cognitive impairment and developmental delays. Here we present a 3-year-old boy with drug-resistant focal onset seizures due to hemimegalencephaly who previously underwent functional hemispherotomy followed by ventriculoperitoneal shunt placement for postoperative hydrocephalus. The subsequent clinical course was complicated by delayed diagnosis of shunt overdrainage in the absence of significant image findings. Maintaining a high index of suspicion for the possibility of shunt overdrainage is critical even in the face of unremarkable imaging findings.

  14. Injury of the Inferior Alveolar Nerve during Implant Placement: a Literature Review

    OpenAIRE

    Gintaras Juodzbalys; Hom-Lay Wang; Gintautas Sabalys

    2011-01-01

    ABSTRACT Objectives The purpose of present article was to review aetiological factors, mechanism, clinical symptoms, and diagnostic methods as well as to create treatment guidelines for the management of inferior alveolar nerve injury during dental implant placement. Material and Methods Literature was selected through a search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were inferior alveolar nerve injury, inferior alveolar nerve injuries, inferior alveo...

  15. Transarterial Fiducial Marker Placement for Image-guided Proton Therapy for Malignant Liver Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Ohta, Kengo, E-mail: yesterday.is.yesterday@gmail.com; Shimohira, Masashi, E-mail: mshimohira@gmail.com [Nagoya City University Graduate School of Medical Sciences, Department of Radiology (Japan); Sasaki, Shigeru, E-mail: ssasaki916@yahoo.co.jp; Iwata, Hiromitsu, E-mail: h-iwa-ncu@nifty.com; Nishikawa, Hiroko, E-mail: piroko1018@gmail.com; Ogino, Hiroyuki, E-mail: oginogio@gmail.com; Hara, Masaki, E-mail: mhara@med.nagoya-cu.ac.jp [Nagoya City West Medical Center, Department of Radiation Oncology, Nagoya Proton Therapy Center (Japan); Hashizume, Takuya, E-mail: tky300@gmail.com; Shibamoto, Yuta, E-mail: yshiba@med.nagoya-cu.ac.jp [Nagoya City University Graduate School of Medical Sciences, Department of Radiology (Japan)

    2015-10-15

    PurposeThe aim of this study is to analyze the technical and clinical success rates and safety of transarterial fiducial marker placement for image-guided proton therapy for malignant liver tumors.Methods and MaterialsFifty-five patients underwent this procedure as an interventional treatment. Five patients had 2 tumors, and 4 tumors required 2 markers each, so the total number of procedures was 64. The 60 tumors consisted of 46 hepatocellular carcinomas and 14 liver metastases. Five-mm-long straight microcoils of 0.018 inches in diameter were used as fiducial markers and placed in appropriate positions for each tumor. We assessed the technical and clinical success rates of transarterial fiducial marker placement, as well as the complications associated with it. Technical success was defined as the successful delivery and placement of the fiducial coil, and clinical success was defined as the completion of proton therapy.ResultsAll 64 fiducial coils were successfully installed, so the technical success rate was 100 % (64/64). Fifty-four patients underwent proton therapy without coil migration. In one patient, proton therapy was not performed because of obstructive jaundice due to bile duct invasion by hepatocellular carcinoma. Thus, the clinical success rate was 98 % (54/55). Slight bleeding was observed in one case, but it was stopped immediately and then observed. None of the patients developed hepatic infarctions due to fiducial marker migration.ConclusionTransarterial fiducial marker placement appears to be a useful and safe procedure for proton therapy for malignant liver tumors.

  16. Fluoroscopic-guided covered metallic stent placement for gastric outlet obstruction and post-operative gastroenterostomy anastomotic stricture

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Min; Han, Young Min; Kim, Chong Soo; Lee, Sang Young; Lee, Soo Teik; Yang, Doo Hyun

    2001-07-01

    AIM: To evaluate the feasibility and safety of fluoroscopic-guided covered metallic stent placements in providing palliative care for patients with inoperable malignant gastric outlet obstruction. MATERIALS AND METHODS: Under fluoroscopic guidance, placement of self-expandable, covered stents was attempted in 20 patients with inoperable or recurrent gastric cancer (age range 36-79 years). All patients had inoperable gastric outlet obstruction, 13 with native anatomy and seven with post-operative anatomy (gastrointestinal anastomotic sites). All patients had intolerance to oral alimentation and/or vomiting after ingestion. Success was defined both technically and clinically. RESULTS: The placement of the stent was technically successful in 18 patients and failed in two patients (technical success: 90%). The cause of the technical failures was an inability to negotiate the guide wire through the obstruction sites in spite of the use of both fluoroscopic and endoscopic guidance. After stent placement, 15 patients were able to ingest at least liquids and had a markedly decreased incidence of vomiting (clinical success: 75%). During the mean follow-up of 6 weeks, there have been no stent reocclusion and no life-threatening complications except migration of two stents in one patient. CONCLUSION: Fluoroscopically guided covered metallic stent placement appears to be valuable for the palliative treatment of malignant obstruction of gastric outlet and post-operative gastrointestinal anastomoses. Lee, J.M. et al. (2001)

  17. Iliac Artery Stent Placement Relieves Claudication in Patients with Iliac and Superficial Femoral Artery Lesions

    Energy Technology Data Exchange (ETDEWEB)

    Ichihashi, Shigeo, E-mail: shigeoichihashi@yahoo.co.jp; Higashiura, Wataru; Itoh, Hirofumi; Sakaguchi, Shoji; Kichikawa, Kimihiko [Nara Medical University, Department of Radiology (Japan)

    2013-06-15

    Purpose. To evaluate the efficacy of iliac artery stent placement for relief of claudication in patients with both iliac and superficial femoral artery (SFA) lesions. Methods. Stent placement for only iliac artery occlusive disease was performed in 94 limbs (74 patients) with both iliac and SFA occlusive disease on the same limb. All procedures were performed because intermittent claudication did not improve after continuation of antiplatelet medication therapy and home-based exercise for 3 months. Rutherford classification was 2 in 20 limbs and 3 in 74 limbs. Patients with critical limb ischemia were excluded. Median duration of follow-up was 40 months. Primary patency rates of the iliac stent, clinical improvement rates, and risk factors for requiring additional SFA procedures were evaluated. Results. Primary patency rates of the iliac stent at 1, 3, 5, and 7 years were 97, 93, 79, and 79 %, respectively. The initial clinical improvement rate was 87 %. Continued clinical improvement rates at 1, 3, 5, and 7 years were 87, 81, 69, and 66 %, respectively. SFA Trans-Atlantic Inter-Society Consensus (TASC) II C/D lesion was a significant risk factor for requiring additional SFA procedures. Conclusion. Intermittent claudication was relieved by iliac stent placement in most patients with both iliac and SFA lesions. Thus, the indications for treatment of the SFA intended for claudicants should be evaluated after treatment of the iliac lesion.

  18. Ultrasound guided transarterial coil placement in the internal and external carotid artery in horses.

    Science.gov (United States)

    Muñoz, Juan; Iglesias, Manuel; Chao, Eduardo Lloret; Bussy, Christian

    2015-04-01

    To assess ultrasound guided transarterial coil placement (UGTACP) for occlusion of the internal carotid artery (ICA) and external carotid artery (ECA) in horses. Cadaveric and in vivo study. Cadaveric horses (n = 10), healthy horses (3), and 1 clinical case. Cadaveric and in vivo (healthy horses): UGTACP was performed in the caudal part of the ICA and ECA. Coil placement in the rostral part of the ICA was performed blindly and controlled by conventional radiography. No coils were placed in the rostral part of the ECA. UGTACP of the ICA was in a horse with guttural pouch mycosis of the left guttural pouch. Accurate ultrasound-guided catheterization of the ICA and ECA was performed in all specimens. Ultrasound-guided coil placement was successfully performed in all cases except 1. No complications occurred in the in vivo study. The clinical case fully recovered and returned to its intended use. Based on our study, UGTACP of the ICA and ECA caudal part is a feasible alternative to fluoroscopy. An advantage of this technique is the accuracy with which you can catheterize both ICA and ECA and the ability to identify unusual branching at the origin of the ICA. Regarding the rostral part of the ICA, angiographic catheter guidance in this region is probably more precise using fluoroscopy as it is performed blindly. In a clinical situation, combination of US and fluoroscopy guidance can result in reduction of radiation exposure time. © Copyright 2014 by The American College of Veterinary Surgeons.

  19. Transgressive first clinical experiences

    DEFF Research Database (Denmark)

    Jensen, Carsten Juul; Jeppesen, Lise Kofoed; Drachmann, Merete

    2014-01-01

    This Study seeks to comprehend learning experiences of nursing students during their first clinical in-service placement. This Paper is part of a longitudinal development project interviewing the Student Nurse after each one of the five clinical in-service placements and then one year after gradu...... to advanced beginner, and adjusting to the workplace community. The conclusion is that the learning of nursing students during their first clinical in-service placement appears informal and not founded on evident best practice....... graduation as a Nurse. The Study has a qualitative methodology, inspired by Michael Eraut’s thoughts on learning in the workplace. When the workplace perspective is applied, learning seems to be concentrated on actual situations which the Learner is in, in contrast to employing constructed concepts...

  20. Executive Abilities as Reflected by Clock Hand Placement: Frontotemporal Dementia Versus Early-Onset Alzheimer Disease.

    Science.gov (United States)

    Barrows, Robin J; Barsuglia, Joseph; Paholpak, Pongsatorn; Eknoyan, Donald; Sabodash, Valeriy; Lee, Grace J; Mendez, Mario F

    2015-12-01

    The clock-drawing test (CDT) is widely used in clinical practice to diagnose and distinguish patients with dementia. It remains unclear, however, whether the CDT can distinguish among the early-onset dementias. Accordingly, we examined the ability of both quantitative and qualitative CDT analyses to distinguish behavioral variant frontotemporal dementia (bvFTD) and early-onset Alzheimer disease (eAD), the 2 most common neurodegenerative dementias with onset <65 years of age. We hypothesized that executive aspects of the CDT would discriminate between these 2 disorders. The study compared 15 patients with bvFTD and 16 patients with eAD on the CDT using 2 different scales and correlated the findings with neuropsychological testing and magnetic resonance imaging. The total CDT scores did not discriminate bvFTD and eAD; however, specific analysis of executive hand placement items successfully distinguished the groups, with eAD exhibiting greater errors than bvFTD. The performance on those executive hand placement items correlated with measures of naming as well as visuospatial and executive function. On tensor-based morphometry of the magnetic resonance images, executive hand placement correlated with right frontal volume. These findings suggest that lower performance on executive hand placement items occurs with involvement of the right dorsolateral frontal-parietal network for executive control in eAD, a network disproportionately affected in AD of early onset. Rather than the total performance on the clock task, the analysis of specific errors, such as executive hand placement, may be useful for early differentiation of eAD, bvFTD, and other conditions.

  1. SYNCHRONIZATION PLACEMENT REGULATION LEGISLATION ON PERSONNEL PLACEMENT IN REMOTE, THE BORDER AND ISLANDS

    Directory of Open Access Journals (Sweden)

    Turniani Laksmiarti

    2014-08-01

    Full Text Available Background: Policy Ministry of Health on medical personnel in Remote Areas, Border and Islands (DTPK has beenquite clear to be implemented, but in a decentralized also has the authority as a whole in terms of the mechanism ofrecruitment of health workers. This study analyzed whether government regulations and local government authorities inthe medical staffing DTPK synchronization has occurred. When the study was conducted over five months, with the cityof North Minahasa and Sumenep. Method: Research method is done through legislation (statute approach and in depthinterviews to the offender legislation. Result: Results of the study showed that the local regulations concerning the placement of medical personnel in DTPK has not been published, so the rules of appointment and placement of medical personnelin DTPK refers to regulations issued by the Ministry of Health number. 7 of 2013 (lex derograt legi generali. Through vertical synchronization theory, Act number 36 of 2009 on the Regulation of the Minister of Health ‘s health number 7 in 2013 has generally been in synchronized, the terms of Act number. 32 of 2004, article 12 paragraph (1 to the Minister of Health Regulation number. 7 of 2013 article 4 paragraph (3 there is no synchronization. Sort order legislation described in Law number. 12 of 2011, Regulation order system needs to refer and consider higher regulations. In the horizontal synchronization, regulation number 32 of 2004 is directly related to regional autonomy, the regulation number 36 of Article12 paragraph (1, the second law is still there are some items that are less synchronous the removal and placement financing medical personnel conducted by the local government. The results of the study also stated that the rules of appointment and placement of medical personnel in DTPK there are legal dualism, which it feared would cause ambiguity. Recommendation: Given that placement of medical personnel still use the PTT Ministry of

  2. Foster care placement improves children's functioning.

    Science.gov (United States)

    Horwitz, S M; Balestracci, K M; Simms, M D

    2001-11-01

    To examine changes in reported functioning over a 12-month follow-up period and predictors of those changes for a cohort of young children enrolled in foster care. Data came from a longitudinal follow-up of a cohort of young children entering foster care in one Connecticut region. These data were originally assembled to evaluate the effectiveness of a specialized set of services designed to provide a baseline multidisciplinary assessment and ongoing monitoring for young children entering foster care. From February 1, 1992, through July 31, 1993, all young children (N = 120) entering foster care in one Connecticut region were enrolled in this study. Children were assessed at entry into care and at 6 and 12 months after entry. Participation rates exceeded 90% at each follow-up period. The principal outcome of interest for these analyses is 12-month functioning as measured by the Vineland Adaptive Behavior Scale (VABS) scores completed by their foster mothers. At entry into foster care, children ranged in age from 11 to 76 months, were evenly divided by sex, and had a mean VABS score of 79.5 signifying functioning below the average range. At 6 months children gained an average of 7.87 points on their VABS score. By 12 months children showed an average change of 9.65 points, for a mean VABS score of 94.5, well within the nationally normed average range. The multivariate linear model predicting the 12-month VABS score showed that, controlling for the baseline VABS score, when children who were abused, older at placement, female, of African American ethnicity, spent more time in foster care, and had fewer recommended services while in care, they were more likely to show improvement on the foster mother-reported VABS evaluation. These results demonstrate that children's reported functioning improves over the course of placement in foster care and that sociodemographic characteristics, reason for placement, length of time in foster care, and fewer recommended services at

  3. Sensitivity of the OLGA and VCM models to erroneous marker placement: effects on 3D-gait kinematics

    NARCIS (Netherlands)

    Groen, B.E.; Geurts, M.; Nienhuis, B.; Duysens, J.E.J.

    2012-01-01

    Gait data need to be reliable to be valuable for clinical decision-making. To reduce the impact of marker placement errors, the Optimized Lower Limb Gait Analysis (OLGA) model was developed. The purpose of this study was to assess the sensitivity of the kinematic gait data to a standard marker displ

  4. Conscious sedation as an anaesthetic technique in patients undergoing nonthoracotomy placement of automatic implantable cardioverter defibrillator : an initial experience.

    Directory of Open Access Journals (Sweden)

    Singh V

    2004-01-01

    Full Text Available Six adult patients with life threatening recurrent ventricular arrhythmias who underwent non- thoracotomy placement of automatic implantable cardioverter defibrillator under conscious sedation are reported. Our clinical experience, patient satisfaction, recovery profile, complications and cardiologist perception about the technique of conscious sedation is presented and discussed.

  5. Distinguishing implicit from explicit brand attitudes in brand placement research

    NARCIS (Netherlands)

    Wennekers, A.M.; Vandeberg, L.; Zoon, K.; van Reijmersdal, E.A.; Verlegh, P.; Voorveld, H.; Eisend, M.

    2016-01-01

    Brand placement is a popular topic, both in business and academia. Brands are placed in a wide-ranging array of media, including television programs, movies, radio shows, magazines, games, music videos, and websites. Expenditures on brand placement are still growing (PQ Media, 2013), as well as the

  6. 33 CFR 183.566 - Fuel pumps: Placement.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Fuel pumps: Placement. 183.566...) BOATING SAFETY BOATS AND ASSOCIATED EQUIPMENT Fuel Systems Manufacturer Requirements § 183.566 Fuel pumps: Placement. Each fuel pump must be on the engine it serves or within 12 inches of the engine, unless it is...

  7. 12 CFR 22.7 - Forced placement of flood insurance.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Forced placement of flood insurance. 22.7... HAVING SPECIAL FLOOD HAZARDS § 22.7 Forced placement of flood insurance. If a bank, or a servicer acting... or mobile home and any personal property securing the designated loan is not covered by...

  8. 12 CFR 339.7 - Forced placement of flood insurance.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Forced placement of flood insurance. 339.7... GENERAL POLICY LOANS IN AREAS HAVING SPECIAL FLOOD HAZARDS § 339.7 Forced placement of flood insurance. If... not covered by flood insurance or is covered by flood insurance in an amount less than the...

  9. 12 CFR 614.4945 - Forced placement of flood insurance.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Forced placement of flood insurance. 614.4945... OPERATIONS Flood Insurance Requirements § 614.4945 Forced placement of flood insurance. If a System... not covered by flood insurance or are covered by flood insurance in an amount less than the...

  10. 12 CFR 572.7 - Forced placement of flood insurance.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Forced placement of flood insurance. 572.7... HAVING SPECIAL FLOOD HAZARDS § 572.7 Forced placement of flood insurance. If a savings association, or a... not covered by flood insurance or is covered by flood insurance in an amount less than the...

  11. 12 CFR 760.7 - Forced placement of flood insurance.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Forced placement of flood insurance. 760.7... LOANS IN AREAS HAVING SPECIAL FLOOD HAZARDS § 760.7 Forced placement of flood insurance. If a credit... not covered by flood insurance, or is covered by flood insurance in an amount less than the...

  12. Determining Classroom Placement for First Year English Language Learner Students

    Science.gov (United States)

    Peña, Rodrigo H.; Maxwell, Gerri M.

    2015-01-01

    This study explores classroom placement for first year English Language Learner (ELL) students from the perspective of a dual language director and two bilingual education strategists. The study strives to interrogate classroom placement for first year ELL students whose language proficiency level is at beginning level. Through a process of coding…

  13. Quick foot placement adjustments during gait: direction matters

    NARCIS (Netherlands)

    Hoogkamer, W.; Potocanac, Z.; Duysens, J.

    2015-01-01

    To prevent falls, adjustment of foot placement is a frequently used strategy to regulate and restore gait stability. While foot trajectory adjustments have been studied during discrete stepping, online corrections during walking are more common in daily life. Here, we studied quick foot placement ad

  14. Memoirs of a Trip into the Placement Culture of Japan.

    Science.gov (United States)

    Weatherall, Robert K.

    1991-01-01

    Presents observations of a U.S. college placement officer who participated in a careers conference in Japan. Describes changing desires of Japanese college students; hospitable treatment U.S. students received; their sightseeing experiences; the placement office at Waseda University; and the conference experience. (ABL)

  15. Understanding the Heritage Language Student: Proficiency and Placement

    Science.gov (United States)

    Thompson, Gregory L.

    2015-01-01

    Given the ever-growing number of Spanish heritage learners in both universities and colleges, the need has continued to grow for the development of placement exams that accurately measure language ability, are simple to evaluate, and are easy to administer to large numbers of students. This article analyzes the implementation of a placement exam…

  16. Distinguishing implicit from explicit brand attitudes in brand placement research

    NARCIS (Netherlands)

    Wennekers, A.M.; Vandeberg, L.; Zoon, K.; van Reijmersdal, E.A.; Verlegh, P.; Voorveld, H.; Eisend, M.

    2016-01-01

    Brand placement is a popular topic, both in business and academia. Brands are placed in a wide-ranging array of media, including television programs, movies, radio shows, magazines, games, music videos, and websites. Expenditures on brand placement are still growing (PQ Media, 2013), as well as the

  17. Placement Evaluations and Remedial Education: Are Students Shopping for Bargains?

    Science.gov (United States)

    Fletcher, Stephen H.

    2014-01-01

    The purpose of this study is to provide evidence that students may be doing comparison shopping when it comes to community college placement in English and mathematics courses. Comparisons may occur because of the difference in the placement process across campuses and the variation in the levels of developmental education offered. The…

  18. Economic and Demographic Factors Impacting Placement of Students with Autism

    Science.gov (United States)

    Kurth, Jennifer A.; Mastergeorge, Ann M.; Paschall, Katherine

    2016-01-01

    Educational placement of students with autism is often associated with child factors, such as IQ and communication skills. However, variability in placement patterns across states suggests that other factors are at play. This study used hierarchical cluster analysis techniques to identify demographic, economic, and educational covariates…

  19. Consumers with Major Depressive Disorder: Factors Influencing Job Placement

    Science.gov (United States)

    Hergenrather, Kenneth C.; Haase, Eileen; Zeglin, Robert J.; Rhodes, Scott D.

    2013-01-01

    The theory of planned behavior (TPB) was applied to study the factors that influence the intention of public rehabilitation placement professionals to place consumers with major depressive disorder (MDD) in jobs. A sample of 108 public rehabilitation placement professionals in the Mid-Atlantic region of the United States completed the MDD…

  20. Computer-Assisted Placement: Effective Aid or Paper Albatross?

    Science.gov (United States)

    Sampson, James P.

    1978-01-01

    A short time ago, the computer was a concept of the future which scared many and amazed even more. Now a reality, the computer has become as common on the placement front as the interview. The computer's value to placement is discussed. (Author)

  1. Children's School Placement in Germany: Does Kindergarten Attendance Matter?

    Science.gov (United States)

    Spiess, C. Katharina; Buchel, Felix; Wagner, Gert G.

    2003-01-01

    Examined the relationship between kindergarten attendance and seventh-grade school placement of children in West Germany, differentiating associations for children of citizens from those of immigrants' children. Found a significant relationship between kindergarten attendance and later school placement for children in immigrant households but not…

  2. The Man From Dow: Placement Officer for a Year

    Science.gov (United States)

    Ideus, Harvey S.

    1974-01-01

    A professional (on leave of absence) in the Placement Office at University of Wisconsin-La Crosse was temporarily replaced by a personnel specialist from Dow Chemical. This exchange experience is separately described by the former director of Placement and Career Advising at the university and by "the man from Dow" himself. (EAK)

  3. 41 CFR 60-2.16 - Placement goals.

    Science.gov (United States)

    2010-07-01

    ... publicly announced preference for American Indians as is authorized in 41 CFR 60-1.5(a)(6) may reflect in... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Placement goals. 60-2.16...-AFFIRMATIVE ACTION PROGRAMS Purpose and Contents of Affirmative Action Programs § 60-2.16 Placement goals....

  4. Consumers with Major Depressive Disorder: Factors Influencing Job Placement

    Science.gov (United States)

    Hergenrather, Kenneth C.; Haase, Eileen; Zeglin, Robert J.; Rhodes, Scott D.

    2013-01-01

    The theory of planned behavior (TPB) was applied to study the factors that influence the intention of public rehabilitation placement professionals to place consumers with major depressive disorder (MDD) in jobs. A sample of 108 public rehabilitation placement professionals in the Mid-Atlantic region of the United States completed the MDD…

  5. 46 CFR 130.460 - Placement of machinery alarms.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Placement of machinery alarms. 130.460 Section 130.460..., AND MISCELLANEOUS EQUIPMENT AND SYSTEMS Automation of Unattended Machinery Spaces § 130.460 Placement of machinery alarms. (a) Visible and audible alarms must be installed at the pilothouse to...

  6. Content replication and placement in mobile networks

    CERN Document Server

    La, Chi-Anh; Casetti, Claudio; Chiasserini, Carla-Fabiana; Fiore, Marco

    2011-01-01

    Performance and reliability of content access in mobile networks is conditioned by the number and location of content replicas deployed at the network nodes. Location theory has been the traditional, centralized approach to study content replication: computing the number and placement of replicas in a static network can be cast as a facility location problem. The endeavor of this work is to design a practical solution to the above joint optimization problem that is suitable for mobile wireless environments. We thus seek a replication algorithm that is lightweight, distributed, and reactive to network dynamics. We devise a solution that lets nodes (i) share the burden of storing and providing content, so as to achieve load balancing, and (ii) autonomously decide whether to replicate or drop the information, so as to adapt the content availability to dynamic demands and time-varying network topologies. We evaluate our mechanism through simulation, by exploring a wide range of settings, including different node ...

