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Sample records for frequent routine monitoring

  1. Assessment of three frequently used blood glucose monitoring devices in clinical routine.

    Zueger, Thomas; Schuler, Vanessa; Stettler, Christoph; Diem, Peter; Christ, Emanuel R

    2012-07-12

    Self-monitoring of blood glucose plays an important role in the management of diabetes and has been shown to improve metabolic control. The use of blood glucose meters in clinical practice requires sufficient reliability to allow adequate treatment. Direct comparison of different blood glucose meters in clinical practice, independent of the manufactures is scarce. We, therefore, aimed to evaluate three frequently used blood glucose meters in daily clinical practice. Capillary blood glucose was measured simultaneous using the following glucose meters: Contour® (Bayer Diabetes Care, Zürich, Switzerland), Accu-Chek® aviva (Roche Diagnostics, Rotkreuz, Switzerland), Free-Style® lite (Abbott Diabetes Care, Baar, Switzerland). The reference method consisted of the HemoCue® Glucose 201+ System (HemoCue® AB, Ängelholm, Sweden) with plasma conversion. The devices were assessed by comparison of the Mean Absolute Relative Differences (MARD), the Clarke Error Grid Analysis (EGA) and the compliance with the International Organization of Standardization criteria (ISO 15197:2003). Capillary blood samples were obtained from 150 patients. MARD was 10.1 ± 0.65%, 7.0 ± 0.62% and 7.8 ± 0.48% for Contour®, Accu-Chek® and Free-Style®, respectively. EGA showed 99.3% (Contour®), 98.7% (Accu-Chek®) and 100% (Free-Style®) of all measurements in zone A and B (clinically acceptable). The ISO criteria were fulfilled by Accu-Chek® (95.3%) and Free-Style® (96%), but not by Contour® (92%). In the present study the three glucose meters provided good agreement with the reference and reliable results in daily clinical routine. Overall, the Free-Style® and Accu-Chek® device slightly outperformed the Contour® device.

  2. Routine Radiological Environmental Monitoring Plan

    Bechtel Nevada

    1998-01-01

    The U.S. Department of Energy manages the Nevada Test Site in a manner that meets evolving DOE Missions and responds to the concerns of affected and interested individuals and agencies. This Routine Radiological Monitoring Plan addressess complicance with DOE Orders 5400.1 and 5400.5 and other drivers requiring routine effluent monitoring and environmental surveillance on the Nevada Test Site. This monitoring plan, prepared in 1998, addresses the activities conducted onsite NTS under the Final Environmental Impact Statement and Record of Decision. This radiological monitoring plan, prepared on behalf of the Nevada Test Site Landlord, brings together sitewide environmental surveillance; site-specific effluent monitoring; and operational monitoring conducted by various missions, programs, and projects on the NTS. The plan provides an approach to identifying and conducting routine radiological monitoring at the NTS, based on integrated technical, scientific, and regulatory complicance data needs

  3. Routine sanitary radiation monitoring

    Marej, A.N.

    1984-01-01

    Hygienic bases and organization principles of radiation monitoring realized in the process of operation of nuclear power engineering enterprises are considered. The monitoring is aimed at prevention from a negative effect of ionizing radiations on public heath. It is achieved by solution of the following tasks: realization of control over radioactive waste disposal into environment, control over the level of radioactive substance content in evironmental objects, control over external and internal irradiation of population assessment of environmental radiactivity of certain regions and of the territory of the country with the subsequent informing the corresponding organizations and population

  4. 40 CFR 141.621 - Routine monitoring.

    2010-07-01

    ... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Routine monitoring. 141.621 Section....621 Routine monitoring. (a) Monitoring. (1) If you submitted an IDSE report, you must begin monitoring..., you must monitor at the location(s) and dates identified in your monitoring plan in § 141.132(f...

  5. Routine Radiological Environmental Monitoring Plan. Volume 1

    Bechtel Nevada

    1999-12-31

    The U.S. Department of Energy manages the Nevada Test Site in a manner that meets evolving DOE Missions and responds to the concerns of affected and interested individuals and agencies. This Routine Radiological Monitoring Plan addressess complicance with DOE Orders 5400.1 and 5400.5 and other drivers requiring routine effluent monitoring and environmental surveillance on the Nevada Test Site. This monitoring plan, prepared in 1998, addresses the activities conducted onsite NTS under the Final Environmental Impact Statement and Record of Decision. This radiological monitoring plan, prepared on behalf of the Nevada Test Site Landlord, brings together sitewide environmental surveillance; site-specific effluent monitoring; and operational monitoring conducted by various missions, programs, and projects on the NTS. The plan provides an approach to identifying and conducting routine radiological monitoring at the NTS, based on integrated technical, scientific, and regulatory complicance data needs.

  6. Routine environmental monitoring schedule, calendar year 1997

    Markes, B.M., Westinghouse Hanford

    1996-12-10

    This document provides the Environmental Restorations Contractor (ERC) and the Project Hanford Management Contractor.(PHMC) a schedule in accordance with the WHC-CM-7-5, Environmental Compliance` and BHI- EE-02, Environmental Requirements, of monitoring and sampling routines for the Near-Field Monitoring (NFM) program during calendar year (CY) 1997. Every attempt will be made to consistently follow this schedule; any deviation from this schedule will be documented by an internal memorandum (DSI) explaining the reason for the deviation. The DSI will be issued by the scheduled performing organization and directed to Near-Field Monitoring. The survey frequencies for particular sites are determined by the technical judgment of Near- Field Monitoring and may depend on the site history, radiological status, use, and general conditions. Additional surveys may be requested at irregular frequencies if conditions warrant. All radioactive wastes sites are scheduled to be surveyed at least annually. Any newly discovered wastes sites not documented by this schedule will be included in the revised schedule for CY 1998. The outside perimeter road surveys of 200 East and West Area and the rail survey from the 300 Area to Columbia Center will be performed in the year 2000 per agreement with Department of Energy. Richland Field Office. This schedule does not discuss staffing needs, nor does it list the monitoring equipment to be used in completing specific routines. Personnel performing routines to meet this schedule shall communicate any need for assistance in completing these routines to Radiological Control management and Near-Field Monitoring. After each routine survey is completed, a copy of the survey record, maps, and data sheets will be forwarded to Near-Field Monitoring. These routine surveys will not be considered complete until this documentation is received. At the end of each month, the ERC and PHMC radiological control organizations shall forward a copy of the Routine

  7. Radiation dose monitoring in the clinical routine

    Guberina, Nika [UK Essen (Germany). Radiology

    2017-04-15

    Here we describe the first clinical experiences regarding the use of an automated radiation dose management software to monitor the radiation dose of patients during routine examinations. Many software solutions for monitoring radiation dose have emerged in the last decade. The continuous progress in radiological techniques, new scan features, scanner generations and protocols are the primary challenge for radiation dose monitoring software systems. To simulate valid dose calculations, radiation dose monitoring systems have to follow current trends and stay constantly up-to-date. The dose management software is connected to all devices at our institute and conducts automatic data acquisition and radiation dose calculation. The system incorporates 18 virtual phantoms based on the Cristy phantom family, estimating doses in newborns to adults. Dose calculation relies on a Monte Carlo simulation engine. Our first practical experiences demonstrate that the software is capable of dose estimation in the clinical routine. Its implementation and use have some limitations that can be overcome. The software is promising and allows assessment of radiation doses, like organ and effective doses according to ICRP 60 and ICRP 103, patient radiation dose history and cumulative radiation doses. Furthermore, we are able to determine local diagnostic reference doses. The radiation dose monitoring software systems can facilitate networking between hospitals and radiological departments, thus refining radiation doses and implementing reference doses at substantially lower levels.

  8. Routine environmental monitoring schedule, calendar year 1995

    Schmidt, J.W.; Markes, B.M.; McKinney, S.M.

    1994-12-01

    This document provides Bechtel Hanford, Inc. (BHI) and Westinghouse Hanford Company (WHC) a schedule of monitoring and sampling routines for the Operational Environmental Monitoring (OEM) program during calendar year (CY) 1995. Every attempt will be made to consistently follow this schedule; any deviation from this schedule will be documented by an internal memorandum (DSI) explaining the reason for the deviation. The DSI will be issued by the scheduled performing organization and directed to Near-Field Monitoring. The survey frequencies for particular sites are determined by the technical judgment of Near-Field Monitoring and may depend on the site history, radiological status, use and general conditions. Additional surveys may be requested at irregular frequencies if conditions warrant. All radioactive wastes sites are scheduled to be surveyed at least annually. Any newly discovered wastes sites not documented by this schedule will be included in the revised schedule for CY 1995

  9. Routine intracranial pressure monitoring in acute coma.

    Forsyth, Rob J; Raper, Joseph; Todhunter, Emma

    2015-11-02

    We know that the brain damage resulting from traumatic and other insults is not due solely to the direct consequences of the primary injury. A significant and potentially preventable contribution to the overall morbidity arises from secondary hypoxic-ischaemic damage. Brain swelling accompanied by raised intracranial pressure (ICP) prevents adequate cerebral perfusion with well-oxygenated blood.Detection of raised ICP could be useful in alerting clinicians to the need to improve cerebral perfusion, with consequent reductions in brain injury. To determine whether routine ICP monitoring in severe coma of any cause reduces the risk of all-cause mortality or severe disability at final follow-up. We searched the Cochrane Injuries Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (OvidSP), EMBASE (OvidSP), CINAHL Plus, ISI Web of Science (SCI-EXPANDED & CPCI-S), clinical trials registries and reference lists. We ran the most recent search on 22 May 2015. All randomised controlled studies of real-time ICP monitoring by invasive or semi-invasive means in acute coma (traumatic or non-traumatic aetiology) versus clinical care without ICP monitoring (that is, guided only by clinical or radiological inference of the presence of raised ICP). Two authors (ET and RF) worked independently to identify the one study that met inclusion criteria. JR and RF independently extracted data and assessed risk of bias. We contacted study authors for additional information, including details of methods and outcome data. One randomized controlled trial (RCT) meeting the selection criteria has been identified to date.The included study had 324 participants. We judged risk of bias to be low for all categories except blinding of participants and personnel, which is not feasible for this intervention. There were few missing data, and we analysed all on an intention-to-treat basis.Participants could be 13 years of age or older (mean age of sample 29

  10. Routine Radiological Environmental Monitoring Plan. Appendices

    Bechtel Nevada

    1998-01-01

    Supporting material for the plan includes: QUALITY ASSURANCE, ANALYSIS, AND SAMPLING PLAN FOR NTS AIR; QUALITY ASSURANCE, ANALYSIS, AND SAMPLING PLAN FOR WATER ON AND OFF THE NEVADA TEST SITE; QUALITY ASSURANCE, ANALYSIS, AND SAMPLING PLAN FOR NTS BIOTA; QUALITY ASSURANCE, ANALYSIS, AND SAMPLING PLAN FOR DIRECT RADIATION MONITORING; DATA QUALITY OBJECTIVES PROCESS; VADOSE ZONE MONITORING PLAN CHECKLIST

  11. Mobile monitoring in routine operations and emergencies

    Barth, Joachim; Bucher, Benno; Estier, Sybille

    2011-01-01

    Gaining actuality after the Fukushima accident and in a certain way complementing the main topic of the most recent issue (Emergency Preparedness), articles deal with mobile monitoring in its various aspects. Mobile laboratories and measuring devices are presented ranging from aerosol samplers in aeroplanes over helicopters, environmental monitoring cars, a fire brigades CBRN-reconnaissance vehicle and mobile in-vivo laboratories to the special van of an emergency response team carrying among others hand-held instruments. (orig.)

  12. Routine monitoring of eye dose; and reply

    Palmer, K; Jeans, S P; Faulkner, K; Bardsley, R A; Love, H G

    1985-12-01

    This letter briefly reports the assessment at Papworth Hospital of the feasibility of monitoring eye doses of staff using a film badge worn on the shoulder in addition to the badge worn under the lead apron. For three consecutive months hand and eye (forehead) dose were monitored using TLDs, while shoulder and body dose, recorded under the lead apron, were measured with film badges. For the four doctors monitored, (two radiologists and two cardiologists) the shoulder badge somewhat overestimated the eye dose. In the case of nurses, the dose recorded by the shoulder badge was of a similar order to the TLD-recorded eye dose. The reply from the Christie Hospital at Manchester comments on the use of the shoulder badge and contends that the use of forehead dosemeters to measure eye dose is to be preferred whenever possible.

  13. Psychiatric status, somatisation, and health care utilization of frequent attenders at the emergency department: a comparison with routine attenders.

    Williams, E R; Guthrie, E; Mackway-Jones, K; James, M; Tomenson, B; Eastham, J; McNally, D

    2001-03-01

    Seventy-seven frequent attenders at an emergency department (ED) in an inner-city hospital in the UK (defined as seven or more visits in the previous 12 months) were compared with 182 patients who were attending the same department on a routine basis. Patients completed the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and the Short Form (SF)-36. Information was obtained on 64% of the frequent attenders and 45% underwent a detailed psychiatric assessment. Of the frequent attenders, 45% had psychiatric disorder and 49% had some form of an alcohol-related disorder. Compared with routine attenders, frequent attenders reported lower health status, had more psychiatric disorder (odds ratio: OR=8.2, 95% confidence interval: CI=3.8--18.1), had more general hospital admissions (OR=19.9, 95% CI=8.3--47.8), more psychiatric admissions (OR=167.5, 95% CI=9.5--2959.0), and more GP visits (95% CI for difference=-10.2 to -5.7). There was no evidence that frequent attenders had more somatisation than routine attenders. Specific treatment and management strategies need to be developed for this group of patients, although a substantial proportion may be difficult to engage in the treatment process.

  14. Reference values for generic instruments used in routine outcome monitoring: the leiden routine outcome monitoring study

    Schulte-van Maaren Yvonne WM

    2012-11-01

    Full Text Available Abstract Introduction The Brief Symptom Inventory (BSI, Mood & Anxiety Symptom Questionnaire −30 (MASQ-D30, Short Form Health Survey 36 (SF-36, and Dimensional Assessment of Personality Pathology-Short Form (DAPP-SF are generic instruments that can be used in Routine Outcome Monitoring (ROM of patients with common mental disorders. We aimed to generate reference values usually encountered in 'healthy' and ‘psychiatrically ill’ populations to facilitate correct interpretation of ROM results. Methods We included the following specific reference populations: 1294 subjects from the general population (ROM reference group recruited through general practitioners, and 5269 psychiatric outpatients diagnosed with mood, anxiety, or somatoform (MAS disorders (ROM patient group. The outermost 5% of observations were used to define limits for one-sided reference intervals (95th percentiles for BSI, MASQ-D30 and DAPP-SF, and 5th percentiles for SF-36 subscales. Internal consistency and Receiver Operating Characteristics (ROC analyses were performed. Results Mean age for the ROM reference group was 40.3 years (SD=12.6 and 37.7 years (SD=12.0 for the ROM patient group. The proportion of females was 62.8% and 64.6%, respectively. The mean for cut-off values of healthy individuals was 0.82 for the BSI subscales, 23 for the three MASQ-D30 subscales, 45 for the SF-36 subscales, and 3.1 for the DAPP-SF subscales. Discriminative power of the BSI, MASQ-D30 and SF-36 was good, but it was poor for the DAPP-SF. For all instruments, the internal consistency of the subscales ranged from adequate to excellent. Discussion and conclusion Reference values for the clinical interpretation were provided for the BSI, MASQ-D30, SF-36, and DAPP-SF. Clinical information aided by ROM data may represent the best means to appraise the clinical state of psychiatric outpatients.

  15. Accuracy and Quality of Routine Immunisation Data Monitoring ...

    TNHJOURNALPH

    Accuracy and Quality of Routine Immunisation Data Monitoring. System in two South-Eastern Districts of Nigeria. AkinolaAyoola Fatiregun, CeciliaAwogu. Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of. Medicine, University ofibadan, Ibadan, Nigeria. ABSTRACT. BACKGROUND.

  16. Less frequently mutated genes in colorectal cancer: evidences from next-generation sequencing of 653 routine cases.

    Malapelle, Umberto; Pisapia, Pasquale; Sgariglia, Roberta; Vigliar, Elena; Biglietto, Maria; Carlomagno, Chiara; Giuffrè, Giuseppe; Bellevicine, Claudio; Troncone, Giancarlo

    2016-09-01

    The incidence of RAS/RAF/PI3KA and TP53 gene mutations in colorectal cancer (CRC) is well established. Less information, however, is available on other components of the CRC genomic landscape, which are potential CRC prognostic/predictive markers. Following a previous validation study, ion-semiconductor next-generation sequencing (NGS) was employed to process 653 routine CRC samples by a multiplex PCR targeting 91 hotspot regions in 22 CRC significant genes. A total of 796 somatic mutations in 499 (76.4%) tumours were detected. Besides RAS/RAF/PI3KA and TP53, other 12 genes showed at least one mutation including FBXW7 (6%), PTEN (2.8%), SMAD4 (2.1%), EGFR (1.2%), CTNNB1 (1.1%), AKT1 (0.9%), STK11 (0.8%), ERBB2 (0.6%), ERBB4 (0.6%), ALK (0.2%), MAP2K1 (0.2%) and NOTCH1 (0.2%). In a routine diagnostic setting, NGS had the potential to generate robust and comprehensive genetic information also including less frequently mutated genes potentially relevant for prognostic assessments or for actionable treatments. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  17. A CR-39 track dosemeter for routine individual neutron monitoring

    Luszik-Bhadra, M.; Alberts, W.G.; Dietz, E.; Guldbakke, S.; Matzke, M.; d'Errico, F.

    1994-01-01

    A personal neutron dosemeter for routine individual monitoring is proposed. It is based on a CR-39 track detector covered on three separate areas by converters with different boron contents and inserted into a commercial TLD albedo dosemeter capsule. The dose readings from three areas of the electrochemically etched CR-39 detector are combined to yield a dose equivalent response which is almost independent of the incident neutron energy in the range from thermal neutrons up to 20 MeV. In addition, the dose contributions of thermal, intermediate and fast neutrons can be determined separately. Unlike the TLD albedo dosemeter, which in general requires prior in-field calibration and whose use is then restricted to that field, this dosemeter can be used in neutron fields without any knowledge of the spectral distribution with the same calibration factor. The angular dependence of the dosemeter's response has been measured and compared with that of the directional dose equivalent H'(10). The lower limit of detection is 0.15 mSv. It is possible to obtain an independent, second dose reading from the same Cr-39 detector for neutron energies above 100 keV. The dosemeter has also been successfully tested for use in accident dosimetry applying chemical etching and an optical density reading of the CR-39 detector. (author)

  18. Routine soil testing to monitor heavy metals and boron

    Abreu Cleide Aparecida de

    2005-01-01

    Full Text Available Microelements are an important issue in agriculture, due to their need as micronutrients for plants and also to the possibility of the build-up of toxic levels for plants and animals. Five micronutrients (B, Cu, Fe, Mn, and Zn are routinely determined in soil analysis for advisory purposes. Other four elements (Cd, Cr, Pb, and Ni are considered environmentally important heavy metals in farmland soils. Thus high contents of these metals in cropland might go eventually unnoticed. In this paper we present an approach that can be used to monitor the contents of the nine elements in farmland soils using advisory soil testing. A total of 13,416 soil samples from 21 Brazilian states, 58% of them from the state of São Paulo, sent by farmers were analyzed. Boron was determined by hot water extraction and the other metals were determined by DTPA (pH 7.3 extraction. The ranges of content, given in mg dm-3 soil, were the following: B, 0.01-10.6; Cu, 0.1-56.2; Fe, 0.5-476; Mn, 1-325; Zn, 1-453; Cd, 0.00-3.43, Cr, 0.00-42.9; Ni, 0.00-65.1; Pb, 0.00-63.9. The respective average values for São Paulo were: B-0.32; Cu-2.5; Fe-36; Mn-16; Zn-4.8; Cd-0.02; Cr-0.03; Ni-0.18; Pb-0.85. For other states the results are in the same ranges. The higher values are indicative of anthropogenic inputs, either due to excess application of fertilizers or to industrial or mining activities. The conclusion is that massive chemical analysis of farmland soil samples could serve as a database for indicating potential micronutrient deficiency and excesses or heavy metal buil-up in croplands, allowing preventive actions to be taken.

  19. Routine Radiological Environmental Monitoring Plan, Volume 2 Appendices

    Bechtel Nevada

    1998-12-31

    Supporting material for the plan includes: QUALITY ASSURANCE, ANALYSIS, AND SAMPLING PLAN FOR NTS AIR; QUALITY ASSURANCE, ANALYSIS, AND SAMPLING PLAN FOR WATER ON AND OFF THE NEVADA TEST SITE; QUALITY ASSURANCE, ANALYSIS, AND SAMPLING PLAN FOR NTS BIOTA; QUALITY ASSURANCE, ANALYSIS, AND SAMPLING PLAN FOR DIRECT RADIATION MONITORING; DATA QUALITY OBJECTIVES PROCESS; VADOSE ZONE MONITORING PLAN CHECKLIST.

  20. Monitoring patients with rheumatoid arthritis in routine care

    Hetland, Merete Lund; Jensen, Dorte Vendelbo; Krogh, Niels Steen

    2014-01-01

    OBJECTIVES: Advances in aggressive use of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) as well as biological DMARDs (bDMARDs) have improved the treatment armamentarium for rheumatologists, and modern treatment principles include a treat-to-target (T2T) strategy. However......, little is known about the feasibility of a T2T strategy in patients with rheumatoid arthritis (RA) treated in routine care. The aim of the present study was to (i) present the annual number of patients included in DANBIO between 2006 and 2013 and their disease characteristics and (ii) estimate coverage...

  1. How conservative is routine personal dosimetry monitoring in diagnostic radiology?

    Boetticher, H. von; Lachmund, J.; Hoffmann, W.

    2007-01-01

    Purpose: Dose values obtained by official personal radiation exposure monitoring are often considered equivalent to the effective dose of a person. This paper provides estimates of the extent of deviation between the two dose concepts under various conditions. Materials and Methods: Doses for patients and personnel were measured using thermoluminescence dosimeters for five different geometries at three work settings in a radiology department. Patients and personnel were simulated with anthropomorphic phantoms. Different types of protective clothing as well as permanent protection shields were considered in the calculations. Results: Dose values obtained by official personal dose monitoring are conservative only for specific radiation protection situations. With state-of-the-art personal protective equipment (wrap-around style lead apron with thyroid shield), the ratio between effective dose and personal dose varies between 0.6 and 1.25. Without thyroid protection the official personal dose systematically underestimates the effective dose: for protective clothing with 0.5 mm lead equivalent without thyroid shielding, the effective dose exceeds the personal dose by factors between 1.7 and 3.1. If protective clothing with lead equivalent 0.35 mm is used, this factor varies between 1.1 and 1.82. (orig.)

  2. System for remote routine monitoring of power equipment at TPP and NPP

    Kantsedalov, V.G.; Samojlenko, V.P.; Doroshenko, V.A.

    1988-01-01

    A system for remote routine monitoring of TPP and NPP pipeline metals is described. The principal functional unit of the system is the unit of remote routine methods and techniques for studying and monitoring the metal and properties. The system is equipped with 5 types of routine monitoring equipment: robots, remote aggregated complexes, periodical diagnostic monitors, other means of metal diagnostics (endoscopes, introscopes). All current information enters the unit for estimating and forecasting the service life of power unit, where it is compared with the standard indices of reliability, duravility and efficiency. The system considered permits to reduce significantly or minimize the scope of works on metal monitoring during overhauls, increase intermonitoring and interrepairing compaigns to 8 years

  3. Monitoring patients with rheumatoid arthritis in routine care

    Hetland, Merete Lund; Jensen, Dorte Vendelbo; Krogh, Niels Steen

    2014-01-01

    disease activity, less disability and radiographic damage. By 2013, 19% of csDMARD (15% of bDMARD) patients were in ACR/Boolean remission. Coverage had increased to between 41% and 79% for patients with RA, for the bDMARD group it was 94%. CONCLUSIONS: Systematic monitoring of RA patients with real....../moderate/high disease activity (i.e. DAS28 (CRP-based, 4 variables) was calculated for each calendar year. RESULTS: From 2006-2013 the number of patients increased from 2,395 to 14,249. By 2013, 29.8% of patients were receiving bDMARD. Patients in the csDMARD group were older, had shorter disease duration, lower...

  4. An approach to routine individual internal dose monitoring at the object 'Shelter' personnel considering uncertainties

    Mel'nichuk, D.V.; Bondarenko, O.O.; Medvedjev, S.Yu.

    2002-01-01

    An approach to organisation of routine individual internal dose monitoring of the personnel of the Object 'Shelter' is presented in the work, that considers individualised uncertainties. In this aspect two methods of effective dose assessment based on bioassay are considered in the work: (1) traditional indirect method at which application results of workplace monitoring are not taken into account, and (2) a combined method in which both results of bioassay measurements and workplace monitoring are considered

  5. [Use of routine data from statutory health insurances for federal health monitoring purposes].

    Ohlmeier, C; Frick, J; Prütz, F; Lampert, T; Ziese, T; Mikolajczyk, R; Garbe, E

    2014-04-01

    Federal health monitoring deals with the state of health and the health-related behavior of populations and is used to inform politics. To date, the routine data from statutory health insurances (SHI) have rarely been used for federal health monitoring purposes. SHI routine data enable analyses of disease frequency, risk factors, the course of the disease, the utilization of medical services, and mortality rates. The advantages offered by SHI routine data regarding federal health monitoring are the intersectoral perspective and the nearly complete absence of recall and selection bias in the respective population. Further, the large sample sizes and the continuous collection of the data allow reliable descriptions of the state of health of the insurants, even in cases of multiple stratification. These advantages have to be weighed against disadvantages linked to the claims nature of the data and the high administrative hurdles when requesting the use of SHI routine data. Particularly in view of the improved availability of data from all SHI insurants for research institutions in the context of the "health-care structure law", SHI routine data are an interesting data source for federal health monitoring purposes.

  6. Model-based prediction of myelosuppression and recovery based on frequent neutrophil monitoring.

    Netterberg, Ida; Nielsen, Elisabet I; Friberg, Lena E; Karlsson, Mats O

    2017-08-01

    To investigate whether a more frequent monitoring of the absolute neutrophil counts (ANC) during myelosuppressive chemotherapy, together with model-based predictions, can improve therapy management, compared to the limited clinical monitoring typically applied today. Daily ANC in chemotherapy-treated cancer patients were simulated from a previously published population model describing docetaxel-induced myelosuppression. The simulated values were used to generate predictions of the individual ANC time-courses, given the myelosuppression model. The accuracy of the predicted ANC was evaluated under a range of conditions with reduced amount of ANC measurements. The predictions were most accurate when more data were available for generating the predictions and when making short forecasts. The inaccuracy of ANC predictions was highest around nadir, although a high sensitivity (≥90%) was demonstrated to forecast Grade 4 neutropenia before it occurred. The time for a patient to recover to baseline could be well forecasted 6 days (±1 day) before the typical value occurred on day 17. Daily monitoring of the ANC, together with model-based predictions, could improve anticancer drug treatment by identifying patients at risk for severe neutropenia and predicting when the next cycle could be initiated.

  7. Interpolation of extensive routine water pollution monitoring datasets: methodology and discussion of implications for aquifer management

    Yuval; Y. Rimon; E. R. Graber; A. Furman

    2013-01-01

    A large fraction of the fresh water available for human use is stored in groundwater aquifers. Since human activities such as mining, agriculture, industry and urbanization often result in incursion of various pollutants to groundwater, routine monitoring of water quality is an indispensable component of judicious aquifer management. Unfortunately, groundwater pollution monitoring is expensive and usually cannot cover an aquifer with the spatial resolution necessary for making adequate...

  8. Possible roles for frequent salivary antiepileptic drug monitoring in the management of epilepsy.

    Herkes, G K; Eadie, M J

    1990-07-01

    Salivary levels of phenytoin, phenobarbitone, carbamazepine and carbamazepine-epoxide correlate with the simultaneous plasma water levels of these substances, after correcting for the effects of pH differences between saliva and plasma in the case of phenobarbitone. Saliva is easy and painless to collect, and salivary levels of the drugs are conveniently measured. Frequent (often daily) monitoring of pre-dose morning anticonvulsant drug concentrations in saliva over periods of weeks or months in 3 groups of epileptic subjects showed that (i) in some but not all poorly controlled epileptic patients seizures tended to occur on days when salivary anticonvulsant levels were lower than on non-seizure days, (ii) in such subjects it was possible to estimate an anticipated optimal drug concentration and dose to minimize seizure activity from the plot of seizure frequency against drug concentrations, (iii) in women with 'catamenial' epilepsy, salivary anticonvulsant levels were lower on perimenstrual days than at mid-cycle in half of the subjects studied, and (iv) in pregnant epileptic women the time course of the change in drug levels relative to dose could be followed more closely throughout pregnancy and the post-natal period than was practicable when using blood level measurements. Frequent measurement of salivary anticonvulsant concentrations appears a promising and inexpensive adjunct to the investigation and management of certain problem areas in epilepsy.

  9. Improvements in routine internal monitoring - An overview of the IDEA project

    Schmitzer, C.; Fischer, H.; Andrasi, A.; Bouvier, C.; Carlan, L.; Franck, D.; Hollriegl, V.; Li, W. B.; Oeh, U.; Ritt, J.; Roth, P.; Wahl, W.; Zombori, P.

    2007-01-01

    The IDEA project aimed to improve the assessment of incorporated radionuclides through developments of advanced in vivo and bioassay monitoring techniques and making use of such enhancements for improvements in routine monitoring. Many of these findings are not new in the sense that they are being already employed in advanced laboratories or for specialised applications. The primary goal was to categorise those new developments regarding their potential and eligibility for the routine monitoring community. Attention has been given to in vivo monitoring techniques with respect to detector characteristics and measurement geometry to improve measurement efficiency with special attention to low energy gamma emitters. Calibration - specifically supported by or through methods of numerical simulation - have been carefully analysed to reduce overall measurement uncertainties and explore ways to accommodate the individual variability based on characteristic features of a given person. For bioassay measurements at low detection limits, inductively coupled plasma mass spectroscopy offers significant advantages both in accuracy, speed, and sample preparation. Specifically, the determination of U and Th in urine and the associated models have been investigated. Finally, the scientific achievements have been analysed regarding their potential to offer benefits for routine monitoring. These findings will be presented in greater detail in other papers at this conference, whereas this paper intends to give an overview and put both the scientific achievements as well as the derived benefits into perspective. (authors)

  10. Improvements in routine internal monitoring - an overview of the IDEA project

    Schmitzer, C.; Fischer, H.; Schlagbauer, M.; Bouvier, C.; Carlan, L.; Franck, D.; Ritt, J.; Hoellriegl, V.; Li, W.B.; Oeh, U.; Roth, P.; Wahl, W.; Andrasi, A.; Zombori, P.

    2005-01-01

    Full text: The IDEA project aimed to improve the assessment of incorporated radionuclides through developments of advanced in-vivo and bioassay monitoring techniques and making use of such enhancements for improvements in routine monitoring. Many of those findings are not new in the sense that they are being already employed in advanced laboratories or for specialized applications. The primary goal was to categorize those new developments regarding their potential and eligibility for the routine monitoring community. Attention has been given to in-vivo monitoring techniques with respect to detector characteristics and measurement geometry to improve measurement efficiency with special attention to low energy gamma emitters. Calibration - specifically supported by or through methods of numerical simulation - have been carefully analyzed to reduce overall measurement uncertainties and explore ways to accommodate the individual variability based on characteristic features of a given person. For bioassay measurements at low detection limits, inductively coupled plasma mass spectroscopy offers significant advantages both in accuracy, speed, and sample preparation. Specifically, the determination of U and Th in urine and the associated models have been investigated. Finally, the scientific achievements have been analyzed regarding their potential to offer benefits for routine monitoring. These findings will be presented in greater detail in other papers at this conference, whereas this paper intends to give an overview and put both the scientific achievements as well as the derived benefits into perspective. (author)

  11. Methods to improve routine bioassay monitoring for freshly separated, poorly transported plutonium

    Bihl, D.E.; Lynch, T.P.; Carbaugh, E.H.; Sula, M.J.

    1988-09-01

    Several human cases involving inhalation of plutonium oxide at Hanford have shown clearance half-times from the lung that are much longer than the 500-day half-time recommended for class Y plutonium in Publication 30 of the International Commission on Radiological Protection(ICRP). The more tenaciously retained material is referred to as super class Y plutonium. The ability to detect super class Y plutonium by current routine bioassay measurements is shown to be poor. Pacific Northwest Laboratory staff involved in the Hanford Internal Dosimetry Program investigated four methods to se if improvements in routine monitoring of workers for fresh super class Y plutonium are feasible. The methods were lung counting, urine sampling, fecal sampling, and use of diethylenetriaminepentaacetate (DTPA) to enhance urinary excretion. Use of DTPA was determined to be not feasible. Routine fecal sampling was found to be feasible but not recommended. Recommendations were made to improve the detection level for routine annual urinalysis and routine annual lung counting. 12 refs., 9 figs., 7 tabs

  12. Assessing the need for a routine monitoring program in three Nuclear Medicine centers in Chile

    Astudillo, R.; Hermosilla, A.; Diaz-Londono, G.; Garcia, M.

    2015-01-01

    The workers performing different activities with radionuclides in nuclear medicine centers are at potential risk of external exposure and internal contamination. The IAEA Safety Guide No. RS-G-1.2 proposed criteria for determining the need for a routine monitoring program to assess internal contamination. For this purpose, an Excel template containing the IAEA criteria was applied in three nuclear medicine centers in Chile. The results show that it is necessary to carry out a routine monitoring program for five workers who handle 131 I and three for 99m Tc. We propose to implement this template at a national level in order to improve the conditions of radiation protection in the participating centers. (authors)

  13. Serum HER-2 concentrations for monitoring women with breast cancer in a routine oncology setting

    Sørensen, Patricia Diana; Jakobsen, Erik Hugger; Langkjer, Sven Tyge

    2009-01-01

    BACKGROUND: The purpose of this study was to determine the positive predictive value (PPV) of positive serum human epidermal growth factor receptor-2 (HER-2) for monitoring women with breast cancer following diagnosis and treatment in a routine clinical setting. METHODS: Serum HER-2 was measured...... could be determined in ten tissue-positive patients was 3-24 months (mean 11.3 months), when compared to standard clinical imaging methods. CONCLUSIONS: Serum HER-2 is a useful marker for the detection of recurrence of breast cancer and for monitoring the effect of treatment, especially in tissue HER-2...... in 1348 patients with breast cancer: 837 during routine oncology clinic visits and 511 following new diagnosis. All patients with positive serum HER-2, 1/5 of negative patients from the oncology clinic, and all the newly diagnosed were followed; a total of 862 patients. Serum HER-2 was measured using...

  14. Omitting cytogenetic assessment from routine treatment response monitoring in chronic myeloid leukemia is safe.

    Geelen, Inge G P; Thielen, Noortje; Janssen, Jeroen J W M; Hoogendoorn, Mels; Roosma, Tanja J A; Valk, Peter J M; Visser, Otto; Cornelissen, Jan J; Westerweel, Peter E

    2018-04-01

    The monitoring of response in chronic myeloid leukemia (CML) is of great importance to identify patients failing their treatment in order to adjust TKI choice and thereby prevent progression to advanced stage disease. Cytogenetic monitoring has a lower sensitivity, is expensive, and requires invasive bone marrow sampling. Nevertheless, chronic myeloid leukemia guidelines continue to recommend performing routine cytogenetic response assessments, even when adequate molecular diagnostics are available. In a population-based registry of newly diagnosed CML patients in the Netherlands, all simultaneous cytogenetic and molecular assessments performed at 3, 6, and 12 months were identified and response of these matched assessments was classified according to European Leukemia Net (ELN) recommendations. The impact of discrepant cytogenetic and molecular response classifications and course of patients with additional chromosomal abnormalities were evaluated. The overall agreement of 200 matched assessments was 78%. In case of discordant responses, response at 24 months was consistently better predicted by the molecular outcome. Cytogenetic response assessments provided relevant additional clinical information only in some cases of molecular "warning." The development of additional cytogenetic abnormalities was always accompanied with molecular failure. We conclude that it is safe to omit routine cytogenetics for response assessment during treatment and to only use molecular monitoring, in order to prevent ambiguous classifications, reduce costs, and reduce the need for invasive bone marrow sampling. Cytogenetic re-assessment should still be performed when molecular response is suboptimal. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Flow cytometric bacterial cell counts challenge conventional heterotrophic plate counts for routine microbiological drinking water monitoring

    Van Nevel, S.

    2017-02-08

    Drinking water utilities and researchers continue to rely on the century-old heterotrophic plate counts (HPC) method for routine assessment of general microbiological water quality. Bacterial cell counting with flow cytometry (FCM) is one of a number of alternative methods that challenge this status quo and provide an opportunity for improved water quality monitoring. After more than a decade of application in drinking water research, FCM methodology is optimised and established for routine application, supported by a considerable amount of data from multiple full-scale studies. Bacterial cell concentrations obtained by FCM enable quantification of the entire bacterial community instead of the minute fraction of cultivable bacteria detected with HPC (typically < 1% of all bacteria). FCM measurements are reproducible with relative standard deviations below 3% and can be available within 15 min of samples arriving in the laboratory. High throughput sample processing and complete automation are feasible and FCM analysis is arguably less expensive than HPC when measuring more than 15 water samples per day, depending on the laboratory and selected staining procedure(s). Moreover, many studies have shown FCM total (TCC) and intact (ICC) cell concentrations to be reliable and robust process variables, responsive to changes in the bacterial abundance and relevant for characterising and monitoring drinking water treatment and distribution systems. The purpose of this critical review is to initiate a constructive discussion on whether FCM could replace HPC in routine water quality monitoring. We argue that FCM provides a faster, more descriptive and more representative quantification of bacterial abundance in drinking water.

  16. Flow cytometric bacterial cell counts challenge conventional heterotrophic plate counts for routine microbiological drinking water monitoring

    Van Nevel, S.; Koetzsch, S.; Proctor, C.R.; Besmer, M.D.; Prest, E.I.; Vrouwenvelder, Johannes S.; Knezev, A.; Boon, N.; Hammes, F.

    2017-01-01

    Drinking water utilities and researchers continue to rely on the century-old heterotrophic plate counts (HPC) method for routine assessment of general microbiological water quality. Bacterial cell counting with flow cytometry (FCM) is one of a number of alternative methods that challenge this status quo and provide an opportunity for improved water quality monitoring. After more than a decade of application in drinking water research, FCM methodology is optimised and established for routine application, supported by a considerable amount of data from multiple full-scale studies. Bacterial cell concentrations obtained by FCM enable quantification of the entire bacterial community instead of the minute fraction of cultivable bacteria detected with HPC (typically < 1% of all bacteria). FCM measurements are reproducible with relative standard deviations below 3% and can be available within 15 min of samples arriving in the laboratory. High throughput sample processing and complete automation are feasible and FCM analysis is arguably less expensive than HPC when measuring more than 15 water samples per day, depending on the laboratory and selected staining procedure(s). Moreover, many studies have shown FCM total (TCC) and intact (ICC) cell concentrations to be reliable and robust process variables, responsive to changes in the bacterial abundance and relevant for characterising and monitoring drinking water treatment and distribution systems. The purpose of this critical review is to initiate a constructive discussion on whether FCM could replace HPC in routine water quality monitoring. We argue that FCM provides a faster, more descriptive and more representative quantification of bacterial abundance in drinking water.

  17. Interpolation of extensive routine water pollution monitoring datasets: methodology and discussion of implications for aquifer management.

    Yuval, Yuval; Rimon, Yaara; Graber, Ellen R; Furman, Alex

    2014-08-01

    A large fraction of the fresh water available for human use is stored in groundwater aquifers. Since human activities such as mining, agriculture, industry and urbanisation often result in incursion of various pollutants to groundwater, routine monitoring of water quality is an indispensable component of judicious aquifer management. Unfortunately, groundwater pollution monitoring is expensive and usually cannot cover an aquifer with the spatial resolution necessary for making adequate management decisions. Interpolation of monitoring data is thus an important tool for supplementing monitoring observations. However, interpolating routine groundwater pollution data poses a special problem due to the nature of the observations. The data from a producing aquifer usually includes many zero pollution concentration values from the clean parts of the aquifer but may span a wide range of values (up to a few orders of magnitude) in the polluted areas. This manuscript presents a methodology that can cope with such datasets and use them to produce maps that present the pollution plumes but also delineates the clean areas that are fit for production. A method for assessing the quality of mapping in a way which is suitable to the data's dynamic range of values is also presented. A local variant of inverse distance weighting is employed to interpolate the data. Inclusion zones around the interpolation points ensure that only relevant observations contribute to each interpolated concentration. Using inclusion zones improves the accuracy of the mapping but results in interpolation grid points which are not assigned a value. The inherent trade-off between the interpolation accuracy and coverage is demonstrated using both circular and elliptical inclusion zones. A leave-one-out cross testing is used to assess and compare the performance of the interpolations. The methodology is demonstrated using groundwater pollution monitoring data from the coastal aquifer along the Israeli

  18. Monitoring plan for routine organic air emissions at the Radioactive Waste Management Complex Waste Storage Facilities

    Galloway, K.J.; Jolley, J.G.