  7. Energy Efficient Military Mobile Base Station Placement

    Directory of Open Access Journals (Sweden)

    Saikat Ray

    2010-11-01

    Full Text Available This research deals with an energy efficient network for military mobile base station placement. Theproposed method is based on minimizing the energy loss of military communication networks where thebase station is moving along a preset path and the users are constantly moving in an independent speedand direction. It takes into account the free space loss and the knife edge effect for the energy loss toestablish a path weight for the shortest path model. Then, it evaluates the neighboring points to the basestation for the energy loss of the network in order to find the position at which the minimum energy lossoccurs. The results show a clear energy saving advantage when compared to Lloyd-Max’s method

  8. Brocade: Optimal flow placement in SDN networks

    CERN Document Server

    CERN. Geneva

    2015-01-01

    Today' network poses several challanges to network providers. These challanges fall in to a variety of areas ranging from determining efficient utilization of network bandwidth to finding out which user applications consume majority of network resources. Also, how to protect a given network from volumetric and botnet attacks. Optimal placement of flows deal with identifying network issues and addressing them in a real-time. The overall solution helps in building new services where a network is more secure and more efficient. Benefits derived as a result are increased network efficiency due to better capacity and resource planning, better security with real-time threat mitigation, and improved user experience as a result of increased service velocity.

  9. Sensor Placement for Modal Parameter Subset Estimation

    DEFF Research Database (Denmark)

    Ulriksen, Martin Dalgaard; Bernal, Dionisio; Damkilde, Lars

    2016-01-01

    The present paper proposes an approach for deciding on sensor placements in the context of modal parameter estimation from vibration measurements. The approach is based on placing sensors, of which the amount is determined a priori, such that the minimum Fisher information that the frequency...... responses carry on the selected modal parameter subset is, in some sense, maximized. The approach is validated in the context of a simple 10-DOF mass-spring-damper system by computing the variance of a set of identified modal parameters in a Monte Carlo setting for a set of sensor configurations, whose......). It is shown that the widely used Effective Independence (EI) method, which uses the modal amplitudes as surrogates for the parameters of interest, provides sensor configurations yielding theoretical lower bound variances whose maxima are up to 30 % larger than those obtained by use of the max-min approach....

  10. Optimal Placement Algorithms for Virtual Machines

    CERN Document Server

    Bellur, Umesh; SD, Madhu Kumar

    2010-01-01

    Cloud computing provides a computing platform for the users to meet their demands in an efficient, cost-effective way. Virtualization technologies are used in the clouds to aid the efficient usage of hardware. Virtual machines (VMs) are utilized to satisfy the user needs and are placed on physical machines (PMs) of the cloud for effective usage of hardware resources and electricity in the cloud. Optimizing the number of PMs used helps in cutting down the power consumption by a substantial amount. In this paper, we present an optimal technique to map virtual machines to physical machines (nodes) such that the number of required nodes is minimized. We provide two approaches based on linear programming and quadratic programming techniques that significantly improve over the existing theoretical bounds and efficiently solve the problem of virtual machine (VM) placement in data centers.

  11. Cumulative Risks of Foster Care Placement for Danish Children

    DEFF Research Database (Denmark)

    Fallesen, Peter; Emanuel, Natalia; Wildeman, Christopher

    2014-01-01

    Although recent research suggests that the cumulative risk of foster care placement is far higher for American children than originally suspected, little is known about the cumulative risk of foster care placement in other countries, which makes it difficult to gauge the degree to which factor...... is for Danish children. Results suggest that at the beginning of the study period (in 1998) the cumulative risk of foster care placement for Danish children was roughly in line with the risk for American children. Yet, by the end of the study period (2010), the risk had declined to half the risk for American...... foster care placement is salient in other contexts. In this article, we provide companion estimates to those provided in recent work on the US by using Danish registry data and synthetic cohort life tables to show how high and unequally distributed the cumulative risk of foster care placement...

  12. Strategies for Controlled Placement of Nanoscale Building Blocks

    Directory of Open Access Journals (Sweden)

    Koh SeongJin

    2007-01-01

    Full Text Available AbstractThe capability of placing individual nanoscale building blocks on exact substrate locations in a controlled manner is one of the key requirements to realize future electronic, optical, and magnetic devices and sensors that are composed of such blocks. This article reviews some important advances in the strategies for controlled placement of nanoscale building blocks. In particular, we will overview template assisted placement that utilizes physical, molecular, or electrostatic templates, DNA-programmed assembly, placement using dielectrophoresis, approaches for non-close-packed assembly of spherical particles, and recent development of focused placement schemes including electrostatic funneling, focused placement via molecular gradient patterns, electrodynamic focusing of charged aerosols, and others.

  13. On Optimizing Gateway Placement for Throughput in Wireless Mesh Networks

    Directory of Open Access Journals (Sweden)

    Wang Xudong

    2010-01-01

    Full Text Available An innovative gateway placement scheme is proposed for wireless mesh networks (WMNs in this paper. It determines the location of a gateway based on a new performance metric called multihop traffic-flow weight (MTW. The MTW computation takes into account many factors that impact the throughput of WMNs, that is, the number of mesh routers, the number of mesh clients, the number of gateways, traffic demand from mesh clients, locations of gateways, and possible interference among gateways. Thus, the proposed gateway placement scheme provides a framework of significantly improving throughput of WMNs through proper placement of gateways. To evaluate the performance of the new gateway placement scheme, a nonasymptotic throughput of WMNs is derived by considering TDMA scheduling. The derivations also provide a guideline for designing scheduling schemes of WMNs. Numeric results show that the proposed gateway placement scheme constantly outperforms other schemes by a large margin.

  14. Two-Phase Algorithm for Optimal Camera Placement

    Directory of Open Access Journals (Sweden)

    Jun-Woo Ahn

    2016-01-01

    Full Text Available As markers for visual sensor networks have become larger, interest in the optimal camera placement problem has continued to increase. The most featured solution for the optimal camera placement problem is based on binary integer programming (BIP. Due to the NP-hard characteristic of the optimal camera placement problem, however, it is difficult to find a solution for a complex, real-world problem using BIP. Many approximation algorithms have been developed to solve this problem. In this paper, a two-phase algorithm is proposed as an approximation algorithm based on BIP that can solve the optimal camera placement problem for a placement space larger than in current studies. This study solves the problem in three-dimensional space for a real-world structure.

  15. Placement History of Foster Children : A Study of Placement History and Outcomes in Long-Term Family Foster Care

    NARCIS (Netherlands)

    Strijker, Johan; Knorth, Erik J.; Knot-Dickscheit, Jana

    2008-01-01

    The files of 419 children in family foster care and kinship foster care were used in a retrospective longitudinal design study that examined their placement histories in child welfare. Significant associations were found between the number of placements on one hand, and the prevalence of attachment

  16. Placement History of Foster Children: A Study of Placement History and Outcomes in Long-Term Family Foster Care

    Science.gov (United States)

    Strijker, Johan; Knorth, Erik J.; Knot-Dickscheit, Jana

    2008-01-01

    The files of 419 children in family foster care and kinship foster care were used in a retrospective longitudinal design study that examined their placement histories in child welfare. Significant associations were found between the number of placements on one hand, and the prevalence of attachment disorders, severity of behavioral problems, and…

  17. Poor self-rated health did not increase permanent nursing home placement or mortality in people with mild Alzheimer's disease

    DEFF Research Database (Denmark)

    Nielsen, Anni Brit Sternhagen; Siersma, Volkert Dirk; Waldemar, Gunhild;

    2016-01-01

    Background: Self-rated health (SRH) has in many population-based studies predicted adverse health outcomes, e.g. morbidity, permanent nursing home (NH) placement, and mortality. However, the predictive value of SRH to NH placement and mortality among elderly people is not consistent. This may......). Methods: Data are from The Danish Alzheimer Intervention StudY (DAISY), a large randomized controlled trial of psychosocial intervention for patients with mild dementia and their caregivers with 3-years’ follow-up. Five out of 14 Danish counties participated and 321 home-living elderly (mean age: 76...... analysis: In the fully adjusted models HR was 0.63 (95 % CI 0.38-1.05) and 1.28 (95 % CI 0.67-2.45), respectively. Conclusions. When poor SRH was present we found no increased risk for NH placement or death among elderly people with mild AD. SRH is a widely used parameter in clinical and epidemiological...

  18. Impact of work experience placements on school students' attitude towards mental illness.

    Science.gov (United States)

    Kennedy, Vanathi; Belgamwar, Ravindra B

    2014-08-01

    Aims and method Research shows that 16- to 19-year-olds express the greatest level of negative attitudes towards people with mental illness. Our aim was to assess the effectiveness of work experience placements in influencing secondary-school students' attitudes towards mental illness and career choices. The Adolescent Attitude Towards Mental Illness questionnaire measured and assessed the adolescents' attitude changes. Pre- and post-evaluation questionnaires assessed changes in their career choices. Results There was a statistically significant change in the adolescents' attitudes, especially regarding categorical thinking and perceptions that people with mental illness are violent and out of control. There was also a positive shift in their career choices towards options in the field of mental health. Clinical implications Work experience placements can have a positive impact on secondary-school students' attitudes towards mental illness and may improve the level of student recruitment into the field of psychiatry.

  19. Implant placement and immediate loading in aesthetic zone- A report of three cases

    Directory of Open Access Journals (Sweden)

    Vijay Deshmukh

    2009-01-01

    Full Text Available Single teeth replaced by implants in the aesthetic zone are one of the most challenging situations faced by a clinician. Recent studies have encouraged a progressive shortening of the healing period for single-tooth implants with immediate implantation and immediate loading being proposed for the aesthetic zone in the maxilla. The present report describes three cases with single tooth replacement in the anterior maxillary region by implant therapy with flapless technique followed by immediate provisionalization of the implant with all-ceramic crown. The patients exhibited no clinical or radiologic complications 1 year after loading. Implant placement and immediate loading of single tooth can provide an attractive treatment option in the aesthetic zone. Careful assessment must be made of mucosal and bone volumes in relation to implant placement for optimum aesthetic outcome.

  20. Facial development, continuous tooth eruption, and mesial drift as compromising factors for implant placement.

    Science.gov (United States)

    Heij, Danny G Op; Opdebeeck, Heidi; van Steenberghe, Daniel; Kokich, Vincent G; Belser, Urs; Quirynen, Marc

    2006-01-01

    The replacement of teeth lost by children because of trauma can be an important indication for early implant therapy. Osseointegrated dental implants, like ankylosed teeth, alter position as growth-related changes occur within the jawbones (displacement, remodeling, mesial drift). Facial growth of the child and even of the adolescent, as well as the continuous eruption of the adjacent anterior teeth, create significant risk of a less favorable esthetic and/or functional outcome. For patients with a normal facial profile, the placement of an implant should be postponed until growth is complete. For patients with a short or long face type, further growth, especially the continuous eruption of adjacent teeth, creates a serious risk even after the age of 20 years, as illustrated by some recent clinical studies. This review aims to explain these phenomena and provides some recommendations for implant placement.

  1. Medical graduates becoming rural doctors: rural background versus extended rural placement.

    Science.gov (United States)

    Clark, Tyler R; Freedman, Saul B; Croft, Amanda J; Dalton, Hazel E; Luscombe, Georgina M; Brown, Anthony M; Tiller, David J; Frommer, Michael S

    2013-12-16

    To determine whether recruitment of rural students and uptake of extended rural placements are associated with students' expressed intentions to undertake rural internships and students' acceptance of rural internships after finishing medical school, and to compare any associations. Longitudinal study of three successive cohorts (commencing 2005, 2006, 2007) of medical students in the Sydney Medical Program (SMP), University of Sydney, New South Wales, using responses to self-administered questionnaires upon entry to and exit from the Sydney Medical School and data recorded in rolls. Students' expressed intentions to undertake rural internships, and their acceptance of rural internships after finishing medical school. Data from 448 students were included. The proportion of students preferring a rural career dropped from 20.7% (79/382) to 12.5% (54/433) between entry into and exit from the SMP. A total of 98 students took extended rural placements. Ultimately, 8.1% (35/434) accepted a rural internship, although 14.5% (60/415) had indicated a first preference for a rural post. Students who had undertaken an extended rural placement were more than three times as likely as those with rural backgrounds to express a first preference for a rural internship (23.9% v 7.7%; χ(2) = 7.04; P = 0.008) and more than twice as likely to accept a rural internship (21.3% v 9.9%; χ(2) = 3.85; P = 0.05). For the three cohorts studied, rural clinical training through extended placements in rural clinical schools had a stronger association than rural background with a preference for, and acceptance of, rural internship.

  2. Combined 25-gauge vitrectomy and posterior tube shunt placement for advanced glaucoma.

    Science.gov (United States)

    Reichstein, David; Kammer, Jeffrey; Recchia, Franco

    2011-01-01

    To report the initial clinical outcomes of a combined procedure utilizing 25-gauge vitrectomy and posterior tube shunt placement in eyes with refractory glaucoma not amenable to standard treatment. Retrospective chart review. We included 10 eyes (10 consecutive adult patients, mean age 61 years) with advanced glaucoma and anterior segment abnormalities precluding tube placement in the anterior chamber who were treated with combined 25-gauge vitrectomy and posterior tube shunt placement. Records of consecutive patients were reviewed for demographics, etiology of glaucoma, preoperative clinical data (visual acuity, intraocular pressure, number of ocular antihypertensive medications), and postoperative outcome measures at predetermined time points. (1) Intraocular pressure (IOP) at 1, 2, 6, and 12 months postoperatively; (2) number of ocular antihypertensive medications needed at 12 months postoperatively; (3) visual acuity (VA) at 12 months postoperatively; and (4) incidence of hypotony, retinal detachment, endophthalmitis, and corneal decompensation. Preoperatively, mean IOP was 31 mmHg, and patients required a mean of 2.5 ocular antihypertensive medications. Mean IOP at 1, 2, 6, and 12 months postoperatively were 17.0, 16.1, 17.8, and 16.1 mmHg, respectively, and significantly lower than preoperative IOP (P < 0.005 at all time points). At 1 year postoperatively, 90% of patients had an IOP < 20 mmHg, and 50% of patients required ≤ 2 ocular antihypertensive medications. At 1 year postoperatively, VA was the same or improved in 70% of patients, and no worse than 1 Snellen line in any patient. Corneal edema developed in 2 patients. No patient developed hypotony or endophthalmitis. Combined 25-gauge vitrectomy and posterior tube shunt placement can be successful in lowering IOP in eyes with advanced glaucoma not amenable to other therapies. Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  3. Teaching teamwork: an evaluation of an interprofessional training ward placement for health care students

    Directory of Open Access Journals (Sweden)

    Morphet J

    2014-06-01

    Full Text Available Julia Morphet,1 Kerry Hood,2 Robyn Cant,2 Julie Baulch,3 Alana Gilbee,3 Kate Sandry4 1School of Nursing and Midwifery, Monash University, Frankston, Victoria, Australia; 2School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia; 3Southern Clinical School, Monash University, Monash Health, Clayton, Victoria, Australia; 4Dandenong Emergency Department, Monash Health, David St, Dandenong, Victoria, Australia Abstract: The establishment of interprofessional teamwork training in the preprofessional health care curriculum is a major challenge for teaching faculties. Interprofessional clinical placements offer an opportunity for teamwork education, as students in various professions can work and learn together. In this sequential, mixed-method study, focus group and survey techniques were used to evaluate students' educational experiences after 2-week ward-based interprofessional clinical placements. Forty-five senior nursing, medicine, and other health care students cared for patients in hospital wards under professional supervision, with nursing-medicine student "teams" leading care. Thirty-six students attended nine exit focus groups. Five central themes that emerged about training were student autonomy and workload, understanding of other professional roles, communication and shared knowledge, interprofessional teamwork/collaboration, and the "inner circle", or being part of the unit team. The learning environment was described as positive. In a postplacement satisfaction survey (n=38, students likewise rated the educational experience highly. In practicing teamwork and collaboration, students were able to rehearse their future professional role. We suggest that interprofessional clinical placements be regarded as an essential learning experience for senior preprofessional students. More work is needed to fully understand the effect of this interactive program on students' clinical learning and preparation for practice

  4. Why wait: early enteral feeding after pediatric gastrostomy tube placement.

    Science.gov (United States)

    Jensen, Amanda R; Renaud, Elizabeth; Drucker, Natalie A; Staszak, Jessica; Senay, Ayla; Umesh, Vaibhavi; Williams, Regan F; Markel, Troy A

    2017-06-27

    Early initiation of feedings after gastrostomy tube (GT) placement may reduce associated hospital costs, but many surgeons fear complications could result from earlier feeds. We hypothesized that, irrespective of placement method, starting feedings within the first 6h following GT placement would not result in a greater number of post-operative complications. An IRB-approved retrospective review of all GTs placed between January 2012 and December 2014 at three academic institutions was undertaken. Data was stratified by placement method and whether the patient was initiated on feeds at less than 6h or after. Baseline demographics, operative variables, post-operative management and complications were analyzed. Descriptive statistics were used and P-values <0.05 were considered significant. One thousand and forty-eight patients met inclusion criteria. GTs were inserted endoscopically (48.9%), laparoscopically (44.9%), or via an open approach (6.2%). Demographics were similar in early and late fed groups. When controlling for method of placement, those patients who were fed within the first 6h after gastrostomy placement had shorter lengths of stay compared to those fed greater than 6h after placement (P<0.05). Total post-operative outcomes were equivalent between feeding groups for all methods of placement (laparoscopic (P=0.87), PEG (P=0.94), open (P=0.81)). Early initiation of feedings following GT placement was not associated with an increase in complications. Feeds initiated earlier may shorten hospital stays and decrease overall hospital costs. Multi-institutional retrospective. III. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. 脑室腹腔分流化疗泵置入术治疗高颅压脑膜转移瘤的临床观察%Clinical study of ventriculo-peritoneal shunt surgery plus chemotherapy pump placement in high intracranial pressure caused by meningitis metastasis

    Institute of Scientific and Technical Information of China (English)

    周士振; 朱玉方; 徐军; 岳晓; 王勇; 王秀华; 赵玉娥; 陶荣杰

    2012-01-01

    OBJECTIVE: To investigate the clinical feature,diagnosis,therapies and prognosis of the high intracranial pressure caused by meningitis metastasis, and explore the role of ventriculoperitoneal shunt and intrathecal chemotherapy in the me-ningeal metastases. METHODS! A total of 30 consecutive diagnosed meningitis metastasis patients' whole saliva samples collected from Aug 2009 to Jul 2011 were retrospectively reviewed and analyzed systematically. RESULTS; 30 meningitis metastasis patients had manifested increased intracranial pressure by lumbar puncture tests which were detected greater than 200 mm H2O and appeared headache. Twenty-four cases were positive in cerebro-spinal fluid (CSF) cytology detection. All patients were dealed with peritoneal shunt, and 23 patients received peritoneal shunt and chemotherapy pump implantation. These patients received therapies including surgery, intrathecal chemotherapy, radiotherapy and systemical chemotherapy. The median survival time was 10 months (range 4 weeks to 24 months). CONCLUSIONS;MC is one of the most serious complications of cancer due to the poor prognosis. In this study, MR combined with CSF cytology detection is helpful to the diagnosis of this disease. The ventriculoperitoneal shunt surgery plus chemotherapy pump placement should be considered having satisfactory efficacy for these patients.%目的:总结颅内高压的脑膜转移瘤病例的临床资料,探讨腹腔分流+化疗泵置入术在脑膜转移瘤中的治疗作用.方法:对2009-08-2011-07收治的72例脑膜转移病例中30例颅内压增高的患者进行系统的临床资料回顾性分析.结果:30例患者均有头痛等颅内压增高表现,行腰穿检查均>200 mm H2O.CSF细胞学诊断阳性24例,23例患者接受腹腔分流及化疗泵置入术,7例患者单纯接受腹腔分流术,总生存期为4周~24个月,中位生存期为10个月.结论:脑膜转移瘤是恶性肿瘤严重并发症之一,预后差,颅脑MR结合CSF细胞学

  6. Efficient sensor placement for state estimation in structural dynamics

    Science.gov (United States)

    Hernandez, Eric M.

    2017-02-01

    This paper derives a computationally efficient algorithm to determine optimal sequential sensor placement for state estimation in linear structural systems subjected to unmeasured excitations and noise contaminated measurements. The proposed algorithm is developed within the context of the Kalman filter and it minimizes the variance of the state estimate among all possible sequential sensor locations. The paper investigates the effects of measurement type, covariance matrix partition selection, spatial correlation of excitation and model selection on optimal sensor placement. The paper shows that the sequential approach reaches the optimal sensor placement as the number of sensor increases.

  7. A New Method for Optimal Harmonic Meter Placement

    Directory of Open Access Journals (Sweden)

    A. Ketabi

    2008-01-01

    Full Text Available In this research, a new method based on Singular Value Decomposition (SVD is proposed to solve the problem of optimal placement of meters for static estimation of harmonic sources in a power system. Also, the Binary Genetic Algorithm (BGA is used to solve the problem of optimization. IEEE 14-bus test system is provided to validate the measurement placement algorithm. It has been observed that the quality of estimation is improved and the Number of Observable Variable (NOV is increased. Moreover, the BGA-based meter placement strategy yields the same solution as obtained from the complete enumeration technique but in shorter time.

  8. Does Individual Placement and Support satisfy the users` needs?

    Directory of Open Access Journals (Sweden)

    Sandra eViering

    2015-06-01

    Full Text Available This study aims to investigate clients’ satisfaction with Individual Placement and Support (IPS at the University Hospital for Psychiatry Zurich (PUK. Furthermore this study aims to investigate if clients feel the approach of IPS as a useful approach to fulfill their needs. 125 people were recruited from one of the three IPS services of PUK and were asked to complete a structured questionnaire. The following IPS services were available: i randomized controlled trial ZHEPP (www.zhepp.ch, ii randomized controlled trial ZInEP (www.zinep.ch and iii us clinical SE service of PUK (IPS-PUK. The clients mostly indicated that the IPS was generally useful and fitted their needs. Overall satisfaction of the participants with the IPS services of PUK was very high. Furthermore, this study confirms that client satisfaction and symptom severity are associated. In conclusion, participants of the IPS services received the support they were looking for. This means that the approach of IPS fits the needs of different patient groups and can be used without any modifications. The most important limitation is the unequal group sizes. Therefore, the obtained results need to be strengthen by future research.

  9. Complications after placement of peritoneal catheter

    Directory of Open Access Journals (Sweden)

    Đurđević-Mirković Tatjana

    2011-01-01

    Full Text Available Introduction. Peritoneal dialysis is one of the modalities used for treatment of end-stage chronic kidney failure. Nowadays, this method is complementary to haemodialysis and renal transplantation. Owing to the rich vascularization of the peritoneum, it is used in the processes of osmosis and diffusion, enabling the removal of uremic material from the body. The procedure includes introduction of peritoneal fluid via the peritoneal catheter. Complications. The catheter is placed through the anterior abdominal wall with its tip positioned in the small pelvis. There are several techniques for catheter placement considered minimally invasive, which, however, may be associated with various complications. These complications can be divided into mechanical (catheter dysfunction, cuff protrusion, hernia, dialysate leaks, visceral perforation and infectious (early peritonitis, exit site or tunnel infection, surgical wounds. In most cases, such complications are rare and can be successfully managed using conservative therapy; however, in some situations severe complications can endanger the life of the patient. On-time recognition of complications, particularly in patients at risk, is of paramount importance for an effective treatment. The development of complications can increase the morbidity and the chance of treatment failure, and therefore transfer to haemodialysis. Conclusion. The preoperative evaluation and determination of the risk factors as well as the early recognition and adequate management of complications are essential in their prevention.

  10. Nasogastric Tube Placement in Newborns Before Discharge.

    Science.gov (United States)

    Alnemri, Abdulrahman M; Saeed, Anjum; Assiri, Asaad M

    2016-04-01

    The aim of this study was to assess the knowledge of medical staff (physicians) at different levels about insertion or placement of nasogastric tube (NGT) in a normal newborn before discharge. It was a survey-based, observational study conducted at King Khalid University Hospital. Atotal of 103 doctors were sent text message; among those 81 (78.6%) responded. Among the respondents, 27, 16, 11 and 27 were neonatologists, general physicians, obstetricians/ ENT/pediatric surgeons, and senior registrars neonatology (SRN), respectively. Majority of physicians, 57 (70.3%) rejected the idea of insertion of NGTin a normal newborn but in 24 (29.6%), answer was to insert NGTin all the newborns before discharge to check the patency of nasal cavities. Regarding the position, region of doctors and their response, majority from Center said ‘No’(not in favour of insertion) but from South, 17/18 (94.4%) said ‘Yes’(in favour of insertion). Regarding other specialties, majority of them showed rejection of this idea. In conclusion, most of the healthcare professionals, directly involved with neonatal care, rejected the idea of routine insertion of NGTin normal newborn examination before discharge; rather, some non-invasive technique could be opted.

  11. A Risk-Based Sensor Placement Methodology

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ronald W [ORNL; Kulesz, James J [ORNL

    2006-08-01

    A sensor placement methodology is proposed to solve the problem of optimal location of sensors or detectors to protect population against the exposure to and effects of known and/or postulated chemical, biological, and/or radiological threats. Historical meteorological data are used to characterize weather conditions as wind speed and direction pairs with the percentage of occurrence of the pairs over the historical period. The meteorological data drive atmospheric transport and dispersion modeling of the threats, the results of which are used to calculate population at risk against standard exposure levels. Sensor locations are determined via a dynamic programming algorithm where threats captured or detected by sensors placed in prior stages are removed from consideration in subsequent stages. Moreover, the proposed methodology provides a quantification of the marginal utility of each additional sensor or detector. Thus, the criterion for halting the iterative process can be the number of detectors available, a threshold marginal utility value, or the cumulative detection of a minimum factor of the total risk value represented by all threats.

  12. Optimal Camera Placement for Motion Capture Systems.

    Science.gov (United States)

    Rahimian, Pooya; Kearney, Joseph K

    2017-03-01

    Optical motion capture is based on estimating the three-dimensional positions of markers by triangulation from multiple cameras. Successful performance depends on points being visible from at least two cameras and on the accuracy of the triangulation. Triangulation accuracy is strongly related to the positions and orientations of the cameras. Thus, the configuration of the camera network has a critical impact on performance. A poor camera configuration may result in a low quality three-dimensional (3D) estimation and consequently low quality of tracking. This paper introduces and compares two methods for camera placement. The first method is based on a metric that computes target point visibility in the presence of dynamic occlusion from cameras with "good" views. The second method is based on the distribution of views of target points. Efficient algorithms, based on simulated annealing, are introduced for estimating the optimal configuration of cameras for the two metrics and a given distribution of target points. The accuracy and robustness of the algorithms are evaluated through both simulation and empirical measurement. Implementations of the two methods are available for download as tools for the community.

  13. Is it possible to enhance the confidence of student dietitians prior to professional placements? A design-based research model.

    Science.gov (United States)

    Ross, L J; Mitchell, L J; Williams, L T

    2017-10-01

    Student confidence is an important contributor to a successful professional placement experience. The present study aimed to evaluate a placement preparation program for student dietitians and to assess the impact on self-rated confidence with respect to commencing placements. The present study is part of a design-based research approach that involves students in a cyclic enquiry to evaluate and improve curricula. Nutrition and Dietetics students at an Australian university participated in a 1-week mandatory workshop - Pre-Placement week (PrePW), N = 98 students: in 2015 (n = 54) and 2016 (n = 44). An online survey was conducted before and after PrePW using a five-point Likert scale (1 = not confident; 5 = very confident) to assess self-rated confidence to commence placements. Mean (SD) scores were calculated. Paired and independent t-tests evaluated within- and between-group differences, respectively. Before PrePW, the mean (SD) for student confidence to commence placements overall (in all areas of practise) was 'somewhat confident' [2.9 (0.6) in 2015 and 3.0 (0.7) in 2016]. Students were least confident to commence Clinical Practice [2015: 2.5 (0.6); 2016: 2.8 (0.6)] compared to Food Service Management (FSM) [2015: 3.2 (0.9); 2016: 3.1 (0.9)] and Community and Public Health Nutrition (CPHN) [2015: 3.3 (0.9); 2016: 3.2 (0.8)]. Student feedback from PrePW 2015 was used to change the curriculum and PrePW program. The 2016 students reported significantly greater confidence within all areas of practice: Clinical Practice [3.4 (0.6)], FSM [3.7 (0.6)] and CPHN [3.8 (0.6)], including confidence to commence placements overall [3.6 (0.6)] (P confidence in preparation for professional placement. © 2017 Commonwealth of Australia. Journal of Human Nutrition and Dietetics © 2017 The British Dietetic Association Ltd.

  14. A prospective assessment of pelvic infection risk following same-day sexually transmitted infection testing and levonorgestrel intrauterine system placement.

    Science.gov (United States)

    Turok, David K; Eisenberg, David L; Teal, Stephanie B; Keder, Lisa M; Creinin, Mitchell D

    2016-11-01

    Misperceptions persist that intrauterine device placement is related to pelvic infections and Chlamydia and gonorrhea testing results are needed prior to placement. We sought to evaluate the relationship of Chlamydia and gonorrhea screening to pelvic infection for up to 2 years following placement of the levonorgestrel 52-mg intrauterine system. A total of 1751 nulliparous and multiparous females 16 to 45 years old enrolled in a multicenter trial designed to evaluate the efficacy and safety of a new levonorgestrel intrauterine system for up to 7 years. Participants had Chlamydia screening at study entry and yearly if they were age ≤25 years. Women also had baseline gonorrhea screening if testing had not been performed since starting their current sexual relationship. Those who changed sexual partners during the trial had repeated Chlamydia and gonorrhea testing. Intrauterine system insertion could occur on the same day as screening. Participants did not receive prophylactic antibiotics for intrauterine system placement. Investigators performed pelvic examinations after 12 and 24 months and when clinically indicated during visits at 3, 6, and 18 months after placement and unscheduled visits. Pelvic infection included any clinical diagnosis of pelvic inflammatory disease or endometritis. Most participants (n = 1364, 79.6%) did not have sexually transmitted infection test results available prior to intrauterine system placement. In all, 29 (1.7%) participants had positive baseline testing for a sexually transmitted infection (Chlamydia, n = 25; gonorrhea, n = 3; both, n = 1); 6 of these participants had known results (all with Chlamydia infection) prior to intrauterine system placement and received treatment before enrollment. The 23 participants whose results were not known at the time of intrauterine system placement received treatment without intrauterine system removal and none developed pelvic infection. The incidence of positive Chlamydia testing was

  15. 38 CFR 36.4706 - Forced placement of flood insurance.

    Science.gov (United States)

    2010-07-01

    ... (CONTINUED) LOAN GUARANTY Sale of Loans, Guarantee of Payment, and Flood Insurance § 36.4706 Forced placement... any time during the term of a designated loan that the building or mobile home and any...

  16. Critical Path-Based Thread Placement for NUMA Systems

    Energy Technology Data Exchange (ETDEWEB)

    Su, C Y; Li, D; Nikolopoulos, D S; Grove, M; Cameron, K; de Supinski, B R

    2011-11-01

    Multicore multiprocessors use a Non Uniform Memory Architecture (NUMA) to improve their scalability. However, NUMA introduces performance penalties due to remote memory accesses. Without efficiently managing data layout and thread mapping to cores, scientific applications, even if they are optimized for NUMA, may suffer performance loss. In this paper, we present algorithms and a runtime system that optimize the execution of OpenMP applications on NUMA architectures. By collecting information from hardware counters, the runtime system directs thread placement and reduces performance penalties by minimizing the critical path of OpenMP parallel regions. The runtime system uses a scalable algorithm that derives placement decisions with negligible overhead. We evaluate our algorithms and runtime system with four NPB applications implemented in OpenMP. On average the algorithms achieve between 8.13% and 25.68% performance improvement compared to the default Linux thread placement scheme. The algorithms miss the optimal thread placement in only 8.9% of the cases.

  17. Lumbar pedicle screw placement: Using only AP plane imaging

    Directory of Open Access Journals (Sweden)

    Anil Sethi

    2012-01-01

    Conclusion: Placement of pedicle screws under fluoroscopic guidance using AP plane imaging alone with tactile guidance is safe, fast, and reliable. However, a good understanding of the radiographic landmarks is a prerequisite.

  18. Rotation placements help students' understanding of intensive care.

    Science.gov (United States)

    Abbott, Lisa

    2011-07-01

    It is vital that children's nursing students are fit for practice when they qualify and are able to meet various essential skills as defined by the Nursing and Midwifery Council (NMC). To gain the knowledge and skills required, students need placements in areas where high dependency and potentially intensive care are delivered. Efforts to maximise the number of students experiencing intensive care as a placement have led to the development of the paediatric intensive care unit (PICU) rotation, increasing placements on the PICU from 5 to 40 per cent of the student cohort per year. The lecturer practitioner organises the rotation, providing credible links between university and practice areas, while supporting students and staff in offering a high-quality placement experience. Students say the rotation offers a positive insight into PICU nursing, helping them develop knowledge and skills in a technical area and creating an interest in this specialty.

  19. Heterocyst placement strategies to maximize growth of cyanobacterial filaments

    CERN Document Server

    Brown, Aidan I

    2012-01-01

    Under conditions of limited fixed-nitrogen, some filamentous cyanobacteria develop a regular pattern of heterocyst cells that fix nitrogen for the remaining vegetative cells. We examine three different heterocyst placement strategies by quantitatively modelling filament growth while varying both external fixed-nitrogen and leakage from the filament. We find that there is an optimum heterocyst frequency which maximizes the growth rate of the filament; the optimum frequency decreases as the external fixed-nitrogen concentration increases but increases as the leakage increases. In the presence of leakage, filaments implementing a local heterocyst placement strategy grow significantly faster than filaments implementing random heterocyst placement strategies. With no extracellular fixed-nitrogen, consistent with recent experimental studies of Anabaena sp. PCC 7120, the modelled heterocyst spacing distribution using our local heterocyst placement strategy is qualitatively similar to experimentally observed patterns...

  20. Cumulative risks of foster care placement for Danish children

    National Research Council Canada - National Science Library

    Fallesen, Peter; Emanuel, Natalia; Wildeman, Christopher

    2014-01-01

    Although recent research suggests that the cumulative risk of foster care placement is far higher for American children than originally suspected, little is known about the cumulative risk of foster...

  1. A Closer Look at an Advanced Placement Calculus Problem.

    Science.gov (United States)

    Rudd, David

    1985-01-01

    Answers and justifications for an interesting problem on the Advanced Placement Calculus AB Examination are discussed. The problem provides diverse ways in which students can gain appreciation and understanding for the subject. (MNS)

  2. Advanced in In Situ Inspection of Automated Fiber Placement Systems

    Science.gov (United States)

    Juarez, Peter D.; Cramer, K. Elliott; Seebo, Jeffrey P.

    2016-01-01

    Automated Fiber Placement (AFP) systems have been developed to help take advantage of the tailorability of composite structures in aerospace applications. AFP systems allow the repeatable placement of uncured, spool fed, preimpregnated carbon fiber tape (tows) onto substrates in desired thicknesses and orientations. This automated process can incur defects, such as overlapping tow lines, which can severely undermine the structural integrity of the part. Current defect detection and abatement methods are very labor intensive, and still mostly rely on human manual inspection. Proposed is a thermographic in situ inspection technique which monitors tow placement with an on board thermal camera using the preheated substrate as a through transmission heat source. An investigation of the concept is conducted, and preliminary laboratory results are presented. Also included will be a brief overview of other emerging technologies that tackle the same issue. Keywords: Automated Fiber Placement, Manufacturing defects, Thermography

  3. Complications of nasogastric tube placement--don't blow it.

    LENUS (Irish Health Repository)

    Leonard, S

    2012-04-01

    Preventable complications maybe associated with the placement of nasogastric tubes. Our report raises awareness of the potentially fatal complications that can occur. We also recommend an approach for clinicians which maybe used to avoid significant patient morbidity.

  4. Placement of trans-sternal wires according to an ellipsoid pressure vessel model of sternal forces.

    Science.gov (United States)

    Casha, Aaron R; Manché, Alex; Gauci, Marilyn; Camilleri-Podesta, Marie-Therese; Schembri-Wismayer, Pierre; Sant, Zdenka; Gatt, Ruben; Grima, Joseph N

    2012-03-01

    Dehiscence of median sternotomy wounds remains a clinical problem. Wall forces in thin-walled pressure vessels can be calculated by membrane stress theory. An ellipsoid pressure vessel model of sternal forces is presented together with its application for optimal wire placement in the sternum. Sternal forces were calculated by computational simulation using an ellipsoid chest wall model. Sternal forces were correlated with different sternal thicknesses and radio-density as measured by computerized tomography (CT) scans of the sternum. A comparison of alternative placement of trans-sternal wires located either at the levels of the costal cartilages or the intercostal spaces was made. The ellipsoid pressure vessel model shows that higher levels of stress are operative at increasing chest diameter (P cartilage levels when compared with adjacent intercostal spaces. This results in a decrease of average sternal stress from 438 kPa at the intercostal space level to 338 kPa at the costal cartilage level (P = 0.003). Biomechanical modelling suggests that placement of trans-sternal wires at the thicker bone and more radio-dense level of the costal cartilages will result in reduced stress.

  5. Stent placement for palliation of cor triatriatum dexter in a dog with suspected patent foramen ovale.

    Science.gov (United States)

    Barncord, Kristin; Stauthammer, Christopher; Moen, Sean L; Hanson, Melissa; Gruenstein, Daniel H

    2016-03-01

    An 11 month old spayed, female dog presented with exercise intolerance and cyanosis upon exertion. Echocardiography revealed an imperforate cor triatriatum dexter with mild tricuspid valve dysplasia, an underfilled right ventricle and significant right to left shunting across a presumptive patent foramen ovale. Balloon dilation of the abnormal atrial membrane was initially successful in creating a communication between the right atrial chambers, but stenosis of the original perforation and persistent clinical signs prompted a second intervention. A balloon expandable biliary stent was placed across the abnormal partition, improving caudal venous return to the right ventricle and reducing the right to left shunt. Three months after stent placement, resting oxygen saturation had normalized. Six months after stent placement, exercise tolerance had improved and exertional cyanosis had resolved. Long term follow up will be necessary to assess for remodeling of the right ventricle with improved venous return. Stent placement can be considered as a palliative treatment option for cor triatriatum dexter, especially for stenosis post-balloon dilation.

  6. ROUTINE PLACEMENT OF DRAIN IN THYROID SURGERY: IS THERE ANY SCIENTIFIC BASIS?

    Directory of Open Access Journals (Sweden)

    Srikanth

    2016-03-01

    Full Text Available OBJECTIVE To determine the efficacy of routine placement of drain after Thyroid surgery. To compare patients undergoing thyroid surgery without placement of suction drain versus patients undergoing surgery with placement of suction drain. METHODOLOGY This is a Single Surgeon’s Clinical study over a period of 8 years in 2 teaching hospitals; 112 patients undergoing thyroid surgeries for various diagnoses from July 2007 to August 2015 were studied retrospectively. Variables taken into account were duration of hospital stay, postoperative pain and postoperative complications. RESULTS The study included 112 patients undergoing thyroid surgeries being grouped into two groups. The length of the hospital stay was reduced in the no drain group. Mean duration of hospital stay was 5+/-1.78 days in drain group and 2+/-0.72 in no drain group. But no significant difference was found between the groups in the postoperative complications like haematoma and seroma formation. CONCLUSION Drains should be used only in selected cases of Thyroid surgeries. Drainless thyroidectomy causes less discomfort, short hospital stay and does not increase the risk of postoperative complications.

  7. SINUS FLOOR AUGMENTATION WITH BONE BLOCK GRAFTING AND SIMULTANEOUS IMPLANT PLACEMENT.

    Directory of Open Access Journals (Sweden)

    George S. Manev

    2013-07-01

    Full Text Available Placement of dental implants in the posterior maxillary edentulous areas is often compromised by the limited volume of bone due to the anatomy of the maxillary sinuses. In such cases, the technique of Sinus Lift is indicated to provide a sufficient volume of hard tissue in order to achieve primary stability at implant placement. Simultaneous augmentation of the sinus floor and implant placement is severely limited by the amount of residual bone of the floor of the sinus.A clinical case of minimal residual bone at the bottom of the sinus is demonstrated. A sinus floor augmentation with bone block harvested from the mandibular symphysis is performed. The bone block is placed in the sinus after membrane elevation and fixed with a screw to the sinus floor. After fixation of the bone block in the sinus implant (10/4.1 mm TSV (Zimmer is placed in reconstructed bone with good primary stability. Healing occurs without complications and the third month X-ray showed normal density of bone around the implant. The technique is very sensitive to surgeon’s skills.

  8. Massive Lingual and Sublingual Haematoma following Postextractive Flapless Implant Placement in the Anterior Mandible

    Directory of Open Access Journals (Sweden)

    Luisa Limongelli

    2015-01-01

    Full Text Available Dental implants placement in the anterior mandible with flap or flapless technique is a routine procedure and is considered to be safe. However, serious life-threatening complications may occur. We report the first case of massive lingual and sublingual haematoma following postextractive implant placement in the anterior mandible with flapless technique. A 45-year-old female patient underwent placement of four immediately postextractive implants in the anterior mandible using flapless technique. During the procedure, the patient referred intense acute pain and worsening sign of airway obstruction, dysphagia, dyspnea, and speech difficulties. Bimanual compression of the mouth floor, lingual surface of the mandible, and submental skin was maintained for approximately 25 minutes in order to stop the bleeding. Computerized tomography highlighted the massive lingual and sublingual haematoma. The symptoms and signs had almost completely resolved in the next 48 hours. The prevention of these complications is mandatory with clinical and CT analyses, in order to highlight mandibular atrophy and to select carefully the correct length and angulation of bone drilling and to keep more attention to the flapless technique considering the elevation of a lingual mucoperiosteal flap to access the mandibular contour intraoperatively and to protect the sublingual soft tissues and vasculature in high risk cases.

  9. Exploring Effectiveness of Computer-Aided Planning in Implant Positioning for a Single Immediate Implant Placement.

    Science.gov (United States)

    Edelmann, Alexander R; Hosseini, Bashir; Byrd, Warren C; Preisser, John S; Tyndall, Donald A; Nguyen, Tung; Bencharit, Sompop

    2016-06-01

    The value of computer-aided implant planning using cone-beam computerized tomography (CBCT) for single immediate implants was explored. Eighteen patients requiring extraction of a tooth followed by a single immediate implant were enrolled. Small volume preoperative CBCT scans were used to plan the position of the implant. A taper screwed-type implant was immediately placed into a fresh socket using only the final 1 or 2 drills for osteotomy. Postoperative CBCTs were used for the analysis of actual implant placement positioning. Measurements of the planned and the actual implant position were made with respect to their position relative to the adjacent teeth. Mesio-distal displacements and the facial-lingual deviation of the implant from the planned position were determined. Changes in the angulation of the planned and actual implant position in relation to the clinical crown were also measured. To statistically summarize the results, box plots and 95% CIs for means of paired differences were used. The analysis showed no statistical difference between the planned position and final implant placement position in any measurement. The CBCT scans coupled with the computer-aided implant planning program along with a final 1-to-2 drill protocol may improve the accuracy of single immediate implant placement for taper screwed-type implants.

  10. Platelet-Derived Growth Factor-Mediated Guided Bone Regeneration in Immediate Implant Placement in Molar Sites with Buccal Bone Defects.

    Science.gov (United States)

    Santana, Ronaldo B; Santana, Carolina Mm; Dibart, Serge

    2015-01-01

    This study compared the clinical outcomes of recombinant human platelet-derived growth factor BB and beta-tricalcium phosphate (rhPDGF-BB/βTCP) with guided bone regeneration (GBR) in immediate implant placement in molar extraction sockets with buccal bone defects versus conventional implant placement. Twenty-eight implants were placed in fourteen patients. Clinical and radiographic evaluations assessed peri-implant soft and hard tissue parameters after 12 months. No implants were lost during the 1-year observation period, yielding a survival rate of 100%. Similar clinical and radiographic parameters were observed for both treatment groups. Use of rhPDGF-BB/βTCP and GBR in immediate implants in molars was as successful as conventional implant placement in fully healed extraction sites.

  11. Student nurses' experiences of community-based practice placement learning: a qualitative exploration.

    Science.gov (United States)

    Baglin, M R; Rugg, Sue

    2010-05-01

    United Kingdom (UK) health policy has adopted an increasing community and primary care focus over recent years (Department of Health, 1997; Department of Health, 1999. Making a Difference: Strengthening the Nursing, Midwifery and Health Visitor Contribution to Health and Health Care. Department of Health, London; Department of Health, 2004. The NHS Knowledge and Skills Framework (NHS KSF). Department of Health, London). Nursing practice, education and workforce planning are called upon to adapt accordingly (Department of Health, 2004. The NHS Knowledge and Skills Framework (NHS KSF). Department of Health, London; Kenyon, V., Smith, E., Hefty, L., Bell, M., Martaus, T., 1990. Clinical competencies for community health nursing. Public Health Nursing 7(1), 33-39; United Kingdom Central Council for Nursing, Midwifery and Health Visiting, 1986. Project 2000: A New Preparation for Practice. UKCC, London). Such changes have major implications for pre-registration nursing education, including its practice placement element. From an educational perspective, the need for increased community nursing capacity must be balanced with adequate support for student nurses' learning needs during community-based placements. This qualitative study explored six second year student nurses' experiences of 12 week community-based practice placements and the extent to which these placements were seen to meet their perceived learning needs. The data came from contemporaneous reflective diaries, completed by participants to reflect their 'lived experience' during their practice placements (Landeen, J., Byrne, Brown, B., 1995. Exploring the lived experiences of psychiatric nursing students through self-reflective journals. Journal of Advanced Nursing 21(5), 878-885; Kok, J., Chabeli, M.M., 2002. Reflective journal writing: how it promotes reflective thinking in clinical nursing education: a students' perspective. Curationis 25(3), 35-42; Löfmark, A., Wikblad, K., 2001. Facilitating and

  12. 术前计划在脊柱微创手术机器人椎弓根螺钉置入操作中的价值探讨%Clinical value of preoperative plan in spinal minimal invasive robot system assisted drilling for pedicle screw placement on cattle lumbar spine

    Institute of Scientific and Technical Information of China (English)

    王洪伟; 张鹤; 李长青; 赵忆文; 韩建达; 周跃

    2013-01-01

    [Objective] To evaluate and investigate the clinical value of the drilling for pedicle screw placement on cattle lumbar spine through preoperative plan by using spinal minimal invasive robot system, summarize the experience, optimize the design of the system. [ Methods] Sixteen cattle lumbar spines were randomly divided into two groups. Preoperative computed to-mographic ( CT) scan of 8 lumbar spines in experimental group (EG) in axial plane were captured for each vertebra from the CT film, the surgeon planed the entry point and trajectory of the screws. Intraoperative fluoroscopic X - rays was used to locate the relative position of the robotic arm and the speciman. On the basis of preoperative CT scan and introoperative fluoroscopic data, we aligned the robot to the desired entry point and trajectory, as dictated by the surgeons preoperative plan. The other 8 cattle lumbar spines in contral group (CG) were drilled the pedicle hole in operation under the guidance of introperative C - arm fluo-roscopy. Sixteen cattle lumbar spines were inserted 160 K -wires by using the spinal minimal invasive robot system. The time for system registration and pedicle drilling, fluoroscopic times and the radiation exposure time were measured and recorded. Postoperative CT scans were used to assess the position of the K - wires. [ Results] Assisted by spinal minimal invasive robot system, the average time for system registration was (351. 7 ±24. 9) s, the time for procedure of drilling one K - wire in EG and CG was respectively (89. 5 ± 6. 1) s and (447. 5 ± 90. 7) s , fluoroscopic for the procesure was respectively (2. 9 ±0. 8) times and ( 11. 5 ± 3. 8) times, the radiation exposure time was respectively (2. 9 ± 1.0) s and (11.1 ±3.2) s , there were significant difference between the two groups (P =0.000, t = - 11. 143; P =0. 000, t= -6. 243; P =0.000, t = -7.002) . Overall, only twelve (15. 0% ) of the 80 screws in EG violated the pedicle wall. Four screws (5.0% ) were

  13. Speeding Up FPGA Placement via Partitioning and Multithreading

    Directory of Open Access Journals (Sweden)

    Cristinel Ababei

    2009-01-01

    placement subproblems are created by partitioning and then processed concurrently by multiple worker threads that are run on multiple cores of the same processor. Our main goal is to investigate the speedup that can be achieved with this simple approach compared to previous approaches that were based on distributed computing. The new hybrid parallel placement algorithm achieves an average speedup of 2.5× using four worker threads, while the total wire length and circuit delay after routing are minimally degraded.