    1994-06-01

    This monitoring plan provides the information necessary to perform routine organic air emissions monitoring at the Waste Storage Facilities located at the Transuranic Storage Area of the Radioactive Waste Management Complex at the Idaho National Engineering Laboratory. The Waste Storage Facilities include both the Type I and II Waste Storage Modules. The plan implements a dual method approach where two dissimilar analytical methodologies, Open-Path Fourier Transform Infrared Spectroscopy (OP-FTIR) and ancillary SUMMA reg-sign canister sampling, following the US Environmental Protection Agency (EPA) analytical method TO-14, will be used to provide qualitative and quantitative volatile organic concentration data. The Open-Path Fourier Transform Infrared Spectroscopy will provide in situ, real time monitoring of volatile organic compound concentrations in the ambient air of the Waste Storage Facilities. To supplement the OP-FTIR data, air samples will be collected using SUMMA reg-sign, passivated, stainless steel canisters, following the EPA Method TO-14. These samples will be analyzed for volatile organic compounds with gas chromatograph/mass spectrometry analysis. The sampling strategy, procedures, and schedules are included in this monitoring plan. The development of this monitoring plan is driven by regulatory compliance to the Resource Conservation and Recovery Act, State of Idaho Toxic Air Pollutant increments, Occupational Safety and Health Administration. The various state and federal regulations address the characterization of the volatile organic compounds and the resultant ambient air emissions that may originate from facilities involved in industrial production and/or waste management activities

  19. A portable detection system for in vivo monitoring of 131I in routine and emergency situations

    Lucena, EA; Dantas, ALA; Dantas, BM

    2018-03-01

    In vivo monitoring of 131I in human thyroid is often used to evaluate occupational exposure in nuclear medicine facilities and in the case of accidental intakes in nuclear power plants for the monitoring of workers and population. The device presented in this work consists on a Pb-collimated NaI(Tl)3”x3” scintillation detector assembled on a tripod and connected to a portable PC. The evaluation of the applicability and limitations of the system is based on the estimation of the committed effective doses associated to the minimum detectable activities in different facilities. It has been demonstrated that the system is suitable for use in routine and accidental situations.

  20. Interpolation of extensive routine water pollution monitoring datasets: methodology and discussion of implications for aquifer management

    Yuval; Rimon, Y.; Graber, E. R.; Furman, A.

    2013-07-01

    A large fraction of the fresh water available for human use is stored in groundwater aquifers. Since human activities such as mining, agriculture, industry and urbanization often result in incursion of various pollutants to groundwater, routine monitoring of water quality is an indispensable component of judicious aquifer management. Unfortunately, groundwater pollution monitoring is expensive and usually cannot cover an aquifer with the spatial resolution necessary for making adequate management decisions. Interpolation of monitoring data between points is thus an important tool for supplementing measured data. However, interpolating routine groundwater pollution data poses a special problem due to the nature of the observations. The data from a producing aquifer usually includes many zero pollution concentration values from the clean parts of the aquifer but may span a wide range (up to a few orders of magnitude) of values in the polluted areas. This manuscript presents a methodology that can cope with such datasets and use them to produce maps that present the pollution plumes but also delineates the clean areas that are fit for production. A method for assessing the quality of mapping in a way which is suitable to the data's dynamic range of values is also presented. Local variant of inverse distance weighting is employed to interpolate the data. Inclusion zones around the interpolation points ensure that only relevant observations contribute to each interpolated concentration. Using inclusion zones improves the accuracy of the mapping but results in interpolation grid points which are not assigned a value. That inherent trade-off between the interpolation accuracy and coverage is demonstrated using both circular and elliptical inclusion zones. A leave-one-out cross testing is used to assess and compare the performance of the interpolations. The methodology is demonstrated using groundwater pollution monitoring data from the Coastal aquifer along the Israeli

  1. [Incorporation monitoring of employees of a radioiodine therapy ward. Is incorporation monitoring required for routine?].

    Happel, C; Kratzel, U; Selkinski, I; Bockisch, B; Etzel, M; Korkusuz, H; Sauter, B; Staudt, J; von Müller, F; Grünwald, F; Kranert, W T

    2013-01-01

    Aim of the study was to determine the annual incorporation of staff on a radioiodine therapy ward and the resulting annual effective dose (aed). Following the German incorporation guideline (gig), incorporation monitoring is not necessary for potential aed below 0.5 mSv/a. For aed > 0.5 mSv/a adherence to the 1 mSv dose limit must be verified. For doses > 1 mSv/a incorporation has to be monitored by the authority. Furthermore, the (131)I incorporation factor from the gig should be verified. To determine the actual work related incorporation, the (131)I activity concentration in urine samples (collection over 24 h) of 14 employees of different professions were examined over a period of 27 months. Measured activity concentrations were related to the individual time of exposure. A constant activity supply for at least three days was assumed. The mean annual effective doses were 2.4 · 10⁻¹ mSv/a (nursing staff; n = 3), 5.6 · 10⁻² mSv/a (cleaning staff; n = 2), 2.8 · 10⁻³ mSv/a (technical staff; n = 2) and 5.2 · 10⁻³ mSv/a (physicians; n = 7). All aed were below the dose limits of the gig. The calculated mean incorporation factors ranged from 3.0 · 10⁻⁸ for the nursing staff to 3.6 · 10⁻¹⁰ for the technical staff (cleaning staff: 7 · 10⁻⁹; physicians: 6.5 · 10⁻¹⁰) and were therefore well below the (131)I incorporation factor defined by the gig. To estimate the aed caused by incorporation of (131)I it has to be subdivided for the different requirements in the diverse fields of activity of the employees. Regarding those who spend most of their time nearby the patient an incorporation monitoring by the authority might be required. The (131)I incorporation factor from the guideline (10⁻⁶) can be reduced by a factor of 10. For (99m)Tc and (18)F an incorporation factor of 10⁻⁷ is accepted.

  2. Impact of routine transvaginal ultrasound monitoring of cervical length in twins on administration of antenatal corticosteroids.

    Marcellin, Louis; Senat, Marie Victoire; Benachi, Alexandra; Regis, Sophie; Cabrol, Dominique; Goffinet, François

    2017-05-24

    To evaluate whether routine measurement of cervical length (CL) by transvaginal ultrasound (TVU) in twin pregnancies can enable identification of women who will give birth before 34 weeks and require antenatal corticosteroids (ACSs), and whether it can limit their administration to women who will give birth later. Retrospective comparative study in two tertiary referral centers in France. Women with twin gestations followed in two tertiary university hospital maternity units and who delivered from January 1, 2007 to December 31, 2009 were included. In one center, TVU was targeted to women with cases of suspected preterm labor, while the other center used it monthly for all twin pregnancies. The main outcome measure was the administration of a full course of ACS to twins delivered before 34 weeks. Two hundred and seventy women were eligible in the "targeted use" group, and 296 women in the "routine use" group. The rate of administration of at least one full course of ACS for twins born before 34 weeks did not differ between the two groups (85.0% in the targeted use group and 90.0% in the routine use group, P=0.40), but the rate of such administration for those born after 34 weeks was lower in the targeted use group (25.7% vs. 81.2%, P<0.01). On adjusting for confounders using logistic regression modeling, no significant difference in ACS administration before 34 weeks was found between the two groups [adjusted odds ratio (aOR), 0.71, 95% confidence interval (CI), 0.39-1.30]. Routine monitoring performed every month of CL with TVU does not affect the rate of administration of ACS to twins born before 34 weeks, but is associated with a higher rate of such administration for those born later in the specific center of the study.

  3. Direct internal dosimetry. A new way for routine incorporation monitoring of γ-emitting radionuclides

    Doerfel, H.

    1996-01-01

    The INDOS detector system offers the following advantages with respect to routine incorporation monitoring: The measurement is performed automatically and there is no need for trained staff. The measuring time is short and thus a relative large number of persons may be monitored with a relative high measuring frequency. First estimates of the individual effective dose equivalent rate are available immediately after the measurement. 1) The direct determination of the dose equivalent in principle is more precise than the conventional procedures for internal dosimetry, because (i) the retention of radionuclides in the body may be measured explicitly and (ii) the dependence of the dose equivalent on the body proportions is corrected implicitly. 2) The measuring procedure is comparable to the external dosimetry with respect to accuracy and lower limit of detection. Thus, the results of internal and external dosimetry can be summed up in an easy and reasonable manner. 3) The detector system can be installed in any building; it also can be installed as a mobile unit in a car or a container for long distance transportation by aircraft or train. 4) Last but not least, the cost for monitoring with INDOS is much lower than for the conventional monitoring procedures using whole body counters. (author)

  4. Test-retest of computerized health status questionnaires frequently used in the monitoring of knee osteoarthritis

    Gudbergsen, Henrik; Bartels, Else M.; Krusager, Peter

    2011-01-01

    ABSTRACT: BACKGROUND: To compare data based on touch screen to data based on traditional paper versions of questionnaires frequently used to examine patient reported outcomes in knee osteoarthritis patients and to examine the impact of patient characteristics on this comparison METHODS: Participa......ABSTRACT: BACKGROUND: To compare data based on touch screen to data based on traditional paper versions of questionnaires frequently used to examine patient reported outcomes in knee osteoarthritis patients and to examine the impact of patient characteristics on this comparison METHODS...... subgroups, completing either the paper or touch screen version first. Mean, mean differences (95% CI), median, median differences and Intraclass Correlation Coefficients (ICCs) were calculated for all questionnaires. RESULTS: ICCs between data based on computerized and paper versions ranged from 0.86 to 0.......99. Analysis revealed a statistically significant difference between versions of the ADL Taxonomy, but not for the remaining questionnaires. Age, computer experience or education-level had no significant impact on the results. The computerized questionnaires were reported to be easier to use. CONCLUSION...

  5. Routine Outcome Monitoring and Clinical Decision-Making in Forensic Psychiatry Based on the Instrument for Forensic Treatment Evaluation.

    van der Veeken, Frida C A; Lucieer, Jacques; Bogaerts, Stefan

    2016-01-01

    Rehabilitation in forensic psychiatry is achieved gradually with different leave modules, in line with the Risk Need Responsivity model. A forensic routine outcome monitoring tool should measure treatment progress based on the rehabilitation theory, and it should be predictive of important treatment outcomes in order to be usable in decision-making. Therefore, this study assesses the predictive validity for both positive (i.e., leave) and negative (i.e., inpatient incidents) treatment outcomes with the Instrument for Forensic Treatment Evaluation (IFTE). Two-hundred and twenty-four patients were included in this study. ROC analyses were conducted with the IFTE factors and items for three leave modules: guided, unguided and transmural leave for the whole group of patients. Predictive validity of the IFTE for aggression in general, physical aggression specifically, and urine drug screening (UDS) violations was assessed for patients with the main diagnoses in Dutch forensic psychiatry, patients with personality disorders and the most frequently occurring co-morbid disorders: those with combined personality and substance use disorders. Results tentatively imply that the IFTE has a reasonable to good predictive validity for inpatient aggression and a marginal to reasonable predictive value for leave approvals and UDS violations. The IFTE can be used for information purposes in treatment decision-making, but reports should be interpreted with care and acknowledge patients' personal risk factors, strengths and other information sources.

  6. Improvement of burn pain management through routine pain monitoring and pain management protocol.

    Yang, Hyeong Tae; Hur, Giyeun; Kwak, In-Suk; Yim, Haejun; Cho, Yong Suk; Kim, Dohern; Hur, Jun; Kim, Jong Hyun; Lee, Boung Chul; Seo, Cheong Hoon; Chun, Wook

    2013-06-01

    Pain management is an important aspect of burn management. We developed a routine pain monitoring system and pain management protocol for burn patients. The purpose of this study is to evaluate the effectiveness of our new pain management system. From May 2011 to November 2011, the prospective study was performed with 107 burn patients. We performed control group (n=58) data analysis and then developed the pain management protocol and monitoring system. Next, we applied our protocol to patients and performed protocol group (n=49) data analysis, and compared this to control group data. Data analysis was performed using the Numeric Rating Scale (NRS) of background pain and procedural pain, Clinician-Administered PTSD Scale (CAPS), Hamilton Depression Rating Scale (HDRS), State-Trait Anxiety Inventory Scale (STAIS), and Holmes and Rahe Stress Scale (HRSS). The NRS of background pain for the protocol group was significantly decreased compared to the control group (2.8±2.0 versus 3.9±1.9), and the NRS of procedural pain of the protocol group was significantly decreased compared to the control group (4.8±2.8 versus 3.7±2.5). CAPS and HDRS were decreased in the protocol group, but did not have statistical significance. STAIS and HRSS were decreased in the protocol group, but only the STAIS had statistical significance. Our new pain management system was effective in burn pain management. However, adequate pain management can only be accomplished by a continuous and thorough effort. Therefore, pain control protocol and pain monitoring systems need to be under constant revision and improvement using creative ideas and approaches. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  7. Determination of contamination operational value by routine monitoring in research laboratories

    Salomao, Edeilson; Medeiros, Regina Bitelli; Mattos, Maria Fernanda S.S.; Daros, Kellen Adriana Curci

    2008-01-01

    The radioisotopes have a large spectrum of applicability in many areas of science, as in medicine, agriculture and industry in general. In the biological area, the radioisotopes have brought many benefits to study physiological processes in living organisms and in vitro. The most radioisotopes used in biological research are emitters of radiation of low energy, mainly β, and are used as unsealed sources. The manipulation of these radioisotopes generates radioactive wastes and eventually can cause contamination in the areas of handling or even occasionally in areas to which access is not controlled. According to CNEN-NE-3.02 standard is necessary and mandatory the exposure and contamination levels control in the areas of handling of unsealed sources. The goal of the work is to establish how often the monitoring should be done through the survey of the contamination and exposure levels, in areas designed to manipulate 32 P and how this monitoring can contribute to the improvement the conditions of radiological protection. From the twenty eight research laboratories registered by 'Nucleo de Protecao Radiologica' (NPR) were selected four where the activities are not restrict to 32 P biological assays. The levels of contamination and exposure were evaluated using monitors GM and the layout of laboratories containing the points to be tracker defined based on the researchers' routine. At each point three values were obtained to measure the rate of contamination on the surface and exposure rate. The measures were made twice a week before and after the radioisotope manipulation. Based on these data was possible to establish the range from 0,306 to 0,678 Bq.cm -2 as operational average level to the superficial contamination. The average exposure rate measured was 5.16 n C/Kg.h. The results were important to demonstrating to researchers how they can contribute to the improvement of radiological protection conditions. (author)

  8. Family Routines and Parental Monitoring as Protective Factors among Early and Middle Adolescents Affected by Maternal HIV/AIDS

    Murphy, Debra A.; Marelich, William D.; Herbeck, Diane M.; Payne, Diana L.

    2009-01-01

    The influence of parenting skills on adolescent outcomes among children affected by maternal HIV/AIDS (N = 118, M age = 13) was investigated. Among families with more frequent family routines, over time adolescents showed lower rates of aggression, anxiety, worry, depression, conduct disorder, binge drinking, and increased self-concept. Among…

  9. Routine individual monitoring of aircrew: Czech experience and results since 1998

    Spurny, F.; Ploc, O.

    2005-01-01

    Full text: International Commission on Radiological Protection (ICRP) recommended in its Publication 60 that the radiation exposure due to the cosmic component at high altitudes be taken into account when appropriate as part of occupational exposure to the radiation. Air crew members have become in such a way another group of workers for whom the exposure to ionizing radiation is one of important occupational hazard. The recommendation mentioned was incorporated to the Czech regulation already at 1997, the studies how to perform individual dosimetry of Czech companies aircrew has started immediately after. The contribution describes first the preliminary studies with the goal to elaborate optimal procedure for the aircrew routine individual dosimetry. It was decided to perform individual monitoring through the calculation based on the information on the flights realized during a period and the list of aircrew members participated in them. As a transport code CARI was chosen, since the beginning the version 6 has been used. The information on the flight schedules and the participation of aircrew in is received from the air company. In the Czech Republic, three companies are concerned with. The procedure was proposed to the Czech authorities and it received their accreditation. Routine individual dosimetry has started since 1998. It is regularly checked and innovated. Main results for the period 1998 - 2003 are as follows: both relative frequencies as well as average annual effective dosis vary with the company and with the year, without any evident general tendency; the average values of E are between 1.5 and 2 mSv, closely to the higher value; this average value is slightly higher for charter type air-companies. Further more detailed analysis will be presented, as well as future possible modifications of the procedure. (author)

  10. Annual evaluation of routine radiological survey/monitoring frequencies for the High Ranking Facilities Deactivating Project at Oak Ridge, Tennessee

    1998-12-01

    The Bethel Valley Watershed at the Oak Ridge National Laboratory (ORNL) has several Environmental Management (EM) facilities that are designated for deactivation and subsequent decontamination and decommissioning (D and D). The Surplus Facilities Program at ORNL provides surveillance and maintenance support for these facilities as deactivation objectives are completed to reduce the risks associated with radioactive material inventories, etc. The Bechtel Jacobs Company LLC Radiological Control (RADCON) Program has established requirements for radiological monitoring and surveying radiological conditions in these facilities. These requirements include an annual evaluation of routine radiation survey and monitoring frequencies. Radiological survey/monitoring frequencies were evaluated for two High Ranking Facilities Deactivation Project facilities, the Bulk Shielding Facility and Tower Shielding Facility. Considerable progress has been made toward accomplishing deactivation objectives, thus the routine radiological survey/monitoring frequencies are being reduced for 1999. This report identifies the survey/monitoring frequency adjustments and provides justification that the applicable RADCON Program requirements are also satisfied

  11. INAA analysis of rocks: A routine method using Fe as an internal flux monitor

    Kay, R.W.; Kay, S. Mahlburg

    1992-01-01

    Over the past decade at Cornell, trace elements in over 2500 rocks have been analyzed by INAA. The samples, mainly volcanic rocks, have known concentrations of major elements (e.g. Si, Ti, Al, Mg, Ca, K, Fe, Na) and the last two of these (Fe and Na) are also determined by activation, using rock standards (e.g. USGS standards BCRl, BHVO, etc.). Differences between Fe determined by INAA and that determined as a part of the major element analysis are mainly attributed to volatile (H 2 O, CO 2 ) loss (especially when major element analyses were done by electron microprobe on fused powders, whereas the INAA analyses were done on the powders), and to flux variability during irradiation. Instead of reporting two values for Fe we use Fe as an internal flux monitor, with Na and the trace elements being reported relative to the given Fe value. The ratio Na/Fe is used as a sensitive check on the identity of the sample and as a monitor of alkali loss affecting the major element analysis. Other than this modification (Kay et aL 1987, also reported in Chappell and Hergt, 1989) we use an INAA method similar to mat practiced by many labs. Powdered samples (about 0.5 g) are sealed in high-purity silica tubes and irradiated in the Cornell Triga reactor. Samples are counted for a minimum of 2 hours (up to 10 hours) 7 and 40 days after irradiation. Data are reduced using a program written at Cornell, with peak and background regions that have been checked for interferences. Corrections are routinely applied for Ce (Fe), Nd (Br), Tb (Th), Eu (Ba), Lu (U), and Yb (Th) (interference is from element in parentheses). A U fission yield correction is applied to La, Ce, Nd, and Ba. A correction for Ta introduced by grinding in WC containers can be made using known Ta/W ratios in the grinding containers. The correction amounted to 10-20% of the Ta gross peak. Recently, samples have been prepared in a ceramic grinding containers; for these, no Ta correction is needed. Trace elements determined

  12. Routine outcome monitoring and clinical decision-making in forensic psychiatry based on the Instrument for Forensic Treatment Evaluation

    van der Veeken, F.C.A.; Lucieer, Jacques; Bogaerts, S.

    2016-01-01

    Background Rehabilitation in forensic psychiatry is achieved gradually with different leave modules, in line with the Risk Need Responsivity model. A forensic routine outcome monitoring tool should measure treatment progress based on the rehabilitation theory, and it should be predictive of

  13. Long-term dust climatology in the western United States reconstructed from routine aerosol ground monitoring

    D. Q. Tong

    2012-06-01

    Full Text Available This study introduces an observation-based dust identification approach and applies it to reconstruct long-term dust climatology in the western United States. Long-term dust climatology is important for quantifying the effects of atmospheric aerosols on regional and global climate. Although many routine aerosol monitoring networks exist, it is often difficult to obtain dust records from these networks, because these monitors are either deployed far away from dust active regions (most likely collocated with dense population or contaminated by anthropogenic sources and other natural sources, such as wildfires and vegetation detritus. Here we propose an approach to identify local dust events relying solely on aerosol mass and composition from general-purpose aerosol measurements. Through analyzing the chemical and physical characteristics of aerosol observations during satellite-detected dust episodes, we select five indicators to be used to identify local dust records: (1 high PM10 concentrations; (2 low PM2.5/PM10 ratio; (3 higher concentrations and percentage of crustal elements; (4 lower percentage of anthropogenic pollutants; and (5 low enrichment factors of anthropogenic elements. After establishing these identification criteria, we conduct hierarchical cluster analysis for all validated aerosol measurement data over 68 IMPROVE sites in the western United States. A total of 182 local dust events were identified over 30 of the 68 locations from 2000 to 2007. These locations are either close to the four US Deserts, namely the Great Basin Desert, the Mojave Desert, the Sonoran Desert, and the Chihuahuan Desert, or in the high wind power region (Colorado. During the eight-year study period, the total number of dust events displays an interesting four-year activity cycle (one in 2000–2003 and the other in 2004–2007. The years of 2003, 2002 and 2007 are the three most active dust periods, with 46, 31 and 24

  14. Reference values for anxiety questionnaires: the Leiden Routine Outcome Monitoring Study.

    Schulte-van Maaren, Yvonne W M; Giltay, Erik J; van Hemert, Albert M; Zitman, Frans G; de Waal, Margot W M; Carlier, Ingrid V E

    2013-09-25

    The monitoring of patients with an anxiety disorder can benefit from Routine Outcome Monitoring (ROM). As anxiety disorders differ in phenomenology, several anxiety questionnaires are included in ROM: Brief Scale for Anxiety (BSA), PADUA Inventory Revised (PI-R), Panic Appraisal Inventory (PAI), Penn State Worry Questionnaire (PSWQ), Worry Domains Questionnaire (WDQ), Social Interaction, Anxiety Scale (SIAS), Social Phobia Scale (SPS), and the Impact of Event Scale-Revised (IES-R). We aimed to generate reference values for both 'healthy' and 'clinically anxious' populations for these anxiety questionnaires. We included 1295 subjects from the general population (ROM reference-group) and 5066 psychiatric outpatients diagnosed with a specific anxiety disorder (ROM patient-group). The MINI was used as diagnostic device in both the ROM reference group and the ROM patient group. To define limits for one-sided reference intervals (95th percentile; P95) the outermost 5% of observations were used. Receiver Operating Characteristics (ROC) analyses were used to yield alternative cut-off values for the anxiety questionnaires. For the ROM reference-group the mean age was 40.3 years (SD=12.6), and for the ROM patient-group it was 36.5 years (SD=11.9). Females constituted 62.8% of the reference-group and 64.4% of the patient-group. P95 ROM reference group cut-off values for reference versus clinically anxious populations were 11 for the BSA, 43 for the PI-R, 37 for the PAI Anticipated Panic, 47 for the PAI Perceived Consequences, 65 for the PAI Perceived Self-efficacy, 66 for the PSWQ, 74 for the WDQ, 32 for the SIAS, 19 for the SPS, and 36 for IES-R. ROC analyses yielded slightly lower reference values. The discriminative power of all eight anxiety questionnaires was very high. Substantial non-response and limited generalizability. For eight anxiety questionnaires a comprehensive set of reference values was provided. Reference values were generally higher in women than in men

  15. Cost effectiveness analysis of clinically driven versus routine laboratory monitoring of antiretroviral therapy in Uganda and Zimbabwe.

    Antonieta Medina Lara

    Full Text Available Despite funding constraints for treatment programmes in Africa, the costs and economic consequences of routine laboratory monitoring for efficacy and toxicity of antiretroviral therapy (ART have rarely been evaluated.Cost-effectiveness analysis was conducted in the DART trial (ISRCTN13968779. Adults in Uganda/Zimbabwe starting ART were randomised to clinically-driven monitoring (CDM or laboratory and clinical monitoring (LCM; individual patient data on healthcare resource utilisation and outcomes were valued with primary economic costs and utilities. Total costs of first/second-line ART, routine 12-weekly CD4 and biochemistry/haematology tests, additional diagnostic investigations, clinic visits, concomitant medications and hospitalisations were considered from the public healthcare sector perspective. A Markov model was used to extrapolate costs and benefits 20 years beyond the trial.3316 (1660LCM;1656CDM symptomatic, immunosuppressed ART-naive adults (median (IQR age 37 (32,42; CD4 86 (31,139 cells/mm(3 were followed for median 4.9 years. LCM had a mean 0.112 year (41 days survival benefit at an additional mean cost of $765 [95%CI:685,845], translating into an adjusted incremental cost of $7386 [3277,dominated] per life-year gained and $7793 [4442,39179] per quality-adjusted life year gained. Routine toxicity tests were prominent cost-drivers and had no benefit. With 12-weekly CD4 monitoring from year 2 on ART, low-cost second-line ART, but without toxicity monitoring, CD4 test costs need to fall below $3.78 to become cost-effective (<3xper-capita GDP, following WHO benchmarks. CD4 monitoring at current costs as undertaken in DART was not cost-effective in the long-term.There is no rationale for routine toxicity monitoring, which did not affect outcomes and was costly. Even though beneficial, there is little justification for routine 12-weekly CD4 monitoring of ART at current test costs in low-income African countries. CD4 monitoring

  16. Development and Validation of a National System for Routine Monitoring of Mortality in People Recently Released from Prison.

    Stuart A Kinner

    Full Text Available People released from prison are at increased risk of death. However, no country has established a system for routine monitoring of mortality in this population. The aims of this study were to (a evaluate a system for routine monitoring of deaths after release from prison in Australia and (b estimate the number of deaths annually within 28 and 365 days of prison release from 2000 to 2013.Persons released from prison and deaths were identified in records held by Centrelink, Australia's national provider of unemployment benefits. Estimates generated in this manner were compared with those from a study that probabilistically linked correctional records with the National Death Index (NDI, for each calendar year 2000 to 2007. Using Centrelink data, national estimates of mortality within 28 and 365 days of release were produced for each calendar year 2000 to 2013.Compared with estimates based on linkage with the NDI, the estimated crude mortality rate based on Centrelink records was on average 52% lower for deaths within 28 days of release and 24% lower for deaths within 365 days of release. Nationally, over the period 2000 to 2013, we identified an average of 32 deaths per year within 28 days of release and 188 deaths per year within 365 days of release. The crude mortality rate for deaths within both 28 and 365 days of release increased over this time.Using routinely collected unemployment benefits data we detected the majority of deaths in people recently released from prison in Australia. These data may be sufficient for routine monitoring purposes and it may be possible to adopt a similar approach in other countries. Routine surveillance of mortality in ex-prisoners serves to highlight their extreme vulnerability and provides a basis for evaluating policy reforms designed to reduce preventable deaths.

  17. A portable detection system for in vivo monitoring of {sup 131}I in routine and emergency situations

    Lucena, Eder A.; Dantas, Ana Letícia A.; Dantas, Bernardo M., E-mail: bmdantas@ird.gov.br [Instituto de Radioproteção e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

    2017-07-01

    In vivo monitoring of {sup 131}I in human thyroid is often used to evaluate occupational exposure in nuclear medicine facilities and in the case of accidental intakes in nuclear power plants for the monitoring of workers and population. The device presented in this work consists on a Pb-collimated NaI(Tl)3” x 3” detector assembled on a tripod and connected to a portable PC. The evaluation of the applicability and limitations of the system is based on the estimation of the committed effective doses associated to the minimum detectable activities in different facilities. The system is suitable for use in routine and accidental situations. (author)

  18. Comparison of land use regression models for NO2 based on routine and campaign monitoring data from an urban area of Japan.

    Kashima, Saori; Yorifuji, Takashi; Sawada, Norie; Nakaya, Tomoki; Eboshida, Akira

    2018-08-01

    Typically, land use regression (LUR) models have been developed using campaign monitoring data rather than routine monitoring data. However, the latter have advantages such as low cost and long-term coverage. Based on the idea that LUR models representing regional differences in air pollution and regional road structures are optimal, the objective of this study was to evaluate the validity of LUR models for nitrogen dioxide (NO 2 ) based on routine and campaign monitoring data obtained from an urban area. We selected the city of Suita in Osaka (Japan). We built a model based on routine monitoring data obtained from all sites (routine-LUR-All), and a model based on campaign monitoring data (campaign-LUR) within the city. Models based on routine monitoring data obtained from background sites (routine-LUR-BS) and based on data obtained from roadside sites (routine-LUR-RS) were also built. The routine LUR models were based on monitoring networks across two prefectures (i.e., Osaka and Hyogo prefectures). We calculated the predictability of the each model. We then compared the predicted NO 2 concentrations from each model with measured annual average NO 2 concentrations from evaluation sites. The routine-LUR-All and routine-LUR-BS models both predicted NO 2 concentrations well: adjusted R 2 =0.68 and 0.76, respectively, and root mean square error=3.4 and 2.1ppb, respectively. The predictions from the routine-LUR-All model were highly correlated with the measured NO 2 concentrations at evaluation sites. Although the predicted NO 2 concentrations from each model were correlated, the LUR models based on routine networks, and particularly those based on all monitoring sites, provided better visual representations of the local road conditions in the city. The present study demonstrated that LUR models based on routine data could estimate local traffic-related air pollution in an urban area. The importance and usefulness of data from routine monitoring networks should be

  19. The Investigation of Unexpected Arsenic Compounds Observed in Routine Biological Monitoring Urinary Speciation Analysis

    Elizabeth Leese

    2017-05-01

    Full Text Available This study investigates the identity of two unexpected arsenic species found separately in a number of urine samples sent to the Health and Safety Executive’s Health and Safety Laboratory for arsenic speciation (arsenobetaine, AB; arsenite, As3+; arsenate, As5+; monomethylarsonic acid, MMA5+; and dimethylarsinic acid, DMA5+. Micro liquid chromatography coupled to inductively coupled plasma mass spectrometry (µLC-ICP-MS and electrospray time of flight tandem mass spectrometry (ESI-QqTOF-MS/MS were used to identify the two arsenic peaks by comparison to several characterized arsenicals: arsenocholine, AC; trimethyl arsine oxide, TMAO; dimethylarsenoacetate, DMAA; dimethylarsenoethanol, DMAE; thio-dimethylarsinate, thio-DMA; thio-dimethylarsenoacetate, thio-DMAA and thio-dimethylarsenoethanol, thio-DMAE. The results from both the ICP-MS and ESI-QqTOF-MS/MS investigations indicate that the unexpected arsenic species termed peak 1 was thio-DMA. While the unexpected arsenic species termed peak 2 has yet to be identified, this investigation shows that it was not AC, TMAO, DMAA, DMAE, thio-DMA, thio-DMAA or thio-DMAE. This study demonstrates the incidence of unexpected arsenic species in both routine and non-routine urine samples from both workers and hospital patients.

  20. Tests of an electron monitor for routine quality control measurements of electron energies

    Ramsay, E.B.; Reinstein, L.E.; Meek, A.G.

    1991-01-01

    The depth dose for electrons is sensitive to energy and the AAPM Task Group 24 has recommended that tests be performed at monthly intervals to assure electron beam energy constancy by verifying the depth for the 80% dose to within ±3 mm. Typically, this is accomplished by using a two-depth dose ratio technique. Recently, a new device, the Geske monitor, has been introduced that is designed for verifying energy constancy in a single reading. The monitor consists of nine parallel plate detectors that alternate with 5-mm-thick absorbers made of an aluminum alloy. An evaluation of the clinical usefulness of this monitor for the electron beams available on a Varian Clinac 20 has been undertaken with respect to energy discrimination. Beam energy changes of 3 mm of the 80% dose give rise to measurable output changes ranging from 1.7% for 20-MeV electron beams to 15% for 6-MeV electron beams

  1. Revising the WHO verbal autopsy instrument to facilitate routine cause-of-death monitoring

    Leitao, Jordana; Chandramohan, Daniel; Byass, Peter; Jakob, Robert; Bundhamcharoen, Kanitta; Choprapawon, Chanpen; de Savigny, Don; Fottrell, Edward; França, Elizabeth; Frøen, Frederik; Gewaifel, Gihan; Hodgson, Abraham; Hounton, Sennen; Kahn, Kathleen; Krishnan, Anand; Kumar, Vishwajeet; Masanja, Honorati; Nichols, Erin; Notzon, Francis; Rasooly, Mohammad Hafiz; Sankoh, Osman; Spiegel, Paul; AbouZahr, Carla; Amexo, Marc; Kebede, Derege; Alley, William Soumbey; Marinho, Fatima; Ali, Mohamed; Loyola, Enrique; Chikersal, Jyotsna; Gao, Jun; Annunziata, Giuseppe; Bahl, Rajiv; Bartolomeus, Kidist; Boerma, Ties; Ustun, Bedirhan; Chou, Doris; Muhe, Lulu; Mathai, Matthews

    2013-01-01

    Objective Verbal autopsy (VA) is a systematic approach for determining causes of death (CoD) in populations without routine medical certification. It has mainly been used in research contexts and involved relatively lengthy interviews. Our objective here is to describe the process used to shorten, simplify, and standardise the VA process to make it feasible for application on a larger scale such as in routine civil registration and vital statistics (CRVS) systems. Methods A literature review of existing VA instruments was undertaken. The World Health Organization (WHO) then facilitated an international consultation process to review experiences with existing VA instruments, including those from WHO, the Demographic Evaluation of Populations and their Health in Developing Countries (INDEPTH) Network, InterVA, and the Population Health Metrics Research Consortium (PHMRC). In an expert meeting, consideration was given to formulating a workable VA CoD list [with mapping to the International Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) CoD] and to the viability and utility of existing VA interview questions, with a view to undertaking systematic simplification. Findings A revised VA CoD list was compiled enabling mapping of all ICD-10 CoD onto 62 VA cause categories, chosen on the grounds of public health significance as well as potential for ascertainment from VA. A set of 221 indicators for inclusion in the revised VA instrument was developed on the basis of accumulated experience, with appropriate skip patterns for various population sub-groups. The duration of a VA interview was reduced by about 40% with this new approach. Conclusions The revised VA instrument resulting from this consultation process is presented here as a means of making it available for widespread use and evaluation. It is envisaged that this will be used in conjunction with automated models for assigning CoD from VA data, rather than involving physicians. PMID

  2. Routine individual monitoring of aircraft crew exposure; Czech experience and results 1998-2008

    Malušek, Alexandr; Ploc, Ondřej; Kovář, Ivan; Brabcová, Kateřina; Spurný, František

    2011-01-01

    Roč. 144, 1-4 (2011), s. 684-687 ISSN 0144-8420 R&D Projects: GA ČR GA205/09/0171 Grant - others:Evropské společenství ILSRA(XE) FIGM-CT2000-00068 $c; JSPS(JP) P09753 Institutional research plan: CEZ:AV0Z10480505 Keywords : aircraft * crew exposure * monitoring Subject RIV: BG - Nuclear, Atomic and Molecular Physics, Colliders Impact factor: 0.822, year: 2011

  3. Simple routine tests to improve the performance of the DPRSN TLD-based individual monitoring system

    Alves, J.G.; Batel, V.I.; Silva, P.B.; Roda, A.; Santos, L.

    2002-01-01

    This paper presents some of the results of a simple quality control program developed and implemented at the thermoluminescence sector of the IMS. The European Union (EU) Directive 96/29/EURATOM has not yet been transposed to national legislation and Portuguese law concerning the monitoring of radiation workers still establishes an annual dose limit of 50 mSv. However, new legislation has recently been published with requirements on the performance of dosimetric services. Some of the results of the tests reported herein will show compliance with the above mentioned requirements

  4. Evaluation of subcutaneous glucose monitoring systems under routine environmental conditions in patients with type 1 diabetes.

    Aberer, Felix; Hajnsek, Martin; Rumpler, Markus; Zenz, Sabine; Baumann, Petra M; Elsayed, Hesham; Puffing, Adelheid; Treiber, Gerlies; Pieber, Thomas R; Sourij, Harald; Mader, Julia K

    2017-07-01

    Continuous and flash glucose monitoring (GM) systems have been established in diabetes care. We compared the sensor performance of 3 commercially available GM systems. A total of 12 patients with type 1 diabetes were included in a single-centre, open-label study in which the sensor performance of the Abbott FreeStyle libre (Abbott), Dexcom G4 Platinum (Dexcom) and Medtronic MiniMed 640G (Medtronic) systems over 12 hours was compared during mimicked real-life conditions (meals, exercise, hypo- and hyperglycaemia). Sensor performance was determined by fulfilment of ISO 15197:2013 criteria, calculating mean absolute relative difference (MARD), and was also illustrated using Parkes error grid and Bland-Altman plots. Sensor performance during changes in metabolic variables (lactate, betahydroxybutyrate, glucagon, non-esterified-fatty-acids) was determined by Spearman's rank correlation coefficient testing. The systems fulfilled ISO 15197:2013 criteria by 73.2% (Abbott), 56.1% (Dexcom) and 52.0% (Medtronic). The MARDs ± standard deviation in the entire glycaemic range were 13.2% ± 10.9% (Abbott), 16.8% ± 12.3% (Dexcom) and 21.4% ± 17.6% (Medtronic), respectively. All sensors performed less accurately during hypoglycaemia and best during hyperglycaemia. We did not observe an influence of metabolic variables on sensor performance. © 2017 John Wiley & Sons Ltd.

  5. Monitoring of the coastal waters of Niedersachsen - routine tests 1998; Ueberwachung der niedersaechsischen Kuestengewaesser - Routineuntersuchungen 1998

    NONE

    1999-11-01

    Since 1994, the Niedersaechsisches Landesamt fuer Oekologie - Forschungsstelle Kueste (NLOe-FSK) has been carrying out physical-chemical and biological experiments for monitoring the coastal waters of Niedersachsen according to a concept agreed with the Niedersachsen Minister of the Environment. Owing to a lack of funds, only the first stage is being implemented at the moment (Forschungsstelle Kueste 1995a). The findings for 1994 - 1997 have been published in several reports. This is the 1998 report. [German] Seit 1994 werden vom Niedersaechsischen Landesamt fuer Oekologie - Forschungsstelle Kueste - (NLOe-FSK) physikalisch-chemische und biologische Untersuchungen zur Ueberwachung der niedersaechsischen Kuestengewaesser nach einem mit dem Niedersaechsischen Umweltministerium abgestimmten Konzept durchgefuehrt. Das Konzept enthaelt unterschiedlich umfangreiche Ueberwachungsvarianten, von denen aufgrund der geringen verfuegbaren Ressourcen derzeit ddie Ausbaustufe I, das sogenannte 'reduzierte Rumpfprogramm', verwirklicht wird (Forschungsstelle Kueste 1995a). Die in den Jahren 1994-1997 ermittelten Untersuchungsergebnisse sind in mehreren Berichten wiedergegeben (Forschungsstelle Kueste 1995b, c; 1996, 1998, 1999). Die Befunde der 'Routineuntersuchungen' des Jahres 1998 werden in dem vorliegenden Berichtsheft vorgestellt. (orig.)

  6. Remediating radium contaminated legacy sites: Advances made through machine learning in routine monitoring of “hot” particles

    Varley, Adam, E-mail: a.l.varley@stir.ac.uk [Department of Biological and Environmental Sciences, University of Stirling, Stirling FK9 4LA (United Kingdom); Tyler, Andrew, E-mail: a.n.tyler@stir.ac.uk [Department of Biological and Environmental Sciences, University of Stirling, Stirling FK9 4LA (United Kingdom); Smith, Leslie, E-mail: l.s.smith@cs.stir.ac.uk [Department of Computing Science and Mathematics, University of Stirling, Stirling FK9 4LA (United Kingdom); Dale, Paul, E-mail: paul.dale@sepa.org.uk [Scottish Environmental Protection Agency, Radioactive Substances, Strathallan House, Castle Business Park, Stirling FK9 4TZ (United Kingdom); Davies, Mike, E-mail: Mike.Davies@nuvia.co.uk [Nuvia Limited, The Library, Eight Street, Harwell Oxford, Didcot, Oxfordshire OX11 0RL (United Kingdom)

    2015-07-15

    The extensive use of radium during the 20th century for industrial, military and pharmaceutical purposes has led to a large number of contaminated legacy sites across Europe and North America. Sites that pose a high risk to the general public can present expensive and long-term remediation projects. Often the most pragmatic remediation approach is through routine monitoring operating gamma-ray detectors to identify, in real-time, the signal from the most hazardous heterogeneous contamination (hot particles); thus facilitating their removal and safe disposal. However, current detection systems do not fully utilise all spectral information resulting in low detection rates and ultimately an increased risk to the human health. The aim of this study was to establish an optimised detector-algorithm combination. To achieve this, field data was collected using two handheld detectors (sodium iodide and lanthanum bromide) and a number of Monte Carlo simulated hot particles were randomly injected into the field data. This allowed for the detection rate of conventional deterministic (gross counts) and machine learning (neural networks and support vector machines) algorithms to be assessed. The results demonstrated that a Neural Network operated on a sodium iodide detector provided the best detection capability. Compared to deterministic approaches, this optimised detection system could detect a hot particle on average 10 cm deeper into the soil column or with half of the activity at the same depth. It was also found that noise presented by internal contamination restricted lanthanum bromide for this application. - Highlights: • Land contaminated with radium is hazardous to human health. • Routine monitoring permits identification and removal of radioactive hot particles. • Current alarm algorithms do not provide reliable hot particle detection. • Spectral processing using Machine Learning significantly improves detection.

  7. Remediating radium contaminated legacy sites: Advances made through machine learning in routine monitoring of “hot” particles

    Varley, Adam; Tyler, Andrew; Smith, Leslie; Dale, Paul; Davies, Mike

    2015-01-01

    The extensive use of radium during the 20th century for industrial, military and pharmaceutical purposes has led to a large number of contaminated legacy sites across Europe and North America. Sites that pose a high risk to the general public can present expensive and long-term remediation projects. Often the most pragmatic remediation approach is through routine monitoring operating gamma-ray detectors to identify, in real-time, the signal from the most hazardous heterogeneous contamination (hot particles); thus facilitating their removal and safe disposal. However, current detection systems do not fully utilise all spectral information resulting in low detection rates and ultimately an increased risk to the human health. The aim of this study was to establish an optimised detector-algorithm combination. To achieve this, field data was collected using two handheld detectors (sodium iodide and lanthanum bromide) and a number of Monte Carlo simulated hot particles were randomly injected into the field data. This allowed for the detection rate of conventional deterministic (gross counts) and machine learning (neural networks and support vector machines) algorithms to be assessed. The results demonstrated that a Neural Network operated on a sodium iodide detector provided the best detection capability. Compared to deterministic approaches, this optimised detection system could detect a hot particle on average 10 cm deeper into the soil column or with half of the activity at the same depth. It was also found that noise presented by internal contamination restricted lanthanum bromide for this application. - Highlights: • Land contaminated with radium is hazardous to human health. • Routine monitoring permits identification and removal of radioactive hot particles. • Current alarm algorithms do not provide reliable hot particle detection. • Spectral processing using Machine Learning significantly improves detection

  8. Demonstrating the reliability of transdiagnostic mHealth Routine Outcome Monitoring in mental health services using experience sampling technology.

    Simone J W Verhagen

    Full Text Available Routine Outcome Monitoring (ROM should provide a dynamic, within-treatment forward feedback loop to guide individual treatment decisions across diagnostic categories. It has been suggested that the Experience Sampling Method (ESM, capturing the film of daily life adaptive processes, offers a flexible, personalised and transdiagnostic feedback system for monitoring and adapting treatment strategies. This is the first study that uses an ESM application (the PsyMate™ as a routine mobile-ROM (mROM tool in an ambulatory mental health setting.To demonstrate adequate psychometric properties of the PsyMate™ app assessing both symptom severity levels as well as daily life functioning.In a transdiagnostic sample of 64 outpatients, an mROM protocol (ESM for 6 days, at 10 semi-random moments a day and a standard ROM instrument (HADS were administered at baseline and at three-month follow-up. We measured positive affect (PA, negative affect (NA, quality of sleep, positive social interaction, activity-related stress, tiredness, and feeling unwell.Subjects completed 53% of the measurements at baseline (N = 64 and 48% at follow-up (N = 29. Factor analysis and subsequent reliability analysis of PA and NA confirmed the two constructs. Significant and meaningful correlations were found between PA, NA and HADS scores (ranging from r = .4 to r = .7. Multilevel analyses yielded significant change scores for all measures.The ESM-based, transdiagnostic mROM tool can be used reliably in clinical settings: it shows adequate psychometric properties, as well as concurrent validity and sensitivity to change over time with respect to relevant ROM constructs. Person-tailored items can be added. In addition, mROM offers added value over standard symptom-based ROM, as it provides information on adaptive functioning in the daily environment of patients.

  9. Does less frequent routine monitoring of patients on a stable, fully suppressed cART regimen lead to an increased risk of treatment failure?

    Reekie, Joanne; Mocroft, Amanda; Sambatakou, Helen

    2008-01-01

    SIDA study who maintained a stable and fully suppressed cART regimen for 1 year were included in the analysis. METHODS: Risk of treatment failure, defined by viral rebound, fall in CD4 cell count, development of new AIDS-defining illness, serious opportunistic infection or death, in the 12 months following...... interval (CI) 0.1-0.5], 2.2% (95% CI 1.6-2.8) and 6.0% (95% CI 5.0-7.0) risk of treatment failure, respectively. Patients who spent more than 80% of their time on cART with fully suppressed viraemia prior to baseline had a 38% reduced risk of treatment failure, hazard ratio 0.62 (95% CI 0.42-0.90, P = 0...

  10. Frequent VLBI Monitoring on Parsec-Scales of 450+ Extragalactic FERMI Sources at 8 and 32 GHz

    Jacobs, Christopher S.; Majid, W. A.; Romero-Wolf, A.; García-Mirí, C.; Horiuchi, S.; Snedeker, L. G.; Sotuela, I.

    2012-10-01

    Executive Summary: An existing Ka-band (32 GHz, 9mm) catalog of 450+ sources is being monitored every 6-10 weeks on Giga-lambda baselines. These observations are sensitive to parsec scale activity in the AGN cores providing unique tests of gamma ray emission models. Abstract: The Fermi Large Area Telescope (LAT) has now released the 2nd catalog of high-energy gamma-ray sources (2FGL) derived from the first 24 months of mission science data with 1873 sources detected and characterized in the 100 MeV to 100 GeV range. 1017 of 1873 sources at high Galactic latitude (abs(b) > 10 degrees) are associated statistically with active galactic nuclei (AGNs). Parsec-scale VLBI measurements play an important role in characterizing the nature of the candidate AGNs by providing crucial extra information to improve the probability of correct identification - VLBI filters out objects which do not host strong compact jets at parsec scale. We are carrying out regular VLBI monitoring of 450+ compact extragalactic sources using Deep Space Network (DSN) 34-meter antennas over intercontinental baselines simultaneously at 8 and 32 GHz. In addition to precision astrometric measurements of AGN compact cores used to maintain the JPL extragalactic reference frame, this program has the potential to provide regular simultaneous flux density measurements at 8 and 32 GHz with precision level of ~20%. By providing measurements on both East-West and North-South baselines with large antennas and Gbit/s recording capability, our program can probe sources down to a flux limit of 30 mJy (10-sigma), potentially increasing the sample to a fainter population of sources. In these regards, our program complements well existing northern and southern hemisphere VLBI monitoring programs, by providing flux measurements at 32 GHz, covering a fainter population sample, and by filling the gap for sources in the -20 to -45 degree declination range. Further, our program also provides additional flexibility for

  11. Frequent screening for syphilis as part of HIV monitoring increases the detection of early asymptomatic syphilis among HIV-positive homosexual men.

    Bissessor, Melanie; Fairley, Christopher K; Leslie, David; Howley, Kerri; Chen, Marcus Y

    2010-10-01

    Syphilis continues to be a significant public health problem among HIV-positive men who have sex with men (MSM) internationally. This study aimed to determine whether the routine inclusion of syphilis serology with every blood test performed as part of HIV monitoring increases the detection of early asymptomatic syphilis among HIV-positive MSM. We examined the effect of this intervention, implemented in January 2007, on the detection of early asymptomatic syphilis among HIV-positive MSM attending the Melbourne Sexual Health Centre, Australia, and compared this with the previous clinic policy of annual syphilis screening. In the 18 months before and after the intervention, the median number of syphilis tests performed per man per year was 1 and 2, respectively. The proportion of MSM diagnosed with early syphilis who were asymptomatic was 21% (3 of 14) and 85% (41 of 48) for the 2 respective periods (P = 0.006). The time between the midpoint since last syphilis serology and diagnosis of syphilis was a median of 107 days (range 9-362) and 45 days (range 23-325) for the 2 periods, respectively (P = 0.018). The inclusion of routine syphilis serology with every blood test performed as part of HIV monitoring in HIV-positive MSM resulted in a large increase in the proportion of men diagnosed with early asymptomatic syphilis. This simple intervention probably also decreased the duration of infectiousness, enhancing syphilis control while also reducing morbidity.

  12. Routine monitoring and assessment of adults living with HIV: results of the British HIV Association (BHIVA) national audit 2015.

    Molloy, A; Curtis, H; Burns, F; Freedman, A

    2017-09-13

    The clinical care of people living with HIV changed fundamentally as a result of the development of effective antiretroviral therapy (ART). HIV infection is now a long-term treatable condition. We report a national audit to assess adherence to British HIV Association guidelines for the routine investigation and monitoring of adult HIV-1-infected individuals. All UK sites known as providers of adult HIV outpatient services were invited to complete a case-note review and a brief survey of local clinic practices. Participating sites were asked to randomly select 50-100 adults, who attended for specialist HIV care during 2014 and/or 2015. Each site collected data electronically using a self-audit spreadsheet tool. This included demographic details (gender, ethnicity, HIV exposure, and age) and whether 22 standardised and pre-defined clinical audited outcomes had been recorded. Data were collected on 8258 adults from 123 sites, representing approximately 10% of people living with HIV reported in public health surveillance as attending UK HIV services. Sexual health screening was provided within 96.4% of HIV services, cervical cytology and influenza vaccination within 71.4% of HIV services. There was wide variation in resistance testing across sites. Only 44.9% of patients on ART had a documented 10-year CVD risk within the past three years and fracture risk had been assessed within the past three years for only 16.7% patients aged over 50 years. There was high participation in the national audit and good practice was identified in some areas. However improvements can be made in monitoring of cardiovascular risk, bone and sexual health.

  13. Patients' experiences with routine outcome monitoring and clinical feedback systems: A systematic review and synthesis of qualitative empirical literature.

    Solstad, Stig Magne; Castonguay, Louis Georges; Moltu, Christian

    2017-05-19

    Routine outcome monitoring (ROM) and clinical feedback (CF) systems have become important tools for psychological therapies, but there are challenges for their successful implementation. To overcome these challenges, a greater understanding is needed about how patients experience the use of ROM/CF. We conducted a systematic literature search of qualitative studies on patient experiences with the use of ROM/CF in mental health services. The findings from 16 studies were synthesized, resulting in four meta-themes: (1) Suspicion towards service providers, (2) Flexibility and support to capture complexity, (3) Empowering patients, and (4) Developing collaborative practice. We discuss the implications of these meta-themes for further development and implementation of ROM/CF into clinical practice, acknowledging the limitations of our review and suggesting avenues for further research. Clinical or methodological significance of this article: This article provides useful and actionable knowledge about the patient perspective on ROM/CF, an important discussion on the current state of research in this area, and useful and concrete suggestions for further avenues of research.

  14. Monitoring Results in Routine Immunization: Development of Routine Immunization Dashboard in Selected African Countries in the Context of the Polio Eradication Endgame Strategic Plan.

    Poy, Alain; van den Ent, Maya M V X; Sosler, Stephen; Hinman, Alan R; Brown, Sidney; Sodha, Samir; Ehlman, Daniel C; Wallace, Aaron S; Mihigo, Richard

    2017-07-01

    To monitor immunization-system strengthening in the Polio Eradication Endgame Strategic Plan 2013-2018 (PEESP), the Global Polio Eradication Initiative identified 1 indicator: 10% annual improvement in third dose of diphtheria- tetanus-pertussis-containing vaccine (DTP3) coverage in polio high-risk districts of 10 polio focus countries. A multiagency team, including staff from the African Region, developed a comprehensive list of outcome and process indicators measuring various aspects of the performance of an immunization system. The development and implementation of the dashboard to assess immunization system performance allowed national program managers to monitor the key immunization indicators and stratify by high-risk and non-high-risk districts. Although only a single outcome indicator goal (at least 10% annual increase in DTP3 coverage achieved in 80% of high-risk districts) initially existed in the endgame strategy, we successfully added additional outcome indicators (eg, decreasing the number of DTP3-unvaccinated children) as well as program process indicators focusing on cold chain, stock availability, and vaccination sessions to better describe progress on the pathway to raising immunization coverage. When measuring progress toward improving immunization systems, it is helpful to use a comprehensive approach that allows for measuring multiple dimensions of the system. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  15. Follow-up results on monitoring and discussing health-related quality of life in adolescent diabetes care: benefits do not sustain in routine practice

    de Wit, M.; Delemarre-van de Waal, H.A.; Bokma, J.A.; Haasnoot, K.; Houdijk, M.C.; Gemke, R.J.B.J.; Snoek, F.J.

    2010-01-01

    Objective: We previously demonstrated that adding monitoring and discussion of health-related quality of life (HRQoL) of adolescents with type 1 diabetes to routine periodic consultations positively impacts psychosocial well-being and satisfaction with care. The current study examines whether these

  16. An LC-MS Assay with Isocratic Separation and On-Line Solid Phase Extraction to Improve the Routine Therapeutic Drug Monitoring of Busulfan in Plasma

    Ialongo Cristiano

    2017-04-01

    Full Text Available Background: Busulfan (Bu requires therapeutic drug monitoring (TDM in subjects undergoing a conditioning regimen for hematopoietic stem cell transplantation (HSCT. To speed up the procedure and increase reproducibility, we improved our routine LC-MS/MS assay using the on-line solid-phase extraction (SPE of samples.

  17. Pitfalls in the Assessment, Analysis, and Interpretation of Routine Outcome Monitoring (ROM) Data : Results from an Outpatient Clinic for Integrative Mental Health

    Hoenders, Rogier H. J.; Bos, Elisabeth H.; Bartels-Velthuis, Agna A.; Vollbehr, Nina K.; van der Ploeg, Karen; de Jonge, Peter; de Jong, Joop T. V. M.

    There is considerable debate about routine outcome monitoring (ROM) for scientific or benchmarking purposes. We discuss pitfalls associated with the assessment, analysis, and interpretation of ROM data, using data of 376 patients. 206 patients (55 %) completed one or more follow-up measurements.

  18. Shared Decision Making in mental health care using Routine Outcome Monitoring as a source of information: a cluster randomised controlled trial

    Metz, M.J.; Franx, G.C.; Verbeek, M.A.; de Beurs, E.; van der Feltz-Cornelis, C.M.; Beekman, A.T.

    2015-01-01

    Background Shared Decision Making (SDM) is a way to empower patients when decisions are made about treatment. In order to be effective agents in this process, patients need access to information of good quality. Routine Outcome Monitoring (ROM) may provide such information and therefore may be a key

  19. Anti-malarial drug safety information obtained through routine monitoring in a rural district of South-Western Senegal

    Brasseur Philippe

    2012-12-01

    Full Text Available Abstract Background Knowing the safety profile of anti-malarial treatments in routine use is essential; millions of patients receive now artemisinin combination therapy (ACT annually, but the return on information through current systems is as yet inadequate. Cohort event monitoring (CEM is a WHO (World Health Organization-recommended practice; testing its performance and feasibility in routine practice in malaria-endemic is important. Methods A nine-year CEM-based study of the safety of artesunate-amodiaquine (ASAQ at five peripheral health facilities in a rural district of South-western Senegal. Staff (nurses, health workers were trained to collect actively and systematically information on the patient, treatment and events on a purposely designed questionnaire. The occurrence and severity of events was collected before, during and after treatment up to 28 days in order to generate information on all adverse events (AEs as well as treatment-emerging signs/symptoms (TESS. Laboratory tests (haematology, liver and renal was planned for at least 10% of cases. Results During 2001–2009, 3,708 parasitologically-confirmed malaria cases (mean age = 16.0 ± 12.7 years were enrolled (26% and 52% of all and parasitologically-confirmed ASAQ treatments, respectively. Treatment was supervised in 96% of cases. Products changed over time: 49% were a loose combination of individually-packaged products (available 2001–03, 42% co-blistered products (2004–09 and 9% a fixed-dose co-formulation (2006–09; dosing was age-based for 42%, weight-based for 58%. AS and AQ were correctly dosed in 97% and 82% of cases with the loose and 93% and 86% with the fixed combination, but only 50% and 42% with the co-blistered product. Thirty-three per cent (33% of patients had at least one sign/symptom pre-treatment, 12% had at least one AE and 9% a TESS (total events 3,914, 1,144 and 693, respectively. AEs overestimated TESS by 1.2-2 fold (average 1.7. Changes in

  20. Routine viral load monitoring in HIV-infected infants and children in low- and middle-income countries: challenges and opportunities.

    Arpadi, Stephen M; Shiau, Stephanie; De Gusmao, Eduarda Pimentel; Violari, Avy

    2017-11-01

    The objective of this commentary is to review considerations for implementing routine viral load (VL) monitoring programmes for HIV-infected infants and children living in low- and middle-income countries (LMIC). Since 2013, the World Health Organization (WHO) guidelines recommend VL testing as the preferred monitoring approach for all individuals treated with ART in order to assess treatment response, detect treatment failure and determine the need to switch to a second-line regimen in a timely manner. More recently, WHO guidelines from 2016 identify HIV-infected infants and children as a priority group for routine VL monitoring. There are a number of reasons why HIV-infected infants and children should be prioritized for routine VL monitoring. Data from national VL monitoring programmes as well as systematic reviews and meta-analyses from LMIC indicate rates of viral suppression are lower for infants and children compared to adults. The number of antiretroviral drugs and palatable formulations suitable for young children are limited. In addition, emotional and developmental issues particular to children can make daily medication administration difficult and pose a challenge to adherence and achievement of sustained viral suppression. VL monitoring can be instrumental for identifying those in need of additional adherence support, reducing regimen switches and preserving treatment options. The needs of infants and children warrant consideration in all aspects of VL monitoring services. If capacity for paediatric venipuncture is not assured, platforms that accept dried blood spot specimens are necessary in order for infants and children to have equitable access. Healthcare systems also need to prepare to manage the substantial number of infants and children identified with elevated VL, including adherence interventions that are appropriate for children. Establishing robust systems to evaluate processes and outcomes of routine VL monitoring services and to support

  1. Brief behavioural surveys in routine HIV sentinel surveillance: a new tool for monitoring the HIV epidemic in Viet Nam

    Duong Cong Thanh

    2015-01-01

    Full Text Available In this report we describe a new approach in HIV sentinel surveillance that was piloted in Viet Nam in 2009 and is currently being rolled out in all provinces. It comprises a brief behavioural questionnaire added to the HIV sentinel surveillance surveys conducted routinely among people who inject drugs, female sex workers and men who have sex with men. Timely reporting of data from this system has resulted in improvements to HIV prevention efforts for most at-risk populations.

  2. Brief behavioural surveys in routine HIV sentinel surveillance: a new tool for monitoring the HIV epidemic in Viet Nam.

    Thanh, Duong Cong; Hien, Nguyen Tran; Tuan, Nguyen Anh; Ha, Hoang Thi Thanh; Thang, Pham Hong; Ha, Nguyen Thi Thanh; Tuan, Le Anh; Quang, Tran Dai; Tram, Tran Hong; Le Hai, Nguyen; Huong, Phan Thi Thu; Son, Vo Hai; Duc, Bui Hoang; Nga, Nguyen Thien; Jacka, David; Sabin, Keith

    2015-01-01

    In this report we describe a new approach in HIV sentinel surveillance that was piloted in Viet Nam in 2009 and is currently being rolled out in all provinces. It comprises a brief behavioural questionnaire added to the HIV sentinel surveillance surveys conducted routinely among people who inject drugs, female sex workers and men who have sex with men. Timely reporting of data from this system has resulted in improvements to HIV prevention efforts for most at-risk populations.

  3. Concept for creating program-technical complex of safety monitoring with system of safety parameters presentation functions on the basis of routine WWER-1000 systems

    Dunaev, V.G.; Tarasov, M. V.; Povarov, P.V.

    2005-01-01

    Prerequisites of creating the software-hardware complex for reactor safety monitoring on the Volgodonsk NPP are analyzed and generalized. The concept of this complex is based on functions of the safety parameters presentation system. It will serve as an interface between operator and technological process and give to operator a possibility to estimate quickly the state of the safety of the nuclear power unit. The complex will be created on the basis of routine reactor monitoring and control systems intended for the WWER-1000 reactor. In addition to existing soft- and hard-wares for reactor monitoring and for analysis of technological archive, it is proposed to create and connect in parallel the new software-hardware complex which ensures calculation and presentation of generalized factors of reactor safety [ru

  4. Plan of routine environmental radiological monitoring in the vicinity of nuclear and radioactive facilities of the Country

    Czerniczyniec, M.A; Bonetto, J.P.; Giustina, Daniel

    2009-01-01

    The Nuclear Regulatory Authority (ARN) carries out the monitoring of the environment surrounding Argentina nuclear power plants, independently from the operators' own monitoring programmes. Recently, there has been a review of the criteria used for selecting target radionuclides, sampling matrix, sampling location, and sampling frequency. This revision was based on ARN objectives for an environmental radiological monitoring programme, which are: verification of discharge monitoring results and detection of unadverted/unauthorized emissions; verification of models assumptions and checking that doses to the critical groups are not exceeded; detection of radionuclides presence in the environment and trend analysis; and to provide information to the public. The criteria proposed for adoption implies the monitoring of the relevant radionuclides mentioned in the discharge authorization license, using specific analysis for those considered indicators and screening techniques for the others. The matrix to be sampled must be related with the different exposure pathways, from those related with direct exposure, which require higher sampling frequencies, to accumulating/concentrating matrices, which imply lower sampling frequencies. At least, three points should be sampled, related to both airborne and liquid emissions: a background location, the representative person location, and that where the concentration of a target radionuclide is expected to be maximum. Available modeling software was used for positioning the sampling points. (author)

  5. Accuracy of a radiofrequency identification (RFID) badge system to monitor hand hygiene behavior during routine clinical activities.

    Pineles, Lisa L; Morgan, Daniel J; Limper, Heather M; Weber, Stephen G; Thom, Kerri A; Perencevich, Eli N; Harris, Anthony D; Landon, Emily

    2014-02-01

    Hand hygiene (HH) is a critical part of infection prevention in health care settings. Hospitals around the world continuously struggle to improve health care personnel (HCP) HH compliance. The current gold standard for monitoring compliance is direct observation; however, this method is time-consuming and costly. One emerging area of interest involves automated systems for monitoring HH behavior such as radiofrequency identification (RFID) tracking systems. To assess the accuracy of a commercially available RFID system in detecting HCP HH behavior, we compared direct observation with data collected by the RFID system in a simulated validation setting and to a real-life clinical setting over 2 hospitals. A total of 1,554 HH events was observed. Accuracy for identifying HH events was high in the simulated validation setting (88.5%) but relatively low in the real-life clinical setting (52.4%). This difference was significant (P RFID system, almost half of the HH events were missed. More research is necessary to further develop these systems and improve accuracy prior to widespread adoption. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  6. Responding to the challenge of antimalarial drug resistance by routine monitoring to update national malaria treatment policies

    Vestergaard, Lasse S; Ringwald, Pascal

    2007-01-01

    of rational and updated malaria treatment policies, but defining and updating such policies requires a sufficient volume of high-quality drug-resistance data collected at national and regional levels. Three main tools are used for drug resistance monitoring, including therapeutic efficacy tests, in vitro...... additional information about changing patterns of resistance. However, some of the tests are technically demanding, and thus there is a need for more resources for training and capacity building in endemic countries to be able to adequately respond to the challenge of drug resistance.......Reduced sensitivity of Plasmodium falciparum to formerly recommended cheap and well-known antimalarial drugs places an increasing burden on malaria control programs and national health systems in endemic countries. The high costs of the new artemisinin-based combination treatments underline the use...

  7. Impact assessment of malaria vector control using routine surveillance data in Zambia: implications for monitoring and evaluation

    Chanda Emmanuel

    2012-12-01

    Full Text Available Abstract Background Malaria vector control using long-lasting insecticidal nets (LLINs and indoor residual spraying (IRS, with pyrethroids and DDT, to reduce malaria transmission has been expansively implemented in Zambia. The impact of these interventions on malaria morbidity and mortality has not previously been formally assessed at the population level in Zambia. Methods The impact of IRS (15 urban districts and LLINs (15 rural districts implementation on severe malaria cases, deaths and case fatality rates in children below the age of five years were compared. Zambian national Health Management Information System data from 2007 to 2008 were retrospectively analysed to assess the epidemiological impact of the two interventions using odds ratios to compare the pre-scaling up year 2007 with the scaling-up year 2008. Results Overall there were marked reductions in morbidity and mortality, with cases, deaths and case fatality rates (CFR of severe malaria decreasing by 31%, 63% and 62%, respectively between 2007 and 2008. In urban districts with IRS introduction there was a significant reduction in mortality (Odds Ratio [OR] = 0.37, 95% CI = 0.31-0.43, P = 0.015, while the reduction in mortality in rural districts with LLINs implementation was not significant (OR = 0.83, 95% CI = 0.67-1.04, P = 0.666. A similar pattern was observed for case fatality rates with a significant reduction in urban districts implementing IRS (OR = 0.34, 95% CI = 0.33-0.36, P = 0.005, but not in rural districts implementing LLINs (OR = 0.96, 95% CI = 0.91-1.00, P = 0.913. No substantial difference was detected in overall reduction of malaria cases between districts implementing IRS and LLINs (P = 0.933. Conclusion Routine surveillance data proved valuable for determining the temporal effects of malaria control with two strategies, IRS and LLINs on severe malaria disease in different types of Zambian districts. However, this analysis did not take into account the effect

  8. Pre-adult versus adult onset major depressive disorder in a naturalistic patient sample: the Leiden Routine Outcome Monitoring Study.

    van Noorden, M S; Minkenberg, S E; Giltay, E J; den Hollander-Gijsman, M E; van Rood, Y R; van der Wee, N J; Zitman, F G

    2011-07-01

    Pre-adult onset of major depressive disorder (MDD) may predict a more severe phenotype of depression. As data from naturalistic psychiatric specialty care settings are scarce, we examined phenotypic differences between pre-adult and adult onset MDD in a large sample of consecutive out-patients. Altogether, 1552 out-patients, mean age 39.2 ± 11.6 years, were diagnosed with current MDD on the Mini-International Neuropsychiatric Interview Plus diagnostic interview as part of the usual diagnostic procedure. A total of 1105 patients (71.2%) had complete data on all variables of interest. Pre-adult onset of MDD was defined as having experienced the signs and symptoms of a first major depressive episode before the age of 18 years. Patients were stratified according to the age at interview (20-40/40-65 years). Correlates of pre-adult onset were analysed using logistic regression models adjusted for age, age squared and gender. Univariate analyses showed that pre-adult onset of MDD had a distinct set of demographic (e.g. less frequently living alone) and clinical correlates (more co-morbid DSM-IV - Text Revision diagnoses, more social phobia, more suicidality). In the multivariate model, we found an independent association only for a history of suicide attempts [odds ratio (OR) 3.15, 95% confidence intervals (CI) 1.97-5.05] and current suicidal thoughts (OR 1.81, 95% CI 1.26-2.60) in patients with pre-adult versus adult onset MDD. Pre-adult onset of MDD is associated with more suicidality than adult onset MDD. Age of onset of depression is an easy to ascertain characteristic that may help clinicians in weighing suicide risk.

  9. Monitoring and assessment of radiation exposure from routine radioactive discharges, and its relevance to the question of disease clusters

    Jones, S.R.

    1989-01-01

    Over the period of more than 30 years in which nuclear facilities have been operating, monitoring of the environment around such facilities has produced a wealth of information about the levels of radioactivity in the environment and about how radioactivity, introduced into the environment from effluent discharges, behaves in natural systems. Techniques for estimating radiation exposure to people from environmental measurements, or from theoretical models relating discharges to radiation exposure, have also been developed and validated where possible. The existence of localised excesses of leukaemia near the reprocessing plants at Sellafield and Dounreay, which cannot be explained on the basis of radiation exposure using these established methodologies, could be taken to imply that the methodologies are defective. However the radiation risk estimates have been shown to be robust to many of the suggested deficiencies and there are other, more qualitative, indications that discharges may not be a causative factor. It is argued that a broader search for possible causative factors may be more productive in resolving the conundrum. (author)

  10. Operational feasibility of lot quality assurance sampling (LQAS) as a tool in routine process monitoring of filariasis control programmes.

    Vanamail, P; Subramanian, S; Srividya, A; Ravi, R; Krishnamoorthy, K; Das, P K

    2006-08-01

    Lot quality assurance sampling (LQAS) with two-stage sampling plan was applied for rapid monitoring of coverage after every round of mass drug administration (MDA). A Primary Health Centre (PHC) consisting of 29 villages in Thiruvannamalai district, Tamil Nadu was selected as the study area. Two threshold levels of coverage were used: threshold A (maximum: 60%; minimum: 40%) and threshold B (maximum: 80%; minimum: 60%). Based on these thresholds, one sampling plan each for A and B was derived with the necessary sample size and the number of allowable defectives (i.e. defectives mean those who have not received the drug). Using data generated through simple random sampling (SRSI) of 1,750 individuals in the study area, LQAS was validated with the above two sampling plans for its diagnostic and field applicability. Simultaneously, a household survey (SRSH) was conducted for validation and cost-effectiveness analysis. Based on SRSH survey, the estimated coverage was 93.5% (CI: 91.7-95.3%). LQAS with threshold A revealed that by sampling a maximum of 14 individuals and by allowing four defectives, the coverage was >or=60% in >90% of villages at the first stage. Similarly, with threshold B by sampling a maximum of nine individuals and by allowing four defectives, the coverage was >or=80% in >90% of villages at the first stage. These analyses suggest that the sampling plan (14,4,52,25) of threshold A may be adopted in MDA to assess if a minimum coverage of 60% has been achieved. However, to achieve the goal of elimination, the sampling plan (9, 4, 42, 29) of threshold B can identify villages in which the coverage is LQAS are more cost-effective than SRSH to detect a village with a given level of coverage. The cost per village was US dollars 76.18 under SRSH. The cost of LQAS was US dollars 65.81 and 55.63 per village for thresholds A and B respectively. The total financial cost of classifying a village correctly with the given threshold level of LQAS could be reduced by

  11. Frequent monitoring of mineral metabolism in hemodialysis patients with secondary hyperparathyroidism: associations with achievement of treatment goals and with adjustments in therapy.

    Yokoyama, Keitaro; Kurita, Noriaki; Fukuma, Shingo; Akizawa, Tadao; Fukagawa, Masafumi; Onishi, Yoshihiro; Kurokawa, Kiyoshi; Fukuhara, Shunichi

    2017-03-01

    Dialysis guidelines in Japan recommend more frequent measurement of mineral metabolism markers than the Kidney Disease: Improving Global Outcomes guidelines. However, the extent to which frequent marker measurement contributes to achievement of target ranges and to therapy adjustment is unknown. This multicenter cohort study involved 3276 hemodialysis patients with secondary hyperparathyroidism. Data on laboratory measurements and drug prescriptions were collected every 3 months. Main exposures were frequencies of measuring serum calcium and phosphorus [weekly/biweekly/monthly (reference)] and serum parathyroid hormone (PTH) [monthly/bimonthly/trimonthly (reference)] levels. Outcomes were achievement of guideline-specified ranges of mineral metabolism markers when serum levels were over, and maintenance of ranges when levels were already within, respective specified ranges, use of intravenous vitamin D receptor activator (VDRA) and initiation of cinacalcet use. Associations were examined via generalized estimating equations. When serum marker levels exceeded the target range, weekly measurement of calcium and phosphorus was positively associated with achievement of the guideline-specified calcium range [adjusted odds ratio (AOR): 1.57, 95% confidence interval (CI) 1.09-2.26] but not phosphorus range (AOR: 0.99, 95% CI 0.74-1.33). Monthly measurement of PTH was positively associated with achievement of the guideline-specified PTH range (AOR: 1.14, 95% CI 1.01-1.27). When serum marker levels were within the guideline-specified range, increased frequency of measurements was not associated with in-range maintenance of marker levels for any of the three mineral markers assessed. Regarding treatment regimen, relatively frequent measurement of serum calcium and phosphorus was positively associated with cinacalcet initiation and relatively frequent measurement of serum PTH with cinacalcet initiation and intravenous VDRA use. Our results suggest that increasing frequency of

  12. Intelligent Routines

    Anastassiou, George A

    “Intelligent Routines II: Solving Linear Algebra and Differential Geometry with Sage” contains numerous of examples and problems as well as many unsolved problems. This book extensively applies the successful software Sage, which can be found free online http://www.sagemath.org/. Sage is a recent and popular software for mathematical computation, available freely and simple to use. This book is useful to all applied scientists in mathematics, statistics and engineering, as well for late undergraduate and graduate students of above subjects. It is the first such book in solving symbolically with Sage problems in Linear Algebra and Differential Geometry. Plenty of SAGE applications are given at each step of the exposition.

  13. Development of ACROSS (Accurately Controlled, Routinely Operated, Signal System) to realize constant monitoring the invisible earth's interiors by means of stationary coherent elastic and electromagnetic waves

    Kumazawa, Mineo; Kunitomo, Takahiro; Nakajima, Takahiro; Fujii, Naoyuki; Shigeta, Naotaka; Tsuruga, Kayoko; Hasada, Yoko; Nagao, Hiromichi; Matsumoto, Hiroshi; Kasahara, Junzo

    2007-03-01

    The developmental study made at Tono Geoscience Center under the Earthquake Frontier Research Project since 1996 is reported for a brand new technology system called ACROSS (Accurately Controlled, Routinely Operated, Signal System invented at Kagoya University in 1994). Various technology elements have been combined together under a specific theoretical framework for the underground exploration and monitoring of structures and physical states. The ACROSS is essentially a spectroscopy of the underground space consisted of complex media subjected to environmental noise. The robustness against noise is devised by utilizing coherent elastic and electromagnetic waves with phase controlled very accurately. Demanded hardware technology has been developed successfully and know how has been accumulated for practical applications. Accurate synchronization of transmission and observation systems has provided us with reliable data on the tensor transfer function between the source and receiver, which is equivalent to Green function within a limited frequency range. Several examples of the field application are demonstrated by the test experiments at Tono Mine site. After the developmental works of 10 years, the ACROSS is brought to be a practical method applied to the remote monitoring of temporal variation of underground states at the Horonobe Underground Research Laboratory and also it is being applied to the expected focal region of the coming Tokai earthquake near Hamaoka in Shizuoka prefecture. Whereas ACROSS technology is not mature enough yet, it is shown to be a potential and versatile methodology applied even for the health monitoring of the construction such as building strongly coupled with the ground in addition to the underground study. (author)

  14. Using the Sustainability Monitoring and Assessment Routine (SMART for the Systematic Analysis of Trade-Offs and Synergies between Sustainability Dimensions and Themes at Farm Level

    Christian Schader

    2016-03-01

    Full Text Available When trying to optimize the sustainability performance of farms and farming systems, a consideration of trade-offs and synergies between different themes and dimensions is required. The aim of this paper is to perform a systematic analysis of trade-offs and synergies across all dimensions and themes. To achieve this aim we used the Sustainability Monitoring and Assessment Routine (SMART-Farm Tool which operationalizes the Sustainability Assessment of Food and Agriculture Systems (SAFA Guidelines by defining science-based indicator sets and assessment procedures. It identifies the degree of goal achievement with respect to the 58 themes defined in the SAFA Guidelines using an impact matrix that defines 327 indicators and 1769 relations between sustainability themes and indicators. We illustrate how the SMART-Farm Tool can be successfully applied to assess the sustainability performance of farms of different types and in different geographic regions. Our analysis revealed important synergies between themes within a sustainability dimension and across dimensions. We found major trade-offs within the environmental dimension and between the environmental and economic dimension. The trade-offs within the environmental dimension were even larger than the trade-offs with other dimensions. The study also underlines the importance of the governance dimension with regard to achieving a good level of performance in the other dimensions.

  15. Routine Responses to Disruption of Routines

    Guha, Mahua

    2015-01-01

    "Organisational routines" is a widely studied research area. However, there is a dearth of research on disruption of routines. The few studies on disruption of routines discussed problem-solving activities that are carried out in response to disruption. In contrast, this study develops a theory of "solution routines" that are a…

  16. Pre- and post-irradiation fading effect for LiF:Mg,Ti and LiF:Mg,Cu,P materials used in routine monitoring

    Carinou, E.; Askounis, P.; Dimitropoulou, F.; Kiranos, G.; Kyrgiakou, H.; Nirgianaki, E.; Papadomarkaki, E.; Kamenopoulou, V.

    2011-01-01

    LiF is a well-known thermoluminescent (TL) material used in individual monitoring, and its fading characteristics have been studied for years. In the present study, the fading characteristics (for a period of 150 d) of various commercial LiF materials with different dopants have been evaluated. The materials used in the study are those used in routine procedures by the Personal Dosimetry Dept. of Greek Atomic Energy Commission and in particular, LiF:Mg,Ti (MTS-N, TL Poland), LiF:Mg,Cu,P (MCP-N, TL Poland), LiF:Mg,Cu,P (MCP-Ns, thin active layer detector, TL Poland) and LiF:Mg,Cu,P (TLD100H, Harshaw). The study showed that there is a sensitivity loss in signal of up to 20 % for the MTS-N material for a 150-d period in the pre-irradiation fading phase. The MCP-N has a stable behaviour in the pre-irradiation fading phase, but this also depends on the readout system. As far as the post-irradiation fading effect is concerned, a decrease of up to 20 % for the MTS-N material is observed for the same time period. On the other hand, the LiF:Mg,Cu,P material presents a stable behaviour within ±5 %. These results show that the fading effect is different for each material and should be taken into account when estimating doses from dosemeters that are in use for >2 months. (authors)

  17. Testing an mHealth momentary assessment Routine Outcome Monitoring application: a focus on restoration of daily life positive mood states.

    Jim van Os

    Full Text Available Routine Outcome Monitoring (ROM is used as a means to enrich the process of treatment with feedback on patient outcomes, facilitating patient involvement and shared decision making. While traditional ROM measures focus on retrospective accounts of symptoms, novel mHealth technology makes it possible to collect real life, in-the-moment ambulatory data that allow for an ecologically valid assessment of personalized and contextualized emotional and behavioural adjustment in the flow daily life (mROM.In a sample of 34 patients with major depressive disorder, treated with antidepressants, the combined effect of treatment and natural course was examined over a period of 18 weeks with Ecological Momentary Assessment (EMA. EMA consisted of repeated, within-subject, mini-measurements of experience (eg positive affect, negative affect, medication side effects and context (eg stressors, situations, activities at 10 unselected semi-random moments per day, for a period of six days, repeated three times over the 18-week period (baseline, week 6 and week 18.EMA measures of emotional and behavioural adjustment were sensitive to the effects of treatment and natural course over the 18-week period, particularly EMA measures focussing on positive mood states and the ability to use natural rewards (impact of positive events on positive mood states, with standardized effect sizes of 0.4-0.5. EMA measures of activities, social interaction, stress-sensitivity and negative mood states were also sensitive to change over time.This study supports the use of mROM as a means to involve the patient in the process of needs assessment and treatment. EMA data are meaningful to the patient, as they reflect daily life circumstances. Assessment of treatment response with mROM data allows for an interpretation of the effect of treatment at the level of daily life emotional and social adjustment--as an index of health, obviating the need for an exclusive focus on traditional measures

  18. Frequent Questions on Recycling

    This is a list of frequent questions on recycling, broken down into five categories. These are answers to common questions that EPA has received from press and web inquiries. This list is located on the Reduce, Reuse, Recycle website.

  19. Scalable Frequent Subgraph Mining

    Abdelhamid, Ehab

    2017-01-01

    Given an input graph, the Frequent Subgraph Mining (FSM) task finds all subgraphs with frequencies exceeding a given threshold. FSM is crucial for graph analysis, and it is an essential building block in a variety

  20. Liquid-containing Refluxes and Acid Refluxes May Be Less Frequent in the Japanese Population Than in Other Populations: Normal Values of 24-hour Esophageal Impedance and pH Monitoring

    Kawamura, Osamu; Kohata, Yukie; Kawami, Noriyuki; Iida, Hiroshi; Kawada, Akiyo; Hosaka, Hiroko; Shimoyama, Yasuyuki; Kuribayashi, Shiko; Fujiwara, Yasuhiro; Iwakiri, Katsuhiko; Inamori, Masahiko; Kusano, Motoyasu; Hongo, Micho

    2016-01-01

    Background/Aims Twenty-four-hour esophageal impedance and pH monitoring allows detection of all types of reflux episodes and is considered the best technique for identifying gastroesophageal refluxes. However, normative data for the Japanese population are lacking. This multicenter study aimed to establish the normal range of 24-hour esophageal impedance and pH data both in the distal and the proximal esophagus in Japanese subjects. Methods Forty-two healthy volunteers (25 men and 17 women) with a mean ± standard deviation age of 33.3 ± 12.4 years (range: 22–72 years) underwent a combined 24-hour esophageal impedance and pH monitoring. According to the physical and pH properties, distal or proximal esophageal reflux events were categorized. Results Median 45 reflux events occurred in 24 hours, and the 95th percentile was 85 events. Unlike previous reports, liquid-containing reflux events are median 25/24 hours with the 95th percentile of 62/24 hours. Acidic reflux events were median 11/24 hours with the 95th percentile of 39/24 hours. Non-acidic gas reflux events were median 15/24 hours with the 95th percentile of 39/24 hours. Proximal reflux events accounted for 80% of the total reflux events and were mainly non-acidic gas refluxes. About 19% of liquid and mixed refluxes reached the proximal esophagus. Conclusions Unlike previous studies, liquid-containing and acidic reflux events may be less frequent in the Japanese population. Non-acidic gas reflux events may be frequent and a cause of frequent proximal reflux events. This study provides important normative data for 24-hour impedance and pH monitoring in both the distal and the proximal esophagus in the Japanese population. PMID:27247103

  1. Shared Decision Making in mental health care using Routine Outcome Monitoring as a source of information: a cluster randomised controlled trial.

    Metz, Margot J; Franx, Gerdien C; Veerbeek, Marjolein A; de Beurs, Edwin; van der Feltz-Cornelis, Christina M; Beekman, Aartjan T F

    2015-12-15

    Shared Decision Making (SDM) is a way to empower patients when decisions are made about treatment. In order to be effective agents in this process, patients need access to information of good quality. Routine Outcome Monitoring (ROM) may provide such information and therefore may be a key element in SDM. This trial tests the effectiveness of SDM using ROM, primarily aiming to diminish decisional conflict of the patient while making decisions about treatment. The degree of decisional conflict, the primary outcome of this study, encompasses personal certainty about choosing an appropriate treatment, information about options, clarification of patient values, support from others and patients experience of an effective decision making process. Secondary outcomes of the study focus on the working alliance between patient and clinician, adherence to treatment, and clinical outcome and quality of life. This article presents the study protocol of a multi-centre two-arm cluster randomised controlled trial (RCT). The research is conducted in Dutch specialised mental health care teams participating in the ROM Quality Improvement Collaborative (QIC), which aims to implement ROM in daily clinical practice. In the intervention teams, ROM is used as a source of information during the SDM process between the patient and clinician. Control teams receive no specific SDM or ROM instructions and apply decision making as usual. Randomisation is conducted at the level of the participating teams within the mental health organisations. A total of 12 teams from 4 organisations and 364 patients participate in the study. Prior to data collection, the intervention teams are trained to use ROM during the SDM process. Data collection will be at baseline, and at 3 and 6 months after inclusion of the patient. Control teams will implement the SDM and ROM model after completion of the study. This study will provide useful information about the effectiveness of ROM within a SDM framework

  2. Mining frequent binary expressions

    Calders, T.; Paredaens, J.; Kambayashi, Y.; Mohania, M.K.; Tjoa, A.M.

    2000-01-01

    In data mining, searching for frequent patterns is a common basic operation. It forms the basis of many interesting decision support processes. In this paper we present a new type of patterns, binary expressions. Based on the properties of a specified binary test, such as reflexivity, transitivity

  3. Frequent hemodialysis in children.

    Warady, Bradley A; Fischbach, Michel; Geary, Denis; Goldstein, Stuart L

    2007-07-01

    Frequent hemodialysis is currently conducted in a limited number of pediatric dialysis centers. However, the preliminary experience with children who have undergone procedures such as "daily" intensive hemodiafiltration and nocturnal hemodialysis has been positive, with the allowance for unrestricted diets and fluid intake, the lack of need for phosphate binders, excellent metabolic and blood pressure control, and, in the case of hemodiafiltration, excellent growth. The provision of frequent daily hemodialysis with the NxStage System has also recently been introduced to pediatrics. An overview about what is currently understood regarding the technical and clinical application of these approaches to therapy for children with end-stage renal disease form the basis for this article and highlight the impact of the procedures to date and the need for additional experience and collaborative data collection.