  14. On Design of Automatic Choosing Control by Pole Placement

    OpenAIRE

    高田, 等; 提, 祐樹; 八野, 知博; TAKATA, Hitoshi; Sage, Yuki; HACHINO, Tomohiro

    2009-01-01

    This paper is concerned with design of an augmented automatic choosing control (AACC) for nonlinear systems. The AACC is synthesized by smoothly uniting a set of sectionwise linear controls, in which pole placement approach is used. An observer theory is applied to it in a case that the state vector includes some unmeasurable variables directly. Control and observer's gains are obtained by the pole placement method.

  15. Long term results of endovascular treatment in renal arterial stenosis from Takayasu arteritis: Angioplasty versus stent placement

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hong Suk, E-mail: hongsukpark@gmail.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Do, Young Soo, E-mail: ysdo@skku.edu [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Park, Kwang Bo, E-mail: kbjh.park@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Kim, Duk-Kyung, E-mail: dukkyung.kim@samsung.com [Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Choo, Sung Wook, E-mail: sw.choo@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Shin, Sung Wook, E-mail: sw88.shin@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Cho, Sung Ki, E-mail: sungkismc@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Hyun, Dongho, E-mail: mesentery.hyun@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Choo, In Wook, E-mail: inwook.choo@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of)

    2013-11-01

    Purpose: To retrospectively evaluate and compare the long term patency and antihypertensive effect of angioplasty and stent insertion in renal artery stenosis caused by Takayasu arteritis, with CT angiography and clinical follow-up. Materials and methods: We retrospectively analyzed and compared effects on hypertension and patency of renal artery in 16 patients (age ranging from 16 to 58 years, mean: 32.1 years) with renovascular hypertension caused by Takayasu arteritis who underwent endovascular treatment including angioplasty (n = 13) and stent placement (n = 9) for 22 stenotic renal arteries. Results: Technical success was 95% (21/22) without major complications. In the last follow-up CT angiogram (mean 85 ± 41 months), restenosis was 8% (1/12) in angioplasty and 66% (6/9) in stent. Patency rates of angioplasty were 100%, 91.7%, 91.7% and primary unassisted and primary assisted patency rates of stent placement were 55.6%, 33.3%, 33.3% and 88.9%, 66.7%, 55.6% at 1-, 3- and 5-years, respectively. In clinical follow-up (mean 120 ± 37.8 months, range 48–183 months), beneficial effects on hypertension were obtained in 87% of patients (13/15) and there was no significant difference between the patients who were treated by only angioplasty and the patients who received stent placement in at least one renal artery, regardless of whether or not angioplasty had been performed in the other renal artery. Conclusion: Compared with stent placement, angioplasty demonstrated better long term patency and similar clinical benefit on renovascular hypertension in renal artery stenosis of Takayasu arteritis. We suggest that stent placement should be reserved for obvious angioplasty failure.

  16. A Sea-of-Gates Style FPGA Placement Algorithm

    Directory of Open Access Journals (Sweden)

    Kalapi Roy

    1996-01-01

    Full Text Available Field Programmable Gate Arrays (FPGAs have a pre-defined chip boundary with fixed cell locations and routing resources. Placement objectives for flexible architectures (e.g., the standard cell design style such as minimization of chip area do not reflect the primary placement goals for FPGAs. For FPGAs, the layout tools must seek 100% routability within the architectural constraints. Routability and congestion estimates must be made directly based on the demand and availability of routing resources for detailed routing of the particular FPGA. We. present a hierarchical placement approach consisting of two phases: a global placement phase followed by a detailed placement phase. The global placement phase minimizes congestion estimates of the global routing regions and satisfies all constraints at a coarser level. The detailed placer seeks to maximize the routability of the FPGA by considering factors which cause congestion at the detailed routing level and to precisely satisfy all of the constraints. Despite having limited knowledge about the gate level architectural details, we have achieved a 90%reduction in the number of unrouted nets in comparison to an industrial tool (the only other tool developed specifically for this architecture.

  17. Correction of placement error in EBL using model based method

    Science.gov (United States)

    Babin, Sergey; Borisov, Sergey; Militsin, Vladimir; Komagata, Tadashi; Wakatsuki, Tetsuro

    2016-10-01

    The main source of placement error in maskmaking using electron beam is charging. DISPLACE software provides a method to correct placement errors for any layout, based on a physical model. The charge of a photomask and multiple discharge mechanisms are simulated to find the charge distribution over the mask. The beam deflection is calculated for each location on the mask, creating data for the placement correction. The software considers the mask layout, EBL system setup, resist, and writing order, as well as other factors such as fogging and proximity effects correction. The output of the software is the data for placement correction. Unknown physical parameters such as fogging can be found from calibration experiments. A test layout on a single calibration mask was used to calibrate physical parameters used in the correction model. The extracted model parameters were used to verify the correction. As an ultimate test for the correction, a sophisticated layout was used for verification that was very different from the calibration mask. The placement correction results were predicted by DISPLACE, and the mask was fabricated and measured. A good correlation of the measured and predicted values of the correction all over the mask with the complex pattern confirmed the high accuracy of the charging placement error correction.

  18. Placement of students to high schools in Turkey: Factors affecting student achievement in placement tests

    Directory of Open Access Journals (Sweden)

    Hasan Basri Gündüz

    2010-04-01

    Full Text Available The objective of the research is to identify factors that affect the degree the most successful and the most unsuccessful ten students get at their class levels and in their dwelling units in "Level Determination Examination" which is a form of placement test held at provincial levels in allocation of students from elementary to secondary education. The research was conducted in Sakarya Province. The sample of the research comprised of 420 6th, 7th and 8th grade students in total who ranked among the first and the last 10 groups in dwelling units in the examination held at provincial level. It was ascertained that 82% (Nagelkerke R2 = 0.82 of student's ranking among the first most successful or the last most unsuccessful group of ten people in their own dwelling unit and at their own class level in the Placement Test could be predicted by TE, PA, BÇG, BY, SİD and Ç factors according to Stepwise logistic regression analysis. AKD, AİFK and AO are the variables which were not found to be meaningful in the last regression equation.

  19. Placement of students to high schools in Turkey: Factors affecting student achievement in placement tests

    Directory of Open Access Journals (Sweden)

    Hasan Basri Gündüz

    2010-04-01

    Full Text Available The objective of the research is to identify factors that affect the degree the most successful and the most unsuccessful ten students get at their class levels and in their dwelling units in "Level Determination Examination" which is a form of placement test held at provincial levels in allocation of students from elementary to secondary education.   The research was conducted in Sakarya Province.  The sample of the research comprised of 420 6th, 7th and 8th grade students in total who ranked among the first and the last 10 groups in dwelling units in the examination held at provincial level.  It was ascertained that 82% (Nagelkerke R2 = 0.82 of student's ranking among the first most successful or the last most unsuccessful group of ten people in their own dwelling unit and at their own class level in the Placement Test could be predicted by TE, PA, BÇG, BY, SİD and Ç factors according to Stepwise logistic regression analysis.  AKD, AİFK and AO are the variables which were not found to be meaningful in the last regression equation. 

  20. Mixing advertising and editorial content in radio programmes: appreciation and recall of brand placements versus commercials

    NARCIS (Netherlands)

    van Reijmersdal, E.A.

    2011-01-01

    Although the literature on brand placement is rapidly evolving, no studies thus far have focused on radio brand placement or on the effects of the combination of brand placement and commercials. Therefore, the present experiment (N = 153) focused on the effects of radio brand placement on liking, cr

  1. What Are Clinical Trial Phases?

    Medline Plus

    Full Text Available ... Cancers Metastatic Cancer Recurrent Cancer Research NCI’s Role in Cancer Research Intramural Research Extramural Research Bioinformatics and ... Annual Report to the Nation Cancer Snapshots Milestones in Cancer Research and Discovery Stories of Discovery R& ...

  2. Effect of immersive workplace experience on undergraduate nurses' mental health clinical confidence.

    Science.gov (United States)

    Patterson, Christopher; Moxham, Lorna; Taylor, Ellie K; Perlman, Dana; Brighton, Renee; Sumskis, Susan; Heffernan, Tim; Lee-Bates, Benjamin

    2017-02-03

    Preregistration education needs to ensure that student nurses are properly trained with the required skills and knowledge, and have the confidence to work with people who have a mental illness. With increased attention on non-traditional mental health clinical placements, further research is required to determine the effects of non-traditional mental health clinical placements on mental health clinical confidence. The aim of the present study was to investigate the impact of a non-traditional mental health clinical placement on mental health nursing clinical confidence compared to nursing students undergoing traditional clinical placements. Using the Mental Health Nursing Clinical Confidence Scale, the study investigated the relative effects of two placement programmes on the mental health clinical confidence of 79 nursing students. The two placement programmes included a non-traditional clinical placement of Recovery Camp and a comparison group that attended traditional clinical placements. Overall, the results indicated that, for both groups, mental health placement had a significant effect on improving mean mental health clinical confidence, both immediately upon conclusion of placement and at the 3-month follow up. Students who attended Recovery Camp reported a significant positive difference, compared to the comparison group, for ratings related to communicating effectively with clients with a mental illness, having a basic knowledge of antipsychotic medications and their side-effects, and providing client education regarding the effects and side-effects of medications. The findings suggest that a unique clinical placement, such as Recovery Camp, can improve and maintain facets of mental health clinical confidence for students of nursing. © 2017 Australian College of Mental Health Nurses Inc.

  3. Rural placements in Tasmania: do experiential placements and background influence undergraduate health science student's attitudes toward rural practice?

    Science.gov (United States)

    Dalton, Lisa M; Routley, Georgina K; Peek, Karla J

    2008-01-01

    Each year growing numbers of undergraduate health science students, from a variety of disciplines, participate in a University of Tasmania Department of Rural Health supported rural placement program in Tasmania. This study aimed to investigate the influence rural placement and rural background had on students' intentions to live and work in a rural or remote location after graduation. Between January 2005 and December 2006, 336 students participated in the placement program. Students were requested to complete a survey at the completion of their placement. A response rate of 239 was achieved (71%). The survey measured students' stated rural career intentions and rural background status according to location of primary and secondary school attendance. A demographic analysis of respondents was undertaken and results cross tabulated according to the rural, remote and metropolitan area (RRMA) classification system. Statistical analyses, including paired t-tests and a Wilcoxon signed rank test, were conducted to compare reported mean intention to practise rurally both prior to and after placement. The results from this survey show that rural placements in the undergraduate health science programs have a predominantly positive influence on students' intention to work in a rural community post-graduation. While these findings were significant for the disciplines of nursing, medicine and allied health, the results were not significant for pharmacy students. Students' average intention to practise rurally significantly increased after the placement for students from RRMA classifications 1 and 3-5. The value of rural placements as a method for increasing health science students' intentionality to take up rural practice as a positive and viable career option is considerable.

  4. Hypervideo meets product placement: a study of product placement and its recall and recognition effects in interactive digital music video

    OpenAIRE

    Jaramillo, Artemisa

    2016-01-01

    The emergence of new digital video technologies, combined with the increasing ubiquity of Internet access, is challenging classical video-based marketing practices. As technological evolution has enabled the World Wide Web to improve its infrastructure, more sophisticated forms of digital video have emerged. Digital videos have the potential to add new dimensions of interactivity to product placements embedded within them. This thesis investigates how product placement effectiveness might be ...

  5. Navigated placement of iliac bolts: description of a new technique.

    Science.gov (United States)

    Garrido, Ben J; Wood, Ken E

    2011-04-01

    Image navigation has improved the safety and ability to perform complex spinal procedures where visibility is not optimal or anatomic deformity is present. Numerous published studies are available demonstrating its effectiveness in improved pedicle screw placement in complex multiplanar deformities. Studies have also demonstrated image navigation technology versatility; however, stabilization of the lumbopelvic junction with navigated iliac bolt fixation has not been reported. To describe an innovative versatile application of image navigation technology in spine surgery. We examine the safety, accuracy, and effectiveness of navigated iliac bolt placement while minimizing challenges associated with current techniques. Case series. Five patients requiring lumbopelvic fixation for multiple indications, including lumbosacral pseudoarthrosis, complex sacral fracture patterns, compromised revision sacral fixation, and as an adjunct to degenerative deformity with multilevel fusion, underwent navigated iliac bolt placement. Accurate placement was verified using intraoperative computed tomography (CT) imaging using O-ARM (Medtronic, Inc.) after placement. Five patients requiring lumbopelvic fixation have undergone navigated iliac bolt placement using Medtronic Stealth Station Treon in conjunction with the O-ARM (Medtronic, Inc.). A right percutaneous posterior superior iliac spine (PSIS) reference frame was placed at the superior lateral margin of the PSIS, and bilateral iliac bolts were placed via navigation using both the anatomic and traditional surgical techniques. Both techniques were performed without direct notch palpation and minimal soft-tissue exposure. Postplacement intraoperative CT imaging was obtained to confirm position and trajectory of the bolts using O-ARM (Medtronic, Inc.). Ten iliac bolts were successfully placed in five patients. Intraoperative CT demonstrated ideal iliac screw bone placement projecting within 2 cm over sciatic notch, between pelvic

  6. Laryngeal mask placement in a teaching institution: analysis of difficult placements [version 1; referees: 2 approved, 1 approved with reservations

    Directory of Open Access Journals (Sweden)

    Anastasia D Katsiampoura

    2015-04-01

    Full Text Available Background: Laryngeal mask airway (LMA placement is now considered a common airway management practice. Although there are many studies which focus on various airway techniques, research regarding difficult LMA placement is limited, particularly for anesthesiologist trainees. In our retrospective analysis we tried to identify predictive factors of difficult LMA placement in an academic training program. Methods: This retrospective analysis was derived from a research airway database, where data were collected prospectively at the Memorial Hermann Hospital, Texas Medical Center, Houston, TX, USA, from 2008 to 2010. All non-obstetric adult patients presenting for elective surgery requiring general anesthesia, were enrolled in this study: anesthesiology residents primarily managed the airways. The level of difficulty, number of attempts, and type of the extraglottic device placement were retrieved. Results: Sixty-nine unique Laryngeal Mask Airways (uLMAs were utilized as a primary airway device. Two independent predictors for difficult LMA placement were identified: gender and neck circumference. The sensitivity for one factor is 87.5% with a specificity of 50%. However with two risk factors, the specificity increases to the level of 93% and the sensitivity is 63%. Conclusion: In a large academic training program, besides uLMA not been used routinely, two risk factors for LMA difficulty were identified, female gender and large neck circumference. Neck circumference is increasingly being recognized as a significant predictor across the spectrum of airway management difficulties while female gender has not been previously reported as a risk factor for difficult LMA placement.

  7. Electromagnetic-Guided Bedside Placement of Nasoenteral Feeding Tubes by Nurses Is Non-Inferior to Endoscopic Placement by Gastroenterologists: A Multicenter Randomized Controlled Trial

    NARCIS (Netherlands)

    Gerritsen, A.; Rooij, T. de; Dijkgraaf, M.G.; Busch, O.R.; Bergman, J.J.; Ubbink, D.T.; Duijvendijk, P. van; Erkelens, G.W.; Klos, M.; Kruyt, P.M.; Bac, D.J.; Rosman, C.; Tan, A.C.; Molenaar, I.Q.; Monkelbaan, J.F.; Mathus-Vliegent, E.M.; Besselink, M.G.

    2016-01-01

    OBJECTIVES: Electromagnetic (EM)-guided bedside placement of nasoenteral feeding tubes by nurses may improve efficiency and reduce patient discomfort and costs compared with endoscopic placement by gastroenterologists. However, evidence supporting this task shift from gastroenterologists to nurses i

  8. Placement of a peripherally inserted central catheter into the azygous vein

    Energy Technology Data Exchange (ETDEWEB)

    Franklin, Iain, E-mail: iain.franklin@health.qld.gov.au; Gilmore, Christopher [The Prince Charles Hospital, Brisbane, Queensland (Australia)

    2015-06-15

    Peripherally inserted central catheters (PICC) are used for a variety of infusion therapies. They are indicated in patients requiring long-term venous access. Incorrect positioning of the insertion of a PICC line is one of the known complications when inserting the device in clinical practice. Radiographers once performing imaging will commonly check if the tip of a PICC has entered the superior vena cava. This case study will report on a lesser known incorrect placement of a PICC line into the azygous vein and how this can be detected on radiographic imaging. This outcome for the patient can be detrimental as it has an increased risk of perforation, thrombus, and fistula formation.

  9. Dry Ribbon for Heated Head Automated Fiber Placement

    Science.gov (United States)

    Hulcher, A. Bruce; Marchello, Joseph M.; Hinkley, Jeffrey A.; Johnston, Norman J.; Lamontia, Mark A.

    2000-01-01

    Ply-by-ply in situ processes involving automated heated head deposition are being developed for fabrication of high performance, high temperature composite structures from low volatile content polymer matrices. This technology requires (1) dry carbon fiber towpreg, (2) consolidation of towpreg to quality, placement-grade unidirectional ribbon or tape, and (3) rapid, in situ, accurate, ply-by-ply robotic placement and consolidation of this material to fabricate a composite structure. In this study, the physical properties of a candidate thermoplastic ribbon, PIXA/IM7, were evaluated and screened for suitability in robotic placement. Specifically, towpreg was prepared from PIXA powder. Various conditions (temperatures) were used to convert the powder-coated towpreg to ribbons with varying degrees of processability. Ribbon within preset specifications was fabricated at 3 temperatures: 390, 400 and 410 C. Ribbon was also produced out-of-spec by purposely overheating the material to a processing temperature of 450 C. Automated placement equipment at Cincinnati Milacron and NASA Langley was used to fabricate laminates from these experimental ribbons. Ribbons were placed at 405 and 450 C by both sets of equipment. Double cantilever beam and wedge peel tests were used to determine the quality of the laminates and, especially, the interlaminar bond formed during the placement process. Ribbon made under conditions expected to be non-optimal (overheated) resulted in poor placeability and composites with weak interlaminar bond strengths, regardless of placement conditions. Ribbon made under conditions expected to be ideal showed good processability and produced well-consolidated laminates. Results were consistent from machine to machine and demonstrated the importance of ribbon quality in heated-head placement of dry material forms. Preliminary screening criteria for the development and evaluation of ribbon from new matrix materials were validated.

  10. Implant placement in the atrophic posterior maxilla with sinus elevation without bone grafting: a 2-year prospective study.

    Science.gov (United States)

    Rajkumar, Garudanahally Chikkalingaiah; Aher, Vinit; Ramaiya, Shashikala; Manjunath, Gavi Siddhaiah; Kumar, Devaraj Veerendra

    2013-01-01

    The purpose of this study was to evaluate changes in alveolar bone height after direct sinus elevation and simultaneous implant placement in the posterior edentulous maxilla. A prospective clinical study was conducted of patients undergoing sinus elevation for implant placement in the posterior maxilla to replace missing teeth. Residual alveolar bone height was between 4 and 7.5 mm. Lateral osteotomy of the maxillary sinus, followed by simultaneous implant placement without bone grafting, was performed under local anesthesia. Prosthetic restoration was completed 9 months later. The changes in alveolar bone height at the sinus floor were assessed radiographically after 1 week and 6, 9, 18, and 28 months after implant placement. Probing depths, implant mobility, and crestal bone loss were assessed at the same intervals. Twenty-eight patients (17 women and 11 men) participated in the study. Forty-five implants were placed and followed after prosthetic rehabilitation. At 18 months after loading of the implants, alveolar bone height in the area of sinus elevation ranged from 7.40 to 11.55 mm. Increases in alveolar bone height at the sinus floor ranged from 2.05 to 5.40 mm at a minimum of 18 months after loading, a statistically significant gain. Crestal bone loss and changes in probing depths were not significant in any patients, and all implants remained clinically stable. The implant success rate was 100% without any complications after 18 to 28 months of follow-up. Placement of endosseous implants in the atrophic posterior maxilla in conjunction with sinus elevation without bone grafting resulted in a significant amount of bone formation around the implants at the sinus floor, resulting in successful restorations and eliminating the need for bone grafting.

  11. Effect of epilepsy magnetic source imaging on intracranial electrode placement

    Science.gov (United States)

    Knowlton, Robert C.; Razdan, Shantanu N.; Limdi, Nita; Elgavish, Rotem A.; Killen, Jeff; Blount, Jeffrey; Burneo, Jorge G.; Ver Hoef, Lawrence; Paige, Lebron; Faught, Edward; Kankirawatana, Pongkiat; Bartolucci, Al; Riley, Kristen; Kuzniecky, Ruben

    2009-01-01

    Objective Intracranial electroencephalography (ICEEG) with chronically implanted electrodes is a costly invasive diagnostic procedure that remains necessary for a large proportion of patients who undergo evaluation for epilepsy surgery. This study was designed to evaluate whether magnetic source imaging (MSI), a non-invasive test based on magnetoencephalography source localization, can supplement ICEEG by affecting electrode placement to improve sampling of the seizure onset zone(s). Methods Of 298 consecutive epilepsy surgery candidates (between 2001-2006) 160 cases were prospectively enrolled on the basis of insufficient localization from seizure monitoring and MRI results. Prior to presenting MSI results, decisions were made as to whether to proceed with ICEEG, and if so, where to place electrodes such that the hypothetical seizure onset zone would be sampled. MSI results were then provided with allowance of changes to the original plan. Results MSI indicated additional electrode coverage in 18 of 77 (23%) ICEEG cases. In 39% percent (95% CI: 16.4, 61.4) seizure onset ICEEG patterns involved the additional electrodes indicated by MSI. Sixty-two patients underwent surgical resection based on ICEEG recording of seizures. Highly localized MSI was significantly associated with seizure-free outcome (mean=3.4 years, minimum > 1 year) for the entire surgical population (n=62). Interpretation MSI spike localization increases the chance that the seizure onset zone is sampled when patients undergo ICEEG for presurgical epilepsy evaluations. The clinical impact of this effect–-improving diagnostic yield of ICEEG–-should be considered in surgery candidates that do not have satisfactory indication of epilepsy localization from seizure semiology, EEG, and MRI. PMID:19557860

  12. The role of intraoperative micro-Doppler ultrasound in verifying proper clip placement in intracranial aneurysm surgery.