  4. FY1995 study of the development of high resolution sub-surface fluid monitoring system using accurately controlled routine operated seismic system; 1995 nendo seimitsu seigyo shingen ni yoru chika ryutai koseido monitoring no kenkyu

    NONE

    1997-03-01

    The development of new seismic sounding system based on the new concept of ACROSS (Accurately Controlled Routine-Operated Signal System) are aimed. The system includes not only new seismic sources but also the analyzing software specialize for the monitoring of the change in subsurface velocity structure, especially in the area of fluid resources. Powerful sources with good portability are strongly required for the practical data acquisition. Portable ACROSS sources (HIT) are developed. The system is mainly used to obtain the high resolution structure with relatively short penetration distance. The principal specifications are as follows: (1) 100Hz in maximum. (2) Linearly oscillating single force. This is generated by the combined two rotator moving opposite directions. (3) Variable force with little work. (4) Very simple source-ground coupler just put even on the soft ground. The system was operated at Yamagawa geothermal plant for two months. The result of the experiments are: (1) We confirmed the stability of the source over wide frequency range up to 100Hz. (2) We confirmed that amplitude and phase of ACROSS signal can be obtained very precisely. (3) Very small change of signal which arise from subsurface velocity change are detected. This indicates that the system can detect the slight velocity change due to variation of subsurface fluid system. (NEDO)

  5. A systematic review of the routine monitoring of growth in children of primary school age to identify growth-related conditions.

    Fayter, D; Nixon, J; Hartley, S; Rithalia, A; Butler, G; Rudolf, M; Glasziou, P; Bland, M; Stirk, L; Westwood, M

    2007-06-01

    To clarify the role of growth monitoring in primary school children, including obesity, and to examine issues that might impact on the effectiveness and cost-effectiveness of such programmes. Electronic databases were searched up to July 2005. Experts in the field were also consulted. Data extraction and quality assessment were performed on studies meeting the review's inclusion criteria. The performance of growth monitoring to detect disorders of stature and obesity was evaluated against National Screening Committee (NSC) criteria. In the 31 studies that were included in the review, there were no controlled trials of the impact of growth monitoring and no studies of the diagnostic accuracy of different methods for growth monitoring. Analysis of the studies that presented a 'diagnostic yield' of growth monitoring suggested that one-off screening might identify between 1:545 and 1:1793 new cases of potentially treatable conditions. Economic modelling suggested that growth monitoring is associated with health improvements [incremental cost per quality-adjusted life-year (QALY) of 9500 pounds] and indicated that monitoring was cost-effective 100% of the time over the given probability distributions for a willingness to pay threshold of 30,000 pounds per QALY. Studies of obesity focused on the performance of body mass index against measures of body fat. A number of issues relating to human resources required for growth monitoring were identified, but data on attitudes to growth monitoring were extremely sparse. Preliminary findings from economic modelling suggested that primary prevention may be the most cost-effective approach to obesity management, but the model incorporated a great deal of uncertainty. This review has indicated the potential utility and cost-effectiveness of growth monitoring in terms of increased detection of stature-related disorders. It has also pointed strongly to the need for further research. Growth monitoring does not currently meet all NSC

  6. Workup and management of patients with frequent premature ventricular contractions.

    Giles, Katie; Green, Martin S

    2013-11-01

    Premature ventricular contractions (PVCs) are a frequently encountered entity in clinical cardiology. They rarely affect prognosis or management. However, they might produce bothersome symptoms and, in select individuals with a high PVC burden, they might contribute to left ventricular (LV) dysfunction. Workup of patients with very frequent PVCs consists of a thorough history and physical examination to screen for underlying cardiac disease and potential triggers. Routine investigations include a standard 12-lead electrocardiogram, as well as an echocardiogram. A Holter monitor should be performed in those with severe symptoms, a history of syncope, or a malignant family history. Exercise stress testing has a role in evaluating for ischemia and in the assessment of patients with exertional symptoms. More advanced testing is not warranted if these initial investigations are reassuring. Referral to an arrhythmia specialist should be considered in patients with LV dysfunction whose PVC burden exceeds 15%. Frequent ventricular ectopy represents a rare, but reversible cause of LV dysfunction and these patients should be further evaluated for possible catheter ablation. Copyright © 2013 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  7. Comparison of recording of pericarditis and lung disorders at routine meat inspection with findings at systematic health monitoring in Danish finisher pigs

    Nielsen, Søren Saxmose; Nielsen, Gitte Blach; Denwood, Matt

    2015-01-01

    purpose that is required of them. Routine meat inspection data were originally collected with the purpose of safeguarding food, but have been re-tasked to also include animal welfare assessment. The objective of the present study was to compare the recording of pericarditis, pleuritis and lungs......). Conclusions Overall, the results suggest that the correlation between findings at RMI and SHM was moderate for pleuritis and lungs with lesions, but poor for pericarditis. The latter could partly be explained by the type of meat inspection conducted at the abattoir. We conclude that caution should be used...

  8. Scalable Frequent Subgraph Mining

    Abdelhamid, Ehab

    2017-06-19

    A graph is a data structure that contains a set of nodes and a set of edges connecting these nodes. Nodes represent objects while edges model relationships among these objects. Graphs are used in various domains due to their ability to model complex relations among several objects. Given an input graph, the Frequent Subgraph Mining (FSM) task finds all subgraphs with frequencies exceeding a given threshold. FSM is crucial for graph analysis, and it is an essential building block in a variety of applications, such as graph clustering and indexing. FSM is computationally expensive, and its existing solutions are extremely slow. Consequently, these solutions are incapable of mining modern large graphs. This slowness is caused by the underlying approaches of these solutions which require finding and storing an excessive amount of subgraph matches. This dissertation proposes a scalable solution for FSM that avoids the limitations of previous work. This solution is composed of four components. The first component is a single-threaded technique which, for each candidate subgraph, needs to find only a minimal number of matches. The second component is a scalable parallel FSM technique that utilizes a novel two-phase approach. The first phase quickly builds an approximate search space, which is then used by the second phase to optimize and balance the workload of the FSM task. The third component focuses on accelerating frequency evaluation, which is a critical step in FSM. To do so, a machine learning model is employed to predict the type of each graph node, and accordingly, an optimized method is selected to evaluate that node. The fourth component focuses on mining dynamic graphs, such as social networks. To this end, an incremental index is maintained during the dynamic updates. Only this index is processed and updated for the majority of graph updates. Consequently, search space is significantly pruned and efficiency is improved. The empirical evaluation shows that the

  9. Cost-effectiveness and Budget Impact of Routine Use of Fractional Exhaled Nitric Oxide Monitoring for the Management of Adult Asthma Patients in Spain.

    Sabatelli, L; Seppälä, U; Sastre, J; Crater, G

    Fractional exhaled nitric oxide (FeNO) is a marker for type 2 airway inflammation. The objective of this study was to evaluate the cost-effectiveness and budget impact of FeNO monitoring for management of adult asthma in Spain. A cost-effectiveness analysis model was used to evaluate the effect on costs of adding FeNO monitoring to asthma management. Over a 1-year period, the model estimated the incremental cost per quality-adjusted life year and incremental number of exacerbations avoided when FeNO monitoring was added to standard guideline-driven asthma care compared with standard care alone. Univariate and multivariate sensitivity analyses were applied to explore uncertainty in the model. A budget impact model was used to examine the impact of FeNO monitoring on primary care costs across the Spanish health system. The results showed that adding FeNO to standard asthma care saved €62.53 per patient-year in the adult population and improved quality-adjusted life years by 0.026 per patient-year. The budget impact analysis revealed a potential net yearly saving of €129 million if FeNO monitoring had been used in primary care settings in Spain. The present economic model shows that adding FeNO to the treatment algorithm can considerably reduce costs and improve quality of life when used to manage asthma in combination with current treatment guidelines.

  10. Interferences of homogentisic acid (HGA) on routine clinical chemistry assays in serum and urine and the implications for biochemical monitoring of patients with alkaptonuria.

    Curtis, S L; Roberts, N B; Ranganath, L R

    2014-05-01

    We have assessed the effect of elevated concentrations of homogentisic acid (HGA) as in alkaptonuria (AKU), on a range of routine chemistry tests in serum and urine. HGA was added to pooled serum and a range of assays was analysed with Roche Modular chemistries. Effects on urine were assessed by diluting normal urine with urine from a patient with AKU, adding HGA to urine and after lowering output of urinary HGA with nitisinone treatment. Serum enzymatic creatinine showed 30% negative interference with 100μmol/L HGA and >50% at 400μmol/L. Serum urate 100 to 480μmol/L was reduced up to 20% at 100 and to 50% with 400μmol/L HGA. Serum cholesterol between 3 and 11mmol/L was reduced by 0.5mmol/L with 400μmol/L HGA. Urine enzymatic creatinine and urate with >2mmol/L HGA showed concentration dependent negative interference up to 80%. A positive interference in urine total protein by benzethonium turbidometric assay was observed, with 10mmol/L HGA equivalent to 1g/L protein. Jaffe creatinine, Na, K, Cl, Mg, Ca, phosphate, ALT, GGT, ALP activities and urea in serum and or urine were not affected by increases in HGA. To avoid interferences by HGA in alkaptonuria concentration of HGA should be established before samples are assayed with peroxidase assays and benzethonium urine protein. Copyright © 2013 The Canadian Society of Clinical Chemists. All rights reserved.

  11. Targeting, Monitoring and Effect of Oral Iron Therapy on Haemoglobin Levels in Older Patients Discharged to Primary Care from Inpatient Rehabilitation: A Cohort Study Using Routinely Collected Data.

    Thomson, Zach; Hands, Katherine J; Witham, Miles D

    2016-08-01

    Oral iron is commonly prescribed to older patients with suspected or confirmed iron-deficiency anaemia; however, few studies have examined the effectiveness of oral iron therapy in the real world in this population. We therefore determined the prevalence of iron deficiency in older people prescribed oral iron, examined the response mounted to therapy and ascertained predictors of response to oral iron. We analysed a routinely collected, linked dataset from older patients who had undergone inpatient rehabilitation between 1999 and 2011. An initial analysis examined patients within this cohort who were prescribed iron after rehabilitation and derived three groups based upon their ferritin and transferrin indices: probably, possibly and not iron deficient. A second analysis compared pre- and post-treatment haemoglobin to determine the degree of response to iron therapy across each category of deficiency. Finally, patient demographics, linked biochemistry data and comorbid disease based on International Classification of Disease (ICD-10) codes from previous hospital admissions were used in regression modelling to evaluate factors affecting response to therapy. A total of 490 patients were prescribed oral iron within 90 days of rehabilitation discharge. Of these, 413 (84 %) had iron indices performed; 94 (23 %) were possibly deficient, 224 (54 %) were probably deficient, and 95 (23 %) were not deficient. Of the 490 patients, 360 had both pre- and post-treatment haemoglobin data and iron indices; probably deficient patients mounted a slightly greater response to oral iron (17 vs. 12 g/L for not deficient; p < 0.05). Only pre-treatment haemoglobin, mean cell volume and lower gastrointestinal pathology were significant predictors of a response to oral iron therapy. Notably, acid-suppressant use was not a predictor of response. We conclude that many older patients are exposed to oral iron without good evidence of either iron deficiency or a significant response to

  12. Development of a reference material for routine performance monitoring of methods measuring polychlorinated dibenzo-p-dioxins, polychlorinated dibenzofurans and dioxin-like polychlorinated biphenyls.

    Selliah, S S; Cussion, S; MacPherson, K A; Reiner, E J; Toner, D

    2001-06-01

    Matrix-matched environmental certified reference materials (CRMs) are one of the most useful tools to validate analytical methods, assess analytical laboratory performance and to assist in the resolution of data conflicts between laboratories. This paper describes the development of a lake sediment as a CRM for polychorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs) and dioxin-like polychlorinated biphenyls (DLPCBs). The presence of DLPCBs in the environment is of increased concern and analytical methods are being developed internationally for monitoring DLPCBs in the environment. This paper also reports the results of an international interlaboratory study involving thirty-five laboratories from seventeen countries, conducted to characterize and validate levels of a sediment reference material for PCDDs, PCDFs and DLPCBs.

  13. Data format translation routines

    Burris, R.D.

    1981-02-01

    To enable the effective connection of several dissimilar computers into a network, modification of the data being passed from one computer to another may become necessary. This document describes a package of routines which permit the translation of data in PDP-8 formats to PDP-11 or DECsystem-10 formats or from PDP-11 format to DECsystem-10 format. Additional routines are described which permit the effective use of the translation routines in the environment of the Fusion Energy Division (FED) network and the Elmo Bumpy Torus (EBT) data base

  14. Routines and Organizational Change

    Yi, Sangyoon; Becker, Markus; Knudsen, Thorbjørn

    2014-01-01

    Routines have been perceived as a source of inertia in the process of organizational change. In this study, we suggest an overlooked, but prevalent, mechanism by which the inertial nature of routines helps, rather than hinders, organizational adaptation. Routine-level inertia plays a hidden role...... to cope with its task environment. In our nuanced perspective, inertia is not only a consequence of adaptation but also a source of adaptation. This logic is helpful to understand why reliable but apparently inertial organizations keep surviving and often exhibit outstanding performance. We conclude...

  15. Routine sputum culture

    Sputum culture ... There, it is placed in a special dish (culture). It is then watched to see if bacteria ... Elsevier; 2018:chap 36. Chernecky CC, Berger BJ. Culture, routine. In: Chernecky CC, Berger BJ, eds. Laboratory ...

  16. Consuming technologies - developing routines

    Gram-Hanssen, Kirsten

    2008-01-01

    technologies and in this article these processes will be investigated from three different perspectives: an historical perspective of how new technologies have entered homes, a consumer perspective of how both houses and new technologies are purchased and finally, as the primary part of the article, a user...... perspective of how routines develop while these technologies are being used. In the conclusion these insights are discussed in relation to possible ways of influencing routines....

  17. Experience with a routine fecal sampling program for plutonium workers

    Bihl, D.E.; Buschbom, R.L.; Sula, M.J.

    1993-01-01

    A quarterly fecal sampling program was conducted at the U. S. Department of Energy's Hanford site for congruent to 100 workers at risk for an intake of plutonium oxide and other forms of plutonium. To our surprise, we discovered that essentially all of the workers were excreting detectable activities of plutonium. Further investigation showed that the source was frequent, intermittent intakes at levels below detectability by normal workplace monitoring, indicating the extraordinary sensitivity of fecal sampling. However, the experience of this study also indicated that the increased sensitivity of routine fecal sampling relative to more common bioassay methods is offset by many problems. These include poor worker cooperation; difficulty in distinguishing low-level chronic intakes from a more significant, acute intake; difficulty in eliminating interference from ingested plutonium; and difficulty in interpreting what a single void means in terms of 24-h excretion. Recommendations for a routine fecal program include providing good communication to workers and management about reasons and logistics of fecal sampling prior to starting, using annual (instead of quarterly) fecal sampling for class Y plutonium, collecting samples after workers have been away from plutonium exposure for a least 3 d, and giving serious consideration to improving urinalysis sensitivity rather than going to routine fecal sampling

  18. Climate Leadership Awards Frequent Questions

    Provides answers to frequently asked questions regarding the Climate Leadership Awards, sponsored by EPA's Center for Corporate Climate Leadership with co-sponsorship from the Center for Climate and Energy Solutions and The Climate Registry.

  19. Changing in Convergence: The Impact of TV News Routines on the Usage of Online UGC Sources

    Huei-Ling Liu

    2014-10-01

    Full Text Available Online videos, or so called user-generated content, have been used in TV news frequently because of recent media convergence. This study examined whether this phenomenon influences news routines, and whether new characteristics of news routines have emerged because of the dependency on UGC sources. A qualitative research method was adopted, and 15 Taiwanese TV journalists were interviewed. The results show that the high dependence on the Internet for obtaining news has encouraged journalists producing news without having to leave newsroom. New routines have been formed in new production. At organizational levels, the search for online materials has been routinized, Journalist’ newsgathering and reporting are no longer original and initial but follow the hit topics on the Internet, Moreover, and news coverage currently focuses on format instead of meaning. At interorganizational level, TV news organizations monitor and imitate each other to adjust their routines. This paper shows that some unprofessional behaviors of journalists have become reasonable because of news routines changed. Consequently, the ethical and professional controversies have been ignored in newsroom.

  20. In search for effective methods of routine formation

    Kandora Marcin

    2017-05-01

    Full Text Available Organizational routines are a frequently researched phenomenon in contemporary management science. Although the available theoretical foundations of Routine Theory seem to have reached a significant degree of maturity over the last thirty years, the same could not be said about the availability of material advice for the management practice. This paper addresses this gap and proposes a framework for an effective routine shaping process. It builds on a brief analysis of available literature on routine formation, supported by case study findings. The approach proposed stresses the importance of the controlled learning process and underlines the importance of deliberate implementation, in contrast to the evolutionary and engineering views on routine emergence.

  1. The Most Frequent English Homonyms

    Parent, Kevin

    2012-01-01

    This article distinguishes homonymy, homophony, homography and polysemy, and provides a list of the most frequent homonyms using corpus-derived data. For most of the homonyms, the most common meaning accounts for 90% or more of the total uses of the form. The pedagogical and research implications of these findings are discussed. (Contains 5…

  2. Corporate Governance Frequently Asked Questions

    International Finance Corporation

    2016-01-01

    This guidebook is designed to address common questionson corporate governance that are frequently asked byowners and managers of companies in the Middle Eastand North Africa (MENA) region. It familiarizes readerswith the basic concepts of corporate governance,providing a comprehensive overview of the subject matter,using case studies as practical examples of corporategovernance application...

  3. Study of the development of high resolution sub-surface fluid monitoring system using Accurately Controlled Routine Operated Seismic Sources (ACROSS); Seimitsu seigyo shingen ni yoru chika ryutai koseido monitoring no kenkyu

    Kumazawa, M; Ogawa, K; Fujii, N; Yamaoka, K; Kumagai, H; Takei, Y [Nagoya University, Nagoya (Japan). Faculty of Science; Ishihara, K; Nakaya, m [New Energy and Industrial Technology Development Organization, Tokyo, (Japan)

    1997-02-01

    Fourier seismology capable of determining quantities related to elastic wave velocity dispersibility and non-elastic damping is under development, and studies are under way for the development of a sub-surface probing technology utilizing this seismology. It is deemed that the above-said quantities are related to the occurrence of earthquakes, behavior of sub-surface water, and migration of magma. In this method, precisely controlled sinusoidal waves are radiated and the received spectral data is subjected to cepstrum analysis, advantageous over other methods in that it achieves a high S/N ratio in a non-destructive way, facilitates deep structure analysis, and capable of monitoring changes with the elapse of time in such a structure. A newly-developed high-mobility transportable quake generator is described, which covers a wider frequency range and aims at the short-distance exploration of sub-surface conditions. Important components of the quake generator include an eccentric mass bearing capable of dealing with high-speed rotation enabling high frequency oscillation, variable mechanism for the primary moment of inertia, exciter and ground surface coupler allowing operations on a soft ground, and torque cancelling mechanism for the excitation of SH waves only. 3 figs.

  4. Predicting hospital mortality among frequently readmitted patients: HSMR biased by readmission

    Kelder Johannes C

    2011-03-01

    Full Text Available Abstract Background Casemix adjusted in-hospital mortality is one of the measures used to improve quality of care. The adjustment currently used does not take into account the effects of readmission, because reliable data on readmission is not readily available through routinely collected databases. We have studied the impact of readmissions by linking admissions of the same patient, and as a result were able to compare hospital mortality among frequently, as opposed to, non-frequently readmitted patients. We also formulated a method to adjust for readmission for the calculation of hospital standardised mortality ratios (HSMRs. Methods We conducted a longitudinal retrospective analysis of routinely collected hospital data of six large non-university teaching hospitals in the Netherlands with casemix adjusted standardised mortality ratios ranging from 65 to 114 and a combined value of 93 over a five-year period. Participants concerned 240662 patients admitted 418566 times in total during the years 2003 - 2007. Predicted deaths by the HSMR model 2008 over a five-year period were compared with observed deaths. Results Numbers of readmissions per patient differ substantially between the six hospitals, up to a factor of 2. A large interaction was found between numbers of admissions per patient and HSMR-predicted risks. Observed deaths for frequently admitted patients were significantly lower than HSMR-predicted deaths, which could be explained by uncorrected factors surrounding readmissions. Conclusions Patients admitted more frequently show lower risks of dying on average per admission. This decline in risk is only partly detected by the current HSMR. Comparing frequently admitted patients to non-frequently admitted patients commits the constant risk fallacy and potentially lowers HSMRs of hospitals treating many frequently admitted patients and increases HSMRs of hospitals treating many non-frequently admitted patients. This misleading effect can

  5. Predicting hospital mortality among frequently readmitted patients: HSMR biased by readmission

    2011-01-01

    Background Casemix adjusted in-hospital mortality is one of the measures used to improve quality of care. The adjustment currently used does not take into account the effects of readmission, because reliable data on readmission is not readily available through routinely collected databases. We have studied the impact of readmissions by linking admissions of the same patient, and as a result were able to compare hospital mortality among frequently, as opposed to, non-frequently readmitted patients. We also formulated a method to adjust for readmission for the calculation of hospital standardised mortality ratios (HSMRs). Methods We conducted a longitudinal retrospective analysis of routinely collected hospital data of six large non-university teaching hospitals in the Netherlands with casemix adjusted standardised mortality ratios ranging from 65 to 114 and a combined value of 93 over a five-year period. Participants concerned 240662 patients admitted 418566 times in total during the years 2003 - 2007. Predicted deaths by the HSMR model 2008 over a five-year period were compared with observed deaths. Results Numbers of readmissions per patient differ substantially between the six hospitals, up to a factor of 2. A large interaction was found between numbers of admissions per patient and HSMR-predicted risks. Observed deaths for frequently admitted patients were significantly lower than HSMR-predicted deaths, which could be explained by uncorrected factors surrounding readmissions. Conclusions Patients admitted more frequently show lower risks of dying on average per admission. This decline in risk is only partly detected by the current HSMR. Comparing frequently admitted patients to non-frequently admitted patients commits the constant risk fallacy and potentially lowers HSMRs of hospitals treating many frequently admitted patients and increases HSMRs of hospitals treating many non-frequently admitted patients. This misleading effect can only be demonstrated by an

  6. The embeddedness of selfish Routines

    Andersen, Poul Houman

    2001-01-01

    Routines have traditionally been seen as an organisational feature. However, like genes, routines may be carriers and initiators of organisations as well......Routines have traditionally been seen as an organisational feature. However, like genes, routines may be carriers and initiators of organisations as well...

  7. [Everyday stress, routines and bipolar spectrum].

    Gindre, C; Swendsen, J

    2010-06-01

    Bipolar patients relapse more frequently under conditions of stress, even when compliant with prescribed medication. Although the biological bases of stress reactivity remain widely debated, the disruption of biological or circadian rhythms has been suggested as one possible mechanism through which stress increases the risk of episodes. This hypothesis has gained support from recent evidence demonstrating that the disruption of social rhythms is particularly implicated in the onset of manic episodes. However, it is currently unknown to what extent bipolar patients may differ from normal controls in terms of the basic prevalence and nature of daily life routines, or if such individuals are more sensitive to the disruption of such rhythms following exposure to stress. Using a dimensional perspective of bipolar disorder, 1728 French university students were first screened concerning diverse psychological and clinical characteristics. Two hundred and twelve individuals at high or low-risk for mood and substance use disorders were then invited to participate in a week-long period of ambulatory monitoring using the experience sampling method (ESM). During this phase, participants were given a preprogrammed PDA microcomputer which provided ambulatory assessments of behaviour and stress at fixed intervals (randomized across participants). At the end of the ESM phase, the microcomputers were collected and structured diagnostic interviews were administered to each participant. For the purposes of the current study, analyses focused on a subsample of 92 individuals, reflecting the 28 participants who met lifetime criteria for a manic (n=15) or hypomanic episode (n=13), and the 64 individuals who were free of any lifetime disorder. Data were analyzed using hierarchical nonlinear (Bernoulli) models for repeated measures. Covariates included age, sex, frequency of substance use and cognitive vulnerabilities assessed at screening. A Bonferroni correction was applied to adjust

  8. [Does routine outcome monitoring have a promising future? An investigation into the use of shared decision-making combined with ROM for patients with a combination of physical and psychiatric symptoms].

    van der Feltz-Cornelis, C M; Andrea, H; Kessels, E; Duivenvoorden, H J; Biemans, H; Metz, M

    2014-01-01

    Although routine outcome monitoring (ROM) has been developed and widely used in the course of patient centered outcome research in the Netherlands, so far the technique has hardly ever been used to improve the treatment of individual patients. To describe how a rom technique based on the principles of shared decision-making (SDM) was developed and evaluated at the Center for Body, Mind and Health at GGz Breburg, a specialised mental health institution in the Netherlands. We have developed a conceptual model for SDM that involves patient participation and the use of evidence-based decision-aids with cut-off scores. According to the conceptual model for SDM that we developed, the patient and the health professional involved took 'shared' decisions in three phases; the decisions related to triage, the drawing-up of a treatment plan and a follow-up treatment course. At the end of the 6 month intake-phase 7 of the 67 patients who were deemed eligible for ROM/SDM were dropped from the study because they were incapable of performing ROM assessments. Due to diagnostic advice and referral at the end of the intake-phase, 25 patients did not require further treatment. Of the remaining 35 patients, 33 delivered at least one follow-up ROM assessment during the subsequent treatment phases. In these patients somatic and psychiatric symptoms were found to be significantly reduced. ROM combined with sdm can be used successfully with patients who have a combination of physical and psychiatric symptoms and the technique can be applied by the professional in charge. Very few patients dropped out of the follow-up measurements and somatic as well as depressive or psychiatric symptoms diminished significantly. These findings indicate that a Randomised Clinical Trial is warranted in order to test the effectiveness of sdm combined with ROM as a decision-making instrument.

  9. Which adherence measure - self-report, clinician recorded or pharmacy refill - is best able to predict detectable viral load in a public ART programme without routine plasma viral load monitoring?

    Mekuria, Legese A; Prins, Jan M; Yalew, Alemayehu W; Sprangers, Mirjam A G; Nieuwkerk, Pythia T

    2016-07-01

    Combination antiretroviral therapy (cART) suppresses viral replication to an undetectable level if a sufficiently high level of adherence is achieved. We investigated which adherence measurement best distinguishes between patients with and without detectable viral load in a public ART programme without routine plasma viral load monitoring. We randomly selected 870 patients who started cART between May 2009 and April 2012 in 10 healthcare facilities in Addis Ababa, Ethiopia. Six hundred and sixty-four (76.3%) patients who were retained in HIV care and were receiving cART for at least 6 months were included and 642 had their plasma HIV-1 RNA concentration measured. Patients' adherence to cART was assessed according to self-report, clinician recorded and pharmacy refill measures. Multivariate logistic regression model was fitted to identify the predictors of detectable viremia. Model accuracy was evaluated by computing the area under the receiver operating characteristic (ROC) curve. A total of 9.2% and 5.5% of the 642 patients had a detectable viral load of ≥40 and ≥400 RNA copies/ml, respectively. In the multivariate analyses, younger age, lower CD4 cell count at cART initiation, being illiterate and widowed, and each of the adherence measures were significantly and independently predictive of having ≥400 RNA copies/ml. The ROC curve showed that these variables altogether had a likelihood of more than 80% to distinguish patients with a plasma viral load of ≥400 RNA copies/ml from those without. Adherence to cART was remarkably high. Self-report, clinician recorded and pharmacy refill non-adherence were all significantly predictive of detectable viremia. The choice for one of these methods to detect non-adherence and predict a detectable viral load can therefore be based on what is most practical in a particular setting. © 2016 John Wiley & Sons Ltd.

  10. The frequent occurrence of MIC

    Graff, Matthias [Gesellschaft fuer Technische Mikrobiologie und Hygieneueberwachung - Dr. Graff und Partner, Stadtweg 9, D-38176 Wendeburg (Germany); Neubert, Volkmar [Institut fuer Materialpruefung und Werkstofftechnik Dr. Doelling und Dr. Neubert GmbH, Freiberger Strasse 1, D-38678 Clausthal-Zellerfeld (Germany)

    2004-07-01

    Microbial induced corrosion (MIC) is not as rare as many materials scientist and corrosion practitioners do believe. It is not an exotic and scarce event, but can be found frequently in many fields of corrosion research, provided that it is looked for. The reason for the relatively few descriptions of MIC cases seems to be the fact, that the microbiological approach is not widely known and applied in the world of materials science. MIC is not so much a corrosion mechanism on its own, but it enhances the corrosion rates of the 'normal' mechanisms to such an extent, that in some cases 'incredible' fast corrosion progress can be observed. The reason is the microorganisms' function as bio-catalysts: Chemical reactions, which are very slow under normal chemical conditions can be highly accelerated by living organisms. Besides that, several microorganisms do produce very corrosive substances which in natural environments do not occur without the activity of microorganisms, e. g. sulfuric or nitric acid. We want to point out, that it can be very worthy to take microbial induced corrosion into account. MIC is not the general answer for all unsolved corrosion problems, but to think about it helps in many corrosion cases as the authors had to experience. The initial indication for the presence of MIC are markedly increased corrosion rates. In the following, some of our 'lessons' are presented as short case studies: Two of them deal with steel corrosion characterized by increased corrosion rates. The third example presents corrosion damage of aluminium structures, where from a technical point of view corrosion was not expected, least of all microbial induced corrosion. (authors)

  11. Frequently Asked Questions about Monitored Natural Attenuation in Groundwater

    2014-02-01

    14 NEW CONTAMINANTS FOR THE MNA LINEUP 8. Can I apply MNA to metals, inorganics, and...they were "too simple" and often used "erroneously." Instead, they prescribed that MNA projects include identification of key "footprints" of MNA...solvent sites, loss is "Vapor Flux." 16 NEW CONTAMINANTS IN THE MNA LINEUP FAQ 8. Can I apply MNA to metals, inorganics, and radionuclides? Yes

  12. Bedtime routines child wellbeing & development.

    Kitsaras, George; Goodwin, Michaela; Allan, Julia; Kelly, Michael P; Pretty, Iain A

    2018-03-21

    Bedtime routines has shown important associations with areas associated with child wellbeing and development. Research into bedtime routines is limited with studies mainly focusing on quality of sleep. The objectives of the present study were to examine the relationship between bedtime routines and a variety of factors associated with child wellbeing and to examine possible determinants of bedtime routines. A total of 50 families with children between 3 and 5 years old took part in the study. Data on bedtime routines, parenting styles, school readiness, children's dental health, and executive function were collected. Children in families with optimal bedtime routines showed better performance in terms of executive function, specifically working memory (t (44)= - 8.51, p ≤ .001), inhibition and attention (t (48)= - 9.70, p ≤ .001) and cognitive flexibility (t (48)= - 13.1, p ≤ .001). Also, children in households with optimal bedtime routines scored higher in their readiness for school (t (48)= 6.92, p ≤ .001) and had better dental health (U = 85.5, p = .011). Parents in households with suboptimal bedtime routines showed worse performance on all measures of executive function including working memory (t (48)= - 10.47, p ≤ .001), inhibition-attention (t (48)= - 10.50, p ≤ .001) and cognitive flexibility (t (48)= - 13.6, p ≤ .001). Finally, parents with optimal bedtime routines for their children deployed a more positive parenting style in general (i.e. authoritative parenting) compared to those with suboptimal bedtime routines (t (48)= - 6.45, p ≤ .001). The results of the present study highlight the potentially important role of bedtime routines in a variety of areas associated with child wellbeing and the need for further research.

  13. Microfoundations of Routines and Capabilities

    Felin, Teppo; Foss, Nicolai Juul; Heimriks, Koen H.

    We discuss the microfoundations of routines and capabilities, including why a microfoundations view is needed and how it may inform work on organizational and competitive heterogeneity. Building on extant research, we identify three primary categories of micro-level components underlying routines...

  14. Frequently Asked Questions about Bunion Surgery

    ... A | Print | Share Frequently Asked Questions About Bunion Surgery Here are some frequently asked questions (FAQs) and ... best for you. 5. How can I avoid surgery? Sometimes observation of the bunion is all that ...

  15. Adaptive intrusion data system (AIDS) software routines

    Corlis, N.E.

    1980-07-01

    An Adaptive Intrusion Data System (AIDS) was developed to collect information from intrusion alarm sensors as part of an evaluation system to improve sensor performance. AIDS is a unique digital data-compression, storage, and formatting system; it also incorporates a capability for video selection and recording for assessment of the sensors monitored by the system. The system is software reprogrammable to numerous configurations that may be used for the collection of environmental, bilevel, analog, and video data. This report describes the software routines that control the different AIDS data-collection modes, the diagnostic programs to test the operating hardware, and the data format. Sample data printouts are also included

  16. Changing of the Guard: How Different School Leaders Change Organizational Routines

    Enomoto, Ernestine K.; Conley, Sharon

    2008-01-01

    While providing stability and uniformity, organizational routines can foster continuous change. Using Feldman's (2000) performative model of routinized action theory, coupled with leadership succession research, we examined how three successive administrations in a California high school revised a student attendance (tardy-monitoring) routine over…

  17. Supporting Classroom Transitions between Daily Routines: Strategies and Tips

    Banerjee, Rashida; Horn, Eva

    2013-01-01

    The purpose of this article is to provide tools for preschool professionals to plan for transitions between daily routines, to identify challenging transitions during the day, and to offer strategies to support transitions in classrooms to prevent challenging behaviors from occurring due to frequent changes. Specifically, the authors answer three…

  18. Elevated Plasma Soluble CD14 and Skewed CD16+ Monocyte Distribution Persist despite Normalisation of Soluble CD163 and CXCL10 by Effective HIV Therapy: A Changing Paradigm for Routine HIV Laboratory Monitoring?

    Castley, Alison; Berry, Cassandra; French, Martyn; Fernandez, Sonia; Krueger, Romano; Nolan, David

    2014-01-01

    Objective We investigated plasma and flow cytometric biomarkers of monocyte status that have been associated with prognostic utility in HIV infection and other chronic inflammatory diseases, comparing 81 HIV+ individuals with a range of treatment outcomes to a group of 21 healthy control blood donors. Our aim is to develop and optimise monocyte assays that combine biological relevance, clinical utility, and ease of adoption into routine HIV laboratory practice. Design Cross-sectional evaluation of concurrent plasma and whole blood samples. Methods A flow cytometry protocol was developed comprising single-tube CD45, CD14, CD16, CD64, CD163, CD143 analysis with appropriately matched isotype controls. Plasma levels of soluble CD14 (sCD14), soluble CD163 (sCD163) and CXCL10 were measured by ELISA. Results HIV status was associated with significantly increased expression of CD64, CD143 and CD163 on CD16+ monocytes, irrespective of the virological response to HIV therapy. Plasma levels of sCD14, sCD163 and CXCL10 were also significantly elevated in association with viremic HIV infection. Plasma sCD163 and CXCL10 levels were restored to healthy control levels by effective antiretroviral therapy while sCD14 levels remained elevated despite virological suppression (p<0.001). Conclusions Flow cytometric and plasma biomarkers of monocyte activation indicate an ongoing systemic inflammatory response to HIV infection, characterised by persistent alterations of CD16+ monocyte expression profiles and elevated sCD14 levels, that are not corrected by antiretroviral therapy and likely to be prognostically significant. In contrast, sCD163 and CXCL10 levels declined on antiretroviral therapy, suggesting multiple activation pathways revealed by these biomarkers. Incorporation of these assays into routine clinical care is feasible and warrants further consideration, particularly in light of emerging therapeutic strategies that specifically target innate immune activation in HIV

  19. Elevated plasma soluble CD14 and skewed CD16+ monocyte distribution persist despite normalisation of soluble CD163 and CXCL10 by effective HIV therapy: a changing paradigm for routine HIV laboratory monitoring?

    Alison Castley

    Full Text Available OBJECTIVE: We investigated plasma and flow cytometric biomarkers of monocyte status that have been associated with prognostic utility in HIV infection and other chronic inflammatory diseases, comparing 81 HIV+ individuals with a range of treatment outcomes to a group of 21 healthy control blood donors. Our aim is to develop and optimise monocyte assays that combine biological relevance, clinical utility, and ease of adoption into routine HIV laboratory practice. DESIGN: Cross-sectional evaluation of concurrent plasma and whole blood samples. METHODS: A flow cytometry protocol was developed comprising single-tube CD45, CD14, CD16, CD64, CD163, CD143 analysis with appropriately matched isotype controls. Plasma levels of soluble CD14 (sCD14, soluble CD163 (sCD163 and CXCL10 were measured by ELISA. RESULTS: HIV status was associated with significantly increased expression of CD64, CD143 and CD163 on CD16+ monocytes, irrespective of the virological response to HIV therapy. Plasma levels of sCD14, sCD163 and CXCL10 were also significantly elevated in association with viremic HIV infection. Plasma sCD163 and CXCL10 levels were restored to healthy control levels by effective antiretroviral therapy while sCD14 levels remained elevated despite virological suppression (p<0.001. CONCLUSIONS: Flow cytometric and plasma biomarkers of monocyte activation indicate an ongoing systemic inflammatory response to HIV infection, characterised by persistent alterations of CD16+ monocyte expression profiles and elevated sCD14 levels, that are not corrected by antiretroviral therapy and likely to be prognostically significant. In contrast, sCD163 and CXCL10 levels declined on antiretroviral therapy, suggesting multiple activation pathways revealed by these biomarkers. Incorporation of these assays into routine clinical care is feasible and warrants further consideration, particularly in light of emerging therapeutic strategies that specifically target innate immune

  20. Is the Routine Use of Impedance Analysis for the Diagnosis of Gastro-Esophageal Reflux Disease More Expensive than Conventional pH Monitoring? Cost Analysis of Two Procedures.

    Törer, Nurkan; Aytaç, Özgür

    2017-06-01

    Conventional 24-h pH monitoring is the gold standard for the diagnosis of non-erosive, non-acidic gastro-esophageal reflux disease. Multichannel Intraluminal Impedance (MII) analysis markedly improves diagnostic accuracy of non-erosive, non-acidic gastro-esophageal reflux disease. However, MII catheters are more expensive than standard catheters. This study aimed to determine the rates of acid or non-acid reflux and by making a retrospective projection, to predict the costs of two algorithms. We retrospectively reviewed the medical data of 102 patients who presented to our hospital with suspected non-erosive GERD and underwent 24 h impedance/pH-monitoring. Demographic characteristics, Demeester scores, number of reflux episodes, and results of impedance analysis were recorded. According to these data, cost was calculated either for the scenario in which impedance measurement was performed solely or following a negative conventional pH monitoring. Thirty-seven of all 102 patients (36.3 %) had a Demeester score greater than 14.7. These patients were assigned as group 1 (acid reflux). The impedance analysis of the remaining 65 patients detected 34 patients (33.3 %) to have more than 50 reflux episodes over a period of 24 h and assigned as Group 2, and 31 patients (30.4 %) had no reflux (group 3). The cost of the single- step algorithm using MII catheter was calculated as $15,300, while the total cost of two-step scenario would have been predicted as $16,890. Our study showed that an initial conventional pH monitoring can make the diagnosis of GERD in only one third of the patients with suspected non-erosive GERD. In nearly two-thirds of patients, however, repeated procedures and use of impedance catheters are needed. It is clear that this algorithm has certain drawbacks with regard to cost, patient comfort, and workforce loss.

  1. The cognitive role of routine activities: the case of familiar field interventions in nuclear power plants

    Noizet, A.

    2000-01-01

    Routine works incorporate part of the environment as their own control (exo-monitoring). The routine activity is itself in the self-monitoring situation of a cognitive control, which moves with the constraints, and which is not in direct relation with the errors made and detected, but which is in relation with the check of mastery. (J.S.)

  2. The institutionalization of a routine

    Nickelsen, Niels Christian

    2008-01-01

    -which has before largely been treated in overview by institutionalism-plays an important role in the making of a routine. In my empirical study, I demonstrate that the concept and practice of the valve changes, and that it is identified in a number of ways, as it passes through the testing phase...... of production. I argue that the negotiation of these changes during test production is the fulcrum in the routinization of the production procedure. It is through these identity shifts that the valve is both reified, and rendered producible and applicable in the customer world....

  3. Microfoundations of Routines and Capabilities

    Felin, Tippo; Foss, Nicolai Juul; Heimericks, Koen H.

    2012-01-01

    This article introduces the Special Issue and discusses the microfoundations of routines and capabilities, including why a microfoundations view is needed and how it may inform work on organizational and competitive heterogeneity. Building on extant research, we identify three primary categories ...

  4. Frequently Asked Questions about Radiation Emergencies

    ... Frequently Asked Questions (FAQ) about Radiation Emergencies Language: English (US) Español (Spanish) Recommend on Facebook Tweet Share Compartir For more information on radiation, go to the Radiation Dictionary . Get Inside: Why should I get inside during ...

  5. Frequent Pattern Mining Algorithms for Data Clustering

    Zimek, Arthur; Assent, Ira; Vreeken, Jilles

    2014-01-01

    that frequent pattern mining was at the cradle of subspace clustering—yet, it quickly developed into an independent research field. In this chapter, we discuss how frequent pattern mining algorithms have been extended and generalized towards the discovery of local clusters in high-dimensional data......Discovering clusters in subspaces, or subspace clustering and related clustering paradigms, is a research field where we find many frequent pattern mining related influences. In fact, as the first algorithms for subspace clustering were based on frequent pattern mining algorithms, it is fair to say....... In particular, we discuss several example algorithms for subspace clustering or projected clustering as well as point out recent research questions and open topics in this area relevant to researchers in either clustering or pattern mining...

  6. Suicide in America: Frequently Asked Questions

    ... Trials? Finding Help Reprints For More Information Share Suicide in America: Frequently Asked Questions Download PDF Download ... a week. Text “HOME” to 741741. What Is Suicide? Suicide is when people direct violence at themselves ...