    Science.gov (United States)

    Siasios, Ioannis; Kapsalaki, Eftychia Z; Fountas, Kostas N

    2012-10-01

    Aneurysmal subarachnoid hemorrhage constitutes a clinical entity associated with high mortality and morbidity. It is widely accepted that improper clip placement may have as a result of incomplete aneurysm occlusion and/or partial or complete obstruction of an adjacent vessel. Various modalities, including intraoperative or postoperative digital subtracting angiography, near-infrared indocyanine green angiography, micro-Doppler ultrasonography (MDU), and neurophysiological studies, have been utilized for verifying proper clip placement. The aim of our study was to review the role of MDU during aneurysmal surgery. A literature search was performed using any possible combination of the following terms: "aneurysm," "brain," "cerebral," "clip," "clipping," "clip malpositioning," "clip repositioning," "clip suboptimal positioning," "Doppler," "intracranial," "microsurgery," "micro-Doppler," "residual neck," "ultrasonography," "ultrasound," and "vessel occlusion". Additionally, reference lists from the retrieved articles were reviewed for identifying any additional articles. Case reports and miniseries were excluded. A total of 19 series employing intraoperative MDU during aneurysmal microsurgery were retrieved. All studies demonstrated that MDU accuracy is extremely high. The highest reported false-positive rate of MDU was 2 %, while the false-negative rate was reported as high as 1.6 %. It has been demonstrated that the presence of subarachnoid hemorrhage, specific anatomic locations, and large size may predispose to improper clip placement. Intraoperative MDU's technical limitations and weaknesses are adequately identified, in order to minimize the possibility of any misinterpretations. Intraoperative MDU constitutes a safe, accurate, and low cost imaging modality for evaluating blood flow and for verifying proper clip placement during microsurgical clipping.

  13. Use of spinous processes to determine the optimal trajectory for placement of lateral mass screws: technical note.

    Science.gov (United States)

    Stevens, Qualls E; Majd, Mohammad E; Kattner, Keith A; Jones, Cynthia L; Holt, Richard T

    2009-07-01

    Retrospective chart analysis. In the current report, we present a new technique for the placement of lateral mass screws from C3 to C7. The safety, complications, and long-term clinical and imaging follow-up were analyzed. To address potential risk factors for this technique, relevant literature was reviewed and discussed herein. Multiple techniques have been reported to place lateral mass screws in the subaxial cervical spine. The trajectory used aims to avoid the vertebral artery and the exiting nerve root. Because of inherent differences in determining the screw trajectory for placement, there can be considerable differences among surgeons. A retrospective analysis of our experience over the period from 2003 to 2006 was undertaken. Standard practices for obtaining institutional review board approval were followed. Radiographs, hospital records, and office charts of 34 patients were reviewed. There was an equal distribution between males and females and the mean age was 56.3 years. Pain was the most frequent presentation. The indications for posterior instrumentation included instability secondary to pseudoarthrosis, infection, spondylosis, osseous metastasis, trauma, and iatrogenic etiologies. The follow-up period ranged from 1 to 30 months (average 9.1 mo). Postoperative complications included wound infection (3 cases), malpositioned screw (1 case), cerebrospinal fluid leak (1 case), and dislodged rod (1 case). There were no mortalities directly related to the procedure. This technique for placement of lateral mass screws yielded adequate fixation without any appreciable neurovascular complications. It provides a useful alternative for screw placement in patients with intact spinous processes.

  14. Building organizational capacity for effective mentorship of pre-registration nursing students during placement learning: Finnish and British mentors' conceptions.

    Science.gov (United States)

    Jokelainen, Merja; Jamookeeah, David; Tossavainen, Kerttu; Turunen, Hannele

    2011-10-01

    Health-care organizations have a key role in improving the quality of student mentorship in placements. This study presents the findings of Finnish and British mentors' conceptions of how to build organizational capacity for the provision of effective mentorship for pre-registration nursing students during placement learning. The data obtained from nine semistructured focus group interviews were analyzed using a phenomenographic approach. Three categories of description are presented. Organizations were mainly perceived as optimizers of investments in developing clear strategies for the provision of sufficient resources and professional support for mentors. The creation of a positive mentorship culture within a development-oriented, student-centred and goal-directive atmosphere was seen as essential. Furthermore, providing well-prepared placements for clinical practice of students was emerged as crucial, which included adequate working conditions and stakeholders as well as arrangements of learning opportunities. It is concluded that effective student mentorship requires health-care organizations to invest in financial and human resources in order to promote the quality of the placement learning environments. Such provision will enhance students' recruitment, retention and effectiveness, leading to safe practice and cost-benefits for health-care organizations in the longer term. © 2011 Blackwell Publishing Asia Pty Ltd.

  15. Association between symptom burden and time to hospitalization, nursing home placement, and death among the chronically ill urban homebound

    Science.gov (United States)

    Yang, Nancy; Ornstein, Katherine; Reckrey, Jennifer M.

    2017-01-01

    CONTEXT Homebound adults experience significant symptom burden. OBJECTIVES (1) To examine demographic and clinical characteristics associated with high symptom burden in the homebound, and (2) to examine associations between symptom burden and time to hospitalization, nursing home placement, and death. METHODS 318 patients newly enrolled in the Mount Sinai Visiting Doctors Program, an urban home-based primary care program, were studied. Patient sociodemographic characteristics, symptom burden (measured via the Edmonton Symptom Assessment Scale, ESAS), and incidents of hospitalization, nursing home placement, and death were collected via medical chart review. Multivariate Cox proportional hazards models were used to analyze the effect of high symptom burden on time to first hospitalization, nursing home placement, and death. RESULTS 43% of the study sample had severe symptom burden (i.e. ESAS score ≥6 on at least one symptom). Patients with severe symptom burden were younger (82.0 vs 85.5 yrs, pnursing home placement or death. CONCLUSION The homebound with severe symptom burden represent a unique patient cohort who are at increased risk of hospitalization. Tailored symptom management via home-based primary and palliative care programs may prevent unnecessary healthcare utilization in this population. PMID:27033155

  16. Delayed ischemic cecal perforation despite optimal decompression after placement of a self-expanding metal stent: report of a case

    DEFF Research Database (Denmark)

    Knop, Filip Krag; Pilsgaard, Bo; Meisner, Søren

    2004-01-01

    Endoscopic deployment of self-expanding metal stents offers an alternative to surgical intervention in rectocolonic obstructions. Reported clinical failures in the literature are all related to the site of stent placement. We report a case of serious intra-abdominal disease after technically...... and clinically successful stent deployment: a potentially dangerous situation of which the surgeon should be aware. A previously healthy 72-year-old female was referred to our department with symptoms of an obstructing colorectal tumor. Successful stent placement resulted in resolution of the obstructive......, probably caused by ischemic conditions developed before stent-decompression of the colon was revealed during the operation. The patient died in the postoperative course. We discuss the observation of patients treated with self-expanding metal stents based on the selection-strategy used to allocate patients...

  17. Cumulative risks of foster care placement for Danish children.

    Science.gov (United States)

    Fallesen, Peter; Emanuel, Natalia; Wildeman, Christopher

    2014-01-01

    Although recent research suggests that the cumulative risk of foster care placement is far higher for American children than originally suspected, little is known about the cumulative risk of foster care placement in other countries, which makes it difficult to gauge the degree to which factor foster care placement is salient in other contexts. In this article, we provide companion estimates to those provided in recent work on the US by using Danish registry data and synthetic cohort life tables to show how high and unequally distributed the cumulative risk of foster care placement is for Danish children. Results suggest that at the beginning of the study period (in 1998) the cumulative risk of foster care placement for Danish children was roughly in line with the risk for American children. Yet, by the end of the study period (2010), the risk had declined to half the risk for American children. Our results also show some variations by parental ethnicity and sex, but these differences are small. Indeed, they appear quite muted relative to racial/ethnic differences in these risks in the United States. Last, though cumulative risks are similar between Danish and American children (especially at the beginning of the study period), the age-specific risk profiles are markedly different, with higher risks for older Danish children than for older American children.

  18. Frequency of Stent Placement after Ureteroscopic Lithotripsy in a University and a State Hospital

    Directory of Open Access Journals (Sweden)

    Huseyin Celik

    2016-03-01

    Full Text Available Objective: The aim of this study was to compare frequen­cy of ureteral stent placement after ureteroscopic litho­tripsy in a university and a state hospital of two different cities, which are endemic in terms of stone and often ure­terolithotripsy was performed for urolithiasis treatment. Methods: The patients who applied in to urology clinic of Inonu University Turgut Ozal Medical Center (TOMC and urology clinic of Osmaniye State Hospital (OSH between January 2014 and May 2014 were evaluated retrospec­tively. The patients who underwent ureteroscopic lithotrip­sy due to ureteral stone, were evaluated stone locations, stone sizes, grades of pelvicaliectasia and ureteral stent placement status. Results: About 92 patients were enrolled into the study from the both hospital. After the endoscopic ureteral stone treatment, Double J stent was placed in 85 patients in TOMC (92.3% and 82 patients in OSH (89.1%. Stent im­plantation rate in the university hospital was higher than the state hospital but this was not statistically significant. There was a statistically meaningful difference in mean operative time between the 2 groups. Conclusion: Double J stent placament is recently per­formed too often after the endoscopic ureteral stone treat­ment. According to our study, university hospitals have a higher rate of incidence of double j stent placement ac­cording to state hospitals. It can be reason for that, uni­versity hospitals as the last line treatment centers, more complicated cases that refer to these centers. But in this matter, prospective, multicenter and larger series studies are needed.

  19. Palliative stent graft placement combined with subsequent open surgery for retrograde ascending dissection intra-thoracic endovascular aortic repair

    OpenAIRE

    Zhu, Kai; Lai, Hao; Guo, Changfa; Li, Jun; Wang, Chunsheng

    2014-01-01

    Thoracic endovascular aortic repair (TEVAR) is an effective strategy for type B dissection. Retrograde ascending dissection (RAD) intra-TEVAR is a rare complication on clinic. In this case, a 48-year-old Chinese man with Stanford type B aortic dissection suffered acute RAD during the TEVAR. And palliative stent grafts placement was performed in a local hospital, which earned the time for transfer and subsequent total arch replacement surgery in Zhongshan Hospital Fudan University. This report...

  20. The Impact of Structured Inter-professional Education on Health Care Professional Students' Perceptions of Collaboration in a Clinical Setting.

    Science.gov (United States)

    Pinto, Alison; Lee, Sam; Lombardo, Samantha; Salama, Mariam; Ellis, Sandi; Kay, Theresa; Davies, Robyn; Landry, Michel D

    2012-01-01

    To examine how a structured inter-professional education (IPE) clinical placement influences health care professional (HCP) students' perceptions of inter-professional collaboration (IPC) relative to that of students in a traditional clinical placement. This study used a mixed-methods design. The Interdisciplinary Education Perception Scale (IEPS) was administered to HCP students (n=36) in two Toronto hospitals before and after a structured 5-week IPE clinical placement to examine changes in their perceptions of IPC. Students in a traditional clinical placement (n=28) were used as a control group. Focus groups were then conducted with seven students who took part in the structured IPE clinical placement. A coding framework was devised a priori, and the qualitative results were used to explain the quantitative findings. There were no statistically significant differences between groups after the structured IPE clinical placement, but the intervention group showed a greater positive trend in total IEPS scores from baseline to follow-up. Qualitative data suggest that students valued the knowledge and skills gained through the structured IPE clinical placement. Findings suggest that structured IPE clinical placements may provide students with valuable collaborative learning opportunities, enhanced respect for other professionals, and insight into the value of IPC in healthcare delivery. More research is needed to explore other factors that influence specific perceptions among physical therapy students. Purpose: To examine how a structured inter-professional education (IPE) clinical placement influences health care professional (HCP) students' perceptions of inter-professional collaboration (IPC) relative to that of students in a traditional clinical placement. Methods: This study used a mixed-methods design. The Interdisciplinary Education Perception Scale (IEPS) was administered to HCP students (n=36) in two Toronto hospitals before and after a structured 5-week IPE

  1. At the Roots of Product Placement: The Mere Exposure Effect

    Directory of Open Access Journals (Sweden)

    Stefano Ruggieri

    2013-05-01

    Full Text Available The present study aims to analyze the effect of product placement on attitude change and takes into consideration psychological models of the mere exposure effect. A sample of high school students watched an excerpt from two widely-distributed movies in which several products were shown by using the technique known as product placement. The results indicate that students who saw the commercial brand liked the products more than those who didn’t see it. This effect, in line with the literature on the product placement effect, seems to be independent from the recognition of the brand in the movie excerpt. This study also shows that, in the high involvement condition, one exposure is enough to produce a positive attitude toward the brand.

  2. Hierarchical planning for a surface mounting machine placement

    Institute of Scientific and Technical Information of China (English)

    曾又姣; 马登哲; 金烨; 严隽琪

    2004-01-01

    For a surface mounting machine (SMM) in printed circuit board (PCB) assembly line, there are four problems, e.g. CAD data conversion, nozzle selection, feeder assignment and placement sequence determination. A hierarchical planning for them to maximize the throughput rate of an SMM is presented here. To minimize set-up time, a CAD data conversion system was first applied that could automatically generate the data for machine placement from CAD design data files. Then an effective nozzle selection approach was implemented to minimize the time of nozzle changing. And then, to minimize picking time, an algorithm for feeder assignment was used to make picking multiple components simultaneously as much as possible. Finally, in order to shorten pick-and-place time, a heuristic algorithm was used to determine optimal component placement sequence according to the decided feeder positions. Experiments were conducted on a four head SMM. The experimental results were used to analyse the assembly line performance.

  3. Isotropic Optical Mouse Placement for Mobile Robot Velocity Estimation

    Directory of Open Access Journals (Sweden)

    Sungbok Kim

    2014-06-01

    Full Text Available This paper presents the isotropic placement of multiple optical mice for the velocity estimation of a mobile robot. It is assumed that there can be positional restriction on the installation of optical mice at the bottom of a mobile robot. First, the velocity kinematics of a mobile robot with an array of optical mice is obtained and the resulting Jacobian matrix is analysed symbolically. Second, the isotropic, anisotropic and singular optical mouse placements are identified, along with the corresponding characteristic lengths. Third, the least squares mobile robot velocity estimation from the noisy optical mouse velocity measurements is discussed. Finally, simulation results for several different placements of three optical mice are given.

  4. Percutaneous Placement of Peritoneal Dialysis Catheters in ...

    African Journals Online (AJOL)

    Method: We conducted a retrospective study on 25 patients who had their PD ... Medical records were reviewed for demographic and clinical information as well as type and ... The overall peritonitis rate, in terms of episodes per patient-year, was ... of end-stage renal disease (ESRD), and was found in 10 (40%) patients.

  5. Optimal PMU Placement By Improved Particle Swarm Optimization

    DEFF Research Database (Denmark)

    Rather, Zakir Hussain; Liu, Leo; Chen, Zhe;

    2013-01-01

    This paper presents an improved method of binary particle swarm optimization (IBPSO) technique for optimal phasor measurement unit (PMU) placement in a power network for complete system observability. Various effective improvements have been proposed to enhance the efficiency and convergence rate...... of conventional particle swarm optimization method. The proposed method of IBPSO ensures optimal PMU placement with and without consideration of zero injection measurements. The proposed method has been applied to standard test systems like 17 bus, IEEE 24-bus, IEEE 30-bus, New England 39-bus, IEEE 57-bus system...

  6. Manufacturing of smart structures using fiber placement manufacturing processes

    Science.gov (United States)

    Thomas, Matthew M.; Glowasky, Robert A.; McIlroy, Bruce E.; Story, Todd A.

    1995-05-01

    Smart structures research and development, with the ultimate aim of rapid commercial and military production of these structures, are at the forefront of the Synthesis and Processing of Intelligent Cost-Effective Structures (SPICES) program. As part of this ARPA-sponsored program, MDA-E is using fiber placement processes to manufacture integrated smart structure systems. These systems comprise advanced composite structures with embedded fiber optic sensors, shape memory alloys, piezoelectric actuators, and miniature accelerometers. Cost-effective approaches and solutions to smart material synthesis in the fiber-placement process, based upon integrated product development, are discusses herein.

  7. Bottom-Left Placement Theorem for Rectangle Packing

    CERN Document Server

    Huang, Wenqi; Chen, Duanbing

    2011-01-01

    This paper proves a bottom-left placement theorem for the rectangle packing problem, stating that if it is possible to orthogonally place n arbitrarily given rectangles into a rectangular container without overlapping, then we can achieve a feasible packing by successively placing a rectangle onto a bottom-left corner in the container. This theorem shows that even for the real-parameter rectangle packing problem, we can solve it after finite times of bottom-left placement actions. Based on this theorem, we might develop efficient heuristic algorithms for solving the rectangle packing problem.

  8. Immediate placement of dental implants in the mandible

    Directory of Open Access Journals (Sweden)

    Gurkar Haraswarupa Puttaraju

    2013-01-01

    Full Text Available This case describes extraction of teeth in the mandibular arch, i.e., 41 42 43 44 45 51 52 53 54 55 56 57 58 (grade two mobility, followed by immediate placement of four dental implants (3i biomet, two in the 45 55 region and two dental implants in 12 21 region. A prefabricated provisional mandibular denture was immediately placed. The purpose of immediate placement was to aid the patient resume his professional duties the next day itself along with esthetic and functional comfort, psychological well-being and most importantly preserving the remaining tissue in a healthy condition.

  9. [A suitable location for the placement of miniscrews].

    Science.gov (United States)

    Breuning, K H

    2014-02-01

    Miniscrews form a stable attachment point for anchoring during orthodontic treatment with fixed appliances. An additional advantage of this method of anchoring is that a set of teeth can be moved simultaneously, which means that the time required for treatment can be shortened considerably. Miniscrews can also be used for tooth movements that would otherwise be impossible. In selecting a suitable location for the placement of miniscrews, a number offactors play a role. On the basis of the findings reported in the literature on research, a miniscrew atlas has been developed which can serve as a guideline for the selection of a suitable location for the placement of miniscrews.

  10. Bilateral ophthalmoplegia and exophthalmos complicating central hemodialysis catheter placement.

    Science.gov (United States)

    Varelas, P N; Bertorini, T E; Halford, H

    1999-05-01

    We describe a 58-year-old woman who presented with bilateral ophthalmoplegia, exophthalmos, and headache and was found to have retrograde internal jugular vein flow secondary to a high-grade obstruction of the ipsilateral brachiocephalic vein from a previous hemodialysis catheter placement. The patient had also a high-flow dialysis graft in the ipsilateral arm. The cranial and extracranial venous system congestion resolved, and the signs disappeared soon after a balloon angioplasty and stent placement at the level of the obstruction.

  11. FaSa: A Fast and Stable Quadratic Placement Algorithm

    Institute of Scientific and Technical Information of China (English)

    HOU WenTing(侯文婷); HONG XianLong(洪先龙); WU WeiMin(吴为民); CAI YiCi(蔡懿慈)

    2003-01-01

    Placement is a critical step in VLSI design because it dominates overall speed andquality of design flow. In this paper, a new fast and stable placement algorithm called FaSa is pro-posed. It uses quadratic programming model and Lagrange multiplier method to solve placementproblems. And an incremental LU factorization method is used to solve equations for speeding up.The experimental results show that FaSa is very stable, much faster than previous algorithms andits total wire length is comparable with other algorithms.

  12. Kinematically optimal robot placement for minimum time coordinated motion

    Energy Technology Data Exchange (ETDEWEB)

    Feddema, J.T.

    1995-10-01

    This paper describes an algorithm for determining the optimal placement of a robotic manipulator within a workcell for minimum time coordinated motion. The algorithm uses a simple principle of coordinated motion to estimate the time of a joint interpolated motion. Specifically, the coordinated motion profile is limited by the slowest axis. Two and six degree of freedom (DOF) examples are presented. In experimental tests on a FANUC S-800 arm, the optimal placement of the robot can improve cycle time of a robotic operation by as much as 25%. In high volume processes where the robot motion is currently the limiting factor, this increased throughput can result in substantial cost savings.

  13. Manufacturing of Smart Structures Using Fiber Placement Manufacturing Processes

    Science.gov (United States)

    Thomas, Matthew M.; Glowasky, Robert A.; McIlroy, Bruce E.; Story, Todd A.

    1996-01-01

    Smart structures research and development, with the ultimate aim of rapid commercial and military production of these structures, are at the forefront of the Synthesis and Processing of Intelligent Cost-Effective Structures (SPICES) program. As part of this ARPA-sponsored program, MDA-E is using fiber placement processes to manufacture integrated smart structure systems. These systems comprise advanced composite structures with embedded fiber optic sensors, shape memory alloys, piezoelectric actuators, and miniature accelerometers. Cost-effective approaches and solutions to smart material synthesis in the fiber-placement process, based upon integrated product development, are discussed herein.

  14. Gastrostomy tube placement in patients with advanced dementia or near end of life.

    Science.gov (United States)

    Schwartz, Denise Baird; Barrocas, Albert; Wesley, John R; Kliger, Gustavo; Pontes-Arruda, Alessandro; Márquez, Humberto Arenas; James, Rosemarie Lembo; Monturo, Cheryl; Lysen, Lucinda K; DiTucci, Angela

    2014-12-01

    Based on current scientific literature, gastrostomy tube (G-tube) placement or other long-term enteral access devices should be withheld in patients with advanced dementia or other near end-of-life conditions. In many instances healthcare providers are not optimally equipped to implement this recommendation at the bedside. Autonomy of the patient or surrogate decision maker should be respected, as should the patient's cultural, religious, social, and emotional value system. Clinical practice needs to address risks, burdens, benefits, and expected short-term and long-term outcomes in order to clarify practice changes. This paper recommends a change in clinical practice and care strategy based on the results of a thorough literature review and provides tools for healthcare clinicians, particularly in the hospital setting, including an algorithm for decision making and a checklist to use prior to the placement of G-tubes or other long-term enteral access devices. Integrating concepts of patient-centered care, shared decision making, health literacy, and the teach-back method of education enhances the desired outcome of ethical dilemma prevention. The goal is advance care planning and a timely consensus among health team members, family members, and significant others regarding end-of-life care for patients who do not have an advance directive and lack the capacity to advocate for themselves. Achieving this goal requires interdisciplinary collaboration and proactive planning within a supportive healthcare institution environment.

  15. Transjugular Intrahepatic Portosystemic Shunt Placement During Pregnancy: A Case Series of Five Patients

    Energy Technology Data Exchange (ETDEWEB)

    Ingraham, Christopher R., E-mail: cringra@uw.edu; Padia, Siddharth A., E-mail: spadia@uw.edu; Johnson, Guy E., E-mail: gej@uw.edu [University of Washington, Department of Interventional Radiology (United States); Easterling, Thomas R., E-mail: easter@uw.edu [University of Washington, Department of Obstetrics and Gynecology (United States); Liou, Iris W., E-mail: irisl@medicine.washington.edu [University of Washington, Department of Medicine (United States); Kanal, Kalpana M., E-mail: kkanal@uw.edu [University of Washington, Physics Section, Department of Radiology (United States); Valji, Karim, E-mail: kvalji@uw.edu [University of Washington, Department of Interventional Radiology (United States)

    2015-10-15

    Background and AimsComplications of portal hypertension, such as variceal hemorrhage and ascites, are associated with significant increases in both mortality and complications during pregnancy. Transjugular intrahepatic portosystemic shunt (TIPS) is a well-established procedure for treating portal hypertension, but the safety of TIPS during pregnancy is largely unknown. In this series, we review five patients who underwent TIPS placement while pregnant and describe their clinical outcomes.MethodsFive pregnant patients with cirrhosis and portal hypertension underwent elective TIPS for complications of portal hypertension (four for secondary prevention of variceal bleeding and one for refractory ascites). Outcomes measured were recurrent bleeding episodes or need for further paracenteses during pregnancy, estimated radiation dose to the fetus and gestational age at delivery. All patients were followed after delivery to evaluate technical and clinical success of the procedure.ResultsAll five patients survived pregnancy and went on to deliver successfully. When TIPS was performed for secondary prevention of variceal bleeding (n = 4), no patients demonstrated variceal bleeding after TIPS placement. When TIPS was performed for refractory ascites (n = 1), no further paracenteses were required. All patients delivered successfully, albeit prematurely. Average radiation dose estimated to the fetus was 16.3 mGy.ConclusionsThis series suggests that TIPS can be performed in selective pregnant patients with portal hypertension, with little added risk to the mother or fetus.

  16. A longitudinal study of well-being, confidence and competence in junior doctors and the impact of emergency medicine placements

    Science.gov (United States)

    Mason, Suzanne; O'Keeffe, Colin; Carter, Angela; Stride, Chris

    2016-01-01

    Objectives To measure levels of, and change in junior doctor well-being, confidence and self-reported competence over their second postgraduate training year and the impact of emergency department (ED) placements on these outcomes. Design A longitudinal study using an online survey administered at four time points (2010–2011). Setting 28 Acute Hospital Trusts, drawn from nine participating Postgraduate Deaneries in England. Participants Junior doctors who had a placement in an ED as part of their second postgraduate training year. Main outcome measures Levels of anxiety, depression, motivation, job satisfaction, confidence and self-reported competence, collected at four time points spread over the period of the doctor's second training year (F2). Results 217 junior doctors were recruited to the study. Over the year there was a significant increase in their overall job satisfaction, confidence and self-reported competence. Junior doctors also reported significantly increased levels of motivation and anxiety, and significantly decreased levels of extrinsic job satisfaction when working in ED compared with other specialties. There were also significant increases in both junior doctor confidence and self-reported competence after their placement in ED relative to other specialties. Conclusions While elements of junior doctor well-being worsened in their ED placement compared with their time spent in other specialties, the increased levels of anxiety and reduced extrinsic job satisfaction were within the normal range for other healthcare workers. These deficits were also balanced by greater improvements in motivation, confidence in managing common acute clinical conditions and perceived competence in performing acute procedures compared with benefits offered by placements in other specialties. PMID:26338523

  17. [Involuntary placement and treatment of persons with mental health problems].

    Science.gov (United States)

    Ikehara, Yoshikazu

    2013-01-01

    Involuntary placement and treatment of persons with mental health problems were initially discussed from the perspective of personal liberty. However, the autonomy of persons with mental health problems has been growing in importance as an issue of involuntary placement and treatment since the last part of the twentieth century, because the purpose of involuntary placement is not the deprivation of liberty but to provide adequate treatment under medical supervision. The UN Convention on the Rights of Persons with Disabilities (CRPD) adds a new perspective from non-discrimination and equality. Article 14 of CRPD states that "the existence of a disability shall in no case justify a deprivation of liberty." This provision should be construed from a perspective of non-discrimination. Conventional types of involuntary placement mainly based on dangerousness (UN-MI Principle 16-1a) and incompetency (UN-MI Principle16-1b) are not allowed by Article 14. There is a discussion on the difference between "mental disability" and "mental illness". Some people argue that CRPD should apply not to persons with mental illness, but to those with mental disabilities. However, CRPD does not provide a definition of "disability". It states that its definition is developing. ICF also mentions that ICD-10 and ICF should complement each other. Thus, CRPD should apply to the involuntary placement and treatment of persons with mental illness as well. It is clear that Article 14 intends to change the situation whereby persons who have been described using various terms, such as madness, lunacy, insanity, mental illness, mental disability, mental health problems, and users, are involuntarily hospitalized/placed. The significance of Article 14 will be lost if it cannot be applied to psychiatric hospitalization. From the perspective of non-discrimination, we have to universalize involuntary placement and treatment or completely abolish them. We cannot tolerate a situation where a type of

  18. Does a large dehiscent implant surface at placement affect the 5-year treatment outcome? : An assessment of implants placed to support a maxillary overdenture

    NARCIS (Netherlands)

    Boven, G. C.; Meijer, H. J. A.; Slot, W.; Vissink, A.; Raghoebar, G. M.

    2015-01-01

    The aim of this study was to assess the 5-year clinical and radiographic outcome of implants with a dehiscent surface at implant placement. A total of 26 consecutive patients (mean age 61.6 years; SD 8.0 years) with at least one implant with a dehiscent implant surface of >= two thirds of the implan

  19. Percutaneous placement of self-expandable metallic stents in patients with obstructive janudice secondary to metastalic gastric cancer after gastrectomy

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Hyun Pyo [Dept. of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Seo, In Ho; Yu, Jung Rim; Mok, Young Jae; Oh, Joo Hyeong [Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Kwon, Se Hwan [Dept. of Radiology, Kyung Hee University Medical Center, Seoul (Korea, Republic of); Kim, Sam Soo [Dept. of Radiology, Kangwon National University College of Medicine, Chuncheon (Korea, Republic of); Kim, Seung Kwon [Division of Interventional Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (United States)

    2013-10-15

    To evaluate the outcomes of patients undergoing percutaneous placements of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy. Fifty patients (mean age, 62.4 years; range, 27-86 years) who underwent percutaneous placements of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy were included. The technical success rate, clinical success rate, complication rate, stent patency, patient survival and factors associated with stent patency were being evaluated. The median interval between the gastrectomy and stent placement was 23.1 months (range, 3.9-94.6 months). The 50 patients received a total of 65 stents without any major procedure-related complications. Technical success was achieved in all patients. The mean total serum bilirubin level, which had been 7.19 mg/dL ± 6.8 before stent insertion, decreased to 4.58 mg/dL ± 5.4 during the first week of follow-up (p < 0.001). Clinical success was achieved in 42 patients (84%). Percutaneous transhepatic biliary drainage catheters were removed from 45 patients (90%). Infectious complications were noted in two patients (4%), and stent malfunction occurred in seven patients (14%). The median stent patency was 233 ± 99 days, and the median patient survival was 179 ± 83 days. Total serum bilirubin level after stenting was an independent factor for stent patency (p = 0.009). Percutaneous transhepatic placement of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy is a technically feasible and clinically effective palliative procedure.

  20. Predictors of professional placement outcome: cultural background, English speaking and international student status.

    Science.gov (United States)

    Attrill, Stacie; McAllister, Sue; Lincoln, Michelle

    2016-08-01

    Placements provide opportunities for students to develop practice skills in professional settings. Learning in placements may be challenging for culturally and linguistically diverse (CALD) students, international students, or those without sufficient English proficiency for professional practice. This study investigated whether these factors, which are hypothesized to influence acculturation, predict poor placement outcome. Placement outcome data were collected for 854 students who completed 2747 placements. Placement outcome was categorized into 'Pass' or 'At risk' categories. Multilevel binomial regression analysis was used to determine whether being CALD, an international student, speaking 'English as an additional language', or a 'Language other than English at home' predicted placement outcome. In multiple multilevel analysis speaking English as an additional language and being an international student were significant predictors of 'at risk' placements, but other variables tested were not. Effect sizes were small indicating untested factors also influenced placement outcome. These results suggest that students' English as an additional language or international student status influences success in placements. The extent of acculturation may explain the differences in placement outcome for the groups tested. This suggests that learning needs for placement may differ for students undertaking more acculturative adjustments. Further research is needed to understand this and to identify placement support strategies.

  1. A linear programming approach for placement of applicants to academic programs.

    Science.gov (United States)

    Kassa, Biniyam Asmare

    2013-01-01

    This paper reports a linear programming approach for placement of applicants to study programs developed and implemented at the college of Business & Economics, Bahir Dar University, Bahir Dar, Ethiopia. The approach is estimated to significantly streamline the placement decision process at the college by reducing required man hour as well as the time it takes to announce placement decisions. Compared to the previous manual system where only one or two placement criteria were considered, the new approach allows the college's management to easily incorporate additional placement criteria, if needed. Comparison of our approach against manually constructed placement decisions based on actual data for the 2012/13 academic year suggested that about 93 percent of the placements from our model concur with the actual placement decisions. For the remaining 7 percent of placements, however, the actual placements made by the manual system display inconsistencies of decisions judged against the very criteria intended to guide placement decisions by the college's program management office. Overall, the new approach proves to be a significant improvement over the manual system in terms of efficiency of the placement process and the quality of placement decisions.

  2. Surgical Management of Fistula-in-ano Among Patients With Crohn's Disease: Analysis of Outcomes After Fistulotomy or Seton Placement-Single-Center Experience.

    Science.gov (United States)

    Papaconstantinou, I; Kontis, E; Koutoulidis, V; Mantzaris, G; Vassiliou, I

    2017-09-01

    Fistula-in-ano is a common problem among patients with Crohn's disease and carries significant morbidity. We aimed to study the outcomes of surgical treatment of fistula-in-ano after fistulotomy or seton placement in patients with perianal fistulizing Crohn's disease. A retrospective observational study of 59 patients diagnosed with Crohn's disease, who were treated surgically for fistula-in-ano between 2010 and 2014 in our department. The assessment of disease complexity included a detailed physical examination, magnetic resonance imaging of the rectum, and examination under anesthesia. Outcomes for analysis included wound healing rate and postoperative incontinence. High transsphincteric fistula was found in 44% of the patients, while mid or low transsphincteric fistulas were found in 51%. Three women (5%) had a rectovaginal fistula. All patients with high transsphincteric fistulas were treated with loose seton placement. Patients with mid- or low-level transsphincteric fistula were offered either fistulotomy or seton placement based on the clinical evaluation. The mean follow-up duration was 1.6 ± 1.1 years. In terms of recurrence, one patient treated with seton placement presented with recurrence 6 months after seton removal and one patient with fistulotomy failed to achieve wound healing. Minor incontinence was found in six patients treated with fistulotomy and in three patients treated with seton placement; however, this difference was not significant (chi-square = 1.723, df = 1, Monte-Carlo: p = 0.273). Fistulotomy could achieve good results in terms of wound healing and incontinence in strictly selected patients with Crohn's disease suffering from low-lying transsphincteric fistulae. For more high-lying or complicated fistulae, seton placement is more appropriate. For high transsphincteric fistulae, the only option is placement of loose seton.

  3. A contemporary approach for treatment planning of horizontally resorbed alveolar ridge: Ridge split technique with simultaneous implant placement using platelet rich fibrin membrane application in mandibular anterior region.

    Science.gov (United States)

    Parthiban, Prathahini S; Lakshmi, R Vijaya; Mahendra, Jaideep; Sreekumar, K; Namasivayam, Ambalavanan

    2017-01-01

    Treatment of edentulous sites with horizontal atrophy represents a clinical situation in which the positioning of endosseous implants might be complex or sometimes impossible without a staged regenerative approach. This case report presents management of horizontally deficient mandibular anterior ridge with a contemporary approach to treatment planning and application of platelet-rich fibrin membrane for ridge split technique and simultaneous implant placement. Implants in anterior mandibular area are considered to be most predictable, stable, with high success rate and patients' satisfaction with implant esthetics. In contrast to traditional ridge augmentation techniques, ridge splitting allows for immediate implant placement following surgery and eradicates the possible morbidity from a second surgical site.

  4. Race and Teacher Evaluations as Predictors of Algebra Placement

    Science.gov (United States)

    Faulkner, Valerie N.; Stiff, Lee V.; Marshall, Patricia L.; Nietfeld, John; Crossland, Cathy L.

    2014-01-01

    This study is a longitudinal look at the different mathematics placement profiles of Black students and White students from late elementary school through 8th grade. Results revealed that Black students had reduced odds of being placed in algebra by the time they entered 8th grade even after controlling for performance in mathematics. An important…

  5. 22 CFR 96.54 - Placement standards in outgoing cases.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Placement standards in outgoing cases. 96.54 Section 96.54 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES ACCREDITATION OF AGENCIES... print, media, and internet resources designed to communicate with potential prospective adoptive...

  6. Validating Automated Essay Scoring for Online Writing Placement

    Science.gov (United States)

    Ramineni, Chaitanya

    2013-01-01

    In this paper, I describe the design and evaluation of automated essay scoring (AES) models for an institution's writing placement program. Information was gathered on admitted student writing performance at a science and technology research university in the northeastern United States. Under timed conditions, first-year students (N = 879) were…

  7. Developmental, Familial, and Peer Deterrents to Adoption Placement.

    Science.gov (United States)

    Weir, Kyle N.

    2000-01-01

    Examines the developmental, familial, and peer deterrents that form barriers to adoption placement, based on interviews with 17 teen mothers in a residential facility. Analyzes responses based on an Eriksonian developmental model, and notes the role of family "cutoffs" and "re-admissions" and peer pressure as deterrents to…

  8. A Placement Web-Service for Lifelong Learners

    NARCIS (Netherlands)

    Kalz, Marco

    2009-01-01

    Kalz, M. (2009). A Placement Web-Service for Lifelong Learners. Presentation held at the 9th International Conference on Knowledge Management and Knowledge Technologies. September, 2-4, 2009, Graz, Austria. You can embed this presentation from here http://slideshare.net/mkalz

  9. Placements & Salaries Survey 2009: Jobs and Pay Take a Hit

    Science.gov (United States)

    Library Journal, 2009

    2009-01-01

    "It's a recession, baby!" was the common refrain among the Library and Information Science (LIS) graduates of the class of 2008. This was a record year for the number of graduates participating in "Library Journal"'s annual Placements & Salaries survey, and they had stories to tell, providing evidence of both hard times in the job market, and some…

  10. Compassion Fatigue among Social Work Students in Field Placements

    Science.gov (United States)

    Harr, Cynthia; Moore, Brenda

    2011-01-01

    This pilot study, conducted with BSW and MSW field students at a public university in Southwestern United States, explored the psychological effect of compassion fatigue and compassion satisfaction on social work students in field placements. Results from the Professional Quality of Life Scale's compassion satisfaction and fatigue subscales…

  11. Work Placements for Languages Students: A Transformative Experience

    Science.gov (United States)

    Organ, Alison

    2016-01-01

    A work placement module is compulsory in the second year of most degree programmes at York St John University, as part of an institution-wide strategy to embed employability in the curriculum. As most languages students spend their second year studying abroad, the Languages in the Workplace module was designed in such a way that the setting up of…

  12. Curricular Placement of Academic Service-Learning in Higher Education

    Science.gov (United States)

    Phillips, Amy; Bolduc, Steven R.; Gallo, Michael

    2013-01-01

    The higher education service-learning literature is rich with case studies, guidelines for service-learning course and program development, and demonstrations of the impact of service-learning on students. Minimal discussion, however, focuses on the "strategic placement" of service-learning in disciplinary curricula, and how curricular…

  13. Advanced Placement Mathematics Calculus, Grade 12 Curriculum Guide.

    Science.gov (United States)

    Scharf, John; And Others

    This document is a guide to the advanced placement program in calculus for grade 12 in the city schools in Warren, Ohio. The program covers analytic geometry, differential and integral calculus of algebraic functions, elementary transcendental functions, and applications of differentiation and integration. The philosophy and aims of the program…

  14. Phylogenetic placement of two species known only from resting spores

    DEFF Research Database (Denmark)

    Hajek, Ann E; Gryganskyi, Andrii; Bittner, Tonya;

    2016-01-01

    Molecular methods were used to determine the generic placement of two species of Entomophthorales known only from resting spores. Historically, these species would belong in the form-genus Tarichium, but this classification provides no information about phylogenetic relationships. Using DNA from...

  15. Process planning for a modular component placement system

    NARCIS (Netherlands)

    Zijm, Willem H.M.; van Harten, Aart

    1993-01-01

    This paper discusses the design of a hierarchically structured process planning system for a printed circuit board assembly line. Basically, the assembly system consists of a series of independently operating placement modules, connected by a carrierless conveyor system. Both the modules and the

  16. Kernel-Based Discriminant Techniques for Educational Placement

    Science.gov (United States)

    Lin, Miao-hsiang; Huang, Su-yun; Chang, Yuan-chin

    2004-01-01

    This article considers the problem of educational placement. Several discriminant techniques are applied to a data set from a survey project of science ability. A profile vector for each student consists of five science-educational indicators. The students are intended to be placed into three reference groups: advanced, regular, and remedial.…

  17. Evaluating the rural health placements of the Rural Support Network ...

    African Journals Online (AJOL)

    2011-10-19

    Oct 19, 2011 ... Objectives: The Rural Support Network (RSN) is an undergraduate student society that aims to raise awareness among the .... social ... the depth of the problems associated with what we .... Improvements in planning (n = 7), advertising (n = 1) and ... of daily journals during the placements as reflective tools.

  18. Localizing and placement of network node functions in a network

    NARCIS (Netherlands)

    Strijkers, R.J.; Meulenhoff, P.J.

    2014-01-01

    The invention enables placement and use of a network node function in a second network node instead of using the network node function in a first network node. The network node function is e.g. a server function or a router function. The second network node is typically located in or close to the cl

  19. Advanced Placement Economics Improves Both Merit and Equity

    Science.gov (United States)

    Meek, Sally; Morton, John

    2009-01-01

    In 1989, microeconomics and macroeconomics examinations debuted on the Advanced Placement (AP) scene. At that time, many professors of economics were skeptical that college freshmen had the skills and maturity to understand the concepts in principles of economics courses. They thought teaching these concepts to high school students was even more…

  20. Theoretical Perspectives on Assessment in Cooperative Education Placements

    Science.gov (United States)

    Hodges, David; Eames, Chris; Coll, Richard K.

    2014-01-01

    In this paper we examine theoretical perspectives on assessment in cooperative education placements. As assessment is linked to student learning, we focus briefly on the purposes of assessment. We then consider a range of learning theories that have been, and are more recently, explored as ways to explain the process of learning on cooperative…

  1. Developmental Placement: Does It Prevent Future Learning Problems?

    Science.gov (United States)

    May, Deborah C.; Welch, Edward

    1984-01-01

    Of 223 children who were coded as buy-a-year (BAY), overplaced (OP), or traditional (TR) based on their Gesell placement status, there were no significant differences between TR, BAY, or OP children on referrals or classification or on receipt of speech and language service, remedial reading, remedial math, or counseling. (Author/CL)

  2. Component placement on flexible and/or strechable substrates

    NARCIS (Netherlands)

    Koetse, M.M.; Schoo, H.F.M.

    2011-01-01

    According to one aspect, the invention provides a method of placement of a component on a stretchable substrate, comprising the steps of providing a base substrate having a stretchable substrate layer, providing a flexible foil comprising an integral arrangement (20) of a multiple of flexible foil

  3. Poverty and Child Placement: A New/Old Idea.

    Science.gov (United States)

    Gustavsson, Nora S.; MacEachron, Ann E.

    1997-01-01

    Examines historical precedents for removing poor children from their families, reviews relevant experiences of Native Americans, and analyzes child placement through the lens of poverty. The role of the federal government in child protection is examined by comparing the Indian Child Welfare Act and the Adoption Assistance and Child Welfare Act.…

  4. Teaching Melodic Dictation in Advanced Placement Music Theory

    Science.gov (United States)

    Paney, Andrew S.; Buonviri, Nathan O.

    2014-01-01

    In this study approaches to teaching melodic dictation skills used by Advanced Placement (AP) Music Theory teachers were examined. Twelve high school teachers from four states were interviewed. Four themes emerged from the interview transcripts: cognitive frameworks, processing strategies, rhythm, and course design. Participants generally…

  5. Surprise and Sense Making: Undergraduate Placement Experiences in SMEs

    Science.gov (United States)

    Walmsley, Andreas; Thomas, Rhodri; Jameson, Stephanie

    2006-01-01

    Purpose: This paper seeks to explore undergraduate placement experiences in tourism and hospitality SMEs, focusing on the notions of surprise and sense making. It aims to argue that surprises and sense making are important elements not only of the adjustment process when entering new work environments, but also of the learning experience that…

  6. Conceptualizing a Framework for Advanced Placement Statistics Teaching Knowledge

    Science.gov (United States)

    Haines, Brenna

    2015-01-01

    The purpose of this article is to sketch a conceptualization of a framework for Advanced Placement (AP) Statistics Teaching Knowledge. Recent research continues to problematize the lack of knowledge and preparation among secondary level statistics teachers. The College Board's AP Statistics course continues to grow and gain popularity, but is a…

  7. Hip resurfacing femoral neck fracture influenced by valgus placement.

    Science.gov (United States)

    Anglin, Carolyn; Masri, Bassam A; Tonetti, Jérôme; Hodgson, Antony J; Greidanus, Nelson V

    2007-12-01

    Femoral neck fracture is the most common short-term concern after hip resurfacing arthroplasty. Currently, there is little basis to decide between neutral and valgus placement. We loaded 10 notched cadaveric femur pairs to failure; one side was implanted at 0 degrees relative to the femoral neck and the other at 10 degrees valgus. All 20 were dual-energy X-ray absorptiometry-scanned. Failure load correlated with bone mineral density. Valgus placement increased the fracture load by an average of 28% over neutral for specimens with normal bone mineral density but had no effect on fracture load in specimens with low bone mineral density. For specimens with normal bone mineral density (typical of patients undergoing resurfacing arthroplasty), neutral-valgus placement had a greater effect than bone mineral density, explaining 54% of the fracture load variance. Component placement greater than 10 degrees valgus is likely undesirable because this can lead to an increase in component size and a greater likelihood of notching. To reduce fracture risk, we recommend placing the femoral component in valgus and selecting patients with higher bone mineral density.

  8. 38 CFR 21.252 - Job development and placement services.

    Science.gov (United States)

    2010-07-01

    ... AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31 Employment Services § 21.252 Job development and placement services. (a) General... Employment Services and the Veterans' Employment and Training Service of the United States Department...

  9. Immediate implant placement and provisionalisation in the aesthetic zone

    NARCIS (Netherlands)

    Van Nimwegen, W G; Goené, R J; Van Daelen, A C L; Stellingsma, K; Raghoebar, G M; Meijer, H J A

    2016-01-01

    The aim of this retrospective study was to assess the outcome of immediate single-tooth implant placement and provisionalisation in the aesthetic zone regarding hard and soft peri-implant tissue parameters and patient-related outcome measures in a private practice. All consecutively treated patients

  10. 45 CFR 84.35 - Evaluation and placement.

    Science.gov (United States)

    2010-10-01

    ... handicap, needs or is believed to need special education or related services before taking any action with respect to the initial placement of the person in regular or special education and any subsequent..., need or are believed to need special education or related services which ensure that: (1) Tests...

  11. 38 CFR 18.435 - Evaluation and placement.

    Science.gov (United States)

    2010-07-01

    ... evaluation of any qualified person who, because of handicap, needs or is believed to need special education... handicap, need or are believed to need special education or related services which ensure that: (1) Tests... regular or program special education and any subsequent change in placement. (b) Evaluation...

  12. Today's practice of brand placement and the industry behind it

    NARCIS (Netherlands)

    Smit, E.; van Reijmersdal, E.; Neijens, P.

    2009-01-01

    This article presents a content analysis of brand placement on Dutch television, followed by 24 interviews with the parties involved. By combining a content analysis and a practitioners’ perspective, this article offers unique insights into the increasingly popular phenomenon of integrating advertis

  13. Effects of placement point of background music on shopping website.

    Science.gov (United States)

    Lai, Chien-Jung; Chiang, Chia-Chi

    2012-01-01

    Consumer on-line behaviors are more important than ever due to highly growth of on-line shopping. The purposes of this study were to design placement methods of background music for shopping website and examine the effect on browsers' emotional and cognitive response. Three placement points of background music during the browsing, i.e. 2 min., 4 min., and 6 min. from the start of browsing were considered for entry points. Both browsing without music (no music) and browsing with constant music volume (full music) were treated as control groups. Participants' emotional state, approach-avoidance behavior intention, and action to adjust music volume were collected. Results showed that participants had a higher level of pleasure, arousal and approach behavior intention for the three placement points than for no music and full music. Most of the participants for full music (5/6) adjusted the background music. Only 16.7% (3/18) participants for other levels turn off the background music. The results indicate that playing background music after the start of browsing is benefit for on-line shopping atmosphere. It is inappropriate to place background music at the start of browsing shopping website. The marketer must manipulated placement methods of background music for a web store carefully.

  14. Video-Assisted Thoracic Placement of Epicardial Leads

    NARCIS (Netherlands)

    Schouwenburg, Jasper J.; Klinkenberg, Theo J.; Maass, Alexander H.; Mariani, Massimo A.