  7. Frequent flyer business travelers: major exposure hazards.

    Tompkins, Olga S; Randolph, Susan A; Ostendorf, Judith S

    2005-02-01

    Bagshaw (2004) notes "the modern commercial aircraft cabin is maintained with adequate environmental control for the comfort of most healthy individuals" (p. 417). Occupational health nurses frequently deal with a population that may include unhealthy individuals or those with pre-existing conditions. It is critical for occupational health nurses to stay current with major hazards faced by frequent flyer business travelers to assist in identifying and preventing adverse health effects associated with these exposures.

  8. Development of a frequent heartburn index.

    Stull, Donald E; van Hanswijck de Jonge, Patricia; Houghton, Katherine; Kocun, Christopher; Sandor, David W

    2011-09-01

    The aim of this study is to develop and validate a brief instrument for the measurement of overall psychosocial impact of frequent heartburn (heartburn experienced 2+ times weekly) in the general U.S. population, yielding a single, composite score. Item reduction and psychometric analyses of an existing Frequent Heartburn (FHB) Survey, a 52-item, 13-domain, patient-reported outcomes (PRO) survey assessing the impact of frequent heartburn on psychosocial quality of life. Item reduction resulted in 9 items from the original FHB Survey measuring all domains. All retained items in this full Frequent Heartburn Index (FHBI-Full) had moderate to strong factor loadings on the underlying factor (range: 0.66-0.85) and acceptable overall model fit (CFI = 0.93, SRMR = 0.04). Coefficient alpha was 0.92. A shorter FHBI (FHBI-Brief) was created that excludes the two employment-related items. The FHBI-Brief had a coefficient alpha of 0.90. Both FHBI versions have good psychometric properties and capture a full range of psychosocial effects of frequent heartburn. Normed national scores for the FHBI are available against which an individual can compare their own FHBI score. The FHBI-Full and FHBI-Brief show promise as PRO instruments that may help individuals and clinicians better understand the effect of frequent heartburn on psychosocial functioning.

  9. Unsupervised daily routine and activity discovery in smart homes.

    Jie Yin; Qing Zhang; Karunanithi, Mohan

    2015-08-01

    The ability to accurately recognize daily activities of residents is a core premise of smart homes to assist with remote health monitoring. Most of the existing methods rely on a supervised model trained from a preselected and manually labeled set of activities, which are often time-consuming and costly to obtain in practice. In contrast, this paper presents an unsupervised method for discovering daily routines and activities for smart home residents. Our proposed method first uses a Markov chain to model a resident's locomotion patterns at different times of day and discover clusters of daily routines at the macro level. For each routine cluster, it then drills down to further discover room-level activities at the micro level. The automatic identification of daily routines and activities is useful for understanding indicators of functional decline of elderly people and suggesting timely interventions.

  10. Remote level radiation monitoring system for the brazilian IEA-R1 nuclear research reactor for routine radiation protection procedures and as a support tool in case of radiological emergency

    Cardenas, Jose P.N.; Romero Filho, Christovam R.; Madi Filho, Tufic

    2008-01-01

    Nuclear facilities must monitoring radiation levels to establish procedures for radiological protection staff involving workers and the public. The Instituto de Pesquisas Energeticas e Nucleares - IPEN has 5 important plants and in case of accident in one of them, the Institute keeps operational an Emergency Response Plan (ERP). This document (ERP) is designed to coordinate all procedures to assure safe and secure conditions for workers, environment and the public. One of this plants is the IEA-R1 reactor, it is the oldest nuclear research reactor (pool type) in Latin America, reached it first criticality in September of 1957. The reactor is used 60 hours/week with continuous operation and with nominal power of 3.5 MW, with technical conditions to operate at 5 MW thermal power. This reactor has a Radiological Emergency Plan that establishes the implementation of rules for workers and people living at the exclusion area in the case of an emergency situation. This paper aims to describe the implementation of a computational system developed for remote radiation monitoring, in a continuous schedule of IEA-R1 nuclear research reactor containment building. Results of this action can be used as a support mean in a radiological emergency. All necessary modules for radiation detection, signals conditioners and processing, data acquisition board, software development and computer specifications are described. The data acquisition system operating in the reactor shows readings concerned to radiation environment such as activity, doses and concentration in real time and displays a periodical data bank (Data Base) of this features allowing through the surveillance of the operation records anytime, leading to studies and analysis of radiation levels. Results of this data acquisition are shown by means of computer graphics screens developed for windows environment using Visual Basic software. (author)

  11. Quality of routine spirometry tests in Dutch general practices.

    Schermer, T.R.J.; Crockett, A.J.; Poels, P.J.P.; Dijke, J.J. van; Akkermans, R.P.; Vlek, H.F.; Pieters, W.R.

    2009-01-01

    BACKGROUND: Spirometry is an indispensable tool for diagnosis and monitoring of chronic airways disease in primary care. AIM: To establish the quality of routine spirometry tests in general practice, and explore associations between test quality and patient characteristics. DESIGN OF STUDY: Analysis

  12. Routine Violence Risk Assessment in Community Forensic Mental Healthcare

    van den Brink, Rob H. S.; Hooijschuur, Alex; van Os, Titus W. D. P.; Savenije, Wim; Wiersma, Durk

    2010-01-01

    We developed a method for periodic monitoring of violence risk, as part of routine community forensic mental healthcare. The feasibility of the method was tested, as well as its predictive validity for violent and risk enhancing behavior in the subsequent months. Participants were 83 clients who

  13. Analysis of routine EEG usage in a general adult ICU.

    McHugh, J C

    2009-09-01

    Non-convulsive seizures and status epilepticus are common in brain-injured patients in intensive care units. Continuous electroencephalography (cEEG) monitoring is the most sensitive means of their detection. In centres where cEEG is unavailable, routine EEG is often utilized for diagnosis although its sensitivity is lower.

  14. GRALIB, DISSPLA Plot Routines Emulator

    Dunford, L.

    1999-01-01

    1 - Description of program or function: GRALIB is a library of graphics subroutines used by PLOTEF. 2 - Method of solution: The PLOTEF library contains routines to generate and manipulate data which are independent of the output graphics device. In order to produce output for a given graphics device - which interact with GRALIB using the DISSPLA conventions - a device driver must be written by the user for this device

  15. Routine Design for Mechanical Engineering

    Brinkop, Axel; Laudwein, Norbert; Maasen, Rudiger

    1995-01-01

    COMIX (configuration of mixing machines) is a system that assists members of the EKATO Sales Department in designing a mixing machine that fulfills the requirements of a customer. It is used to help the engineer design the requested machine and prepare an offer that's to be submitted to the customer. comix integrates more traditional software techniques with explicit knowledge representation and constraint propagation. During the process of routine design, some design decisions have to be mad...

  16. Performance Evaluation of Frequent Subgraph Discovery Techniques

    Saif Ur Rehman

    2014-01-01

    Full Text Available Due to rapid development of the Internet technology and new scientific advances, the number of applications that model the data as graphs increases, because graphs have highly expressive power to model a complicated structure. Graph mining is a well-explored area of research which is gaining popularity in the data mining community. A graph is a general model to represent data and has been used in many domains such as cheminformatics, web information management system, computer network, and bioinformatics, to name a few. In graph mining the frequent subgraph discovery is a challenging task. Frequent subgraph mining is concerned with discovery of those subgraphs from graph dataset which have frequent or multiple instances within the given graph dataset. In the literature a large number of frequent subgraph mining algorithms have been proposed; these included FSG, AGM, gSpan, CloseGraph, SPIN, Gaston, and Mofa. The objective of this research work is to perform quantitative comparison of the above listed techniques. The performances of these techniques have been evaluated through a number of experiments based on three different state-of-the-art graph datasets. This novel work will provide base for anyone who is working to design a new frequent subgraph discovery technique.

  17. Frequent price changes under menu costs

    Hansen, Per Svejstrup

    1999-01-01

    , the price may be changed more frequent in the short run, and in the long run it definitely will. Hence, observing frequent price changes is not necessarily inconsistent with a firm operating under menu costs. This paper relies on an article by Dixit (1991), (Review of Economic studies, 58, 141......This paper investigates the effect of uncertainty on a single firm's pricing behaviour in a dynamic menu cost model that results in (S,s)-rules where the price is fixed inside a band. It will be demonstrated that even though the band of inaction widens in response to increased uncertainty...

  18. Frequently cited journals in forensic psychology.

    Black, Steve

    2012-02-01

    Works cited in six forensic psychology journals published 2008-2010 were counted to identify the most frequently cited journals. The sample of works cited (N = 21,776) was not a definitive ranked list of important journals in forensic psychology, but was large enough to indicate high-impact journals. The list of frequently cited publications included more general psychiatry and psychology journals than titles specific to forensic psychology. The implications of the proportion of general versus specific titles for collections supporting research in forensic psychology were discussed.

  19. Views of Medical Doctors Regarding the 2013 WHO Adult HIV Treatment Guidelines Indicate Variable Applicability for Routine Patient Monitoring, for Their Family Members and for Themselves, in South-Africa.

    Willem Daniel Francois Venter

    Full Text Available South African doctors (n = 211 experienced in antiretroviral therapy use were asked via an online questionnaire about the WHO 2013 adult antiretroviral integrated guidelines, as well as clinical and personal issues, in three hypothetical scenarios: directing the Minister of Health, advising a family member requiring therapy amidst unstable antiretroviral supplies, and where doctors themselves were HIV-positive. Doctors (54% favoured the 500 cells/μl WHO initiation threshold if advising the Minister; a third recommended retaining the 350 cells/μl threshold used at the time of the survey. However, they favoured a higher initiation threshold for their family member. Doctors were 4.9 fold more likely to initiate modern treatment, irrespective of their CD4 cell count, for themselves than for public-sector patients (95%CI odds ratio = 3.33-7.33; P<0.001, although lower if limited to stavudine-containing regimens. Doctors were equally concerned about stavudine-induced lactic acidosis and lipoatrophy. The majority (84% would use WHO-recommended first-line therapy, with concerns split between tenofovir-induced nephrotoxicity (55%, and efavirenz central nervous system effects (29%. A majority (61%, if HIV-positive, would pay for a pre-initiation resistance test, use influenza-prophylaxis (85%, but not INH-prophylaxis (61%, and treat their cholesterol and blood pressure concerns conventionally (63% and 60%. Over 60% wanted viral loads and creatinine measured six monthly. A third felt CD4 monitoring only necessary if clinically indicated or if virological failure occurred. They would use barrier prevention (83%, but not recommend pre-exposure prophylaxis, if their sexual partner was HIV-negative (68%. A minority would be completely open about their HIV status, but the majority would disclose to their sexual partners, close family and friends. Respondents were overwhelmingly in favour of continued antiretrovirals after breastfeeding. In conclusion, doctors

  20. A frequent flyer program for nuclear mythology

    Robertson, J.A.L.

    1997-01-01

    The anti-nuclear literature contains many erroneous and misleading allegations, collectively constituting a mythology. These are repeated endlessly, however often they are refuted, and are quoted uncritically by the media. Many are collected here, together with my rebuttals. For an explanation of the use here of the term 'frequent flyers', read on... (author)

  1. IMS Learning Design Frequently Asked Questions

    Tattersall, Colin; Manderveld, Jocelyn; Hummel, Hans; Sloep, Peter; Koper, Rob; De Vries, Fred

    2004-01-01

    This list of frequently asked questions was composed on the basis of questions asked of the Educational Technology Expertise Centrum. The questions addessed are: Where can I find the IMS Learning Design Specification? What is meant by the phrase “Learning Design”? What is the IMS LD Specification

  2. Treatment of Anthrax Disease Frequently Asked Questions

    Judd, Kathleen S.; Young, Joan E.; Lesperance, Ann M.; Malone, John D.

    2010-05-14

    This document provides a summary of Frequently Asked Questions (FAQs) on the treatment of anthrax disease caused by a wide-area release of Bacillus anthracis spores as an act bioterrorism. These FAQs are intended to provide the public health and medical community, as well as others, with guidance and communications to support the response and long-term recovery from an anthrax event.

  3. The significance of routines in nursing practice.

    Rytterström, Patrik; Unosson, Mitra; Arman, Maria

    2011-12-01

    The aim of this study was to illuminate the significance of routines in nursing practice. Clinical nursing is performed under the guidance of routines to varying degrees. In the nursing literature, routine is described as having both negative and positive aspects, but use of the term is inconsistent, and empirical evidence is sparse. In the research on organisational routines, a distinction is made between routine as a rule and routine as action. A qualitative design using a phenomenological-hermeneutic approach. Data collection from three focus groups focused on nurses' experience of routines. Seventeen individual interviews from a previous study focusing on caring culture were also analysed in a secondary qualitative analysis. All participants were employed as 'qualified nursing pool' nurses. Routines are experienced as pragmatic, obstructive and meaningful. The aim of the pragmatic routine was to ensure that daily working life works; this routine is practised more on the basis of rational arguments and obvious intentions. The obstructive routine had negative consequences for nursing practice and was described as nursing losing its humanity and violating the patient's integrity. The meaningful routine involved becoming one with the routine and for the nurses, it felt right and meaningful to adapt to it. Routines become meaningful when the individual action is in harmony with the cultural pattern on which the nursing work is based. Instead of letting contemporary practice passively become routine, routines can be assessed and developed using research and theoretical underpinnings as a starting point for nursing practice. Leaders have a special responsibility to develop and support meaningful routines. One approach could be to let wards examine their routines from a patient perspective on the basis of the themes of pragmatic, meaningful and obstructive routine. © 2010 Blackwell Publishing Ltd.

  4. Use of routine interventions in vaginal labor and birth: findings from the Maternity Experiences Survey.

    Chalmers, Beverley; Kaczorowski, Janusz; Levitt, Cheryl; Dzakpasu, Susie; O'Brien, Beverley; Lee, Lily; Boscoe, Madeline; Young, David

    2009-03-01

    Intervention rates in maternity practices vary considerably across Canadian provinces and territories. The objective of this study was to describe the use of routine interventions and practices in labor and birth as reported by women in the Maternity Experiences Survey of the Canadian Perinatal Surveillance System. Rates of interventions and practices are considered in the light of current evidence and both Canadian and international recommendations. A sample of 8,244 estimated eligible women was identified from a randomly selected sample of recently born infants drawn from the May 2006 Canadian Census and stratified primarily by province and territory. Birth mothers living with their infants at the time of interview were invited to participate in a computer-assisted telephone interview conducted by Statistics Canada on behalf of the Public Health Agency of Canada. Interviews averaged 45 minutes long and were completed when infants were between 5 and 10 months old (9-14 mo in the territories). Completed responses were obtained from 6,421 women (78%). Women frequently reported electronic fetal monitoring, a health care practitioner starting or speeding up their labor (or trying to do so), epidural anesthesia, episiotomy, and a supine position for birth. Some women also reported pubic or perineal shaves, enemas, and pushing on the top of their abdomen. Several practices and interventions were commonly reported in labor and birth in Canada, although evidence and Canadian and international guidelines recommend against their routine use. Practices not recommended for use at all, such as shaving, were also reported.

  5. Effects of frequent announced parasitology quizzes on the academic achievement.

    Ghasem Zamini

    2013-12-01

    Full Text Available The effect of frequent examinations on the students' learning has had inconsistent results. This study aimed to assess the effectiveness of frequent announced quizzes on the learning of a representative sample of Iranian medical students.This experimental study was conducted among 37 fifth semester medical students who had taken the course in Protozoology and Helminthology, in which the same basic information were provided about different types of protozoa and worms. Initially, in the teaching of helminthology, ten routine sessions were handled with lectures and interactive questions and answers. Then at the beginning of the protozoology topic in the beginning of all of the next 9 sessions, the students were informed that they will have a quiz at the end of each session. At the end of the semester, the total scores of quizzes were compared with the mean final scores of protozoology and helminthology using paired t and repeated measure tests.The mean final scores of the protozoology lesson were not significantly different from that of the helminthology (10.45 ± 2.75 vs.11.25 ± 2.56 on the scale of 20, respectively, P=0.13. There was no significant difference in the mean score of the five quizzes compared with the mean final term score of protozoology. The overall mean scores in the helminthology lesson (11.25±2.56, protozoology lesson (10.45±2.75, and the quizzes (9.16 ± 3.55 were significantly different (P <0.0001.Frequent announced quizzes were not effective on increasing the medical students' motivation and learning.

  6. Frequent methodological errors in clinical research.

    Silva Aycaguer, L C

    2018-03-07

    Several errors that are frequently present in clinical research are listed, discussed and illustrated. A distinction is made between what can be considered an "error" arising from ignorance or neglect, from what stems from a lack of integrity of researchers, although it is recognized and documented that it is not easy to establish when we are in a case and when in another. The work does not intend to make an exhaustive inventory of such problems, but focuses on those that, while frequent, are usually less evident or less marked in the various lists that have been published with this type of problems. It has been a decision to develop in detail the examples that illustrate the problems identified, instead of making a list of errors accompanied by an epidermal description of their characteristics. Copyright © 2018 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  7. Botulism: A Frequently Forgotten Old Malady

    Teguh Thajeb

    2007-09-01

    Full Text Available A frequently forgotten old malady called botulism has been recognized for more than a century. This ailment occurs worldwide, afflicts human of all age groups from infants to elderly and affects Oriental people more often in several regions of China. Occurrence in Taiwan is uncommon, and therefore, it is often overlooked. The outbreaks of human botulism in various regions of the world, the clinical types, the molecular mechanisms, and the electrophysiologic findings will be highlighted.

  8. Discovering More Accurate Frequent Web Usage Patterns

    Bayir, Murat Ali; Toroslu, Ismail Hakki; Cosar, Ahmet; Fidan, Guven

    2008-01-01

    Web usage mining is a type of web mining, which exploits data mining techniques to discover valuable information from navigation behavior of World Wide Web users. As in classical data mining, data preparation and pattern discovery are the main issues in web usage mining. The first phase of web usage mining is the data processing phase, which includes the session reconstruction operation from server logs. Session reconstruction success directly affects the quality of the frequent patterns disc...

  9. Implementation of the Preventive Radiation Protection Act; here: Regulation governing ambient radioactivity monitoring subject to the Preventive Radiation Protection Act. Pt. 1. Measuring programme for specified normal operation monitoring (routine measuring programme). BMU circular letter dated 28.07.94 -RS II 6 - 15 603/3

    1994-01-01

    The regulation addresses the competent Federal and Land authorities responsible for implementation of the Preventive Radiation Protection Act, and the competent highest Land authorities. The regulation defines the scope of obligatory measurement of ambient radioactivity during normal operation of installations and determines the measuring techniques to be applied for this purpose. The programme determines compulsory instructions to be observed in the performance of the routine measuring programme by the competent Federal and Land authorities and thus ensures nationwide application of standard procedures

  10. Routine Early Angioplasty after Fibrinolysis

    Wang, Zhipeng; Liang, Bo; Mei, Qibing

    2009-01-01

    patients in the group that underwent routine early PCI than in the group that received standard treatment received clopidogrel (Ppatients who undergo PCI, as well as in those who do not, is well established,1...... with early beta-blocker therapy is taken into consideration.3 The overall benefit of clopidogrel and beta-blocker therapy could have influenced the outcome in patients who underwent early PCI. These facts leave the conclusion of the TRANSFER-AMI trial still highly uncertain.......To the Editor: Cantor et al. report that there is a significantly reduced rate of ischemic complications among patients with myocardial infarction with ST-segment elevation who are transferred for PCI within 6 hours after fibrinolysis. However, Table 2 of the article shows that significantly more...

  11. Routine airway surveillance in pediatric tracheostomy patients.

    Gergin, Ozgul; Adil, Eelam; Kawai, Kosuke; Watters, Karen; Moritz, Ethan; Rahbar, Reza

    2017-06-01

    The aim of this study is to review airway findings in children with tracheostomies who underwent surveillance direct laryngoscopy and bronchoscopy (DLB) to determine the yield of routine airway evaluation in these patients. Retrospective chart review at tertiary referral children's hospital. A retrospective chart review was conducted of all of the children with tracheostomies who underwent DLB after tracheostomy between 1984 and 2015. A total of 303 patients met inclusion criteria. The median time interval between tracheostomy and first follow-up DLB was 12.0 months (IQR 4.8-28.9 months). There was no significant difference in the incidence of airway lesions between patients who underwent endoscopy tracheostomy versus those who had a longer time interval between tracheostomy and DLB (p = 0.16). One hundred sixty seven patients (55.1%) were diagnosed with lesions, with suprastomal granulation (39.9%) being the most common. Symptomatic patients were significantly more likely to have an airway lesion identified (69.9% versus 42.0%; p tracheostomy were significantly more likely to have an airway lesion (p = 0.01). The high incidence of airway lesions noted during surveillance DLB support the utility of routine airway endoscopy in pediatric tracheostomy patients. Symptomatic patients, those with ventilator dependence, or cardiopulmonary or trauma indications for tracheostomy are more likely to have airway lesions and should be monitored closely. The ideal time interval between surveillance endoscopies needs to be examined further. Copyright © 2017. Published by Elsevier B.V.

  12. Frequent video game players resist perceptual interference.

    Aaron V Berard

    Full Text Available Playing certain types of video games for a long time can improve a wide range of mental processes, from visual acuity to cognitive control. Frequent gamers have also displayed generalized improvements in perceptual learning. In the Texture Discrimination Task (TDT, a widely used perceptual learning paradigm, participants report the orientation of a target embedded in a field of lines and demonstrate robust over-night improvement. However, changing the orientation of the background lines midway through TDT training interferes with overnight improvements in overall performance on TDT. Interestingly, prior research has suggested that this effect will not occur if a one-hour break is allowed in between the changes. These results have suggested that after training is over, it may take some time for learning to become stabilized and resilient against interference. Here, we tested whether frequent gamers have faster stabilization of perceptual learning compared to non-gamers and examined the effect of daily video game playing on interference of training of TDT with one background orientation on perceptual learning of TDT with a different background orientation. As a result, we found that non-gamers showed overnight performance improvement only on one background orientation, replicating previous results with the interference in TDT. In contrast, frequent gamers demonstrated overnight improvements in performance with both background orientations, suggesting that they are better able to overcome interference in perceptual learning. This resistance to interference suggests that video game playing not only enhances the amplitude and speed of perceptual learning but also leads to faster and/or more robust stabilization of perceptual learning.

  13. Frequent video game players resist perceptual interference.

    Berard, Aaron V; Cain, Matthew S; Watanabe, Takeo; Sasaki, Yuka

    2015-01-01

    Playing certain types of video games for a long time can improve a wide range of mental processes, from visual acuity to cognitive control. Frequent gamers have also displayed generalized improvements in perceptual learning. In the Texture Discrimination Task (TDT), a widely used perceptual learning paradigm, participants report the orientation of a target embedded in a field of lines and demonstrate robust over-night improvement. However, changing the orientation of the background lines midway through TDT training interferes with overnight improvements in overall performance on TDT. Interestingly, prior research has suggested that this effect will not occur if a one-hour break is allowed in between the changes. These results have suggested that after training is over, it may take some time for learning to become stabilized and resilient against interference. Here, we tested whether frequent gamers have faster stabilization of perceptual learning compared to non-gamers and examined the effect of daily video game playing on interference of training of TDT with one background orientation on perceptual learning of TDT with a different background orientation. As a result, we found that non-gamers showed overnight performance improvement only on one background orientation, replicating previous results with the interference in TDT. In contrast, frequent gamers demonstrated overnight improvements in performance with both background orientations, suggesting that they are better able to overcome interference in perceptual learning. This resistance to interference suggests that video game playing not only enhances the amplitude and speed of perceptual learning but also leads to faster and/or more robust stabilization of perceptual learning.

  14. Fit Between Organization Design and Organizational Routines

    Constance E. Helfat

    2014-07-01

    Full Text Available Despite decades of research on both organization design and organizational routines, little research has analyzed the relationship between them. Here we propose a normative theory in which the effectiveness of organization design and redesign depends on the characteristics of routines. The analysis shows which types of organization designs may be useful as well as which design changes may or may not succeed depending on (a the specificity of routines and (b the dynamic versus static purposes of organizational routines.

  15. Valuing real options: frequently made errors

    Fernández, Pablo

    2002-01-01

    In this paper we analyze frequently made errors when valuing real options. The best way of doing it is through examples. We start by analyzing Damodaran's proposal to value the option to expand the business of Home Depot. Some of the errors and problems of this and other approaches are: - Assuming that the option is replicable and using Black and Scholes' formula. - The estimation of the option's volatility is arbitrary and has a decisive effect on the option's value. - As there is no riskles...

  16. Routines Are the Foundation of Classroom Management

    Lester, Robin Rawlings; Allanson, Patricia Bolton; Notar, Charles E.

    2017-01-01

    Classroom management is the key to learning. Routines are the foundation of classroom management. Students require structure in their lives. Routines provide that in all of their life from the time they awake until the time they go to bed. Routines in a school and in the classroom provide the environment for learning to take place. The paper is…

  17. 42 CFR 493.931 - Routine chemistry.

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Routine chemistry. 493.931 Section 493.931 Public... Proficiency Testing Programs by Specialty and Subspecialty § 493.931 Routine chemistry. (a) Program content and frequency of challenge. To be approved for proficiency testing for routine chemistry, a program...

  18. [Frequently accidents and injury at school].

    Gautier Vargas, María; Martínez González, Vanesa

    2011-01-01

    During the time we have been in a private company that provide schools with medical care, we were surprised by the frequent and constant phone calls received to ask for our services. This fact made us take the decision to carry out a survey to find out the accidents and the most frequent injuries. According to the retrospective study we realized throughout two different academic courses in several schools in Cantabria, the 3.23% of the students have any accidents or injuries. We found out children between 11 and 15 have the highest accident rate, being 10.8 % higher when boys (rather than girls) are involved. The most common injuries are contusions 42.85%, followed by sprains 23.45%, being blows the reason in 42% of the cases, and surprisingly acts of aggression in 1%. It was also unexpected to learn that gyms, where children are taught in physical education, have the highest percent on accident rate. All these inquiries lead us to think that age, play and sports are determinant factors in the accidents happened in the school area.

  19. Air Quality Monitoring with Routine Utilization of Ion Beam Analysis

    Wegrzynek, D.

    2013-01-01

    Full text: Information on source contributions to ambient air particulate concentrations is a vital tool for air quality management. Traditional gravimetric analysis of airborne particulate matter is unable to provide information on the sources contributing to air particulate concentrations. Ion beam analysis is used to identify the elemental composition of air particulates for source apportionment and determining the relative contribution of biogenic and anthropogenic sources to air particulate pollution. The elemental composition is obtained by proton induced X-ray emission technique (PIXE), which is an ion beam analysis (IBA) technique. The element concentrations are deduced from the X ray spectra produced when the particulate collected on a filter is bombarded with a high-energy proton beam. As part of the UNDP/IAEA/RCA Project RAS/8/082 ‘Better Management of the Environment, Natural Resources and Industrial Growth through Isotope and Radiation Technology,’ a collaborative alliance was formed between the Institute of Geological and Nuclear Sciences Limited and the Wellington Regional Council, New Zeland [1]. The purpose of the project was to examine the elemental composition of air particulate matter and determine the origins through source apportionment techniques. In New Zealand PM 10 and PM 2.5 fractions have been collected at the industrial area of Seaview, Wellington over two years using a GENT stacked filter unit sampler. Concentrations of elements with atomic mass above neon were determined using ion beam analysis and elemental carbon concentrations were determined using a reflectometer. Specific ambient source elemental 'fingerprints' were then determined by factor analysis and the relative contributions of various local and regional sources were assessed. The significant factors (sources) were determined to be sea salt, soil, industry, and combustion sources. Local industry was found to contribute to ambient lead concentrations. (author)

  20. Routine monitoring of diabetes mellitus in adults at primary health ...

    Glycaemic targets for control in type 1 diabetes mellitus* .... CGM can be useful in selected adults older than 25 years with type 1 diabetes to lower the HbA1c .... Lifestyle modifications should be addressed regularly, including weight loss if ...

  1. Chronic Cough in Otorhinolaryngologic Routine

    Palheta Neto, Francisco Xavier

    2011-04-01

    Full Text Available Introduction: The chronic cough is sometimes manifested as an imprecise symptom, but of great importance for both the diagnosis and the prognosis. In an otorhinolaryngologic approach, several illnesses that can occur with it can be numbered, including 2 of the 3 main causes of chronic cough. Objective: To identify the main otorhinolaryngologic diseases showing the chronic cough as one of their manifestations. Method: A literature's revision was performed in several scientific articles, specialized books and consultation in Birene and Scielo databases. Literature's revision: cough production in the upper airways is usually associated with an inflammatory reaction by stimulating sensitive receptors of these areas or by mechanic stimulus. The main cause of the chronic cough in the otorhinolaryngology day-to-day is the post-nasal drip, gathering together by itself 02 of the most common diseases: rhinitis and sinusitis. Laryngitis as a result of gastroesophageal reflux (GER stands out in the index of chronic cough etiology, but it is not as severe as GER . Neoplasias are also somewhat frequent causes of cough, and the difficulty in diagnosing the cough cause is common in this disease group. Motility disorder, laryngeal irritation persistence, parasitic disease and injuries by inhalation of toxic products were also found as a cause of cough for longer than 03 months. Conclusion:Chronic cough is a frequent and important finding in otorhinolaryngology and cannot be underestimated, and a careful anamnesis is the best way to determine the etiology and perform a correct treatment for the patient's disease.

  2. Optimization of environmental monitoring

    Winter, M.

    1986-01-01

    The routine work and tasks related to prevention in environmental monitoring of nuclear facilities range from low level methodology to the necessity of being likewise prepared to perform environmental impact measurements after nuclear incidents and accidents are presented [pt

  3. Screening mammography interpretation test: more frequent mistakes

    Gozzi, Gino; Ganzetti, Alessandra; Martinoli, Carlo; Bacigalupo, Lorenzo; Bodini, Maria; Fiorentino, Carla; Marini, Ugo Paolo; Santini, Dolores

    2005-01-01

    Purpose: To present the mammographic cases most commonly misinterpreted by the participants in the mammography self-test proposed by the Italian Society of Medical Radiology (SIRM) National Congress in Rimini, Italy, 2002, by analysing the findings responsible for errors, suggesting reasons for the errors, and assessing possible inadequacies in the format of the test. Materials and methods: The self-test was performed on the mammograms of 160 cases (32 positive and 128 negative for cancer as confirmed by histology). The mammograms had been taken in the four standard projections and placed on four multi-panel diaphanoscopes, each displaying a set of 40 cases comprising benign and malignant cases in equal proportions. The participants were given pre-printed forms on which to note down their diagnostic judgement. We evaluated a total of 134 fully-completed forms. Among these, we identified the 23 cases most frequently misread by over 15 participants in percentages varying between 40-90%. Of these cases, 10 were malignancies and 13 were negative mammograms. On review, we also assessed the diagnostic contribution of complementary investigations (not available the participants). The 134 fully-completed forms (all of the 40 cases) yielded a total of 5360 responses, 1180 of which (22.01%) were incorrect. Of these 823 out of the 4288 cases expected to be negative (19.2%) were false positive, and 357 out of the 1072 cases expected to be positive (33.3%) were false negative. As regards the 23 most frequently misread cases, these were 10/32 (31.25%) mammograms positive for malignancy and 13/128 (10.15%) negative mammograms or mammograms showing benign disease. The 10 malignancies included 7 infiltrating ductal carcinomas, 1 infiltrating cribriform carcinoma, 1 infiltrating tubular carcinoma, and 1 carcinoma in situ. The 13 cases of benign disease - as established by histology or long-term follow-up - mistaken for malignancies by the test participants were fibrocystic breast

  4. A 'Puff' dispersion model for routine and accidental releases

    Grsic, Z.; Rajkovic, B.; Milutinovic, P.

    1999-01-01

    A Puff dispersion model for accidental or routine releases is presented. This model was used as a constitutive part of an automatic meteorological station.All measured quantities are continuously displayed on PC monitor in a digital and graphical form, they are averaging every 10 minutes and sending to the civil information center of Belgrade. In the paper simulation of a pollutant plume dispersion from The oil refinery 'Pancevo', on April 18 th 1999 is presented. (author)

  5. Bladder injuries frequently missed in polytrauma patients

    Tanweer Karim

    2010-05-01

    Full Text Available Tanweer Karim, Margaret Topno, Vinod Sharma, Raymond Picardo, Ankur HastirSurgery, MGM Medical College, Kamothe, Navi Mumbai, IndiaAbstract: Bladder injuries are very common in patients who have had road traffic accidents. The method of diagnosis and management of such injuries is well established and accepted. However, trauma to the bladder can be associated with other life-threatening injuries which are frequently missed, and often diagnosed during laparotomy for other reasons. The aim of this study was to diagnose bladder injury in polytrauma patients as early as possible, taking into consideration the fact that these patients are hemodynamically unstable and require rapid evaluation and management. In order to achieve our objective, we used bedside sonography with retrograde instillation of normal saline to diagnose bladder injury in addition to use of the conventional retrograde cystogram.Keywords: bladder injury, bladder rupture, retrograde cystogram

  6. Frequent job change and associated health.

    Metcalfe, Chris; Davey Smith, George; Sterne, Jonathan A C; Heslop, Pauline; Macleod, John; Hart, Carole

    2003-01-01

    The contemporary labour market is widely regarded as having become more "flexible". It is proposed that such flexibility is a characteristic of employment histories which will have effects on psychosocial status, health-related behaviour, and physical health. Recent increases in flexibility are unlikely to have accumulated over sufficient portions of individual employment histories for any effect on health to be apparent, but a "preview" of these effects may be gained from study of older cohorts. This cross-sectional study is based on data collected in the early 1970s from 5399 men and 945 women in paid work, recruited from 27 workplaces in the west of Scotland. A flexible employment history was defined as one encompassing a large number of changes between jobs. Perceived psychological stress, health behaviour (cigarette smoking, alcohol consumption, physical exercise), physiology (diastolic blood pressure, body mass index, forced expiratory volume, plasma cholesterol concentration) and current health (angina, myocardial ischaemia) were assessed. Those individuals who reported having experienced frequent job change were more likely to smoke, consume greater amounts of alcohol, and perhaps to exercise less. Similar findings were observed in both males and females, and for different age and socio-economic groups. We found no suggestion that this association was due to higher levels of psychosocial stress, and the expected consequences for health were not observed. Interpretation of these findings is not straightforward due to an uncertain direction of causation, and a possible selection bias. However, the observed relationship between frequent job changing and a higher incidence of health risk behaviours, in the absence of a relationship with poorer health, invites further research.

  7. Frequent activation of EGFR in advanced chordomas

    Dewaele Barbara

    2011-07-01

    Full Text Available Abstract Background Chordomas are rare neoplasms, arising from notochordal remnants in the midline skeletal axis, for which the current treatment is limited to surgery and radiotherapy. Recent reports suggest that receptor tyrosine kinases (RTK might be essential for the survival or proliferation of chordoma cells, providing a rationale for RTK targeted therapy. Nevertheless, the reported data are conflicting, most likely due to the assorted tumor specimens used for the studies and the heterogeneous methodological approaches. In the present study, we performed a comprehensive characterization of this rare entity using a wide range of assays in search for relevant therapeutic targets. Methods Histopathological features of 42 chordoma specimens, 21 primary and 21 advanced, were assessed by immunohistochemistry and fluorescent in situ hybridization (FISH using PDGFRB, CSF1R, and EGFR probes. Twenty-two of these cases, for which frozen material was available (nine primary and 13 advanced tumors, were selectively analyzed using the whole-genome 4.3 K TK-CGH-array, phospho-kinase antibody array or Western immunoblotting. The study was supplemented by direct sequencing of KIT, PDGFRB, CSF1R and EGFR. Results We demonstrated that EGFR is frequently and the most significantly activated RTK in chordomas. Furthermore, concurrent to EGFR activation, the tumors commonly reveal co-activation of alternative RTK. The consistent activation of AKT, the frequent loss of the tumor suppressor PTEN allele, the recurrent activation of upstream RTK and of downstream effectors like p70S6K and mTOR, all indicate the PI3K/AKT pathway as an important mediator of transformation in chordomas. Conclusions Given the complexity of the signaling in chordomas, combined treatment regimens targeting multiple RTK and downstream effectors are likely to be the most effective in these tumors. Personalized therapy with careful selection of the patients, based on the molecular profile of

  8. Frequent Exertion and Frequent Standing at Work, by Industry and Occupation Group - United States, 2015.

    Shockey, Taylor M; Luckhaupt, Sara E; Groenewold, Matthew R; Lu, Ming-Lun

    2018-01-12

    Repeated exposure to occupational ergonomic hazards, such as frequent exertion (repetitive bending or twisting) and frequent standing, can lead to injuries, most commonly musculoskeletal disorders (1). Work-related musculoskeletal disorders have been estimated to cost the United States approximately $2.6 billion in annual direct and indirect costs (2). A recent literature review provided evidence that prolonged standing at work also leads to adverse health outcomes, such as back pain, physical fatigue, and muscle pain (3). To determine which industry and occupation groups currently have the highest prevalence rates of frequent exertion at work and frequent standing at work, CDC analyzed data from the 2015 National Health Interview Survey (NHIS) Occupational Health Supplement (OHS) regarding currently employed adults in the United States. By industry, the highest prevalence of both frequent exertion and frequent standing at work was among those in the agriculture, forestry, fishing, and hunting industry group (70.9%); by occupation, the highest prevalence was among those in the construction and extraction occupation group (76.9%). Large differences among industry and occupation groups were found with regard to these ergonomic hazards, suggesting a need for targeted interventions designed to reduce workplace exposure.

  9. Frequently asked questions in hypoxia research

    Wenger RH

    2015-09-01

    Full Text Available Roland H Wenger,1,2 Vartan Kurtcuoglu,1,2 Carsten C Scholz,1,2 Hugo H Marti,3 David Hoogewijs1,2,4 1Institute of Physiology and Zurich Center for Human Physiology (ZIHP, University of Zurich, 2National Center of Competence in Research “Kidney.CH”, Zurich, Switzerland; 3Institute of Physiology and Pathophysiology, University of Heidelberg, Heidelberg, 4Institute of Physiology, University of Duisburg-Essen, Essen, Germany Abstract: “What is the O2 concentration in a normoxic cell culture incubator?” This and other frequently asked questions in hypoxia research will be answered in this review. Our intention is to give a simple introduction to the physics of gases that would be helpful for newcomers to the field of hypoxia research. We will provide background knowledge about questions often asked, but without straightforward answers. What is O2 concentration, and what is O2 partial pressure? What is normoxia, and what is hypoxia? How much O2 is experienced by a cell residing in a culture dish in vitro vs in a tissue in vivo? By the way, the O2 concentration in a normoxic incubator is 18.6%, rather than 20.9% or 20%, as commonly stated in research publications. And this is strictly only valid for incubators at sea level. Keywords: gas laws, hypoxia-inducible factor, Krogh tissue cylinder, oxygen diffusion, partial pressure, tissue oxygen levels

  10. Technique for comparing automatic quadrature routines

    Lyness, J N; Kaganove, J J

    1976-02-01

    The present unconstrained proliferation of automatic quadrature routines is a phenomenon which is wasteful in human time and computing resources. At the root of the problem is an absence of generally acceptable standards or benchmarks for comparing or evaluating such routines. In this paper a general technique, based on the nature of the performance profile, is described which can be used for evaluation of routines.

  11. The clinical value of daily routine chest radiographs in a mixed medical-surgical intensive care unit is low

    Graat, Marleen E.; Choi, Goda; Wolthuis, Esther K.; Korevaar, Johanna C.; Spronk, Peter E.; Stoker, Jaap; Vroom, Margreeth B.; Schultz, Marcus J.

    2006-01-01

    INTRODUCTION: The clinical value of daily routine chest radiographs (CXRs) in critically ill patients is unknown. We conducted this study to evaluate how frequently unexpected predefined major abnormalities are identified with daily routine CXRs, and how often these findings lead to a change in care

  12. Vigilance impossible: Diligence, distraction, and daydreaming all lead to failures in a practical monitoring task.

    Casner, Stephen M; Schooler, Jonathan W

    2015-09-01

    In laboratory studies of vigilance, participants watch for unusual events in a "sit and stare" fashion as their performance typically declines over time. But watch keepers in practical settings seldom approach monitoring in such simplistic ways and controlled environments. We observed airline pilots performing routine monitoring duties in the cockpit. Unlike laboratory studies, pilots' monitoring did not deteriorate amidst prolonged vigils. Monitoring was frequently interrupted by other pop-up tasks and misses followed. However, when free from these distractions, pilots reported copious mind wandering. Pilots often confined their mind wandering to times in which their monitoring performance would not conspicuously suffer. But when no convenient times were available, pilots mind wandered anyway and misses ensued. Real-world monitors may be caught between a continuous vigilance approach that is doomed to fail, a dynamic environment that cannot be fully controlled, and what may be an irresistible urge to let one's thoughts drift. Published by Elsevier Inc.