    2014-01-01

    Cardiac resynchronization therapy is one of the cornerstones of heart failure treatment. Inability to access the coronary sinus or one of its sidebranches is one of the most common causes of therapeutic failure. We describe a technique using video-assisted thoracic surgery for epicardial placement o

  15. Compassion Fatigue among Social Work Students in Field Placements

    Science.gov (United States)

    Harr, Cynthia; Moore, Brenda

    2011-01-01

    This pilot study, conducted with BSW and MSW field students at a public university in Southwestern United States, explored the psychological effect of compassion fatigue and compassion satisfaction on social work students in field placements. Results from the Professional Quality of Life Scale's compassion satisfaction and fatigue subscales…

  16. Identifying Good Student Teaching Placements: A Programmatic Perspective.

    Science.gov (United States)

    LaBoskey, Vicki Kubler; Richert, Anna Ershler

    2002-01-01

    Describes Mills College's graduate-level teacher credential program, addressing the appropriateness of student teaching placements in relation to the aims and ideology of the teacher education program and examining the four dimensions of fieldwork as a learning context (nested learning, blending principles, safety, and reflective focus).…

  17. Incremental Placement-Based Clock Network Minimization Methodology

    Institute of Scientific and Technical Information of China (English)

    ZHOU Oiang; CAI Yici; HUANG Liang; HONG Xianlong

    2008-01-01

    Power is the major challenge threatening the progress of very large scale integration (VLSI) tech-nology development. In ultra-deep submicron VLSI designs, clock network size must be minimized to re-duce power consumption, power supply noise, and the number of clock buffers which are vulnerable to process variations. Traditional design methodologies usually let the clock router independently undertake the clock network minimization. Since clock routing is based on register locations, register placement actu-ally strongly influences the clock network size. This paper describes a clock network design methodology that optimizes register placement. For a given cell placement result, incremental modifications are per-formed based on the clock skew specifications by moving registers toward preferred locations that may re-duce the clock network size. At the same time, the side-effects to logic cell placement, such as signal net wirelength and critical path delay, are controlled. Test results on benchmark circuits show that the methodol-ogy can considerably reduce clock network size with limited impact on signal net wirelength and critical path delay.

  18. Advanced Placement Economics Improves Both Merit and Equity

    Science.gov (United States)

    Meek, Sally; Morton, John

    2009-01-01

    In 1989, microeconomics and macroeconomics examinations debuted on the Advanced Placement (AP) scene. At that time, many professors of economics were skeptical that college freshmen had the skills and maturity to understand the concepts in principles of economics courses. They thought teaching these concepts to high school students was even more…

  19. Clitic Placement in Spanish-English Bilingual Children

    Science.gov (United States)

    Perez-Leroux, Ana Teresa; Cuza, Alejandro; Thomas, Danielle

    2011-01-01

    Can transfer occur in child bilingual syntax when surface overlap does not involve the syntax-pragmatics interface? Twenty-three Spanish/English bilingual children participated in an elicited imitation study of clitic placement in Spanish restructuring contexts, where variable word order is not associated with pragmatic or semantic factors.…

  20. Localizing and placement of network node functions in a network

    NARCIS (Netherlands)

    Strijkers, R.J.; Meulenhoff, P.J.

    2014-01-01

    The invention enables placement and use of a network node function in a second network node instead of using the network node function in a first network node. The network node function is e.g. a server function or a router function. The second network node is typically located in or close to the

  1. A Regional Public Health Field Placement Program: making an IMPACT.

    Science.gov (United States)

    McCormick, Lisa C; Hites, Lisle; Jenkins, Crystal; Chauvin, Sheila W; Rucks, Andrew C; Ginter, Peter M

    2014-03-01

    Beginning in 2010, the U.S. Department of Health and Human Services, Health Resources and Services Administration, made provisions in its Public Health Training Center cooperative agreements for field placements. This article describes best practices and lessons learned establishing and managing the South Central Public Health Partnership's Interns and Mentors Program for ACTion (IMPACT) Field Placement Program, which was initially funded through the Centers for Disease Control and Prevention's Centers for Public Health Preparedness Cooperative agreement in 2002. The IMPACT program is based on a six-step process that has been developed and refined over its 10-year history: (a) identifying field placement opportunities, (b) marketing field experience opportunities to students, (c) selecting students seeking field experience opportunities, (d) placing students with practice partners, students with practice partners, (e) evaluating student progress toward field experience objectives, and (f) evaluating the program. This article describes the program's structure and processes, delineates the roles of its academic and practice partners, discusses evidence of its effectiveness, and describes lessons learned from its decade-long history. Hopefully, this information will facilitate the establishment, management and evaluation of internship and field placement programs in other Public Health Training Centers and academic public health programs.

  2. Pragmatic Approach for Multistage Phasor Measurement Unit Placement

    DEFF Research Database (Denmark)

    Rather, Zakir Hussain; Chen, Zhe; Thoegersen, Poul

    2016-01-01

    Effective phasor measurement unit (PMU) placement is a key to the implementation of efficient and economically feasible wide area measurement systems in modern power systems. This paper proposes a pragmatic approach for cost-effective stage-wise deployment of PMUs while considering realistic...

  3. Optimal Placement of Phasor Measurement Units with New Considerations

    DEFF Research Database (Denmark)

    Su, Chi; Chen, Zhe

    2010-01-01

    Conventional phasor measurement unit (PMU) placement methods normally use the number of PMU installations as the objective function which is to be minimized. However, the cost of one installation of PMU is not always the same in different locations. It depends on a number of factors. One...

  4. Accounting for L2 learners’ errors in word stress placement

    Directory of Open Access Journals (Sweden)

    Clara Herlina Karjo

    2016-01-01

    Full Text Available Stress placement in English words is governed by highly complicated rules. Thus, assigning stress correctly in English words has been a challenging task for L2 learners, especially Indonesian learners since their L1 does not recognize such stress system. This study explores the production of English word stress by 30 university students. The method used for this study is immediate repetition task. Participants are instructed to identify the stress placement of 80 English words which are auditorily presented as stimuli and immediately repeat the words with correct stress placement. The objectives of this study are to find out whether English word stress placement is problematic for L2 learners and to investigate the phonological factors which account for these problems. Research reveals that L2 learners have different ability in producing the stress, but three-syllable words are more problematic than two-syllable words. Moreover, misplacement of stress is caused by, among others, the influence of vowel lenght and vowel height.

  5. Placements & Salaries Survey 2010: Stagnant Salaries, Rising Unemployment

    Science.gov (United States)

    Maatta, Stephanie L.

    2010-01-01

    "Library Journal's annual Placements & Salaries Survey, with 1,996 respondents representing 38.7% of the approximately 5160 2009 LIS graduates, found an uptick in starting salaries, but bigger bumps in part-time and temporary jobs, an expanding gender gap, setbacks for minority graduates, and a drop in the number of total graduates. On the up…

  6. Video-Assisted Thoracic Placement of Epicardial Leads

    NARCIS (Netherlands)

    Schouwenburg, Jasper J.; Klinkenberg, Theo J.; Maass, Alexander H.; Mariani, Massimo A.

    2014-01-01

    Cardiac resynchronization therapy is one of the cornerstones of heart failure treatment. Inability to access the coronary sinus or one of its sidebranches is one of the most common causes of therapeutic failure. We describe a technique using video-assisted thoracic surgery for epicardial placement o

  7. 26 CFR 31.3506-1 - Companion sitting placement services.

    Science.gov (United States)

    2010-04-01

    ... the employee-employer relationship when, under §§ 31.3121(d)-1 and 31.3121(d)-2, that relationship... companion sitting placement service, this section has no effect upon that employee-employer relationship. (e.... Issues such as hours of work, amount of payment, and the method by which the services are performed...

  8. Forced orthodontic eruption for augmentation of soft and hard tissue prior to implant placement

    Directory of Open Access Journals (Sweden)

    Rafael Scaf de Molon

    2013-01-01

    Full Text Available Forced orthodontic eruption (FOE is a non-surgical treatment option that allows modifying the osseous and gingival topography. The aim of this article is to present a clinical case of a FOE, which resulted in an improvement of the amount of available bone and soft-tissues for implant site development. Patient was referred for treatment of mobility and unesthetic appearance of their maxillary incisors. Clinical and radiographic examination revealed inflamed gingival tissue, horizontal and vertical tooth mobility and interproximal angular bone defects. It was chosen a multidisciplinary treatment approach using FOE, tooth extraction, and immediate implant placement to achieve better esthetic results. The use of FOE, in periodontally compromised teeth, promoted the formation of a new bone and soft-tissue in a coronal direction, without additional surgical procedures, enabling an esthetic, and functional implant-supported restoration.

  9. Convergent validity of the ASAM Patient Placement Criteria using a standardized computer algorithm.

    Science.gov (United States)

    Staines, Graham; Kosanke, Nicole; Magura, Stephen; Bali, Priti; Foote, Jeffrey; Deluca, Alexander

    2003-01-01

    The study examined the convergent validity of the ASAM Patient Placement Criteria (PPC) by comparing Level of Care (LOC) recommendations produced by two alternative methods: a computerdriven algorithm and a "standard" clinical assessment. A cohort of 248 applicants for alcoholism treatment were evaluated at a multi-modality treatment center. The two methods disagreed (58% of cases) more often than they agreed (42%). The algorithm recommended a more intense LOC than the clinician protocol in 81% of the discrepant cases. Four categories of disagreement accounted for 97% of the discrepant cases. Several major sources of disagreement were identified and examined in detail: clinicians' reasoned departures from the PPC rules, conservatism in algorithm LOC recommendations, and measurement overlap between two specific dimensions. In order for the ASAM PPC and its associated algorithm to be embraced by treatment programs, the observed differences in LOC recommendations between the algorithm and "standard" clinical assessment should be resolved.

  10. Reliability of multidimensional substance abuse treatment matching: implementing the ASAM Patient Placement Criteria.

    Science.gov (United States)

    Baker, Sharon L; Gastfriend, David R

    2003-01-01

    For meaningful adoption, the Patient Placement Criteria (PPC) of the American Society of Addiction Medicine (ASAM) will need adequate interrater reliability. In a decision analysis of the original PPC, we reduced potential sources of unreliability, mapped question items from clinical research instruments to each decision point, and programmed the item map as a computerized structured interview. Then, target videotapes from eight substance dependent adults who had been distributed by the algorithm into three levels of care (LOC) were independently scored by four raters who were blind as to ASAM LOC. The intraclass correlation coefficient for ASAM LOC assignment was .77. For all but two subscales of component instruments, values were above .70 and significant, indicating high interrater reliability. With these methods, excellent reliability is possible for complex decision trees, making it possible to improve the validity of the ASAM Criteria and similar complex hierarchical clinical protocols.

  11. Cost-effectiveness of gastrostomy placement for children with neurodevelopmental disability.

    Science.gov (United States)

    Townsend, J L; Craig, G; Lawson, M; Reilly, S; Spitz, L

    2008-10-01

    Malnutrition and growth deficiency are common in neurologically impaired children. Gastrostomy placement has been shown to result in significant catch-up growth, improved health of the child and reduction in family stress; its cost-effectiveness has not been investigated. Costs related to gastrostomy placement are estimated here from a prospective controlled study of children referred to a tertiary paediatric centre in the UK. Costs of inpatient stay, medication, tests, general practitioner consultations, community healthcare, equipment, and parents' indirect costs were estimated at baseline and follow-up. Costs of the different types of gastrostomy surgery are given. Results for both time periods were available for 54 of the 76 children recruited to the study. Five-day food diaries were kept at baseline and follow-up. Costs of food increased slightly but not significantly post surgery from pound sterling 33 to pound sterling 40 (Euro 44 to Euro 54, US$65 to US$78) per week. Variation in cost between cases was considerable but the mean net cost difference of pound sterling 20.80 (CI - pound sterling 43.79 to pound sterling 85.35) (Euro 28 (CI Euro-59 to Euro 115), US$41 (CI US$-86 to US$167)) per week per child including for food and surgery, was also not significant. Community service costs were significantly lower post surgery. Few parents reported personal costs at either time point, although many had reduced or stopped paid work to care for the child. As gastrostomy placement for these children resulted in significant clinical benefit at no significant extra cost, it is concluded that the procedure is cost-effective.

  12. Metallic stent placement in hemodialysis graft patients after insufficient balloon dilation

    Energy Technology Data Exchange (ETDEWEB)

    Liang, Huei-Lung; Pan, Huay-Ben; Lin, Yih-Huie; Chen, Chiung-Yu; Lai, Pin-Hong; Yang, Chien-Fang [Kaohsiung Veterans General Hospital, Kaohsiung (China); Chung, Hsiao-Min; Wu, Tung-Ho; Chou, Kang-Ju [National Yangming University, Taipei (China)

    2006-06-15

    We wanted to report our experience of metallic stent placement after insufficient balloon dilation in graft hemodialysis patients. Twenty-three patients (13 loop grafts in the forearm and 10 straight grafts in the upper arm) underwent metallic stent placement due to insufficient flow after urokinase thrombolysis and balloon dilation. The indications for metallic stent deployment included 1) recoil and/or kinked venous stenosis in 21 patents (venous anastomosis: 17 patients, peripheral outflow vein: four patients); and 2) major vascular rupture in two patients. Metallic stents 8-10mm in diameter and 40-80 mm in length were used. Of them, eight stents were deployed across the elbow crease. Access patency was determined by clinical follow-up and the overall rates were calculated by Kaplan-Meier survival analysis. No procedure-related complications (stent fracture or central migration) were encountered except for a delayed Wallstent shortening/migration at the venous anastomosis, which resulted in early access failure. The overall primary and secondary patency rates ({+-}standard error) of all the vascular accesses in our 23 patients at 3, 6, 12 and 24 months were 69%{+-}9 and 88%{+-}6,41% {+-}10 and 88%{+-}6, 30%{+-}10 and 77%{+-}10, and 12%{+-}8 and 61%{+-}13, respectively. For the forearm and upper-arm grafts, the primary and secondary patency rates were 51%{+-}16 and 86%{+-}13 vs 45%{+-}15 and 73%{+-}13 at 6 months, and 25%{+-}15 and 71%{+-}17 vs 23%{+-}17 and 73%{+-}13 at 12 months ({rho} = .436 and .224), respectively. Metallic stent placement is a safe and effective means for treating peripheral venous lesions in dialysis graft patients after insufficient balloon dilation. No statistically difference in the patency rates between the forearm and upper-arm patient groups was seen.

  13. Preclinical usability study of multiple augmented reality concepts for K-wire placement.

    Science.gov (United States)

    Fischer, Marius; Fuerst, Bernhard; Lee, Sing Chun; Fotouhi, Javad; Habert, Severine; Weidert, Simon; Euler, Ekkehard; Osgood, Greg; Navab, Nassir

    2016-06-01

    In many orthopedic surgeries, there is a demand for correctly placing medical instruments (e.g., K-wire or drill) to perform bone fracture repairs. The main challenge is the mental alignment of X-ray images acquired using a C-arm, the medical instruments, and the patient, which dramatically increases in complexity during pelvic surgeries. Current solutions include the continuous acquisition of many intra-operative X-ray images from various views, which will result in high radiation exposure, long surgical durations, and significant effort and frustration for the surgical staff. This work conducts a preclinical usability study to test and evaluate mixed reality visualization techniques using intra-operative X-ray, optical, and RGBD imaging to augment the surgeon's view to assist accurate placement of tools. We design and perform a usability study to compare the performance of surgeons and their task load using three different mixed reality systems during K-wire placements. The three systems are interventional X-ray imaging, X-ray augmentation on 2D video, and 3D surface reconstruction augmented by digitally reconstructed radiographs and live tool visualization. The evaluation criteria include duration, number of X-ray images acquired, placement accuracy, and the surgical task load, which are observed during 21 clinically relevant interventions performed by surgeons on phantoms. Finally, we test for statistically significant improvements and show that the mixed reality visualization leads to a significantly improved efficiency. The 3D visualization of patient, tool, and DRR shows clear advantages over the conventional X-ray imaging and provides intuitive feedback to place the medical tools correctly and efficiently.

  14. Subaxial cervical pedicle screw placement using limited opening technique: experimental study and preliminary clinical report%下颈椎椎弓根螺钉置入有限开放技术的实验研究与初步临床应用

    Institute of Scientific and Technical Information of China (English)

    方弘伟; 王向阳; 施达; 吴增晖; 欧阳钧; 赵云珍; 王晓成; 黄晓东; 陈卓

    2009-01-01

    Objectives To evaluate the safety and accuracy of limited opening technique for traspedicular screw placement in subaxial cervical spine. Methods Twenty fresh cervical specimens (C_3-C_7) were included in this study and placed with 199 pedicle screws using limited open technique for evaluation of the location of the screws. Forty C_3-C_4 specimens (80 sides) were used to observe architec-ture of the cervical pedicle and measure parameters related with screw placement. Seven patients with cer-vical instability were treated with pedicle screw fixation (29 screws) using this limited open technique.The cancellous bone in the junction of lateral mass and medical wall of pedicle was removed to find the in-let of the pedicle. The pedicle screws were inserted according to the measurement results of CT and X-ray. The patients were then evaluated radiographically for the location of the pedicle screw. Results The key structure safely leading into the pedicle was the junction between deep cortex of C_3、C_4 lateral mass and medial wall of the pedicle, which was located at the lateral upper quadrant of the lateral mass,with hard contour surface but without nutrient foramens. The screw insertion points were distributed at lat-eral upper quadrant of the lateral mass, with mean debouchement diameter of 5.2 mm, mean inlet width of 7.5 mm, medial angle of 42°and upward angle of 10°. The accuracy rate of screw placement was 94.5% in specimens and 100% in patients. Conclusion Limited opening at lateral mass surface combined with single-blade blunt end probe is proved to be a safe and accurate technique for subaxial cer-vical pedicle screw placement.%目的 评价有限开放技术在置入下颈椎椎弓根螺钉中的安全性和准确性.方法 新鲜尸体20具,利用有限开放技术对C_3~C_7椎弓根置入199枚螺钉,评价螺钉的位置;解剖观察C_3、C_4共40椎、80侧椎弓根管入口形状结构,并测量与钉道位置相关的参数.临床应用7

  15. Percutaneous ureteral stent placement for the treatment of a benign ureteral obstruction in a Sumatran tiger (Panthera tigris sumatrae).

    Science.gov (United States)

    Delk, Katie W; Wack, Raymund F; Burgdorf-Moisuk, Anne; Palm, Carrie A; Zwingenberger, Allison; Glaiberman, Craig B; Ferguson, Kenneth H; Culp, William T N

    2015-01-01

    A 15-year-old, 113 kg intact male Sumatran tiger (Panthera tigris sumatrae) was evaluated for weight loss, polydipsia, and intermittent hematuria. The tiger was immobilized for diagnostic testing including blood work, urinalysis, and abdominal ultrasound. Laboratory testing demonstrated macro- and microhematuria, azotemia, and an increased urine protein:creatinine ratio. Abdominal ultrasound revealed bilateral ureterolithiasis as well as hydronephrosis and ureteral dilation. Ultrasonography performed 5 months later revealed worsening of the right-sided hydronephrosis and hydroureter and a decrease in the severity of dilation on the left side presumably from passage of the left-sided ureteral calculi. Nephroureteral decompression via the placement of a stent was elected. A pigtail ureteral catheter (8.2 French diameter) was placed in the right ureter via an antegrade percutaneous approach utilizing ultrasound and fluoroscopic-guidance. Following stent placement, macrohematuria resolved although microhematuria was noted in opportunistic urine samples. Five months after stent placement, the azotemia had mildly progressed, the urine protein:creatinine ratio was improved, the right hydronephrosis and hydroureter had completely resolved, and the ureteral stent remained in the appropriate position. The tiger had clinically improved with a substantial increase in appetite, weight, and activity level. Ureteral stenting allowed for nephroureteral decompression in the captive large felid of this report, and no complications were encountered. Ureteral stenting provided a minimally invasive method of managing ureteral obstruction in this patient and could be considered in future cases due to the clinical improvement and low morbidity.

  16. Real-Time 3-Dimensional Ultrasound-Assisted Infraclavicular Brachial Plexus Catheter Placement: Implications of a New Technology

    Directory of Open Access Journals (Sweden)

    Steven R. Clendenen

    2010-01-01

    Full Text Available Background. There are a variety of techniques for targeting placement of an infraclavicular blockade; these include eliciting paresthesias, nerve stimulation, and 2-dimensional (2D ultrasound (US guidance. Current 2D US allows direct visualization of a “flat” image of the advancing needle and neurovascular structures but without the ability to extensively analyze multidimensional data and allow for real-time manipulation. Three-dimensional (3D ultrasonography has gained popularity and usefulness in many clinical specialties such as obstetrics and cardiology. We describe some of the potential clinical applications of 3D US in regional anesthesia. Methods. This case represents an infraclavicular catheter placement facilitated by 3D US, which demonstrates 360-degree spatial relationships of the entire anatomic region. Results. The block needle, peripheral nerve catheter, and local anesthetic diffusion were observed in multiple planes of view without manipulation of the US probe. Conclusion. Advantages of 3D US may include the ability to confirm correct needle and catheter placement prior to the injection of local anesthetic. The spread of local anesthetic along the length of the nerve can be easily observed while manipulating the 3D images in real-time by simply rotating the trackball on the US machine to provide additional information that cannot be identified with 2D US alone.

  17. Inlay osteotome sinus floor elevation with concentrated growth factor application and simultaneous short implant placement in severely atrophic maxilla

    Science.gov (United States)

    Chen, Yonghui; Cai, Zhiyu; Zheng, Dingguo; Lin, Pei; Cai, Yahua; Hong, Shuxin; Lai, Yiwei; Wu, Dong

    2016-01-01

    Sinus floor elevation with simultaneous implant placement in severely atrophic maxilla is challenging. The aim of this retrospective study was to evaluate the short-term performance of modified osteotome sinus floor elevation (OSFE) with concentrated growth factor (CGF) application and concurrent placement of a short implant in cases with residual bone height (RBH) of 2–4 mm. Twenty-five short implants were installed in 16 patients with mean RBH of 3.23 mm using modified OSFE with CGFs from January 2012 to April 2014. Postoperatively, the implants were clinically evaluated, and vertical bone gain (VBG) was measured using cone beam computed tomography. The mean duration of follow-up was 19.88 months (12–32 months). All the implants were stable with an overall survival rate of 100%. The mean VBG immediately after surgery was 9.21 mm. Six months later, significant reduction of alveolar bone height (2.90 ± 0.22 mm) was found (P  0.05). Within the limits of this study, modified OSFE with CGF application and simultaneous short implant placement could yield predictable clinical results for severely atrophic maxilla with RBH of 2–4 mm. PMID:27250556

  18. Optimal accelerometer placement on a robot arm for pose estimation

    Science.gov (United States)

    Wijayasinghe, Indika B.; Sanford, Joseph D.; Abubakar, Shamsudeen; Saadatzi, Mohammad Nasser; Das, Sumit K.; Popa, Dan O.

    2017-05-01

    The performance of robots to carry out tasks depends in part on the sensor information they can utilize. Usually, robots are fitted with angle joint encoders that are used to estimate the position and orientation (or the pose) of its end-effector. However, there are numerous situations, such as in legged locomotion, mobile manipulation, or prosthetics, where such joint sensors may not be present at every, or any joint. In this paper we study the use of inertial sensors, in particular accelerometers, placed on the robot that can be used to estimate the robot pose. Studying accelerometer placement on a robot involves many parameters that affect the performance of the intended positioning task. Parameters such as the number of accelerometers, their size, geometric placement and Signal-to-Noise Ratio (SNR) are included in our study of their effects for robot pose estimation. Due to the ubiquitous availability of inexpensive accelerometers, we investigated pose estimation gains resulting from using increasingly large numbers of sensors. Monte-Carlo simulations are performed with a two-link robot arm to obtain the expected value of an estimation error metric for different accelerometer configurations, which are then compared for optimization. Results show that, with a fixed SNR model, the pose estimation error decreases with increasing number of accelerometers, whereas for a SNR model that scales inversely to the accelerometer footprint, the pose estimation error increases with the number of accelerometers. It is also shown that the optimal placement of the accelerometers depends on the method used for pose estimation. The findings suggest that an integration-based method favors placement of accelerometers at the extremities of the robot links, whereas a kinematic-constraints-based method favors a more uniformly distributed placement along the robot links.