  13. Frequent premature ventricular contractions in an orbital spaceflight participant.

    Jennings, Richard T; Stepanek, Jan P; Scott, Luis R; Voronkov, Yury I

    2010-06-01

    Commercial spaceflight participants on orbital flights typically are older than career astronauts and they often have medical conditions that have not been studied at high g or in microgravity. This is a case report of a 56-yr-old orbital spaceflight participant with essential tremor and frequent premature ventricular contractions that occurred at rates up to 7000 per day. Before training and spaceflight, he was required to complete extensive clinical investigations to demonstrate normal cardiac structures and the absence of cardiac pathology. The evaluation included signal averaged ECG, transthoracic stress echocardiography, exercise tolerance tests, electrophysiological studies, cardiac MRI, electron beam CT, Holter monitoring, and overnight oximetry. While no cardiac pathology was demonstrated, the Russian medical team required that the PVCs be treated prior to training and spaceflight. For the initial flight, a selective beta-1 receptor beta blocker was used and for the second a calcium channel blocker was used in combination with a nonselective beta blocker for tremor control. Analogue environment testing assured that this combination of medications was compatible. The spaceflight participant's PVCs were incompletely suppressed with a low-dose selective beta-1 blocker, but were well suppressed by a calcium channel blocker. He tolerated in-flight periodic use of a nonselective beta blocker in combination with a calcium channel blocker. In-flight ECG and blood pressure monitoring results were normal, and an ECG obtained midmission and on landing day showed successful PVC suppression. He did not have any cardiac difficulty with launch, on-orbit operations, entry, or recovery

  14. Daily life activity routine discovery in hemiparetic rehabilitation patients using topic models.

    Seiter, J; Derungs, A; Schuster-Amft, C; Amft, O; Tröster, G

    2015-01-01

    Monitoring natural behavior and activity routines of hemiparetic rehabilitation patients across the day can provide valuable progress information for therapists and patients and contribute to an optimized rehabilitation process. In particular, continuous patient monitoring could add type, frequency and duration of daily life activity routines and hence complement standard clinical scores that are assessed for particular tasks only. Machine learning methods have been applied to infer activity routines from sensor data. However, supervised methods require activity annotations to build recognition models and thus require extensive patient supervision. Discovery methods, including topic models could provide patient routine information and deal with variability in activity and movement performance across patients. Topic models have been used to discover characteristic activity routine patterns of healthy individuals using activity primitives recognized from supervised sensor data. Yet, the applicability of topic models for hemiparetic rehabilitation patients and techniques to derive activity primitives without supervision needs to be addressed. We investigate, 1) whether a topic model-based activity routine discovery framework can infer activity routines of rehabilitation patients from wearable motion sensor data. 2) We compare the performance of our topic model-based activity routine discovery using rule-based and clustering-based activity vocabulary. We analyze the activity routine discovery in a dataset recorded with 11 hemiparetic rehabilitation patients during up to ten full recording days per individual in an ambulatory daycare rehabilitation center using wearable motion sensors attached to both wrists and the non-affected thigh. We introduce and compare rule-based and clustering-based activity vocabulary to process statistical and frequency acceleration features to activity words. Activity words were used for activity routine pattern discovery using topic models

  15. Active Movement Warm-Up Routines

    Walter, Teri; Quint, Ashleigh; Fischer, Kim; Kiger, Joy

    2011-01-01

    This article presents warm-ups that are designed to physiologically and psychologically prepare students for vigorous physical activity. An active movement warm-up routine is made up of three parts: (1) active warm-up movement exercises, (2) general preparation, and (3) the energy system. These warm-up routines can be used with all grade levels…

  16. Master schedule for CY-1981 Hanford environmental surveillance routine program

    Blumer, P.J.; Sula, M.J.; Eddy, P.A.

    1980-12-01

    The current schedule of data collection for the routine environmental surveillance program at the Hanford Site is provided. Questions about specific entries should be referred to the authors since modifications to the schedule are made during the year and special areas of study, usually of short duration, are not scheduled. The environmental surveillance program objectives are to evaluate the levels of radioactive and nonradioactive pollutants in the Hanford environs, as required in Manual Chapter 0513, and to monitor Hanford operations for compliance with applicable environmental criteria given in Manual Chapter 0524 and Washington State Water Quality Standards. Air quality data obtained in a separate program are also reported. The collection schedule for potable water is shown but it is not part of the routine environmental surveillance program. Schedules are presented for the following subjects: air, Columbia River, sanitary water, surface water, ground water, foodstuffs, wildlife, soil and vegetation, external radiation measurement, portable instrument surveys, and surveillance of waste disposal sites

  17. Clinical experience with routine diode dosimetry for electron beam radiotherapy

    Yaparpalvi, Ravindra; Fontenla, Doracy P.; Vikram, Bhadrasain

    2000-01-01

    Purpose: Electron beam radiotherapy is frequently administered based on clinical setups without formal treatment planning. We felt, therefore, that it was important to monitor electron beam treatments by in vivo dosimetry to prevent errors in treatment delivery. In this study, we present our clinical experience with patient dose verification using electron diodes and quantitatively assess the dose perturbations caused by the diodes during electron beam radiotherapy. Methods and Materials: A commercial diode dosimeter was used for the in vivo dose measurements. During patient dosimetry, the patients were set up as usual by the therapists. Before treatment, a diode was placed on the patient's skin surface and secured with hypoallergenic tape. The patient was then treated and the diode response registered and stored in the patient radiotherapy system database via our in-house software. A customized patient in vivo dosimetry report showing patient details, expected and measured dose, and percent difference was then generated and printed for analysis and record keeping. We studied the perturbation of electron beams by diodes using film dosimetry. Beam profiles at the 90% prescription isodose depths were obtained with and without the diode on the beam central axis, for 6-20 MeV electron beams and applicator/insert sizes ranging from a 3-cm diameter circular field to a 25 x 25 cm open field. Results: In vivo dose measurements on 360 patients resulted in the following ranges of deviations from the expected dose at the various anatomic sites: Breast (222 patients) -20.3 to +23.5% (median deviation 0%); Head and Neck (63 patients) -21.5 to +14.8% (median -0.7%); Other sites (75 patients) -17.6 to +18.8% (median +0.5%). Routine diode dosimetry during the first treatment on 360 patients (460 treatment sites) resulted in 11.5% of the measurements outside our acceptable ±6% dose deviation window. Only 3.7% of the total measurements were outside ±10% dose deviation. Detailed

  18. External Agents' Effect on Routine Dynamics:Lack of Compliance Resulting in Routine Breakdown

    Busse Hansen, Nicolai

    2014-01-01

    Prior investigations on organizational routines have called for re- search to enlighten our understanding of how social actors establish and main- tain of routines as well as the causes of their disruption. The present paper con- tributes to this call by conducting systematic microethnographic analyses of naturally occurring interactional routine data in the form of recordings of job interviews in an international oil contractor company. The term interactional routine is used to describe recu...

  19. Barriers and facilitators to reducing frequent laboratory testing for patients who are stable on warfarin: a mixed methods study of de-implementation in five anticoagulation clinics.

    Barnes, Geoffrey D; Misirliyan, Sevan; Kaatz, Scott; Jackson, Elizabeth A; Haymart, Brian; Kline-Rogers, Eva; Kozlowski, Jay; Krol, Gregory; Froehlich, James B; Sales, Anne

    2017-07-14

    Patients on chronic warfarin therapy require regular laboratory monitoring to safely manage warfarin. Recent studies have challenged the need for routine monthly blood draws in the most stable warfarin-treated patients, suggesting the safety of less frequent laboratory testing (up to every 12 weeks). De-implementation efforts aim to reduce the use of low-value clinical practices. To explore barriers and facilitators of a de-implementation effort to reduce the use of frequent laboratory tests for patients with stable warfarin management in nurse/pharmacist-run anticoagulation clinics, we performed a mixed-methods study conducted within a state-wide collaborative quality improvement collaborative. Using a mixed-methods approach, we conducted post-implementation semi-structured interviews with a total of eight anticoagulation nurse or pharmacist staff members at five participating clinic sites to assess barriers and facilitators to de-implementing frequent international normalized ratio (INR) laboratory testing among patients with stable warfarin control. Interview guides were based on the Tailored Implementation for Chronic Disease (TICD) framework. Informed by interview themes, a survey was developed and administered to all anticoagulation clinical staff (n = 62) about their self-reported utilization of less frequent INR testing and specific barriers to de-implementing the standard (more frequent) INR testing practice. From the interviews, four themes emerged congruent with TICD domains: (1) staff overestimating their actual use of less frequent INR testing (individual health professional factors), (2) barriers to appropriate patient engagement (incentives and resources), (3) broad support for an electronic medical record flag to identify potentially eligible patients (incentives and resources), and (4) the importance of personalized nurse/pharmacist feedback (individual health professional factors). In the survey (65% response rate), staff report offering less

  20. Increased Exposure to Rigid Routines Can Lead to Increased Challenging Behavior Following Changes to Those Routines

    Bull, Leah E.; Oliver, Chris; Callaghan, Eleanor; Woodcock, Kate A.

    2015-01-01

    Several neurodevelopmental disorders are associated with preference for routine and challenging behavior following changes to routines. We examine individuals with Prader-Willi syndrome, who show elevated levels of this behavior, to better understand how previous experience of a routine can affect challenging behavior elicited by disruption to…

  1. Skin dose assessment in routine personnel beta/gamma dosimetry

    Christensen, P.

    1980-01-01

    The International Commission on Radiological Protection (Publication 26) has recommended a tissue depth of 5 to 10 mg.cm -2 for skin dose assessments. This requirement is generally not fulfilled by routine monitoring procedures because of practical difficulties in using very thin dosemeters with low sensitivity and therefore a high minimum detectable dose. Especially for low-energy beta-ray exposures underestimations of the skin dose by a factor of more than ten may occur. Low-transparent graphite-mixed sintered LiF and Li 2 B 4 0 7 : Mn dosemeters were produced which show a skin-equivalent response to beta and gamma exposures over a wide range of energies. These have found wide-spread application for extremity dosimetry but have not yet been generally introduced in routine personnel beta/gamma monitoring. The following adaptations of existing routine monitoring systems for improved skin dose assessments have been investigated: 1) Placement of a supplementary, thin, skin-dose equivalent dosemeter in the TLD badge to give additional information on low-energy exposures. 2) Introduction of a second photomultiplier in the read-out chamber which enables a simultaneous determination of emitted TL from both sides of the dosemeter separately. This method makes use of the selfshielding of the dosemeter to give information on the low-energy dose contribution. 3) By diffusion of Li 2 B 4 0 7 into solid LiF-dosemeters it was possible to produce a surface layer with a new distinct glow-peak at about 340 deg C which is not present in the undiffused part of the LiF chip, and which can be utilized for the assessment of the skin-dose. Data on energy response and accuracy of dose measurement for beta/gamma exposures are given for the three methods and advantages and disadvantages are discussed (H.K.)

  2. Master schedule for CY-1980 Hanford Environmental Surveillance Routine Program

    Blumer, P.J.; Houston, J.R.; Eddy, P.A.

    1979-12-01

    The current schedule of data collection for the routine environmental surveillance program at the Hanford Site is presented. The enviromental surveillance program objectives are to evaluate the levels of radioactive and nonradioactive pollutants in the Hanford environs, as required in Manual Chapter 0513, and to monitor Hanford operations for compliance with applicable environmental criteria given in Manual Chapter 0524 and Washington State Water Quality Standards. Data are reported on the following topics: air; Columbia River; sanitary water; surface water; ground water; foodstuffs; wildlife; soil and vegetation; external radiation measurement; portable instrument surveys; and surveillance of waste disposal sites;

  3. Instrumental neutron activation analysis - a routine method

    Bruin, M. de.

    1983-01-01

    This thesis describes the way in which at IRI instrumental neutron activation analysis (INAA) has been developed into an automated system for routine analysis. The basis of this work are 20 publications describing the development of INAA since 1968. (Auth.)

  4. External Agents' Effect on Routine Dynamics

    Busse Hansen, Nicolai

    Prior investigations on organizational routines have called for re- search to enlighten our understanding of how social actors establish and main- tain of routines as well as the causes of their disruption. The present paper con- tributes to this call by conducting systematic microethnographic...... and affiliation are central to how routines are maintained but also susceptible to disruption in case of mis- management. Also the paper contributes with a more fine-tuned understanding of action in terms of them being organized in accordance with preference, which basically means that some actions are preferred...... over others. In producing an action, the relevant next action is projected. However the relevant next action is projected in a specific way and if this is not taken in to account then the routine becomes disrupted. Another core aspect is the notion of deontics that lends itself towards describing who...

  5. Taking medicine at home - create a routine

    ... page: //medlineplus.gov/ency/patientinstructions/000613.htm Taking medicine at home - create a routine To use the ... teeth. Find Ways to Help You Remember Your Medicines You can: Set the alarm on your clock, ...

  6. Master schedule for CY-1984 Hanford environmental surveillance routine sampling program

    Blumer, P.J.; Price, K.R.; Eddy, P.A.; Carlile, J.M.V.

    1983-12-01

    This report provides the current schedule of data collection for the routine Hanford environmental surveillance and ground-water Monitoring Programs at the Hanford Site. The purpose is to evaluate and report the levels of radioactive and nonradioactive pollutants in the Hanford environs. The routine sampling schedule provided herein does not include samples that are planned to be collected during FY-1984 in support of special studies, special contractor support programs, or for quality control purposes

  7. Improving care coordination using organisational routines.

    Prætorius, Thim

    2016-01-01

    The purpose of this paper is to systematically apply theory of organisational routines to standardised care pathways. The explanatory power of routines is used to address open questions in the care pathway literature about their coordinating and organising role, the way they change and can be replicated, the way they are influenced by the organisation and the way they influence health care professionals. Theory of routines is systematically applied to care pathways in order to develop theoretically derived propositions. Care pathways mirror routines by being recurrent, collective and embedded and specific to an organisation. In particular, care pathways resemble standard operating procedures that can give rise to recurrent collective action patterns. In all, 11 propositions related to five categories are proposed by building on these insights: care pathways and coordination, change, replication, the organisation and health care professionals. Research limitations/implications - The paper is conceptual and uses care pathways as illustrative instances of hospital routines. The propositions provide a starting point for empirical research. The analysis highlights implications that health care professionals and managers have to consider in relation to coordination, change, replication, the way the organisation influences care pathways and the way care pathways influence health care professionals. Originality/value - Theory on organisational routines offers fundamental, yet unexplored, insights into hospital processes, including in particular care coordination.

  8. The situational and time-varying context of routines in television viewing: An event history analysis

    Westerik, H.; Renckstorf, K.; Wester, F.P.J.; Lammers, J.G.M.

    2005-01-01

    Building on an action theoretical perspective, it is assumed that most television viewing is a routine response to frequently occurring situations, which together make up everyday life. This interplay between television viewing and everyday life was studied using data from a national survey among

  9. Supporting Frequent Updates in R-Trees: A Bottom-Up Approach

    Lee, Mong Li; Hsu, Wynne; Jensen, Christian Søndergaard

    2004-01-01

    Advances in hardware-related technologies promise to enable new data management applications that monitor continuous processes. In these applications, enormous amounts of state samples are obtained via sensors and are streamed to a database. Further, updates are very frequent and may exhibit loca...

  10. Blood Glucose Monitoring Before and After Type 1 Diabetes Clinic Visits.

    Driscoll, Kimberly A; Johnson, Suzanne Bennett; Wang, Yuxia; Wright, Nancy; Deeb, Larry C

    2017-12-23

    To determine patterns of blood glucose monitoring in children and adolescents with type 1 diabetes (T1D) before and after routine T1D clinic visits. Blood glucose monitoring data were downloaded at four consecutive routine clinic visits from children and adolescents aged 5-18 years. Linear mixed models were used to analyze patterns of blood glucose monitoring in patients who had at least 28 days of data stored in their blood glucose monitors. In general, the frequency of blood glucose monitoring decreased across visits, and younger children engaged in more frequent blood glucose monitoring. Blood glucose monitoring increased before the T1D clinic visits in younger children, but not in adolescents. It declined after the visit regardless of age. Members of the T1D care team need to consider that a T1D clinic visit may prompt an increase in blood glucose monitoring when making treatment changes and recommendations. Tailored interventions are needed to maintain that higher level of adherence across time. © The Author(s) 2017. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  11. Guide and manual of frequent special radiological procedures pertaining frequent pediatric patient

    Quesada Rodriguez, Marco V.

    2012-01-01

    A set of instructions and / or recommendations are afforded, developed in a systematic way, whose purpose is to help treating doctors to make decisions about the mode of study appropriate for a specialized clinical circumstance. The instructions are aimed at radiologists, in order to facilitate the selection and realization of special studies in the pediatric patient images, so that in this way, guide of the best and most efficient way to the resolution of the cases before diagnostic doubts that seek to clarify the treating clinician. The studies most frequently requested are exposed, as well as those with their prompt realization will lead to a quick and timely medical care and / or surgical of a specific problem [es

  12. Master schedule for CY-1979 Hanford environmental surveillance routine program

    Blumer, P.J.; Houston, J.R.; Eddy, P.A.

    1978-12-01

    The current schedule of data collection for the routine environmental surveillance program at the Hanford Site, as conducted by the Environmental Evaluation Section of Battelle, Pacific Northwest Laboratory for the Department of Energy (DOE), is given. Modifications to the schedule are made during the year and special areas of study, usually of short duration, are not scheduled. The environmental surveillance program objectives are to evaluate the levels of radioactive and nonradioactive pollutants in the Hanford environs, and to monitor Hanford operations for compliance with applicable environmental criteria and Washington State Water Quality Standards. Air quality data are obtained in a separate program administered by the Hanford Environmental Health Foundation. The collection schedule for potable water is shown but it is not part of the routine environmental surveillance program. Water quality data for Hanford Site potable water systems are published each year by the Hanford Environmental Health Foundation. The data collected are available in routine reports issued by the Environmental Evaluations staff. Groundwater data and evaluation are reported in the series, ''Radiological Status of the Groundwater Beneath the Hanford Project for...,'' the latest issue being PNL-2624 for CY-1977. Data from locations within the plant boundaries are presented in the annual ''Environmental Status of the Hanford Site for...'' report series, the most recent report being PNL-2677 for 1977. Data from offsite locations are presented in the annual ''Environmental Surveillance at Hanford for...'' series of reports, the latest being PNL-2614 for 1977

  13. Examining daily activity routines of older adults using workflow.

    Chung, Jane; Ozkaynak, Mustafa; Demiris, George

    2017-07-01

    We evaluated the value of workflow analysis supported by a novel visualization technique to better understand the daily routines of older adults and highlight their patterns of daily activities and normal variability in physical functions. We used a self-reported activity diary to obtain data from six community-dwelling older adults for 14 consecutive days. Workflow for daily routine was analyzed using the EventFlow tool, which aggregates workflow information to highlight patterns and variabilities. A total of 1453 events were included in the data analysis. To demonstrate the patterns and variability of each individual's daily activities, participant activity workflows were visualized and compared. The workflow analysis revealed great variability in activity types, regularity, frequency, duration, and timing of performing certain activities across individuals. Also, when workflow approach was applied to spatial information of activities, the analysis revealed the ability to provide meaningful data on individuals' mobility in different levels of life spaces from home to community. Results suggest that using workflows to characterize the daily activities of older adults will be helpful for clinicians and researchers in understanding their daily routines and preparing education and prevention strategies tailored to each individual's activity level. This tool also has the potential to be integrated into consumer informatics technologies, such as patient portals or personal health records, so that consumers may be encouraged to become actively involved in monitoring and managing their health. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Influence of Frequent Nocturnal Home Hemodialysis on Food Preference

    Ipema, Karin; Franssen, Casper; van der Schans, Cees; Smit, Lianne; Noordman, Sabine; Haisma, Hinke

    Objective: Dialysis patients frequently report a change of taste that is reversible after renal transplantation, suggesting that uremic toxins may negatively influence taste. Currently, frequent nocturnal home hemodialysis (NHHD) is the most effective method of hemodialysis, and is associated with

  15. Aerosol Chemical Speciation Monitor (ACSM) Instrument Handbook

    Watson, Thomas B. [Brookhaven National Lab. (BNL), Upton, NY (United States)

    2017-08-15

    The Aerodyne Aerosol Chemical Speciation Monitor (ACSM) measures particle mass loading and chemical composition in real time for non-refractory sub-micron aerosol particles. The ACSM is designed for long-term unattended deployment and routine monitoring applications.

  16. Personal monitoring

    1995-01-01

    Sources of ionizing radiation have innumerable applications in the workplace. The potential exposures of the individual workers involved may need to be routinely monitored and records kept of their cumulative radiation doses. There are also occasions when it is necessary to retrospectively determine a dose which may have been received by a worker. This Module explains the basic terminology associated with personal monitoring and describes the principal types of dosimeters and other related techniques and their application in the workplace. The Manual will be of most benefit if it forms part of more comprehensive training or is supplemented by the advice of a qualified expert in radiation protection. Most of the dosimeters and techniques described in this Module can only be provided by qualified experts

  17. Improving care coordination using organisational routines

    Prætorius, Thim

    2016-01-01

    Purpose – The purpose of this paper is to systematically apply theory of organisational routines to standardised care pathways. The explanatory power of routines is used to address open questions in the care pathway literature about their coordinating and organising role, the way they change......: care pathways and coordination, change, replication, the organisation and health care professionals. Research limitations/implications – The paper is conceptual and uses care pathways as illustrative instances of hospital routines. The propositions provide a starting point for empirical research....... Practical implications – The analysis highlights implications that health care professionals and managers have to consider in relation to coordination, change, replication, the way the organisation influences care pathways and the way care pathways influence health care professionals. Originality...

  18. Focus Group Study Exploring Factors Related to Frequent Sickness Absence.

    Notenbomer, Annette; Roelen, Corné A M; van Rhenen, Willem; Groothoff, Johan W

    2016-01-01

    Research investigating frequent sickness absence (3 or more episodes per year) is scarce and qualitative research from the perspective of frequent absentees themselves is lacking. The aim of the current study is to explore awareness, determinants of and solutions to frequent sickness absence from the perspective of frequent absentees themselves. We performed a qualitative study of 3 focus group discussions involving a total of 15 frequent absentees. Focus group discussions were audiotaped and transcribed verbatim. Results were analyzed with the Graneheim method using the Job Demands Resources (JD-R) model as theoretical framework. Many participants were not aware of their frequent sickness absence and the risk of future long-term sickness absence. As determinants, participants mentioned job demands, job resources, home demands, poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Managing these factors and improving communication (skills) were regarded as solutions to reduce frequent sickness absence. The JD-R model provided a framework for determinants of and solutions to frequent sickness absence. Additional determinants were poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Frequent sickness absence should be regarded as a signal that something is wrong. Managers, supervisors, and occupational health care providers should advise and support frequent absentees to accommodate job demands, increase both job and personal resources, and improve health rather than express disapproval of frequent sickness absence and apply pressure regarding work attendance.

  19. Conversational routines in English convention and creativity

    Aijmer, Karin

    2014-01-01

    It is surprising how much of everyday conversation consists of repetitive expressions such as 'thank you', 'sorry', would you mind?' and their many variants. However commonplace they may be, they do have important functions in communication.This thorough study draws upon original data from the London-Lund Corpus of Spoken English to provide a discoursal and pragmatic account of the more common expressions found in conversational routines, such as apologising, thanking, requesting and offering.The routines studied in this book range from conventionalized or idiomatized phrases t

  20. Routine maintenance prolongs ESP time between failures

    Hurst, T.; Lannom, R.W.; Divine, D.L.

    1992-01-01

    This paper reports that routine maintenance of electric submersible motors (ESPs) significantly lengthened the mean time between motor failures (MTBF), decreased operating costs, and extended motor run life in the Sacroc Unit of the Kelly-Snyder field in West Texas. After the oil price boom of the early 1980s. rapidly eroding profit margins from producing properties caused a much stronger focus on reducing operating costs. In Sacroc, ESP operating life and repair costs became a major target of cost reduction efforts. The routine ESP maintenance program has been in place for over 3 years

  1. Absorptive routines and international patent performance

    Fernando E. García-Muiña

    2017-04-01

    We enrich the treatment of the absorptive capacity phases including the moderating effects between routines associated to the traditional potential-realized absorptive capacities. Taking into account external knowledge search strategies, the deeper external relationships, the better transference and appropriation of specific external knowledge. Nevertheless, when the moderating role of assimilation is included, cooperation agreements appear as the most efficient source of external knowledge. Finally, we show that technological tools let firms store and structure the information making easier its use for international patenting. This positive effect is reinforced in the presence of exploitation routines, since technological knowledge will better fit to the industry's key factors of success.

  2. Effects of frequent hemodialysis on perceived caregiver burden in the Frequent Hemodialysis Network trials.

    Suri, Rita S; Larive, Brett; Hall, Yoshio; Kimmel, Paul L; Kliger, Alan S; Levin, Nathan; Tamura, Manjula Kurella; Chertow, Glenn M

    2014-05-01

    Patients receiving hemodialysis often perceive their caregivers are overburdened. We hypothesize that increasing hemodialysis frequency would result in higher patient perceptions of burden on their unpaid caregivers. In two separate trials, 245 patients were randomized to receive in-center daily hemodialysis (6 days/week) or conventional hemodialysis (3 days/week) while 87 patients were randomized to receive home nocturnal hemodialysis (6 nights/week) or home conventional hemodialysis for 12 months. Changes in overall mean scores over time in the 10-question Cousineau perceived burden scale were compared. In total, 173 of 245 (70%) and 80 of 87 (92%) randomized patients in the Daily and Nocturnal Trials, respectively, reported having an unpaid caregiver at baseline or during follow-up. Relative to in-center conventional dialysis, the 12-month change in mean perceived burden score with in-center daily hemodialysis was -2.1 (95% confidence interval, -9.4 to +5.3; P=0.58). Relative to home conventional dialysis, the 12-month change in mean perceived burden score with home nocturnal dialysis was +6.1 (95% confidence interval, -0.8 to +13.1; P=0.08). After multiple imputation for missing data in the Nocturnal Trial, the relative difference between home nocturnal and home conventional hemodialysis was +9.4 (95% confidence interval, +0.55 to +18.3; P=0.04). In the Nocturnal Trial, changes in perceived burden were inversely correlated with adherence to dialysis treatments (Pearson r=-0.35; P=0.02). Relative to conventional hemodialysis, in-center daily hemodialysis did not result in higher perceptions of caregiver burden. There was a trend to higher perceived caregiver burden among patients randomized to home nocturnal hemodialysis. These findings may have implications for the adoption of and adherence to frequent nocturnal hemodialysis.

  3. Cost-effectiveness of routine imaging of suspected appendicitis.

    D'Souza, N; Marsden, M; Bottomley, S; Nagarajah, N; Scutt, F; Toh, S

    2018-01-01

    Introduction The misdiagnosis of appendicitis and consequent removal of a normal appendix occurs in one in five patients in the UK. On the contrary, in healthcare systems with routine cross-sectional imaging of suspected appendicitis, the negative appendicectomy rate is around 5%. If we could reduce the rate in the UK to similar numbers, would this be cost effective? This study aimed to calculate the financial impact of negative appendicectomy at the Queen Alexandra Hospital and to explore whether a policy of routine imaging of such patients could reduce hospital costs. Materials and methods We performed a retrospective analysis of all appendicectomies over a 1-year period at our institution. Data were extracted on outcomes including appendix histology, operative time and length of stay to calculate the negative appendicectomy rate and to analyse costs. Results A total of 531 patients over 5 years of age had an appendicectomy. The negative appendicectomy rate was 22% (115/531). The additional financial costs of negative appendicectomy to the hospital during this period were £270,861. Universal imaging of all patients with right iliac fossa pain that could result in a 5% negative appendicectomy rate would cost between £67,200 and £165,600 per year but could save £33,896 (magnetic resonance imaging), £105,896 (computed tomography) or £132,296 (ultrasound) depending on imaging modality used. Conclusions Negative appendicectomy is still too frequent and results in additional financial burden to the health service. Routine imaging of patients with suspected appendicitis would not only reduce the negative appendicectomy rate but could lead to cost savings and a better service for our patients.

  4. Generating Novelty Through Interdependent Routines: A Process Model of Routine Work

    Deken, F.; Carlile, P.R.; Berends, H.; Lauche, K.

    2016-01-01

    We investigate how multiple actors accomplish interdependent routine performances directed at novel intended outcomes and how this affects routine dynamics over time. We report findings from a longitudinal ethnographic study in an automotive company where actors developed a new business model around

  5. Is routine measurement of TSH in hospitalized patients necessary?

    Amir Bashkin

    2018-04-01

    Full Text Available TSH routine testing in hospitalized patients has low efficacy, but may be beneficial in a selected subgroup of patients. Our aim was to evaluate the efficacy of routine thyroid function tests among patients admitted to internal medicine departments. It is a retrospective study. A randomly selected cohort of hospitalized patients with abnormal thyroid-stimulating hormone (TSH blood tests drawn as part of admission protocol. Patient data were collected from the electronic medical files and analyzed for its efficacy. TSH as a screening test was proven unnecessary in 75% (174 of the study population. Leading causes were non-thyroidal illness syndrome, drugs affecting the test results and subclinical disorders. TSH testing was found to be clinically helpful in only 9 patients; however, all of them had other clinical need for TSH testing. We found a clinically abnormal TSH in 20 patients, hypothyroidism in 11 patients and thyrotoxicosis in 9 patients. Low efficacy ascribed to TSH screening test by this study correlates with recent recommendations that indicate TSH screening in admitted patients only with accompanying clinical suspicion. Most probably, the majority of patients found by screening to have thyrotoxicosis have non-thyroidal illness or drug effects so the threshold for FT4 to diagnose overt thyrotoxicosis should be higher than that in ambulatory patients. In elderly patients, clinically relevant TSH disturbances are more frequent and are harder to diagnose, therefore, TSH screening in this group of patients might be beneficial.

  6. Community Pharmacies As Possible Centres For Routine ...

    Method: Sixty (60) pre-tested questionnaires were randomly administered to community pharmacists. Forty-three (43) questionnaires were retrieved for analysis. Results: The study revealed that the use of community pharmacies as places where routine immunization services can be provided is feasible as shown by 95.3% ...

  7. Age at BCG administration during routine immunization.

    Age at BCG administration during routine immunization. R.D. Wammanda , M.J. Gambo and I. Abdulkadir. Department of Paediatrics,. Ahmadu Bello University Teaching Hospital,. Zaria. Correspondence to: Dr.R.D. Wammanda. Email: wammanda@yahoo.com. Summary. In Nigeria, as part of the National Programme on ...

  8. Individual Values, Learning Routines and Academic Procrastination

    Dietz, Franziska; Hofer, Manfred; Fries, Stefan

    2007-01-01

    Background: Academic procrastination, the tendency to postpone learning activities, is regarded as a consequence of postmodern values that are prominent in post-industrialized societies. When students strive for leisure goals and have no structured routines for academic tasks, delaying strenuous learning activities becomes probable. Aims: The…

  9. Individual values, learning routines and academic procrastination.

    Dietz, Franziska; Hofer, Manfred; Fries, Stefan

    2007-12-01

    Academic procrastination, the tendency to postpone learning activities, is regarded as a consequence of postmodern values that are prominent in post-industrialized societies. When students strive for leisure goals and have no structured routines for academic tasks, delaying strenuous learning activities becomes probable. The model tested in this study posits that postmodern value orientations are positively related to procrastination and to a lack of daily routines concerning the performance of academic activities. In contrast, modern values are negatively related to procrastination and positively to learning routines. Academic procrastination, in-turn, should be associated with the tendency to prefer leisure activities to schoolwork in case of conflicts between these two life domains. Seven hundred and four students from 6th and 8th grade with a mean age of 13.5 years participated in the study. The sample included students from all tracks of the German educational system. Students completed a questionnaire containing two value prototypes as well as scales on learning routines and procrastination. Decisions in motivational conflicts were measured using two vignettes. Results from structural equation modelling supported the proposed model for the whole sample as well as for each school track. A planned course of the day can prevent procrastination and foster decisions for academic tasks in case of conflicts. Students' learning takes place within a societal context and reflects the values held in the respective culture.

  10. Federal Funding Accountability and Transparency Act frequently asked questions

    One stop shop for Federal Funding Accountability and Transparency Act (FFATA) questions. This frequently asked document will assist with Federal Funding Accountability and Transparency Act (FFATA) related questions.

  11. Effect of radioimmunoassay procedures on therapeutic drug monitoring

    Kampa, I.S.

    1985-01-01

    Methods for the measurement of therapeutic drugs have covered every aspect of analysis from extraction to derivatization. In general, published methods were modified to shorten drug extractions and overall analysis time. The use of different standards, as well as the frequent omission of internal standards, often produced large and clinically unacceptable analytical variations. As a result, physicians would adjust drug dosages according to the physiological response to a standard dose. The introduction of radioimmunoassay techniques for the quantitation of therapeutic drugs have made a significant impact on the clinical chemistry laboratory. The similarities of the various assay methods and the technologists' familiarity with the assay protocols have produced clinically relevant results. Clinical laboratories are now able to frequently analyze a large number of samples with acceptable accuracy and precision. The esoteric test once performed infrequently is today a routine analytical assay often performed STAT. Therapeutic drug monitoring has become a major activity in many clinical laboratories

  12. Comparison of two oestrus synchronisation protocols administered to dairy cows during routine reproduction services

    Viora, L; Denwood, M; Ellis, K

    2015-01-01

    Progesterone-based oestrus synchronisation protocols are frequently used for treatment of cows presented for examination during routine reproduction management service. This study aimed to evaluate the effect of the addition of gonadotrophin-releasing hormone (GnRH) at the start of a progesterone......-based oestrus synchronisation protocol for cows presented for examination during routine veterinary service on a commercial dairy farm over 10 months. Overall 139 animals were retained in the study, of which 78 received a standard progesterone-based treatment (STD) and 61 received the same treatment...

  13. Description of work for routine groundwater sampling at the Environmental Restoration Disposal Facility

    Ford, B.H.

    1996-09-01

    This document provides a description of work and field implementation guidance for routine (post-baseline) groundwater monitoring sampling program at the Environmental Restoration Disposal Facility. The purpose of this program is to (1) meet the intent of the applicable or relevant and appropriate requirements; (2) document baseline groundwater conditions; (3) monitor those conditions for change; and (4) allow for modifications to groundwater sampling if required by the leachate management program

  14. Focus Group Study Exploring Factors Related to Frequent Sickness Absence.

    Annette Notenbomer

    Full Text Available Research investigating frequent sickness absence (3 or more episodes per year is scarce and qualitative research from the perspective of frequent absentees themselves is lacking. The aim of the current study is to explore awareness, determinants of and solutions to frequent sickness absence from the perspective of frequent absentees themselves.We performed a qualitative study of 3 focus group discussions involving a total of 15 frequent absentees. Focus group discussions were audiotaped and transcribed verbatim. Results were analyzed with the Graneheim method using the Job Demands Resources (JD-R model as theoretical framework.Many participants were not aware of their frequent sickness absence and the risk of future long-term sickness absence. As determinants, participants mentioned job demands, job resources, home demands, poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Managing these factors and improving communication (skills were regarded as solutions to reduce frequent sickness absence.The JD-R model provided a framework for determinants of and solutions to frequent sickness absence. Additional determinants were poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Frequent sickness absence should be regarded as a signal that something is wrong. Managers, supervisors, and occupational health care providers should advise and support frequent absentees to accommodate job demands, increase both job and personal resources, and improve health rather than express disapproval of frequent sickness absence and apply pressure regarding work attendance.

  15. Stress steroid levels and the short-term impact of routine dehorning ...

    Routine dehorning procedures resulted in a short-term stress response expressed by a significant increase in fGCM levels 48 h post-dehorning, with stress steroid levels returning to pre-dehorning concentrations 72 h after the procedure. Keywords: faecal glucocorticoid metabolites, non-invasive hormone monitoring, ...

  16. Iron Deficiency In Frequent And First Time Female Blood Donors ...

    Aim of the study: This study was conducted to evaluate the frequency of iron deficiency and relevant factors in frequent and first time female blood donors at Casablanca blood transfusion centre, Morocco. Methods: Between November 2005 and April 2006, twenty-one female first time and twenty-one frequent female blood ...

  17. Emergency Department Frequent Users for Acute Alcohol Intoxication.

    Klein, Lauren R; Martel, Marc L; Driver, Brian E; Reing, Mackenzie; Cole, Jon B

    2018-03-01

    A subset of frequent users of emergency services are those who use the emergency department (ED) for acute alcohol intoxication. This population and their ED encounters have not been previously described. This was a retrospective, observational, cohort study of patients presenting to the ED for acute alcohol intoxication between 2012 and 2016. We collected all data from the electronic medical record. Frequent users for alcohol intoxication were defined as those with greater than 20 visits for acute intoxication without additional medical chief complaints in the previous 12 months. We used descriptive statistics to evaluate characteristics of frequent users for alcohol intoxication, as well as their ED encounters. We identified 32,121 patient encounters. Of those, 325 patients were defined as frequent users for alcohol intoxication, comprising 11,370 of the encounters during the study period. The median maximum number of encounters per person for alcohol intoxication in a one-year period was 47 encounters (range 20 to 169). Frequent users were older (47 years vs. 39 years), and more commonly male (86% vs. 71%). Frequent users for alcohol intoxication had higher rates of medical and psychiatric comorbidities including liver disease, chronic kidney disease, ischemic vascular disease, dementia, chronic obstructive pulmonary disease, history of traumatic brain injury, schizophrenia, and bipolar disorder. In this study, we identified a group of ED frequent users who use the ED for acute alcohol intoxication. This population had higher rates of medical and psychiatric comorbidities compared to non-frequent users.

  18. Classification and Target Group Selection Based Upon Frequent Patterns

    W.H.L.M. Pijls (Wim); R. Potharst (Rob)

    2000-01-01

    textabstractIn this technical report , two new algorithms based upon frequent patterns are proposed. One algorithm is a classification method. The other one is an algorithm for target group selection. In both algorithms, first of all, the collection of frequent patterns in the training set is

  19. Social environment and frequent attendance in Danish general practice

    Vedsted, Peter; Olesen, Frede

    2005-01-01

    of 1423 (73.7%) frequent attenders and 1103 (74.9%) infrequent attenders responded. Male frequent attendance was associated, with statistical significance, with living alone and being without work or on a disability pension. Among women, lack of professional education or being without work tended...

  20. Emergency Department Frequent Users for Acute Alcohol Intoxication

    Marc L. Martel

    2018-02-01

    Full Text Available Introduction: A subset of frequent users of emergency services are those who use the emergency department (ED for acute alcohol intoxication. This population and their ED encounters have not been previously described. Methods: This was a retrospective, observational, cohort study of patients presenting to the ED for acute alcohol intoxication between 2012 and 2016. We collected all data from the electronic medical record. Frequent users for alcohol intoxication were defined as those with greater than 20 visits for acute intoxication without additional medical chief complaints in the previous 12 months. We used descriptive statistics to evaluate characteristics of frequent users for alcohol intoxication, as well as their ED encounters. Results: We identified 32,121 patient encounters. Of those, 325 patients were defined as frequent users for alcohol intoxication, comprising 11,370 of the encounters during the study period. The median maximum number of encounters per person for alcohol intoxication in a one-year period was 47 encounters (range 20 to 169. Frequent users were older (47 years vs. 39 years, and more commonly male (86% vs. 71%. Frequent users for alcohol intoxication had higher rates of medical and psychiatric comorbidities including liver disease, chronic kidney disease, ischemic vascular disease, dementia, chronic obstructive pulmonary disease, history of traumatic brain injury, schizophrenia, and bipolar disorder. Conclusion: In this study, we identified a group of ED frequent users who use the ED for acute alcohol intoxication. This population had higher rates of medical and psychiatric comorbidities compared to non-frequent users.

  1. Quality of routine spirometry tests in Dutch general practices

    Schermer, Tjard RJ; Crockett, Alan J; Poels, Patrick JP; van Dijke, Jacob J; Akkermans, Reinier P; Vlek, Hans F; Pieters, Willem R

    2009-01-01

    Background Spirometry is an indispensable tool for diagnosis and monitoring of chronic airways disease in primary care. Aim To establish the quality of routine spirometry tests in general practice, and explore associations between test quality and patient characteristics. Design of study Analysis of routine spirometry test records. Setting Fifteen general practices which had a working agreement with a local hospital pulmonary function laboratory for spirometry assessment regarding test quality and interpretation. Method Spirometry tests were judged by a pulmonary function technician and a chest physician. Proportions of test adequacy were analysed using markers for manoeuvre acceptability and test reproducibility derived from the 1994 American Thoracic Society spirometry guideline. Associations between quality markers and age, sex, and severity of obstruction were examined using logistic regression. Results Practices performed a mean of four (standard deviation = 2) spirometry tests per week; 1271 tests from 1091 adult patients were analysed; 96.4% (95% confidence interval [CI] = 95.6 to 97.2) of all tests consisted of ≥3 blows. With 60.6% of tests, forced expiratory time was the marker with the lowest acceptability rate. An overall 38.8% (95% CI = 36.0 to 41.6) of the tests met the acceptability as well as reproducibility criteria. Age, sex, and severity of obstruction were associated with test quality markers. Conclusion The quality of routine spirometry tests was better than in previous reports from primary care research settings, but there is still substantial room for improvement. Sufficient duration of forced expiratory time is the quality marker with the highest rate of inadequacy. Primary care professionals should be aware of patient characteristics that may diminish the quality of their spirometry tests. Further research is needed to establish to what extent spirometry tests that are inadequate, according to stringent international expert criteria

  2. A Global Online Handwriting Recognition Approach Based on Frequent Patterns

    C. Gmati

    2018-06-01

    Full Text Available In this article, the handwriting signals are represented based on geometric and spatio-temporal characteristics to increase the feature vectors relevance of each object. The main goal was to extract features in the form of a numeric vector based on the extraction of frequent patterns. We used two types of frequent motifs (closed frequent patterns and maximal frequent patterns that can represent handwritten characters pertinently. These common features patterns are generated from a raw data transformation method to achieve high relevance. A database of words consisting of two different letters was created. The proposed application gives promising results and highlights the advantages that frequent pattern extraction algorithms can achieve, as well as the central role played by the “minimum threshold” parameter in the overall description of the characters.

  3. XML documents cluster research based on frequent subpatterns

    Ding, Tienan; Li, Wei; Li, Xiongfei

    2015-12-01

    XML data is widely used in the information exchange field of Internet, and XML document data clustering is the hot research topic. In the XML document clustering process, measure differences between two XML documents is time costly, and impact the efficiency of XML document clustering. This paper proposed an XML documents clustering method based on frequent patterns of XML document dataset, first proposed a coding tree structure for encoding the XML document, and translate frequent pattern mining from XML documents into frequent pattern mining from string. Further, using the cosine similarity calculation method and cohesive hierarchical clustering method for XML document dataset by frequent patterns. Because of frequent patterns are subsets of the original XML document data, so the time consumption of XML document similarity measure is reduced. The experiment runs on synthetic dataset and the real datasets, the experimental result shows that our method is efficient.

  4. Probability and statistics with integrated software routines

    Deep, Ronald

    2005-01-01

    Probability & Statistics with Integrated Software Routines is a calculus-based treatment of probability concurrent with and integrated with statistics through interactive, tailored software applications designed to enhance the phenomena of probability and statistics. The software programs make the book unique.The book comes with a CD containing the interactive software leading to the Statistical Genie. The student can issue commands repeatedly while making parameter changes to observe the effects. Computer programming is an excellent skill for problem solvers, involving design, prototyping, data gathering, testing, redesign, validating, etc, all wrapped up in the scientific method.See also: CD to accompany Probability and Stats with Integrated Software Routines (0123694698)* Incorporates more than 1,000 engaging problems with answers* Includes more than 300 solved examples* Uses varied problem solving methods

  5. Computer-aided diagnosis in routine mammography

    Sittek, H.; Perlet, C.; Helmberger, R.; Linsmeier, E.; Kessler, M.; Reiser, M.