  19. Mechanisms of Günther Tulip filter tilting during transfemoral placement.

    Science.gov (United States)

    Matsui, Y; Horikawa, M; Ohta, K; Jahangiri Noudeh, Y; Kaufman, J A; Farsad, K

    The purpose of this study was to characterize the mechanisms of Günther Tulip filter (GTF) tilting during transfemoral placement in an experimental model with further validation in a clinical series. In an experimental study, 120 GTF placements in an inferior vena cava (IVC) model were performed using 6 configurations of pre-deployment filter position. The angle between the pre-deployment filter axis and IVC axis, and the proximity of the constrained filter legs to IVC wall prior to deployment were evaluated. The association of those pre-deployment factors with post-deployment filter tilting was analyzed. The association noted in the experimental study was then evaluated in a retrospective clinical series of 21 patients. In the experimental study, there was a significant association between the pre-deployment angle and post-deployment filter tilting (P<0.0001). With a low pre-deployment angle (≤5°), a significant association was noted between filter tilting and the proximity of the constrained filter legs to the far IVC wall (P=0.001). In a retrospective clinical study, a significant association between the pre-deployment angle and post-deployment filter tilting was also noted with a linear regression model (P=0.026). Significant association of the pre-deployment angle with post-deployment GTF tilting was shown in both the experimental and clinical studies. The experimental study also showed that proximity of filter legs is relevant when pre-deployment angle is small. Addressing these factors may result in a lower incidence of filter tilting. Copyright © 2017 Editions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

  20. Laser Interstitial Thermal Therapy Technology, Physics of Magnetic Resonance Imaging Thermometry, and Technical Considerations for Proper Catheter Placement During Magnetic Resonance Imaging-Guided Laser Interstitial Thermal Therapy.

    Science.gov (United States)

    Patel, Nitesh V; Mian, Matthew; Stafford, R Jason; Nahed, Brian V; Willie, Jon T; Gross, Robert E; Danish, Shabbar F

    2016-12-01

    Laser-induced thermal therapy has become a powerful tool in the neurosurgical armamentarium. The physics of laser therapy are complex, but a sound understanding of this topic is clinically relevant, as many centers have incorporated it into their treatment algorithm, and educated patients are demanding consideration of its use for their disease. Laser ablation has been used for a wide array of intracranial lesions. Laser catheter placement is guided by stereotactic planning; however, as the procedure has popularized, the number of ways in which the catheter can be inserted has also increased. There are many technical nuances for laser placement, and, to date, there is not a clear understanding of whether any one technique is better than the other. In this review, we describe the basic physics of magnetic resonance-guided laser-induced thermal therapy and describe the several common techniques for accurate Visualase laser catheter placement in a stepwise fashion.

  1. DIFFERENCES IN ADVANCED PLACEMENT EXAM RESULTS FOR BLACK STUDENTS ACROSS THREE STATES

    OpenAIRE

    Joyner, Sheila A; John R. Slate; Davis, Carolyn; Joyner, Sheila; Slate, John

    2011-01-01

    Differences in Advanced Placement exam results for Black students in Texas, Georgia, and California were examined. Existing data from the College Board 2010 Report were used to compare overall Advanced Placement exam performance and individual Advanced Placement exam performance in English Language, U.S. History, and Calculus AB. Statistically significant differences were present in the performance on Black students on the overall Advanced Placement exam, as well as the three individual AP ...

  2. Partial stent-in-stent placement of biliary metallic stents using a short double-balloon enteroscopy

    Institute of Scientific and Technical Information of China (English)

    Koichiro Tsutsumi; Hironari Kato; Takeshi Tomoda; Kazuyuki Matsumoto; Ichiro Sakakihara; Naoki Yamamoto; Yasuhiro Noma

    2012-01-01

    Endoscopic intervention is less invasive than percutaneous or surgical approaches and should be considered the primary drainage procedure in most cases with obstructive jaundice.Recently,therapeutic endoscopic retrograde cholangiopancreatography (ERCP) using double-balloon enteroscopy (DBE) has been shown to be feasible and effective,even in patients with surgically altered anatomies.On the other hand,endoscopic partial stent-in-stent (PSIS) placement of selfexpandable metallic stents (SEMSs) for malignant hilar biliary obstruction in conventional ERCP has also been shown to be feasible,safe and effective.We performed PSIS placement of SEMSs for malignant hilar biliary obstruction due to liver metastasis using a short DBE in a patient with Roux-en-Y anastomosis and achieved technical and clinical success.This procedure can result in quick relief from obstructive jaundice in a single session and with short-term hospitalization,even in patients with surgically altered anatomies.

  3. Breakdown of teenage placements in Danish out-of-home care

    DEFF Research Database (Denmark)

    Egelund, Tine; Olsson, Martin; Høst, Anders

    2012-01-01

    This study deals with the problem of breakdown in out-of-home placements for Danish teenagers. How often are these placements prematurely terminated against the requests and intentions of the child welfare authorities? Which factors seem to increase and decrease placement breakdown? The sample...

  4. Product placement - metody měření a vyhodnocování

    OpenAIRE

    Vaněk, Tomáš

    2011-01-01

    Marketing and commercial communication and the position of product placement within them; Product placement, the history, forms and the legal frame; Theory of measuring and evaluating commercial communications in general and specifical theories applicable for product placement; Experimental evaluation of these theories on concrete case.

  5. Using a Regression Discontinuity Design to Estimate the Impact of Placement Decisions in Developmental Math

    Science.gov (United States)

    Melguizo, Tatiana; Bos, Johannes M.; Ngo, Federick; Mills, Nicholas; Prather, George

    2016-01-01

    This study evaluates the effectiveness of math placement policies for entering community college students on these students' academic success in math. We estimate the impact of placement decisions by using a discrete-time survival model within a regression discontinuity framework. The primary conclusion that emerges is that initial placement in a…

  6. 34 CFR 300.325 - Private school placements by public agencies.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Private school placements by public agencies. 300.325... Programs, and Educational Placements Development of Iep § 300.325 Private school placements by public... child to, a private school or facility, the agency must initiate and conduct a meeting to develop an IEP...

  7. A new branch of advertising: reviewing factors that influence reactions to product placement

    NARCIS (Netherlands)

    van Reijmersdal, E.; Neijens, P.; Smit, E.G.

    2009-01-01

    This iiterature review presents a quantitative synthesis of 57 studies on product placement and shows which factors are most effective, it shows that placement characteristics, such as placement commerciality, modality, and prominence, have a strong impact on audience reactions. Audience characteris

  8. Waarschuwingen, beroemheden en brand placement: de effecten van type waarschuwing en geloofwaardigheid op kijkerreacties

    NARCIS (Netherlands)

    Dekker, K.; van Reijmersdal, E.

    2010-01-01

    Although many studies on product placement have been conducted, effects of celebrities in product placement remained unstudied. In addition, new legislation forces television programs to show warnings for sponsored content. However, effects of such warnings for product placement are unknown. The pre

  9. Error rate of multi-level rapid prototyping trajectories for pedicle screw placement in lumbar and sacral spine

    Institute of Scientific and Technical Information of China (English)

    Matjaz Merc; Igor Drstvensek; Matjaz Vogrin; Tomaz Brajlih; Tomaz Friedrich; Gregor Recnik

    2014-01-01

    Objective:Free-hand pedicle screw placement has a high incidence of pedicle perforation which can be reduced with fluoroscopy,navigation or an alternative rapid prototyping drill guide template.In our study the error rate of multi-level templates for pedicle screw placement in lumbar and sacral regions was evaluated.Methods:A case series study was performed on 11 patients.Seventy-two screws were implanted using multilevel drill guide templates manufactured with selective laser sintering.According to the optimal screw direction preoperatively defined,an analysis of screw misplacement was performed.Displacement,deviation and screw length difference were measured.The learning curve was also estimated.Results:Twelve screws (17%) were placed more than 3.125 mm out of its optimal position in the centre of pedicle.The tip of the 16 screws (22%) was misplaced more than 6.25 mm out of the predicted optimal position.According to our predefined goal,19 screws (26%) were implanted inaccurately.In 10 cases the screw length was selected incorrectly:1 (1%) screw was too long and 9 (13%) were too short.No clinical signs of neurovascular lesion were observed.Learning curve was insignificantly noticeable (P=0.129).Conclusion:In our study,the procedure of manufacturing and applying multi-level drill guide templates has a 26% chance of screw misplacement.However,that rate does not coincide with pedicle perforation incidence and neurovascular injury.These facts along with a comparison to compatible studies make it possible to summarize that multi-level templates are satisfactorily accurate and allow precise screw placement with a clinically irrelevant mistake factor.Therefore templates could potentially represent a useful tool for routine pedicle screw placement.

  10. Evaluation of an interprofessional practice placement in a UK in-patient palliative care unit.

    Science.gov (United States)

    Dando, Nicholas; d'Avray, Lynda; Colman, Jane; Hoy, Andrew; Todd, Jennifer

    2012-03-01

    This paper reports on undergraduate students' evaluation of a new hospice-based interprofessional practice placement (IPP) that took place in the voluntary sector from 2008 to 2009. Ward-based interprofessional training has been successfully demonstrated in a range of clinical environments. However, the multidisciplinary setting within a hospice in-patient unit offered a new opportunity for interprofessional learning. The development and delivery of the IPP initiative is described, whereby multidisciplinary groups of 12 students provided hands-on care for a selected group of patients, under the supervision of trained health care professionals. The placement was positively evaluated and students reported an increased understanding of both their own role and that of other professionals in the team. The evaluation also suggests that additional learning opportunities were provided by the in-patient palliative care unit. The results of this evaluation suggest that the in-patient unit of a hospice caring for patients with life-limiting illness provides a suitable environment to demonstrate and learn about interprofessional practice.

  11. Implant placement in the maxillary tuberosity: the Summers' technique performed with modified osteotomes.

    Science.gov (United States)

    Nocini, P F; Albanese, M; Fior, A; De Santis, D

    2000-06-01

    The maxillary tuberosity region is becoming increasingly involved in preprosthetic surgery as part of a comprehensive implant treatment planning. The lower success rates in osteointegrated implant placements seen in the posterior regions of the upper maxilla as compared to the anterior regions of the jaws, most often come from bone quality types and the presence of the maxillary sinus. In order to overcome these limitations and obtain a successful result in such a demanding area, several authors suggest that long implants (15.0 to 20.0 mm long) should be placed in the maxillary tuberosity region as an alternative to sinus floor elevation. The challenges frequently associated with the surgical placement of "maxillary tuberosity implants" (MTI), can be reduced through a "Ridge Expansion Osteotomy" (REO) procedure as described by Summers (1994). This indeed improves the recipient bed bone quality and causes no bone overheating. In order to improve this technique performed for MTI, in co-operation with Ing. Albanese G, authors have developed different prototypes of modified osteotomes. A case report using these new instruments is presented. Clinical and radiographic evaluations are obtained.

  12. Effect of TIPS placement on portal and splanchnic arterial blood flow in 4-dimensional flow MRI

    Energy Technology Data Exchange (ETDEWEB)

    Stankovic, Zoran [Northwestern University, Department of Radiology, Feinberg School of Medicine, Chicago, IL (United States); University Medical Center Freiburg, Department of Diagnostic Radiology and Medical Physics, Freiburg (Germany); Roessle, Martin; Schultheiss, Michael [University Medical Center Freiburg, Department of Gastroenterology, Freiburg (Germany); Euringer, Wulf; Langer, Mathias [University Medical Center Freiburg, Department of Diagnostic Radiology and Medical Physics, Freiburg (Germany); Salem, Riad; Barker, Alex; Carr, James; Collins, Jeremy D. [Northwestern University, Department of Radiology, Feinberg School of Medicine, Chicago, IL (United States); Markl, Michael [Northwestern University, Department of Radiology, Feinberg School of Medicine, Chicago, IL (United States); Northwestern University, Department of Biomedical Engineering, McCormick School of Engineering, Chicago, IL (United States)

    2015-09-15

    To assess changes in portal and splanchnic arterial haemodynamics in patients undergoing transjugular intrahepatic portosystemic shunt (TIPS) using four-dimensional (4D) flow MRI, a non-invasive, non-contrast imaging technique. Eleven patients undergoing TIPS implantation were enrolled. K-t GRAPPA accelerated non-contrast 4D flow MRI of the liver vasculature was applied with acceleration factor R = 5 at 3Tesla. Flow analysis included three-dimensional (3D) blood flow visualization using time-resolved 3D particle traces and semi-quantitative flow pattern grading. Quantitative evaluation entailed peak velocities and net flows throughout the arterial and portal venous (PV) systems. MRI measurements were taken within 24 h before and 4 weeks after TIPS placement. Three-dimensional flow visualization with 4D flow MRI revealed good image quality with minor limitations in PV flow. Quantitative analysis revealed a significant increase in PV flow (562 ± 373 ml/min before vs. 1831 ± 965 ml/min after TIPS), in the hepatic artery (176 ± 132 ml/min vs. 354 ± 140 ml/min) and combined flow in splenic and superior mesenteric arteries (770 ml/min vs. 1064 ml/min). Shunt-flow assessment demonstrated stenoses in two patients confirmed and treated at TIPS revision. Four-dimensional flow MRI might have the potential to give new information about the effect of TIPS placement on hepatic perfusion. It may explain some unexpected findings in clinical observation studies. (orig.)

  13. Renal Ultrasound, Dialysis Catheter Placement, and Kidney Biopsy Experience of US Nephrology Fellows.

    Science.gov (United States)

    Sachdeva, Mala; Ross, Daniel W; Shah, Hitesh H

    2016-08-01

    Procedures are a key component to the practice of nephrology. The Accreditation Council for Graduate Medical Education (ACGME) requires nephrology fellows to acquire skills and demonstrate competency in the performance of several procedures during fellowship training, including temporary hemodialysis catheter placement, biopsy of native and transplanted kidneys, and various dialytic therapies. It is also required that fellows acquire competency in the interpretation of renal imaging, including renal ultrasound, during their training. To gain a more recent perspective of nephrology fellows' experiences regarding renal ultrasonography, dialysis catheter placement, and kidney biopsies, we carried out a national survey of nephrology fellows in May 2014. A majority of the programs did not offer formal clinical training in renal ultrasonography. In addition, a significant percentage of fellows in adult nephrology may not be acquiring the required procedural skills and competency during fellowship training. In this perspective, we explore some of the reasons for this occurrence and propose some measures that the nephrology training community can take to enhance procedural skills and competency of fellows. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  14. Same-Day Evaluation and Surgery for Otitis Media and Tympanostomy Tube Placement: A Feasibility Study.

    Science.gov (United States)

    Billings, Kathleen R; Hajduk, John; Rose, Allison; De Oliveira, Gildasio S; Suresh, Suresh S; Thompson, Dana M

    2016-10-01

    To determine the feasibility of providing streamlined same-day evaluation and surgical management of children with recurrent otitis media or chronic serous otitis media who meet criteria for tympanostomy tube (TT) placement. Retrospective matched case series. Tertiary care children's hospital. A comparison group (age, sex, insurance product) was utilized to determine if the same-day process decreased facility time and surgical time for the care episode. A parent satisfaction survey was administered. Thirty children, with a median age of 16 months (range, 12-22 months), participated in the same-day surgery process for TT. Twenty-one patients (70.0%) were male, and these patients were matched to a comparison group (similar age, sex, and insurance product) having non-same-day (routine) TT placement. The same-day patients spent significantly less time in clinic for the preoperative physician visit (average, 15 minutes) when compared with the non-same-day patients (average, 51.5 minutes; P otitis media. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  15. Retrospective review of grafting techniques utilized in conjunction with endosseous implant placement.

    Science.gov (United States)

    Meraw, S J; Eckert, S E; Yacyshyn, C E; Wollan, P C

    1999-01-01

    Bone resorptive patterns may prevent the ideal placement of endosseous implants. Numerous techniques have been described to create a more favorable surgical site for implant placement. This retrospective review was conducted to determine the frequency of need for implant site preparation in an outpatient clinical setting. In addition, different techniques of surgical site preparation were evaluated to determine their frequency of use and surgical outcome. A history review was conducted of all consecutively treated partially edentulous patients between January 1993 and December 1997. This review evaluated the number of implants placed, the age and gender of patient, the type of graft used, and the status of the implant. In all, 542 patients were seen in this time interval, with a total of 1,313 implants placed. Implant site preparation was needed in 4.4% of the patients, with the requirement for grafts occurring more frequently in the maxilla. Implant site preparation is a relatively infrequent requirement in the general population. Grafts are required more frequently in the maxilla than in the mandible. Complications following grafting were relatively infrequent and were not severe.

  16. A system for visualization and automatic placement of the endoclamp balloon catheter

    Science.gov (United States)

    Furtado, Hugo; Stüdeli, Thomas; Sette, Mauro; Samset, Eigil; Gersak, Borut

    2010-02-01

    The European research network "Augmented Reality in Surgery" (ARIS*ER) developed a system that supports minimally invasive cardiac surgery based on augmented reality (AR) technology. The system supports the surgical team during aortic endoclamping where a balloon catheter has to be positioned and kept in place within the aorta. The presented system addresses the two biggest difficulties of the task: lack of visualization and difficulty in maneuvering the catheter. The system was developed using a user centered design methodology with medical doctors, engineers and human factor specialists equally involved in all the development steps. The system was implemented using the AR framework "Studierstube" developed at TU Graz and can be used to visualize in real-time the position of the balloon catheter inside the aorta. The spatial position of the catheter is measured by a magnetic tracking system and superimposed on a 3D model of the patient's thorax. The alignment is made with a rigid registration algorithm. Together with a user defined target, the spatial position data drives an actuator which adjusts the position of the catheter in the initial placement and corrects migrations during the surgery. Two user studies with a silicon phantom show promising results regarding usefulness of the system: the users perform the placement tasks faster and more accurately than with the current restricted visual support. Animal studies also provided a first indication that the system brings additional value in the real clinical setting. This work represents a major step towards safer and simpler minimally invasive cardiac surgery.

  17. Clinical and esthetic outcomes of implants placed in postextraction sites.

    Science.gov (United States)

    Chen, Stephen T; Buser, Daniel

    2009-01-01

    The aim of this review was to evaluate the clinical outcomes for the different time points of implant placement following tooth extraction. A PubMed search and a hand search of selected journals were performed to identify clinical studies published in English that reported on outcomes of implants in postextraction sites. Only studies that included 10 or more patients were accepted. For implant success/survival outcomes, only studies with a mean follow-up period of at least 12 months from the time of implant placement were included. The following outcomes were identified: (1) change in peri-implant defect dimension, (2) implant survival and success, and (3) esthetic outcomes. Of 1,107 abstracts and 170 full-text articles considered, 91 studies met the inclusion criteria for this review. Bone augmentation procedures are effective in promoting bone fill and defect resolution at implants in postextraction sites, and are more successful with immediate (type 1) and early placement (type 2 and type 3) than with late placement (type 4). The majority of studies reported survival rates of over 95%. Similar survival rates were observed for immediate (type 1) and early (type 2) placement. Recession of the facial mucosal margin is common with immediate (type 1) placement. Risk indicators included a thin tissue biotype, a facial malposition of the implant, and a thin or damaged facial bone wall. Early implant placement (type 2 and type 3) is associated with a lower frequency of mucosal recession compared to immediate placement (type 1).

  18. Brand Placement in Establishing Corporate Identity - A University Example -

    Directory of Open Access Journals (Sweden)

    Saliha AĞAÇ

    2015-06-01

    Full Text Available With competition becoming ever fiercer, brands must conform to modern marketing and become more influential on consumer perceptions by developing strategies according to the needs and demands of consumers. Hence it is very important to determine how the br and is perceived and placed in the consumer’s mind. Branding is a key issue on the modern agenda. As universities have understood the importance of establishing corporate identity and brand placement, they have joined the race and begun developing social strategies to develop their brand values. These include establishing brand belongingness, advertising and promotions and efforts to make the university stand out among similar ones. Brand placement in the minds of users is attempted through the name, logo , colors, characters and fonts representing the university used on clothing, office material and similar. Brand placement efforts include definitions by consumers of the product or service or attempts to distinguish these from those of competitors. This r esearch deals with a clothing b rand representing a university, brand image and product perceptions as well as the brand placement efforts. The scanning method was used in the research. The brand of casual clothing used as an example for brand placement as well as similarly known brands were examined for their product variety, prices and consumer portfolios. Measurement devices were prepared for the brand placement of the apparel designed and produced for the university, and a pilot trial was performed. I n the pilot trial, a set of questions was asked to a group of randomly chosen 242 people, consisting of academics, university students and administrative staff. The data obta ined were analyzed using SPSS 16 .0. Findings were given in tables according to sta tus variables. The finding of the research indicate that in brand placing efforts, for the intended consumer the apparel’s fabric, stitching and print/embroidery quality, its price

  19. Treatment of benign biliary leaks with transhepatic placement of coated self-expanding metallic stents.

    Science.gov (United States)

    Páramo, M; García-Barquín, P; Carrillo, M; Millor Muruzábal, M; Vivas, I; Bilbao, J I

    To analyze the safety and efficacy of percutaneous placement of coated self-expanding metallic stents (SEMS) in patients with biliary leaks. This ethics committee at our center approved this study. We retrospectively reviewed all coated SEMS placed between October 2008 and September 2015. We analyzed patient-related factors such as the primary underlying disease, prior hepatic procedures, and clinical outcome. We evaluated the location, the number and type of leak (anastomotic or non-anastomotic), and the characteristics of the interventional procedure (number of stents deployed, location of the stents, technical success, and primary functionality). We recorded the complications registered. We studied 14 patients (11 men and 3 women). The mean follow-up period was 375.5 days (range 15-1920 days). Leaks were postsurgical in 12 patients. One patient developed an arteriobilioportal fistula. In another, the biliary leak occurred secondary to the rupture of the common bile duct after ERCP. A total of 23 coated SEMS were placed, including 21 Fluency(®) stents (Bard, Tempe, AZ, USA) and 2 Wallflex(®) stents (Boston Scientific, Galway, Republic of Ireland). The technical success of the procedure was considered total in 11 (78.6%) patients, partial in 2 (14.3%) patients, and null in 1 (7.2%) patient. The clinical outcome was good in 13 of the 14 patients. The mean period of primary functionality of the coated SEMS was 331 days (range 15-1920 days). No major complications were observed in 11 (78.6%) patients. Percutaneous placement of coated SEMS for the treatment of benign biliary leaks is safe and efficacious, with a high rate of technical and clinical success and a moderate rate of complications. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Addressing culture shock in first year midwifery students: Maximising the initial clinical experience.

    Science.gov (United States)

    Cummins, Allison M; Catling, Christine; Hogan, Rosemarie; Homer, Caroline S E

    2014-12-01

    Many Bachelor of Midwifery students have not had any exposure to the hospital setting prior to their clinical placement. Students have reported their placements are foreign to them, with a specialised confusing 'language'. It is important to provide support to students to prevent culture shock that may lead to them leaving the course. To assist first year midwifery students with the transition into clinical practice by providing a preparatory workshop. An action research project developed resources for a workshop held prior to students' first clinical placement. Four phases were held: Phase one involved holding discussion groups with students returning from clinical practice; Phase two was the creation of vodcasts; Phase three was integration of resources into the clinical subject and phase four was the evaluation and reflection on the action research project. Evaluations of the workshops were undertaken through surveying the students after they returned from their clinical placement. A descriptive analysis of the evaluations was performed. Students rated the workshop, vodcasts and the simulated handover positively. Further recommendations were that complications of labour and birth be included in their first semester as students were unexpectedly exposed to this in their first clinical placement. The students evaluated the workshop positively in reducing the amount of culture shock experienced on the first clinical placement. In addition the students provided further recommendations of strategies that would assist with clinical placement. Copyright © 2014 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.