    1998-01-01

    Purpose: Computer-aided diagnosis in mammography is a topic many study groups have been concerned with since the first presentation of a system for computer-aided interpretation in 1967. Currently, there is only one system avilable for clinical use in mammography, the CAD-System Image Checker (R2 Technology). The purpose of our prospective study was to evaluate whether the integration of the CAD-system into the routine of a radiological breast diagnosis unit is feasible. Results: After the installation of the CAD-system, 300 patients with 1110 mammograms were included for evaluation in the present study. In 54 of these cases histological examination was indicated due to suspect criteria on conventional mammography. In 39 of 54 cases (72,2%) malignancy could be proven histologically. The CAD-system marked 82,1% of the histologically verified carcinomas correctly 94,3% of all 1797 marks made by the CAD-system indicated normal or benign structures. Routinely performed CAD analysis prolonged patients waiting time by about 15 min because the marks of the CAD system had to be interpreted in addition to the routine diagnostic investigations. Conclusion: Our experience with the use of the CAD-system in daily routine showed that CAD analysis can easily be integrated into a preexisting mammography unit. However, the diagnostic benefit is not yet clearly established. Since the rate of false negative marks by the CAD-system Image Checker is still high, the results of CAD analysis must be checked and corrected by an observer well experienced in mammography reading. (orig.) [de

  6. The (Proper) Microfoundations of Routines and Capabilities

    Felin, Teppo; Foss, Nicolai Juul

    2012-01-01

    Sidney Winter (2011), Brian Pentland (2011), and Geoffrey Hodgson and Thorbjørn Knudsen (2011) take issue with the arguments in Teppo Felin and Nicolai J. Foss (2011), along with more generally critiquing the ‘microfoundations project’ related to routines and capabilities. In this rejoinder we ar...... chauvinism; (3) models of mind and man; (4) levels of analysis; (5) agency and uncaused causes; and then further discuss (6) a rationalist alternative....

  7. Peri-colonic haematoma following routine colonoscopy

    Felicity Page; Olfunso Adedeji

    2016-01-01

    Introduction: We present a case of an extra-luminal haematoma following routine colonoscopy. This case highlights an uncommon but potentially life threatening complication in which there is little published literature to date. Presentation of case: A 73 year old male presented with abdominal pain and a reduction in haemoglobin following an uneventful colonoscopy. The imaging had been required as part of colorectal cancer follow up. Initial differential diagnosis included colonic perforatio...

  8. Predictors of Frequent Emergency Room Visits among a Homeless Population.

    Kinna Thakarar

    Full Text Available Homelessness, HIV, and substance use are interwoven problems. Furthermore, homeless individuals are frequent users of emergency services. The main purpose of this study was to identify risk factors for frequent emergency room (ER visits and to examine the effects of housing status and HIV serostatus on ER utilization. The second purpose was to identify risk factors for frequent ER visits in patients with a history of illicit drug use.A retrospective analysis was performed on 412 patients enrolled in a Boston-based health care for the homeless program (HCH. This study population was selected as a 2:1 HIV seronegative versus HIV seropositive match based on age, sex, and housing status. A subgroup analysis was performed on 287 patients with history of illicit drug use. Chart data were analyzed to compare demographics, health characteristics, and health service utilization. Results were stratified by housing status. Logistic models using generalized estimating equations were used to predict frequent ER visits.In homeless patients, hepatitis C was the only predictor of frequent ER visits (OR 4.49, p<0.01. HIV seropositivity was not predictive of frequent ER visits. In patients with history of illicit drug use, mental health (OR 2.53, 95% CI 1.07-5.95 and hepatitis C (OR 2.85, 95% CI 1.37-5.93 were predictors of frequent ER use. HIV seropositivity did not predict ER use (OR 0.45, 95% CI 0.21 - 0.97.In a HCH population, hepatitis C predicted frequent ER visits in homeless patients. HIV seropositivity did not predict frequent ER visits, likely because HIV seropositive HCH patients are engaged in care. In patients with history of illicit drug use, hepatitis C and mental health disorders predicted frequent ER visits. Supportive housing for patients with mental health disorders and hepatitis C may help prevent unnecessary ER visits in this population.

  9. [Routine fluoroscopic investigations after primary bariatric surgery].

    Gärtner, D; Ernst, A; Fedtke, K; Jenkner, J; Schöttler, A; Reimer, P; Blüher, M; Schön, M R

    2016-03-01

    Staple line and anastomotic leakages are life-threatening complications after bariatric surgery. Upper gastrointestinal (GI) tract X-ray examination with oral administration of a water-soluble contrast agent can be used to detect leaks. The aim of this study was to evaluate the impact of routine upper GI tract fluoroscopy after primary bariatric surgery. Between January 2009 and December 2014 a total of 658 bariatric interventions were carried out of which 442 were primary bariatric operations. Included in this single center study were 307 sleeve gastrectomies and 135 Roux-en-Y gastric bypasses. Up to December 2012 upper GI tract fluoroscopy was performed routinely between the first and third postoperative days and the detection of leakages was evaluated. In the investigation period 8 leakages (2.6 %) after sleeve gastrectomy, 1 anastomotic leakage in gastrojejunostomy and 1 in jejunojejunostomy after Roux-en-Y gastric bypass occurred. All patients developed clinical symptoms, such as abdominal pain, tachycardia or fever. In one case the leakage was detected by upper GI fluoroscopy and in nine cases radiological findings were unremarkable. No leakages were detected in asymptomatic patients. Routine upper GI fluoroscopy is not recommended for uneventful postoperative courses after primary bariatric surgery.

  10. Cost calculation for a flash glucose monitoring system for UK adults with type 1 diabetes mellitus receiving intensive insulin treatment.

    Hellmund, Richard; Weitgasser, Raimund; Blissett, Deirdre

    2018-04-01

    To estimate the costs associated with a flash glucose monitoring system as a replacement for routine self-monitoring of blood glucose (SMBG) in patients with type 1 diabetes mellitus (T1DM) using intensive insulin, from a UK National Health Service (NHS) perspective. The base-case cost calculation was created using the maximum frequency of glucose monitoring recommended by the 2015 National Institute for Health and Care Excellence guidelines (4-10 tests per day). Scenario analyses considered SMBG at the frequency observed in the IMPACT clinical trial (5.6 tests per day) and at the frequency of flash monitoring observed in a real-world analysis (16 tests per day). A further scenario included potential costs associated with severe hypoglycaemia. In the base case, the annual cost per patient using flash monitoring was £234 (19%) lower compared with routine SMBG (10 tests per day). In scenario analyses, the annual cost per patient of flash monitoring compared with 5.6 and 16 SMBG tests per day was £296 higher and £957 lower, respectively. The annual cost of severe hypoglycaemia for flash monitoring users was estimated to be £221 per patient, compared with £428 for routine SMBG users (based on 5.6 tests/day), corresponding to a reduction in costs of £207. The flash monitoring system has a modest impact on glucose monitoring costs for the UK NHS for patients with T1DM using intensive insulin. For people requiring frequent tests, flash monitoring may be cost saving, especially when taking into account potential reductions in the rate of severe hypoglycaemia. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

  11. Individual monitoring

    2004-01-01

    This Practical Radiation Technical Manual is one of a series which has been designed to provide guidance on radiological protection for employers, Radiation Protection Officers, managers and other technically competent persons who have a responsibility to ensure the safety of employees working with ionizing radiation. The Manual may be used together with the appropriate IAEA Practical Radiation Safety Manual to provide adequate training, instruction or information on individual monitoring for all employees engaged in work with ionizing radiations. Sources of ionizing radiation have a large number of applications in the workplace. The exposures of the individual workers involved may need to be routinely monitored and records kept of their cumulative radiation doses. There are also occasions when it is necessary to retrospectively determine a dose which may have been received by a worker. This Manual explains the basic terminology associated with individual monitoring and describes the principal types of dosimeters and other related techniques and their application in the workplace. The Manual will be of most benefit if it forms part of more comprehensive training or is supplemented by the advice of a qualified expert in radiation protection. Most of the dosimeters and techniques described in this Manual can only be provided by qualified experts

  12. Functional Near Infrared Spectroscopy: Enabling Routine Functional Brain Imaging.

    Yücel, Meryem A; Selb, Juliette J; Huppert, Theodore J; Franceschini, Maria Angela; Boas, David A

    2017-12-01

    Functional Near-Infrared Spectroscopy (fNIRS) maps human brain function by measuring and imaging local changes in hemoglobin concentrations in the brain that arise from the modulation of cerebral blood flow and oxygen metabolism by neural activity. Since its advent over 20 years ago, researchers have exploited and continuously advanced the ability of near infrared light to penetrate through the scalp and skull in order to non-invasively monitor changes in cerebral hemoglobin concentrations that reflect brain activity. We review recent advances in signal processing and hardware that significantly improve the capabilities of fNIRS by reducing the impact of confounding signals to improve statistical robustness of the brain signals and by enhancing the density, spatial coverage, and wearability of measuring devices respectively. We then summarize the application areas that are experiencing rapid growth as fNIRS begins to enable routine functional brain imaging.

  13. Skin dose assessment in routine personnel beta/gamma dosimetry

    Christensen, P.

    1980-01-01

    Three alternative methods are outlined by which substantial improvements of the capabilities of existing routine monitoring systems for skin dose assessment can be obtained. The introduction of a supplementary skin dosemeter may be an attractive method for systems with badges that have a capability for an additional dosemeter already built-in. The two-side reading method has limited possibilities because of reduced accuracy for mixed radiation and technical difficulties in using it for TLD systems with planchet heating. The use of a boron diffused LiF layer for skin dose assessment seems to be most attractive method since the only modification needed here is replacement of a dosemeter. However the study of this method is so far only in a preliminary stage and further investigations are needed. (U.K.)

  14. Statistical evaluation of effluent monitoring data for the 200 Area Treated Effluent Disposal Facility

    Chou, C.J.; Johnson, V.G.

    2000-01-01

    The 200 Area Treated Effluent Disposal Facility (TEDF) consists of a pair of infiltration basins that receive wastewater originating from the 200 West and 200 East Areas of the Hanford Site. TEDF has been in operation since 1995 and is regulated by State Waste Discharge Permit ST 4502 (Ecology 1995) under the authority of Chapter 90.48 Revised Code of Washington (RCW) and Washington Administrative Code (WAC) Chapter 173-216. The permit stipulates monitoring requirements for effluent (or end-of-pipe) discharges and groundwater monitoring for TEDF. Groundwater monitoring began in 1992 prior to TEDF construction. Routine effluent monitoring in accordance with the permit requirements began in late April 1995 when the facility began operations. The State Waste Discharge Permit ST 4502 included a special permit condition (S.6). This condition specified a statistical study of the variability of permitted constituents in the effluent from TEDF during its first year of operation. The study was designed to (1) demonstrate compliance with the waste discharge permit; (2) determine the variability of all constituents in the effluent that have enforcement limits, early warning values, and monitoring requirements (WHC 1995); and (3) determine if concentrations of permitted constituents vary with season. Additional and more frequent sampling was conducted for the effluent variability study. Statistical evaluation results were provided in Chou and Johnson (1996). Parts of the original first year sampling and analysis plan (WHC 1995) were continued with routine monitoring required up to the present time

  15. Fundamentals for routined utilization of tomography in beam diagnostic

    Reichau, Hermine

    2012-01-01

    A general and systematic approach to implement tomography for beam diagnostics has been invented and exemplarily shown for the invention of beam tomography for the Frankfurt Neutron Source. Following the diagnostic pipeline the first step was to prepare the data basis for the tomography reconstruction. For the monitoring, standard parameters have to be obtained with sufficient accuracy. In the context of this work, tomography has been kept as flexible as possible. Firstly, it will be used for the analysis of beam dynamics but also for the further development of beam tomography for routined utilization. Later on it will have to serve as a monitoring system at the end of the LEBT of FRANZ. The data preparation for tomography was demonstrated step by step. The iterated backprojection (FBP) algorithm was derived to show the basic idea of tomography which is contained in all forms of tomography algorithms. In connection with data exhibiting a high signal to noise ratio the FBP obtains the result with the highest accuracy, beyond that the accuracy can be controlled by the number of projections. The algebraic reconstruction and maximum entropy approach were outlined in a nutshell. By the introduction of the diagnostic pipeline in combination with the decision systematics the basis for a routined utilization of tomography in ion beam diagnostics have been established and exemplarily demonstrated on the introduction of beam tomography for FRANZ. A rotatable vacuum chamber has been developed to close a gap between the availability of projections to use the FBP and the small physical space on which they have to be determined. (orig.)

  16. PHYSIOLOGICAL DEMANDS OF YOUNG WOMEN’S COMPETITIVE GYMNASTIC ROUTINES

    M. Marina

    2014-08-01

    Full Text Available The objective of this study was to investigate the physiological indices of competitive routines in women’s artistic gymnastics by characterizing post-exercise heart rate (HR, oxygen uptake (VO2 and peak blood lactate concentration (Lmax in a group of eight young elite-oriented female gymnasts. HR was continuously monitored with Polar RS400 monitors during the test event simulating a competition environment. Within 5 s of the end of each routine, the breath-by-breath gas analyser mask was placed on the face to record VO2. VO2max was calculated by the backward extrapolation method of the VO2 recovery curve. Lmax was obtained during recovery (min 1, 3, 5, 7 and 10 subsequent to each event. One week later, HR, VO2 and Lmax were measured during an incremental continuous treadmill test. The treadmill test was confirmed as the assessment with the highest physiological demand. The gymnasts reached their highest values of HR (183-199 beats · min- 1, VO2/Bm (33-44 ml · kg-1 · min-1 and Lmax (7-9 mmol · l-1 in the floor and uneven bars exercises. The vault was the event with the lowest HR (154-166 beats · min-1 and Lmax (2.4-2.6 mmol · l-1, and the balance beam had the lowest VO2 (27-35 ml · kg-1 · min-1. The mean relative peak intensities attained in the different events, which ranged from 65 to 85% of the individual VO2max and HRmax recorded in the laboratory, suggest that cardiorespiratory and metabolic demands are higher than previously indicated. The high percentage of VO2 measured, particularly after the floor event, suggests that aerobic power training should not be neglected in women’s artistic gymnastics.

  17. Predictors of Frequent Emergency Room Visits among a Homeless Population.

    Thakarar, Kinna; Morgan, Jake R; Gaeta, Jessie M; Hohl, Carole; Drainoni, Mari-Lynn

    2015-01-01

    Homelessness, HIV, and substance use are interwoven problems. Furthermore, homeless individuals are frequent users of emergency services. The main purpose of this study was to identify risk factors for frequent emergency room (ER) visits and to examine the effects of housing status and HIV serostatus on ER utilization. The second purpose was to identify risk factors for frequent ER visits in patients with a history of illicit drug use. A retrospective analysis was performed on 412 patients enrolled in a Boston-based health care for the homeless program (HCH). This study population was selected as a 2:1 HIV seronegative versus HIV seropositive match based on age, sex, and housing status. A subgroup analysis was performed on 287 patients with history of illicit drug use. Chart data were analyzed to compare demographics, health characteristics, and health service utilization. Results were stratified by housing status. Logistic models using generalized estimating equations were used to predict frequent ER visits. In homeless patients, hepatitis C was the only predictor of frequent ER visits (OR 4.49, phomeless patients. HIV seropositivity did not predict frequent ER visits, likely because HIV seropositive HCH patients are engaged in care. In patients with history of illicit drug use, hepatitis C and mental health disorders predicted frequent ER visits. Supportive housing for patients with mental health disorders and hepatitis C may help prevent unnecessary ER visits in this population.

  18. Frequent Pairs in Data Streams: Exploiting Parallelism and Skew

    Campagna, Andrea; Kutzkow, Konstantin; Pagh, Rasmus

    2011-01-01

    We introduce the Pair Streaming Engine (PairSE) that detects frequent pairs in a data stream of transactions. Our algorithm finds the most frequent pairs with high probability, and gives tight bounds on their frequency. It is particularly space efficient for skewed distribution of pair supports...... items mining in data streams. We show how to efficiently scale these approaches to handle large transactions. We report experimental results showcasing precision and recall of our method. In particular, we find that often our method achieves excellent precision, returning identical upper and lower...... bounds on the supports of the most frequent pairs....

  19. Frequently Asked Questions for Parents of Children with PH

    ... Frequently Asked Questions for Parents of Children with PH What causes pulmonary hypertension in children? I’ve ... of what I read is about adults with PH. What are the primary differences between PH in ...

  20. Frequently Asked Questions about Measles in the U.S.

    ... Pan American Health Organization Frequently Asked Questions about Measles in the U.S. Language: English (US) Español (Spanish) ... I’ve been exposed to someone who has measles. What should I do? A: Immediately call your ...

  1. Stability of the frequent COPD exacerbator in the general population

    Reilev, Mette; Lykkegaard, Jesper; Halling, Anders

    2017-01-01

    Exacerbation frequency is central in treatment strategies for chronic obstructive pulmonary disease. However, whether chronic obstructive pulmonary disease patients from the general population with frequent exacerbations continue to have frequent exacerbations over an extended period of time is c...... considerably over time. This could hold implications for COPD treatment and challenge assumptions made about disease progression....... is currently unknown. In this study, we aimed to investigate the stability of the frequent exacerbator in a population-based setting. To this end, we conducted a nationwide register-based descriptive study with a 10-year follow-up period of chronic obstructive pulmonary disease patients with at least one...... obstructive pulmonary disease treatment guidelines and their practical application. CHRONIC OBSTRUCTIVE LUNG DISEASE: VARIATIONS IN DISEASE PROGRESSION: Patients with chronic obstructive pulmonary disease (COPD) who suffer from frequent exacerbations do not necessarily persist with such severity over time...

  2. Incremental Frequent Subgraph Mining on Large Evolving Graphs

    Abdelhamid, Ehab; Canim, Mustafa; Sadoghi, Mohammad; Bhatta, Bishwaranjan; Chang, Yuan-Chi; Kalnis, Panos

    2017-01-01

    , such as social networks, utilize large evolving graphs. Mining these graphs using existing techniques is infeasible, due to the high computational cost. In this paper, we propose IncGM+, a fast incremental approach for continuous frequent subgraph mining problem

  3. THE FREQUENT SKIN DISEASES DIAGNOSED AT UNIVERSITY STUDENTS

    Yesim KAYMAK

    2005-12-01

    Full Text Available The incidence of some skin diseases are increasing at adolescent and early adulthood period. The most frequent disease at this period is acne vulgaris whereas fungal diseases, dermatitis, dermatosis which are due to stress and other reasons, oral mucosal lesions and herpetic lesions of perioral region are also frequent. In this research we aim to determine the frequent dermatologic diseases of university students and 147 female, 74 male, a total of 221 students are included. We questioned the dermatologic complaints of students, then examined dermatologically in detail and registered ages, sexes, findings of the dermatological examination and dermatological diagnostic informations. As a result it is found out that the most frequent diseases are acne vulgaris (34.1%, allergic and pruritic dermatosis (16.6%, fungal diseases ( 13.0%, and eritamatous-squamous disease (8.3%. [TAF Prev Med Bull 2005; 4(6.000: 313-320

  4. Personalized privacy-preserving frequent itemset mining using randomized response.

    Sun, Chongjing; Fu, Yan; Zhou, Junlin; Gao, Hui

    2014-01-01

    Frequent itemset mining is the important first step of association rule mining, which discovers interesting patterns from the massive data. There are increasing concerns about the privacy problem in the frequent itemset mining. Some works have been proposed to handle this kind of problem. In this paper, we introduce a personalized privacy problem, in which different attributes may need different privacy levels protection. To solve this problem, we give a personalized privacy-preserving method by using the randomized response technique. By providing different privacy levels for different attributes, this method can get a higher accuracy on frequent itemset mining than the traditional method providing the same privacy level. Finally, our experimental results show that our method can have better results on the frequent itemset mining while preserving personalized privacy.

  5. Don't believe everything you hear: Routine validation of audiovisual information in children and adults.

    Piest, Benjamin A; Isberner, Maj-Britt; Richter, Tobias

    2018-04-05

    Previous research has shown that the validation of incoming information during language comprehension is a fast, efficient, and routine process (epistemic monitoring). Previous research on this topic has focused on epistemic monitoring during reading. The present study extended this research by investigating epistemic monitoring of audiovisual information. In a Stroop-like paradigm, participants (Experiment 1: adults; Experiment 2: 10-year-old children) responded to the probe words correct and false by keypress after the presentation of auditory assertions that could be either true or false with respect to concurrently presented pictures. Results provide evidence for routine validation of audiovisual information. Moreover, the results show a stronger and more stable interference effect for children compared with adults.

  6. Frequent Home Monitoring of ICD Is Effective to Prevent Inappropriate Defibrillator Shock Delivery

    Paolo Bifulco

    2014-01-01

    Full Text Available Recently, in the context of telemedicine, telemonitoring services are gaining attention. They are offered, for example, to patients with implantable cardioverter defibrillators (ICDs. A major problem associated with ICD therapy is the occurrence of inappropriate shocks which impair patients’ quality of life and may also be arrhythmogenic. The telemonitoring can provide a valid support to intensify followup visits, in order to improve the prevention of inappropriate defibrillator shock, thus enhancing patient safety. Inappropriate shock generally depends on atrial fibrillation, supraventricular tachycardia, and abnormal sensing (such as those caused by electromagnetic interferences. As a practical example, an unusual case of an ICD patient who risked an inappropriate shock while taking a shower is reported. Continuous remote telemonitoring was able to timely warn cardiologist via GSM-SMS, who were able to detect improper sensing examining the intracardiac electrogram via Web. Patient was promptly contacted and warned to not further come in contact with the hydraulic system and any electrical appliance to prevent an inappropriate defibrillator shock. This demonstrates the effectiveness and usefulness of continuous remote telemonitoring in supporting ICD patients.

  7. Master schedule for CY-1983 Hanford environmental surveillance routine sampling program

    Blumer, P.J.; Sula, M.J.; Eddy, P.A.; Dirkes, R.L.

    1982-12-01

    The current schedule of data collection for the routine Hanford environmental surveillance and ground-water monitoring programs at the Hanford Site is presented. The purpose of the programs is to evaluate and report the levels of radioactive and nonradioactive pollutants in the Hanford environs. Radiological monitoring data are reported for air (particulate filter and gases/vapor), Columbia River water, sanitary water, onsite pond water, foodstuffs (whole milk, leafy vegetables, fruit, wheat/alfalfa, beef, poultry/eggs), wildlife, soil and vegetation, and direct radiation. Information is also given for on site radiation control audit surveys (roadway, railway, aerial, and waste disposal sites, and the Hanford ground-water monitoring program

  8. Perceived Quality of Social Relations and Frequent Drunkenness

    Kjærulff, Thora M; Rivera, Francisco; Jiménez-Iglesias, Antonia

    2014-01-01

    in School-aged Children Study (HBSC) 2010 survey were used including 1177 female and 1126 male students aged between 15 and 16 years. RESULTS: For both genders, students reporting low school satisfaction had increased odds of frequent drunkenness. Among females, low and medium levels of classmate support...... predictors of frequent drunkenness among female than male students and that other factors than social relations may contribute to explain excessive alcohol use among Spanish adolescents....

  9. The Impact of Frequent Shopper Programs in Grocery Retailing

    David Bell; Rajiv Lal

    2002-01-01

    Frequent Shopper programs are becoming ubiquitous in retailing. Retailers seem unsure however about whether these programs are leading to higher loyalty, or to higher profits. In this paper we analyze data from a US supermarket chain that has used a number of frequent shopper rewards to improve sales and profitability. We find that while these programs are profitable, this is only because substantial incremental sales to casual shoppers (cherry pickers) oset subsidies to already loyal custome...

  10. Bridge Scour Monitoring Methods at Three Sites in Wisconsin

    Walker, John F; Hughes, Peter E

    2005-01-01

    .... Geological Survey, in cooperation with the Wisconsin Department of Transportation, the Marathon County Highway Department, and the Jefferson County Highway Department, performed routine monitoring...

  11. The quality of clinical maternal and neonatal healthcare - a strategy for identifying 'routine care signal functions'.

    Stephan Brenner

    Full Text Available A variety of clinical process indicators exists to measure the quality of care provided by maternal and neonatal health (MNH programs. To allow comparison across MNH programs in low- and middle-income countries (LMICs, a core set of essential process indicators is needed. Although such a core set is available for emergency obstetric care (EmOC, the 'EmOC signal functions', a similar approach is currently missing for MNH routine care evaluation. We describe a strategy for identifying core process indicators for routine care and illustrate their usefulness in a field example.We first developed an indicator selection strategy by combining epidemiological and programmatic aspects relevant to MNH in LMICs. We then identified routine care process indicators meeting our selection criteria by reviewing existing quality of care assessment protocols. We grouped these indicators into three categories based on their main function in addressing risk factors of maternal or neonatal complications. We then tested this indicator set in a study assessing MNH quality of clinical care in 33 health facilities in Malawi.Our strategy identified 51 routine care processes: 23 related to initial patient risk assessment, 17 to risk monitoring, 11 to risk prevention. During the clinical performance assessment a total of 82 cases were observed. Birth attendants' adherence to clinical standards was lowest in relation to risk monitoring processes. In relation to major complications, routine care processes addressing fetal and newborn distress were performed relatively consistently, but there were major gaps in the performance of routine care processes addressing bleeding, infection, and pre-eclampsia risks.The identified set of process indicators could identify major gaps in the quality of obstetric and neonatal care provided during the intra- and immediate postpartum period. We hope our suggested indicators for essential routine care processes will contribute to streamlining

  12. The quality of clinical maternal and neonatal healthcare - a strategy for identifying 'routine care signal functions'.

    Brenner, Stephan; De Allegri, Manuela; Gabrysch, Sabine; Chinkhumba, Jobiba; Sarker, Malabika; Muula, Adamson S

    2015-01-01

    A variety of clinical process indicators exists to measure the quality of care provided by maternal and neonatal health (MNH) programs. To allow comparison across MNH programs in low- and middle-income countries (LMICs), a core set of essential process indicators is needed. Although such a core set is available for emergency obstetric care (EmOC), the 'EmOC signal functions', a similar approach is currently missing for MNH routine care evaluation. We describe a strategy for identifying core process indicators for routine care and illustrate their usefulness in a field example. We first developed an indicator selection strategy by combining epidemiological and programmatic aspects relevant to MNH in LMICs. We then identified routine care process indicators meeting our selection criteria by reviewing existing quality of care assessment protocols. We grouped these indicators into three categories based on their main function in addressing risk factors of maternal or neonatal complications. We then tested this indicator set in a study assessing MNH quality of clinical care in 33 health facilities in Malawi. Our strategy identified 51 routine care processes: 23 related to initial patient risk assessment, 17 to risk monitoring, 11 to risk prevention. During the clinical performance assessment a total of 82 cases were observed. Birth attendants' adherence to clinical standards was lowest in relation to risk monitoring processes. In relation to major complications, routine care processes addressing fetal and newborn distress were performed relatively consistently, but there were major gaps in the performance of routine care processes addressing bleeding, infection, and pre-eclampsia risks. The identified set of process indicators could identify major gaps in the quality of obstetric and neonatal care provided during the intra- and immediate postpartum period. We hope our suggested indicators for essential routine care processes will contribute to streamlining MNH program

  13. Enumerating all maximal frequent subtrees in collections of phylogenetic trees.

    Deepak, Akshay; Fernández-Baca, David

    2014-01-01

    A common problem in phylogenetic analysis is to identify frequent patterns in a collection of phylogenetic trees. The goal is, roughly, to find a subset of the species (taxa) on which all or some significant subset of the trees agree. One popular method to do so is through maximum agreement subtrees (MASTs). MASTs are also used, among other things, as a metric for comparing phylogenetic trees, computing congruence indices and to identify horizontal gene transfer events. We give algorithms and experimental results for two approaches to identify common patterns in a collection of phylogenetic trees, one based on agreement subtrees, called maximal agreement subtrees, the other on frequent subtrees, called maximal frequent subtrees. These approaches can return subtrees on larger sets of taxa than MASTs, and can reveal new common phylogenetic relationships not present in either MASTs or the majority rule tree (a popular consensus method). Our current implementation is available on the web at https://code.google.com/p/mfst-miner/. Our computational results confirm that maximal agreement subtrees and all maximal frequent subtrees can reveal a more complete phylogenetic picture of the common patterns in collections of phylogenetic trees than maximum agreement subtrees; they are also often more resolved than the majority rule tree. Further, our experiments show that enumerating maximal frequent subtrees is considerably more practical than enumerating ordinary (not necessarily maximal) frequent subtrees.

  14. Enumerating all maximal frequent subtrees in collections of phylogenetic trees

    2014-01-01

    Background A common problem in phylogenetic analysis is to identify frequent patterns in a collection of phylogenetic trees. The goal is, roughly, to find a subset of the species (taxa) on which all or some significant subset of the trees agree. One popular method to do so is through maximum agreement subtrees (MASTs). MASTs are also used, among other things, as a metric for comparing phylogenetic trees, computing congruence indices and to identify horizontal gene transfer events. Results We give algorithms and experimental results for two approaches to identify common patterns in a collection of phylogenetic trees, one based on agreement subtrees, called maximal agreement subtrees, the other on frequent subtrees, called maximal frequent subtrees. These approaches can return subtrees on larger sets of taxa than MASTs, and can reveal new common phylogenetic relationships not present in either MASTs or the majority rule tree (a popular consensus method). Our current implementation is available on the web at https://code.google.com/p/mfst-miner/. Conclusions Our computational results confirm that maximal agreement subtrees and all maximal frequent subtrees can reveal a more complete phylogenetic picture of the common patterns in collections of phylogenetic trees than maximum agreement subtrees; they are also often more resolved than the majority rule tree. Further, our experiments show that enumerating maximal frequent subtrees is considerably more practical than enumerating ordinary (not necessarily maximal) frequent subtrees. PMID:25061474

  15. Adiponectin as a routine clinical biomarker.

    Kishida, Ken; Funahashi, Tohru; Shimomura, Iichiro

    2014-01-01

    Adiponectin is a protein synthesized and secreted predominantly by adipocytes into the peripheral blood. However, circulating adiponectin level is inversely related with body weight, especially visceral fat accumulation. The mechanism of this paradoxical relation remains obscure. Low circulating adiponectin concentrations (hypoadiponectinemia; osteoporosis, and cancer (endometrial cancer, postmenopausal breast cancer, leukemia, colon cancer, gastric cancer, prostate cancer). On the other hand, hyperadiponectinemia is associated with cardiac, renal and pulmonary diseases. This review article focuses on the significance of adiponectin as a clinical biomarker of obesity-related diseases. Routine measurement of adiponectin in patients with lifestyle-related diseases is highly recommended. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Properties of electret ionization chambers for routine dosimetry in photon radiation fields

    Doerschel, B.; Pretzsch, G.

    1985-01-01

    The main properties of photon routine dosemeters are their energy and angular dependence as well as their measuring range and accuracy. The determination of radiation exposure from dosemeter response is based on the choice of an appropriate conversion factor taking into account the influence of body backscattering on the dosemeter response. Measuring range and accuracy of an electret ionization chamber first of all depend on electret stability, methods of charge measurement, and geometry of the chamber. The dosemeter performance is described for an electret ionization chamber which was designed for application to routine monitoring of radiation workers. (author)

  17. Routine digital pathology workflow: The Catania experience

    Filippo Fraggetta

    2017-01-01

    Full Text Available Introduction: Successful implementation of whole slide imaging (WSI for routine clinical practice has been accomplished in only a few pathology laboratories worldwide. We report the transition to an effective and complete digital surgical pathology workflow in the pathology laboratory at Cannizzaro Hospital in Catania, Italy. Methods: All (100% permanent histopathology glass slides were digitized at ×20 using Aperio AT2 scanners. Compatible stain and scanning slide racks were employed to streamline operations. eSlide Manager software was bidirectionally interfaced with the anatomic pathology laboratory information system. Virtual slide trays connected to the two-dimensional (2D barcode tracking system allowed pathologists to confirm that they were correctly assigned slides and that all tissues on these glass slides were scanned. Results: Over 115,000 glass slides were digitized with a scan fail rate of around 1%. Drying glass slides before scanning minimized them sticking to scanner racks. Implementation required introduction of a 2D barcode tracking system and modification of histology workflow processes. Conclusion: Our experience indicates that effective adoption of WSI for primary diagnostic use was more dependent on optimizing preimaging variables and integration with the laboratory information system than on information technology infrastructure and ensuring pathologist buy-in. Implementation of digital pathology for routine practice not only leveraged the benefits of digital imaging but also creates an opportunity for establishing standardization of workflow processes in the pathology laboratory.

  18. Risk factors associated with incidence and persistence of frequent headaches.

    Marklund, Susanna; Häggman-Henrikson, Birgitta; Wänman, Anders

    2014-11-01

    Headaches represent a significant public health problem, but the knowledge of factors specifically related to incidence and persistence of headaches is still limited. The aim of this study was to evaluate whether gender, self-reported bruxism and variations in the dental occlusion contribute to onset and persistence of frequent headaches. The study population comprised 280 dental students, examined annually in a 2-year prospective study with a questionnaire and a clinical examination of the jaw function. In the analysis subjects were dichotomized into cases with frequent (once a week or more) or without frequent headaches (controls). The 2-year cumulative incidence was based on subjects without frequent headaches at baseline. Cases with 2-year persistent headaches reported such symptoms at all three examinations. Self-reported bruxism and factors in the dental occlusion at baseline were used as independent variables in logistic regression analyses. The 2-year cumulative incidence of frequent headaches was 21%. Female gender (OR = 2.6; CI = 1.3-5.4), self-reported bruxism (OR = 2.3; CI = 1.2-4.4) and mandibular instability in intercuspal position (OR = 3.2; CI = 1.4-7.5) were associated with incidence of frequent headaches. Persistent headaches during the observation period were present in 12 individuals (4%) and significantly related to mandibular instability in intercuspal position (OR = 6.1; CI = 1.6-22.6). The results indicate that female gender, self-reported bruxism and mandibular instability in intercuspal position are of importance in the development of frequent headaches. In management of these patients a multidisciplinary approach including dentists may be important and, thus, advocated.

  19. The bedding environment, sleep position, and frequent wheeze in childhood.

    Ponsonby, Anne-Louise; Dwyer, Terence; Trevillian, Leigh; Kemp, Andrew; Cochrane, Jennifer; Couper, David; Carmichael, Allan

    2004-05-01

    Synthetic quilt use has been associated with increased childhood wheeze in previous studies. Our aim was to examine whether the adverse effect of synthetic quilt use on frequent wheeze differed by usual sleep position. A population-based cross-sectional study of 6378 (92% of those eligible) 7-year-olds in Tasmania, Australia, was conducted in 1995. Exercise-challenge lung function was obtained on a subset of 414 children from randomly selected schools. Child bedding including pillow and overbedding composition and usual sleep position by parental questionnaire. Frequent wheeze (>12 wheeze episodes over the past year), using the International Study of Asthma and Allergies in Childhood parental questionnaire, and baseline and postexercise forced expiratory volume in 1 second lung-function measures. Frequent wheeze (n = 117) was positively associated with synthetic quilts, synthetic pillows, electric blankets, and sleeping in a bottom bunk bed but did not vary by sleep position. In a nested case-control analysis, the association between synthetic quilt use and frequent wheeze differed by sleep position. Among children who slept supine, synthetic (versus feather) quilt use was associated with frequent wheeze (adjusted odds ratio: 2.37 [1.08, 5.23]). However, among nonsupine sleepers, overlying synthetic quilt use was not associated with frequent wheeze (adjusted odds ratio: 1.06 [0.60, 1.88]). This difference in quilt effect by sleep position was highly significant. Similarly, synthetic quilt use was associated with lower postexercise forced expiratory volume in 1 second measures among supine but not nonsupine sleeping children. An increasing focus on the bedding environment immediately adjacent to the nose and mouth is required for respiratory disorders provoked by bedding, such as child asthma characterized by frequent wheeze.

  20. Acute confusional state of unknown cause in the elderly: a study with continuous EEG monitoring.

    Naeije, Gilles; Gaspard, Nicolas; Depondt, Chantal; Pepersack, Thierry; Legros, Benjamin

    2012-03-01

    Acute confusional state (ACS) is a frequent cause of emergency consultation in the elderly. Many causes of ACS are also risk factors for seizures. Both non-convulsive seizures and status epilepticus can cause acute confusion. The yield of routine EEG may not be optimal in case of prolonged post-ictal confusion. We thus, sought to evaluate the yield of CEEG in identifying seizures in elderly patients with ACS of unknown origin. We reviewed our CEEG database for patients over 75 years with ACS and collected EEG, CEEG and clinical information. Thirty-one percent (15/48) of the CEEG performed in elderly patients were done for ACS. Routine EEG did not reveal any epileptic anomalies in 7/15 patients. Among those, CEEG identified interictal epileptiform discharges (IED) in 2 and NCSE in 1. In 8/15 patients, routine EEG revealed epileptiform abnormalities: 3 with IED (including 1 with periodic lateralized discharges), 3 with non-convulsive seizures (NCSz) and 2 with non-convulsive status epilepticus (NCSE). Among patients with only IED, CEEG revealed NCSz in 1 and NCSE in 2. This retrospective study suggests that NCSz and NCSE may account for more cases of ACS than what was previously thought. A single negative routine EEG does not exclude this diagnosis. Continuous EEG (CEEG) monitoring is more revealing than routine EEG for the detection of NCSE and NCSz in confused elderly. The presence of IED in the first routine EEG strongly suggests concomitant NCSz or NCSE. Prospective studies are required to further determine the role of CEEG monitoring in the assessment of ACS in the elderly and to establish the incidence of NCSz and NCSE in this setting. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. Lifestyles and routine activities of South African teenagers at risk of being trafficked for involuntary prostitution.

    Lutya, Thozama Mandisa

    2010-12-01

    The United Nations estimates that 79% of teenage girls trafficked globally every year are forced into involuntary prostitution. About 247 000 South African children work in exploitative conditions; about 40 000 South African female teenagers work as prostitutes. This paper investigates lifestyles and routine activities of teenagers at risk of being trafficked for involuntary prostitution. The key concepts involuntary prostitution, intergenerational sex and exploitative conditions are defined in relation to the lifestyles and routine activities of South African female teenagers. Human trafficking for involuntary prostitution is described, based on a literature review. Lifestyle exposure and routine activities theories help to explain the potential victimisation of these teenagers in human trafficking for involuntary prostitution. Actual lifestyle and routine activities of South African teenagers and risky behaviours (substance abuse, intergenerational sex and child prostitution) are discussed as factors that make teens vulnerable to such trafficking. This paper recommends that human trafficking prevention efforts (awareness programmes and information campaigns) be directed at places frequented by human traffickers and teenagers in the absence of a capable guardian to reduce victimisation, as traffickers analyse the lifestyles and routine activities of their targets. South Africa should also interrogate entrenched practices such as intergenerational sex.

  2. High bandwidth beam current monitor

    Baltrusaitis, R.M.; Ekdahl, C.A.; Cooper, R.G.; Peterson, E.; Warn, C.E.

    1993-01-01

    A stripline directional coupler beam current monitor capable of measuring the time structure of a 30-ps electron beam bunch has been developed. The time response performance of the monitor compares very well with Cherenkov light produced in quartz by the electron beam. The four-pickup monitor is now used on a routine basis for measuring the beam duration, tuning for optimized beam bunching, and centering the bunch in the beam pipe

  3. Defining frequent use of an urban emergency department

    Locker, Thomas E; Baston, Simon; Mason, Suzanne M; Nicholl, Jon

    2007-01-01

    Objective This study aimed to develop a definition of frequent use of an emergency department (ED) by comparing differences in the observed frequency distribution with that of a theoretical frequency distribution. Methods A retrospective analysis of attendance of ED and minor injury unit attendances in one city over 1 year was conducted. From these data, the expected frequency distribution was determined based upon a Poisson distribution. Results During the period studied, 75 141 people attended on 98 908 occasions. The theoretical frequency distribution showed that there were 2764 (3.7%) “frequent users” presenting repeatedly due to non‐random events. These patients made 12 316 (12.4%) attendances. Frequent users were older than chance users (mean age 49.7 vs 44.5 years). A greater proportion arrived by ambulance (55.3% vs 27.5%), presented with psychiatric problems (5.8% vs 1.1%) or alcohol intoxication (1.3% vs 0.5%), and were admitted to hospital (37.4% vs 19.6%). Conclusion We have identified that there is a group of patients who present repeatedly due to non‐random events, confirming the existence of “frequent users”. Their characteristics are clearly different to other patients in the ED. We propose that “frequent users” be defined as any patient who makes more than four attendances per year. PMID:17513534

  4. Individual monitoring of external exposure in terms of personal dose equivalent, Hp(d)

    Fantuzzi, E.

    2001-01-01

    The institute for Radiation Protection of ENEA - Bologna has organised a one day-workshop on the subject: Individual monitoring of external exposure in terms of personal dose equivalent, H p (d). The aim of the workshop was the discussion of the new implications and modifications to be expected in the routine individual monitoring of external radiation, due to the issue of the Decree 241/00 (G.U. 31/8/2000) in charge since 01/01/2001. The decree set up in Italian law the standards contained in the European Directive EURATOM 96/29-Basic Standards for the Protection of Health of Workers and the General Public against Dangers arising from Ionizing Radiation. Among others, the definition of the operational quantities for external radiation for personal and environmental monitoring, H p (d) e H * (d) respectively as defined by ICRU (International Commission for Radiation Units and Measurements), requires to update the methods of measurements and calibration of the personal dosemeters and environmental monitors. This report collects the papers presented at the workshop dealing with the Personal Dose Equivalent, H p (d), the conversion coefficients, H p (d)/K a e H p (d)/ , obtained through Monte Carlo calculations published by ICRU and ICRP (International Commission for Radiation Protection), the new calibration procedures and the practical implication in the routine of individual monitoring in terms of H p (d). Eventually, in the last chapter, the answers to Frequently Asked Questions (FAQ) are briefly reported [it

  5. Social capital and frequent attenders in general practice

    Pasgaard, Alexander A.; Mæhlisen, Maiken H.; Overgaard, Charlotte

    2018-01-01

    weeks. RESULTS: Using multiple logistic regression, we found that frequent attendance was associated with a lower score in interpersonal trust [OR 0.86 (0.79-0.94)] and social network [OR 0.88 (0.79-0.98)] for women, when adjusted for age, education, income and SF12 health scores. Norms of reciprocity...... at the individual level, and includes cognitive (interpersonal trust and norms of reciprocity) as well as structural (social network and civic engagement) dimensions. Frequent attendance is defined as the upper-quartile of the total number of measured consultations with a general practitioner over a period of 148...... and civic engagement were not significantly associated with frequent attendance for women [OR 1.05 (0.99-1.11) and OR 1.01 (0.92-1.11) respectively]. None of the associations were statistically significant for men. CONCLUSION: This study suggests that for women, some aspects of social capital are associated...

  6. Social environment and frequent attendance in Danish general practice

    Vedsted, Peter; Olesen, Frede

    2005-01-01

    inequalities in health or whether social factors in themselves determine the use of general practice. AIM: To examine if social factors are associated with frequent attendance in general practice after adjusting for physical and psychological health variables. DESIGN OF STUDY: Population-based cross......BACKGROUND: A lack of social support is associated with increased morbidity and mortality and a decreased effect of prevention. Frequent attenders to primary care are characterised by poorer social conditions than other patients in general practice, but we do not know whether this is due to social...... during the period November 1997-October 1998. A questionnaire about physical, psychological and social factors was sent to the patients. The associations between social factors and frequent attendance were adjusted for physical and psychological health and tendency towards somatisation. RESULTS: A total...

  7. Frequently Used Coping Scales: A Meta-Analysis.

    Kato, Tsukasa

    2015-10-01

    This article reports the frequency of the use of coping scales in academic journals published from 1998 to 2010. Two thousand empirical journal articles were selected from the EBSCO database. The COPE, Ways of Coping Questionnaire, Coping Strategies Questionnaire, Coping Inventory for Stressful Situations, Religious-COPE and Coping Response Inventory were frequently mentioned. In particular, the COPE (20.2%) and Ways of Coping Questionnaire (13.6%) were used the most frequently. In this literature reviewed, coping scales were most often used to assess coping with health issues (e.g. illness, pain and medical diagnoses) over other types of stressors, and patients were the most frequent participants. Further, alpha coefficients were estimated for the COPE subscales, and correlations between the COPE subscales and coping outcomes were calculated, including depressive symptoms, anxiety, negative affect, psychological distress, physical symptoms and well-being. Copyright © 2013 John Wiley & Sons, Ltd.

  8. Examination of Operation Quality for High-frequent Railway Operation

    Landex, Alex; Kaas, Anders H.

    2009-01-01

    take the first train in their direction. The article examines four different approaches to examine operation quality for high-frequent operation that are based on the experiences of the passengers. These approaches are the service frequency of the operation, travel time extension, a combination......The examination of operation quality for high-frequent operation requires other approaches than the typical evaluation of punctuality (trains on time) and reliability (operated trains). This is because passengers in high-frequent railway systems do not necessarily notice train delays as they just...... of the service frequency and travel time approaches, and passenger delays. The service frequency and travel time approaches are simple measurements with low complexity and complement each other. Therefore, the article recommends combining the service frequency and travel time approaches to get a more accurate...

  9. Understanding Smart Home Sensor Data for Ageing in Place Through Everyday Household Routines: A Mixed Method Case Study.

    van Kasteren, Yasmin; Bradford, Dana; Zhang, Qing; Karunanithi, Mohan; Ding, Hang

    2017-06-13

    An ongoing challenge for smart homes research for aging-in-place is how to make sense of the large amounts of data from in-home sensors to facilitate real-time monitoring and develop reliable alerts. The objective of our study was to explore the usefulness of a routine-based approach for making sense of smart home data for the elderly. Maximum variation sampling was used to select three cases for an in-depth mixed methods exploration of the daily routines of three elderly participants in a smart home trial using 180 days of power use and motion sensor data and longitudinal interview data. Sensor data accurately matched self-reported routines. By comparing daily movement data with personal routines, it was possible to identify changes in routine that signaled illness, recovery from bereavement, and gradual deterioration of sleep quality and daily movement. Interview and sensor data also identified changes in routine with variations in temperature and daylight hours. The findings demonstrated that a routine-based approach makes interpreting sensor data easy, intuitive, and transparent. They highlighted the importance of understanding and accounting for individual differences in preferences for routinization and the influence of the cyclical nature of daily routines, social or cultural rhythms, and seasonal changes in temperature and daylight hours when interpreting information based on sensor data. This research has demonstrated the usefulness of a routine-based approach for making sense of smart home data, which has furthered the understanding of the challenges that need to be addressed in order to make real-time monitoring and effective alerts a reality. ©Yasmin van Kasteren, Dana Bradford, Qing Zhang, Mohan Karunanithi, Hang Ding. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 13.06.2017.

  10. ACCULIB, Program Library of Mathematical Routines

    Van Kats, J.M.; Rusman, C.J.; Van der Vorst, H.A.

    1987-01-01

    Description of program or function - ACCULIB is a collection of programs and subprograms for: - approximation and interpolation problems; - the evaluation of series of orthogonal polynomials; - evaluation of the complementary error function; - sorting problems and permutations; - differential equation problems; - linear algebra eigenvalue problems; - optimization problems; - fast Fourier transformations and Fourier series; - numerical quadrature of continuous functions; - linear systems and other linear algebra problems; - bit manipulation and character handling/transmission; - systems of nonlinear equations, in particular the determination of zeros of polynomials; - solution of over-complete systems; - plotting routines for contouring and surface representation; - statistical investigation of data. In addition, many utilities such as code conversion, microfiche production, disk file surveys, layout improvements for ALGOL60 and FORTRAN programs, and the conversion of IBM FORTRAN programs to CDC FORTRAN are included in the collection

  11. Radioligand purification prior to routine receptor assays

    Le Goff, J.-M.; Berthois, Y.; Martin, P.-M.

    1988-01-01

    The need to repurify the commercially available radioligands [ 3 H]estradiol and [ 3 H]testosterone before use in routine assays was investigated. Storage of these products for 2 months after delivery led to appreciable degradation of [ 3 H]estradiol compared to [ 3 H]testosterone. Unexpectedly, TLC and even HPLC procedures were ineffective in completely restoring the purity of [ 3 H]-estradiol and the unremoved polar products induced important variations in our estrogen receptor assays. An increase in non-specific binding and a concomitant decrease in total binding were observed resulting in an underestimation of specific binding sites and of the affinity constant. In some cases Scatchard analysis was not possible. The authors therefore strongly recommend the repurification of low-stability radioligands and propose an economic time-saving procedure for the purification of [ 3 H]estradiol by solvent differential partition which requires no high-cost investment in apparatus. (author)

  12. ITMETH, Iterative Routines for Linear System

    Greenbaum, A.

    1989-01-01

    1 - Description of program or function: ITMETH is a collection of iterative routines for solving large, sparse linear systems. 2 - Method of solution: ITMETH solves general linear systems of the form AX=B using a variety of methods: Jacobi iteration; Gauss-Seidel iteration; incomplete LU decomposition or matrix splitting with iterative refinement; diagonal scaling, matrix splitting, or incomplete LU decomposition with the conjugate gradient method for the problem AA'Y=B, X=A'Y; bi-conjugate gradient method with diagonal scaling, matrix splitting, or incomplete LU decomposition; and ortho-min method with diagonal scaling, matrix splitting, or incomplete LU decomposition. ITMETH also solves symmetric positive definite linear systems AX=B using the conjugate gradient method with diagonal scaling or matrix splitting, or the incomplete Cholesky conjugate gradient method

  13. ROUTINE IMMUNIZATION IN INDIA: A PERSPECTIVE

    G Taneja

    2013-08-01

    Full Text Available The Universal Immunization Programme is possibly the longest and one of the biggest public health intervention measures undertaken in India. To improve immunization coverage in the country various initiatives have been undertaken since the inception of the programme in 1985; key inputs being strengthening and expanding the cold chain system, establishing a network of outreach immunization sites, alternate vaccine delivery model, capacity building of health functionaries and medical officers and intensified polio control measures. Introduction of new and underutilized vaccines, drafting of the national vaccine policy, tracking of beneficiaries through the Maternal and Child Tracking system are some of the recent developments. However in spite of more than 25 years since inception the programme is still adversely impacted by challenges across key thematic areas of programme management, cold chain and vaccine management, recording and reporting and injection safety. To further strengthen and improve service delivery 2012-13 has been declared as the “Year of Intensification of Routine Immunization” with the objective of improving immunization coverage rates across poor performing districts and states so as to attain Global Immunization Vision and Strategy goals of 90% coverage at national and more than 80% coverage at district level. Key activities planned during the year include sustained advocacy at all levels, improved communication and social mobilization, robust and regular program reviews, comprehensive microplanning, strengthening cold chain and vaccine logistics system, special catch up rounds through immunization weeks, piloting the teeka express, improved surveillance systems, strengthened partnerships and operational research activities. The current review pertains to the existing scenario of Universal Immunization Program in the country with impetus on the existing challenges, progress achieved till date as a result of various

  14. Treatment goals in psoriasis routine care.

    Radtke, M A; Reich, K; Spehr, C; Augustin, Matthias

    2015-07-01

    The treatment goal algorithm for psoriasis, first originated in 2007, has ever since been adopted into treatment guidelines. It remained unclear how many patients have experienced the use of treatment goals in routine care and how these are perceived. The aim of the pilot study was to get first insight in the use and impact of therapeutic goals in a large cohort of patients with psoriasis in routine care. This study is a multicenter, non-interventional, cross-sectional health care study in n = 213 dermatology centers across Germany. A standardized physician and patient questionnaire was used, including demographics, disease and treatment characteristics. To evaluate patient treatment perception and satisfaction, a questionnaire (PsoSat) addressing 8 specific items was designed. Consistency and validity of the questionnaire were controlled by factor analyses and reliability tests. In total n = 1,883 patients were included for analysis (54.2% male). Mean age was 52 years, mean disease duration 19 years. In total 45.5% (n = 856) stated an improvement of psoriatic symptoms in the last 4 weeks. In patients including treatment goals, the course of psoriasis in the last 4 weeks was rated significantly better and predicted significantly higher patient satisfaction. Patients reporting periodic outcomes measurement of psoriasis treatment, also had significantly better course of disease, higher satisfaction and a lower psoriasis severity. A majority of patients experienced the use of treatment goals in practice. The association of using treatment goals with clinical outcomes and treatment satisfaction was markedly positive. These findings indicate that the use of treatment goals and outcome measurements in fact improve psoriasis management.

  15. Master schedule for CY-1978. Hanford Environmental Surveillance Routine Program

    Blumer, P.J.; Myers, D.A.; Fix, J.J.

    1977-12-01

    This report provides the current schedule of data collection for the routine environmental surveillance program at the Hanford Site. No results are presented in this report. The data collected are available in routine reports issued by the Environmental Evaluations staff

  16. An acoustic sensor for monitoring airflow in pediatric tracheostomy patients.

    Ruscher, Thomas; Wicks Phd, Alexandrina; Muelenaer Md, Andre

    2012-01-01

    Without proper monitoring, patients with artificial airways in the trachea are at high risk for complications or death. Despite routine maintenance of the tube, dislodged or copious mucus can obstruct the airway. Young children ( 3yrs) have difficulty tending to their own tubes and are particularly vulnerable to blockages. They require external respiratory sensors. In a hospital environment, ventilators, end-tidal CO2 monitors, thermistors, and other auxiliary equipment provide sufficient monitoring of respiration. However, outpatient monitoring methods, such as thoracic impedance and pulse oximetry, are indirect and prone to false positives. Desensitization of caregivers to frequent false alarms has been cited in medical literature as a contributing factor in cases of child death. Ultrasonic time-of-flight (TOF) is a technique used in specialized industrial applications to non-invasively measure liquid and gas flow. Two transducers are oriented at a diagonal across a flow channel. Velocity measurement is accomplished by detecting slight variations in transit time of contra-propagating acoustic signals with a directional component parallel to air flow. Due to the symmetry of acoustic pathway between sensors, velocity measurements are immune to partial fouling in the tube from mucus, saliva, and condensation. A first generation proof of concept prototype was constructed to evaluate the ultrasonic TOF technique for medical tracheostomy monitoring. After successful performance, a second generation prototype was designed with a smaller form factor and more advanced electronics. This prototype was tested and found to measure inspired volume with a root-mean-square error < 2% during initial trials.

  17. Detecting asymptomatic coronary artery disease using routine ...

    ECG-monitored exercise testing has been proposed as a relatively inexpensive and effective means of screening for asymptomatic coronary artery disease in patients presenting for peripheral vascular surgery. Despite the fact that exercise thallium scintigraphy is also dependent on the patient's ability to exercise, using this ...

  18. Mining Productive-Associated Periodic-Frequent Patterns in Body Sensor Data for Smart Home Care.

    Ismail, Walaa N; Hassan, Mohammad Mehedi

    2017-04-26

    The understanding of various health-oriented vital sign data generated from body sensor networks (BSNs) and discovery of the associations between the generated parameters is an important task that may assist and promote important decision making in healthcare. For example, in a smart home scenario where occupants' health status is continuously monitored remotely, it is essential to provide the required assistance when an unusual or critical situation is detected in their vital sign data. In this paper, we present an efficient approach for mining the periodic patterns obtained from BSN data. In addition, we employ a correlation test on the generated patterns and introduce productive-associated periodic-frequent patterns as the set of correlated periodic-frequent items. The combination of these measures has the advantage of empowering healthcare providers and patients to raise the quality of diagnosis as well as improve treatment and smart care, especially for elderly people in smart homes. We develop an efficient algorithm named PPFP-growth (Productive Periodic-Frequent Pattern-growth) to discover all productive-associated periodic frequent patterns using these measures. PPFP-growth is efficient and the productiveness measure removes uncorrelated periodic items. An experimental evaluation on synthetic and real datasets shows the efficiency of the proposed PPFP-growth algorithm, which can filter a huge number of periodic patterns to reveal only the correlated ones.

  19. Mining Productive-Associated Periodic-Frequent Patterns in Body Sensor Data for Smart Home Care

    Walaa N. Ismail

    2017-04-01

    Full Text Available The understanding of various health-oriented vital sign data generated from body sensor networks (BSNs and discovery of the associations between the generated parameters is an important task that may assist and promote important decision making in healthcare. For example, in a smart home scenario where occupants’ health status is continuously monitored remotely, it is essential to provide the required assistance when an unusual or critical situation is detected in their vital sign data. In this paper, we present an efficient approach for mining the periodic patterns obtained from BSN data. In addition, we employ a correlation test on the generated patterns and introduce productive-associated periodic-frequent patterns as the set of correlated periodic-frequent items. The combination of these measures has the advantage of empowering healthcare providers and patients to raise the quality of diagnosis as well as improve treatment and smart care, especially for elderly people in smart homes. We develop an efficient algorithm named PPFP-growth (Productive Periodic-Frequent Pattern-growth to discover all productive-associated periodic frequent patterns using these measures. PPFP-growth is efficient and the productiveness measure removes uncorrelated periodic items. An experimental evaluation on synthetic and real datasets shows the efficiency of the proposed PPFP-growth algorithm, which can filter a huge number of periodic patterns to reveal only the correlated ones.

  20. Routine organic air emissions at the Radioactive Waste Management Complex Waste Storage Facilities fiscal year 1995 report

    Galloway, K.J.; Jolley, J.G.

    1995-12-01

    This report presents the data and results of the routine organic air emissions monitoring performed in the Radioactive Waste Management Complex Waste Storage Facility, WMF-628, from January 4, 1995 to September 3, 1995. The task objectives were to systematically identify and measure volatile organic compound (VOC) concentrations within WMF-628 that could be emitted into the environment. These routine measurements implemented a dual method approach using Open-Path Fourier Transform Infrared Spectroscopy (OP-FTIR) monitoring and the Environmental Protection Agency (EPA) analytical method TO-14, Summa reg-sign Canister sampling. The data collected from the routine monitoring of WNF-628 will assist in estimating the total VOC emissions from WMF-628

  1. Current concepts in blood glucose monitoring.

    Khadilkar, Kranti Shreesh; Bandgar, Tushar; Shivane, Vyankatesh; Lila, Anurag; Shah, Nalini

    2013-12-01

    Blood glucose monitoring has evolved over the last century. The concept of adequate glycemic control and minimum glycemic variability requires an ideal, accurate and reliable glucose monitoring system. The search for an ideal blood glucose monitoring system still continues. This review explains the various blood glucose monitoring systems with special focus on the monitoring systems like self- monitored blood glucose (SMBG) and continuous glucose monitoring system (CGMS). It also focuses on the newer concepts of blood glucose monitoring and their incorporation in routine clinical management of diabetes mellitus.

  2. Current concepts in blood glucose monitoring

    Khadilkar, Kranti Shreesh; Bandgar, Tushar; Shivane, Vyankatesh; Lila, Anurag; Shah, Nalini

    2013-01-01

    Blood glucose monitoring has evolved over the last century. The concept of adequate glycemic control and minimum glycemic variability requires an ideal, accurate and reliable glucose monitoring system. The search for an ideal blood glucose monitoring system still continues. This review explains the various blood glucose monitoring systems with special focus on the monitoring systems like self- monitored blood glucose (SMBG) and continuous glucose monitoring system (CGMS). It also focuses on the newer concepts of blood glucose monitoring and their incorporation in routine clinical management of diabetes mellitus. PMID:24910827

  3. Current concepts in blood glucose monitoring

    Kranti Shreesh Khadilkar

    2013-01-01

    Full Text Available Blood glucose monitoring has evolved over the last century. The concept of adequate glycemic control and minimum glycemic variability requires an ideal, accurate and reliable glucose monitoring system. The search for an ideal blood glucose monitoring system still continues. This review explains the various blood glucose monitoring systems with special focus on the monitoring systems like self- monitored blood glucose (SMBG and continuous glucose monitoring system (CGMS. It also focuses on the newer concepts of blood glucose monitoring and their incorporation in routine clinical management of diabetes mellitus.

  4. Supervisory Monitoring of Workplace at CIAE in 2011

    2011-01-01

    1 Introduction Based on The Routine Monitoring Programme for Workplace at CIAE in 2011 which approved by Division of Safe and Environmental Protection, a management sector of China Institute of Atomic Energy (CIAE), supervisory monitoring of

  5. Distinguishing the relevant features of frequent suicide attempters.

    Lopez-Castroman, Jorge; Perez-Rodriguez, Maria de las Mercedes; Jaussent, Isabelle; Alegria, Analucia A; Artes-Rodriguez, Antonio; Freed, Peter; Guillaume, Sébastien; Jollant, Fabrice; Leiva-Murillo, Jose Miguel; Malafosse, Alain; Oquendo, Maria A; de Prado-Cumplido, Mario; Saiz-Ruiz, Jeronimo; Baca-Garcia, Enrique; Courtet, Philippe

    2011-05-01

    In spite of the high prevalence of suicide behaviours and the magnitude of the resultant burden, little is known about why individuals reattempt. We aim to investigate the relationships between clinical risk factors and the repetition of suicidal attempts. 1349 suicide attempters were consecutively recruited in the Emergency Room (ER) of two academic hospitals in France and Spain. Patients were extensively assessed and demographic and clinical data obtained. Data mining was used to determine the minimal number of variables that blinded the rest in relation to the number of suicide attempts. Using this set, a probabilistic graph ranking relationships with the target variable was constructed. The most common diagnoses among suicide attempters were affective disorders, followed by anxiety disorders. Risk of frequent suicide attempt was highest among middle-aged subjects, and diminished progressively with advancing age of onset at first attempt. Anxiety disorders significantly increased the risk of presenting frequent suicide attempts. Pathway analysis also indicated that frequent suicide attempts were linked to greater odds for alcohol and substance abuse disorders and more intensive treatment. Novel statistical methods found several clinical features that were associated with a history of frequent suicide attempts. The identified pathways may promote new hypothesis-driven studies of suicide attempts and preventive strategies. Copyright © 2010 Elsevier Ltd. All rights reserved.

  6. Competence-Based Education and Training– about Frequently Asked Questions

    Mulder, M.

    2012-01-01

    This article follows the author's previous piece on practical guidelines for the development of comprehensive competence-based education and training (Mulder, 2012). It is about the questions that have been and are still frequently asked in presentations, workshops and classes about the introduction

  7. Injury patterns in children with frequent emergency department visits

    Laursen, B

    2006-01-01

    -14 years. Information on all ED visits was obtained from the Danish National Patient Registry. Injury type, place of accident, injury mechanism, admission, and distance to ED were compared between children with frequent ED visits (five or more during the three years) and children with only one visit...... less severe injuries and more dislocations, sprains, and strains....

  8. Hybrid Recommendation System Memanfaatkan Penggalian Frequent Itemset dan Perbandingan Keyword

    Suka Parwita, Wayan Gede; Winarko, Edi

    2015-01-01

    Abstrak Recommendation system sering dibangun dengan memanfaatkan data peringkat item dan data identitas pengguna. Data peringkat item merupakan data yang langka pada sistem yang baru dibangun. Sedangkan, pemberian data identitas pada recommendation system dapat menimbulkan kekhawatiran penyalahgunaan data identitas. Hybrid recommendation system memanfaatkan algoritma penggalian frequent itemset dan perbandingan keyword dapat memberikan daftar rekomendasi tanpa menggunakan data identi...

  9. Vaginal microbiota of women with frequent vulvovaginal candidiasis.

    Zhou, Xia; Westman, Rachel; Hickey, Roxana; Hansmann, Melanie A; Kennedy, Colleen; Osborn, Thomas W; Forney, Larry J

    2009-09-01

    Vulvovaginal candidiasis (VVC) is an insidious infection that afflicts a large proportion of women of all ages, and 5 to 8% of affected women experience recurrent VVC (RVVC). The aim of this study was to explore the possible importance of vaginal bacterial communities in reducing the risk of RVVC. The species composition and diversity of microbial communities were evaluated for 42 women with and without frequent VVC based on profiles of terminal restriction fragment polymorphisms of 16S rRNA genes and phylogenetic analysis of cloned 16S rRNA gene sequences from the numerically dominant microbial populations. The data showed that there were no significant differences between the vaginal microbial communities of women in the two groups (likelihood score, 5.948; bootstrap P value, 0.26). Moreover, no novel bacteria were found in the communities of women with frequent VVC. The vaginal communities of most women in both groups (38/42; 90%) were dominated by species of Lactobacillus. The results of this study failed to provide evidence for the existence of altered or unusual vaginal bacterial communities in women who have frequent VVC compared to women who do not have frequent VVC. The findings suggest that commensal vaginal bacterial species may not be able to prevent VVC.

  10. Ban the Book Report: Promoting Frequent and Enthusiastic Reading

    Foster, Graham

    2012-01-01

    Teachers recognize that frequent independent reading increases student knowledge on a wide range of topics, enhances vocabulary, and improves comprehension. "Ban the Book Report" inspires teachers to go beyond narrow and analytical book reports by exploring the potential of book talks, alternate book covers, identifying features of informational…

  11. An Adaptive Algorithm for Finding Frequent Sets in Landmark Windows

    Dang, Xuan-Hong; Ong, Kok-Leong; Lee, Vincent

    2012-01-01

    We consider a CPU constrained environment for finding approximation of frequent sets in data streams using the landmark window. Our algorithm can detect overload situations, i.e., breaching the CPU capacity, and sheds data in the stream to “keep up”. This is done within a controlled error threshold...

  12. Frequent visitors at the psychiatric emergency room - A literature review.

    Schmidt, Manuela

    2018-03-01

    Frequent visitors at the psychiatric emergency room (PER) constitute a small subgroup of patients, yet they are responsible for a disproportionate number of visits and thus claim considerable resources. Their needs are often left unmet and their repetitive visits reflect their dissatisfaction as well as that of PERs' staff. Motivated by these dilemmas, this study systematically reviews the literature about frequent visitors at PER and seeks to answer two questions: What characterizes frequent visitors at PER in the literature? and What characterizes PER in the literature? Based on 29 studies, this paper offers answers to the two questions based on a strength weakness opportunities and threats (SWOT) analysis. The results of the review and subsequent analysis of the literature revealed the multiplicity and complexity of frequent visitors' characteristics and how they appear to converge. Commonalities were more difficult to identify in PER characteristics. In some cases, this happened because the characteristics were poorly described or were context specific. As a result, it was not easy to compare the studies on PER. Based on SWOT and the findings of the analysis, the paper proposes new venues of research and suggests how the field of mental health might develop by taking into account its opportunities and threats.

  13. Frequent epigenetic inactivation of Wnt antagonist genes in breast cancer

    Suzuki, H; Toyota, M; Caraway, H; Gabrielson, E; Ohmura, T; Fujikane, T; Nishikawa, N; Sogabe, Y; Nojima, M; Sonoda, T; Mori, M; Hirata, K; Imai, K; Shinomura, Y; Baylin, S B; Tokino, T

    2008-01-01

    Although mutation of APC or CTNNB1 (β-catenin) is rare in breast cancer, activation of Wnt signalling is nonetheless thought to play an important role in breast tumorigenesis, and epigenetic silencing of Wnt antagonist genes, including the secreted frizzled-related protein (SFRP) and Dickkopf (DKK) families, has been observed in various tumours. In breast cancer, frequent methylation and silencing of SFRP1 was recently documented; however, altered expression of other Wnt antagonist genes is largely unknown. In the present study, we found frequent methylation of SFRP family genes in breast cancer cell lines (SFRP1, 7 out of 11, 64%; SFRP2, 11 out of 11, 100%; SFRP5, 10 out of 11, 91%) and primary breast tumours (SFRP1, 31 out of 78, 40%; SFRP2, 60 out of 78, 77%; SFRP5, 55 out of 78, 71%). We also observed methylation of DKK1, although less frequently, in cell lines (3 out of 11, 27%) and primary tumours (15 out of 78, 19%). Breast cancer cell lines express various Wnt ligands, and overexpression of SFRPs inhibited cancer cell growth. In addition, overexpression of a β-catenin mutant and depletion of SFRP1 using small interfering RNA synergistically upregulated transcriptional activity of T-cell factor/lymphocyte enhancer factor. Our results confirm the frequent methylation and silencing of Wnt antagonist genes in breast cancer, and suggest that their loss of function contributes to activation of Wnt signalling in breast carcinogenesis. PMID:18283316

  14. GRAMI: Generalized Frequent Subgraph Mining in Large Graphs

    El Saeedy, Mohammed El Sayed

    2011-07-24

    Mining frequent subgraphs is an important operation on graphs. Most existing work assumes a database of many small graphs, but modern applications, such as social networks, citation graphs or protein-protein interaction in bioinformatics, are modeled as a single large graph. Interesting interactions in such applications may be transitive (e.g., friend of a friend). Existing methods, however, search for frequent isomorphic (i.e., exact match) subgraphs and cannot discover many useful patterns. In this paper we propose GRAMI, a framework that generalizes frequent subgraph mining in a large single graph. GRAMI discovers frequent patterns. A pattern is a graph where edges are generalized to distance-constrained paths. Depending on the definition of the distance function, many instantiations of the framework are possible. Both directed and undirected graphs, as well as multiple labels per vertex, are supported. We developed an efficient implementation of the framework that models the frequency resolution phase as a constraint satisfaction problem, in order to avoid the costly enumeration of all instances of each pattern in the graph. We also implemented CGRAMI, a version that supports structural and semantic constraints; and AGRAMI, an approximate version that supports very large graphs. Our experiments on real data demonstrate that our framework is up to 3 orders of magnitude faster and discovers more interesting patterns than existing approaches.

  15. Breaking the Waves: Routines and Rituals in Entrepreneurship Education

    Neergaard, Helle; Christensen, Dorthe Refslund

    2017-01-01

    Learning is related to the environment created for the learning experience. This environment is often highly routinized and involves a certain social structure, but in entrepreneurship education, such routinization and structure may actually counteract the learning goals. This article investigates how classroom routines and rituals impact on…

  16. [The controversy of routine articulator mounting in orthodontics].

    Wang, Li; Han, Xianglong; Bai, Ding

    2013-06-01

    Articulators have been widely used by clinicians of dentistry. But routine articulator mounting is still controversial in orthodontics. Orthodontists oriented by gnathology approve routine articulator mounting while nongnathologic orthodontists disapprove it. This article reviews the thoughts of orthodontist that they agree or disagree with routine articulator mounting based on the considerations of biting, temporomandibular disorder (TMD), periodontitis, and so on.

  17. 42 CFR 493.1210 - Condition: Routine chemistry.

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Routine chemistry. 493.1210 Section 493....1210 Condition: Routine chemistry. If the laboratory provides services in the subspecialty of Routine chemistry, the laboratory must meet the requirements specified in §§ 493.1230 through 493.1256, § 493.1267...

  18. Telemetric implantable pressure sensor for short- and long-term monitoring of intracranial pressure.

    Frischholz, M; Sarmento, L; Wenzel, M; Aquilina, K; Edwards, R; Coakham, H B

    2007-01-01

    Patients with hydrocephalus, idiopathic intracranial hypertension and head injury frequently require monitoring of intracranial pressure (ICP) and may need repeated episodes of monitoring months or years apart. The gold standard for measurement of ICP remains the external ventricular catheter. This is a fluid-filled catheter transducer system that allows regular recalibration and correction of zero drift by its position relative to a fixed anatomical reference. It also allows drainage of cerebrospinal fluid (CSF), providing a means of lowering the ICP. Several catheter tip transducer systems are currently in clinical use, including using strain gauges or fiber-optical pressure sensing techniques. In these devices, zero drift and calibration cannot be checked in vivo. All the ICP monitoring devices in current clinical use require a physical connection between the brain and the external environment. This is a source of infection and limits the duration of monitoring. A number of telemetric monitoring devices, in which data is in some way transmitted transcutaneously, have been developed over the last twenty years, but significant technical problems have precluded their use in routine clinical practice. All current ICP monitors are temporary percutaneous implanted devices. Placement of these devices carries significant morbidity, particularly infection. Patients undergoing repeated monitoring require multiple surgical procedures. Apart from decreasing the risk of infection in patients with severe head injury, the clinical value of an accurate telemetric ICP monitoring system which maintains its reliability over a long period of implantation is high.

  19. FASTPLOT, Interface Routines to MS FORTRAN Graphics Library

    1999-01-01

    1 - Description of program or function: FASTPLOT is a library of routines that can be used to interface with the Microsoft FORTRAN Graphics library (GRAPHICS.LIB). The FASTPLOT routines simplify the development of graphics applications and add capabilities such as histograms, Splines, symbols, and error bars. FASTPLOT also includes routines that can be used to create menus. 2 - Methods: FASTPLOT is a library of routines which must be linked with a user's FORTRAN programs that call any FASTPLOT routines. In addition, the user must link with the Microsoft FORTRAN Graphics library (GRAPHICS.LIB). 3 - Restrictions on the complexity of the problem: None noted

  20. Supporting Frequent Updates in R-Trees: A Bottom-Up Approach

    Lee, Mong Li; Hsu, Wynne; Jensen, Christian Søndergaard

    2003-01-01

    Advances in hardware-related technologies promise to enable new data management applications that monitor continuous processes. In these applications, enormous amounts of state samples are obtained via sensors and are streamed to a database. Further, updates are very frequent and may exhibit...... and aims to improve update performance. It has different levels of reorganization—ranging from global to local—during updates, avoiding expensive top-down updates. A compact main-memory summary structure that allows direct access to the R-tree index nodes is used together with efficient bottom...

  1. Diabetes that impacts on routine activities predicts slower recovery after total knee arthroplasty: an observational study

    Nurudeen Amusat

    2014-12-01

    . Physiotherapists could institute closer monitoring within the hospital and community settings for people undergoing TKA who perceive that diabetes impacts on their routine activities. [Amusat N, Beaupre L, Jhangri GS, Pohar SL, Simpson S, Warren S, Jones CA (2014 Diabetes that impacts on routine activities predicts slower recovery after total knee arthroplasty: an observational study. Journal of Physiotherapy 60: 217–223

  2. Reliability and validity of the Marijuana Motives Measure among young adult frequent cannabis users and associations with cannabis dependence.

    Benschop, Annemieke; Liebregts, Nienke; van der Pol, Peggy; Schaap, Rick; Buisman, Renate; van Laar, Margriet; van den Brink, Wim; de Graaf, Ron; Korf, Dirk J

    2015-01-01

    The Marijuana Motives Measure (MMM) has so far been examined mainly in student populations, often with relatively limited involvement in cannabis use. This study evaluated the factor structure of the MMM in a demographically mixed sample of 600 young adult (18-30 years) frequent (≥ 3 days per week) cannabis users in the Netherlands. Analysis confirmed a five-factor solution, denoting coping, enhancement, social, conformity and expansion motives. Additionally, the original MMM was extended with two items (boredom and habit), which formed a distinct, internally consistent sixth factor labelled routine motives. In a multivariable logistic regression analysis, coping and routine motives showed significant associations with 12-month DSM-IV cannabis dependence. The results suggest general reliability and validity of the MMM in a heterogeneous population of experienced cannabis users. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Lunate chondromalacia: evaluation of routine MRI sequences.

    Bordalo-Rodrigues, Marcelo; Schweitzer, Mark; Bergin, Diane; Culp, Randall; Barakat, Mohamed S

    2005-05-01

    Chondromalacia is a commonly encountered abnormality at arthroscopy and may be responsible for significant clinical symptoms and disability. In the wrist, the most common location for chondromalacia is the lunate bone. Consequently, we sought to study the accuracy of clinical MRI in the assessment of lunate articular cartilage. MR images of 34 patients who underwent arthroscopy and had an MRI examination within 1 month of surgery were evaluated by two reviewers for the presence and location of lunate cartilage defects and subchondral edema. Lunate cartilage defects were seen on MRI in 10 of the 13 patients with chondromalacia, but these defects were also incorrectly noted in three of 21 of patients without chondromalacia. The visible locations for cartilage defects were the ulnar aspect of the proximal lunate bone (n = 3), radial aspect of the proximal lunate bone (n = 4), ulnar aspect of the distal lunate bone (n = 2), and radial aspect of the distal lunate bone (n = 1). Subchondral marrow edema was observed in six of the 10 patients with chondromalacia seen on MRI; in all six patients, the edema was seen in the same quadrant as the cartilage defect. Marrow edema was detected in one patient without chondromalacia. We conclude that lunate chondromalacia can be accurately assessed using routine MRI sequences, although there are occasional false-positive interpretations.

  4. Routine dosimetry in a nuclear medicine department

    Dreuille, O. de; Carbonieres, H. de; Briand-Champlong, J.; Foehrenbach, H.; Guevel, E.; Maserlin, P.; Gaillard, J.F.; Treguier, J.Y.

    2002-01-01

    The nuclear medicine department of the Val de Grace Hospital, in cooperation with the Radiological Protection Army Service, has performed an evaluation of the staff's radio-exposure based on routine dosimetry for six months. The most exposed people are the technicians (2.6 mSv/yr) and the nurse (1.7 mS/yr). The nuclear medicine physicians (0.6 mSv/yr) and the secretaries (0.07 mSv/yr) are far less exposed. The most irradiant occupations are the preparation and the injection of the radiopharmaceuticals (18 mSv/dy) and the realization of the Positron Emission Tomography examinations (19 mSv/dy). The increasing number of PET exams and the development of new tomographs, requiring higher activities, will still increase the exposition level of this working post. This study demonstrates that the exposition doses in nuclear medicine are low compared to the regular limits. Based on these results, only the technicians and the nurse are relevant to the A class. However, these dose levels cannot be neglected for particular positions such as the injection and the PET management. (author)

  5. Routine medicare and radiation exposure. Introductory remarks

    Hirata, Hideki; Saito, Tsutomu

    2013-01-01

    As an introduction of the title series, outlines of radiation in physics, chemistry, biochemistry, biological effect and protection are explained from the clinical doctors' aspect of routine medicare, and of radiation exposure in which people's interest is raised after the Fukushima Nuclear Power Plant Accident in 2011. For physics, ionizing effects of radiation are described in relation to its quantum energy transfer and its medical utilization like imaging and radiotherapy. Then mentioned in brief is the radiation from elements consisting of human body, cosmic ray and background radiation from the earth, with reference to natural and standardized limits of exposure doses. Radiations from 226 Rn and 40 K are explained as an instance of environmental natural sources together with the concepts of radioactive decay series/scheme, of internal exposure, of hazard like double strand break (DSB) and of medical use such as boron neutron capture therapy (BNCT). For an artifact radiation source, shown are fission products of 235 U by neutron, first yielded in 1945. Evidence of evolution in biochemical repair mechanisms of DSB is explained with a comparison of irradiated drosophila mutation where linear non-threshold (LNT) hypothesis is proposed, and human non-homologous end joining and homologous recombination. Historical process of occupational, medical, public exposures and their protection is finally described from the discovery of X-ray in 1895 to the first ICRP publication in 1958 via the A-bomb explosion in 1945. (T.T.)

  6. Determinants of frequent attendance in Danish general practice

    Jørgensen, Jeanette Therming; Andersen, John Sahl; Tjønneland, Anne

    2016-01-01

    . below recommended level), and hormone therapy in women (1.52; 1.42-1.63) were all significant determinants of frequent attendance. CONCLUSIONS: In addition to pre-existing medical conditions, gender, socio-demographic and gender-specific factors, lifestyle (obesity, smoking, exercise and alcohol use.......57-0.69, >4 years higher education vs. no vocational training) and employment (0.61; 0.57-0.65) were inversely associated with frequent attendance. Finally, obesity (1.54; 1.14-2.08), smoking (1.21; 1.12-1.30, current vs. never), physical activity (0.84; 0.80-89), alcohol consumption (0.83; 0.78-0.87 above vs...

  7. Frequent rhabdomyolysis in anti-NMDA receptor encephalitis.

    Lim, Jung-Ah; Lee, Soon-Tae; Kim, Tae-Joon; Moon, Jangsup; Sunwoo, Jun-Sang; Byun, Jung-Ick; Jung, Keun-Hwa; Jung, Ki-Young; Chu, Kon; Lee, Sang Kun

    2016-09-15

    The aim of this study was to analyze the clinical presentation and provocation factors of rhabdomyolysis in anti-NMDAR encephalitis. Among the 16 patients with anti-NMDAR encephalitis in our institutional cohort, nine patients had elevated CK enzyme levels and clinical evidence of rhabdomyolysis. Rhabdomyolysis was more frequent after immunotherapy. The use of dopamine receptor blocker (DRB) increased the risk of rhabdomyolysis. None of the patients without rhabdomyolysis received DRBs. Rhabdomyolysis is a frequent complication in anti-NMDAR encephalitis and more common after immunotherapy and the use of DRBs increases the risk. Therefore, DRBs should be administered carefully in patients with anti-NMDAR encephalitis. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Manual on environmental monitoring in normal operation

    1966-01-01

    Many establishments handling radioactive materials produce, and to some extent also discharge, radioactive waste as part of their normal operation. The radiation doses to which members of the public may be exposed during such operation must remain below the stipulated level. The purpose of this manual is to provide technical guidance for setting up programmes of routine environmental monitoring in the vicinity of nuclear establishment. The annex gives five examples of routine environmental monitoring programmes currently in use: these have been indexed separately.

  9. Case Report Frequent malaria illness episodes in two Malawian ...

    Frequent malaria in two patients on ART after stopping CPT 57. Malawi Medical Journal 29 (1): March 2017 http://dx.doi.org/10.4314/mmj.v29i1.12. Wongani J.S. Nyangulu1, Edson Mwinjiwa1, Titus H. Divala2, Randy G. Mungwira2,. Osward Nyirenda2, Maxwell Kanjala2, Gillian Mbambo3, Jane Mallewa4, Terrie E. Taylor2,.

  10. Longleaf pine restoration in context comparisons of frequent fire forests

    Seth Bigelow; Michael C. Stambaugh; Joseph J. O' Brien; Andrew J. Larson; Michael A. Battaglia

    2018-01-01

    To see a frequent-fire forest burn for the first time is to experience a remarkable teat of nature. Most people are accustomed to the slow change of forests with the seasons, not the instantaneous conversion of green and brown plant mass to smoke and char. Yet to visit such a forest a week after it bums is to see bright green shoots emerging, highlighted against a...

  11. Antibody deficiency in patients with frequent exacerbations of Chronic Obstructive Pulmonary Disease (COPD).

    McCullagh, Brian N; Comellas, Alejandro P; Ballas, Zuhair K; Newell, John D; Zimmerman, M Bridget; Azar, Antoine E

    2017-01-01

    Chronic Obstructive Pulmonary Disease is the third leading cause of death in the US, and is associated with periodic exacerbations, which account for the largest proportion of health care utilization, and lead to significant morbidity, mortality, and worsening lung function. A subset of patients with COPD have frequent exacerbations, occurring 2 or more times per year. Despite many interventions to reduce COPD exacerbations, there is a significant lack of knowledge in regards to their mechanisms and predisposing factors. We describe here an important observation that defines antibody deficiency as a potential risk factor for frequent COPD exacerbations. We report a case series of patients who have frequent COPD exacerbations, and who were found to have an underlying primary antibody deficiency syndrome. We also report on the outcome of COPD exacerbations following treatment in a subset with of these patients with antibody deficiency. We identified patients with COPD who had 2 or more moderate to severe exacerbations per year; immune evaluation including serum immunoglobulin levels and pneumococcal IgG titers was performed. Patients diagnosed with an antibody deficiency syndrome were treated with either immunoglobulin replacement therapy or prophylactic antibiotics, and their COPD exacerbations were monitored over time. A total of 42 patients were identified who had 2 or more moderate to severe COPD exacerbations per year. Twenty-nine patients had an underlying antibody deficiency syndrome: common variable immunodeficiency (8), specific antibody deficiency (20), and selective IgA deficiency (1). Twenty-two patients had a follow-up for at least 1 year after treatment of their antibody deficiency, which resulted in a significant reduction of COPD exacerbations, courses of oral corticosteroid use and cumulative annual dose of oral corticosteroid use, rescue antibiotic use, and hospitalizations for COPD exacerbations. This case series identifies antibody deficiency as a

  12. Incremental Frequent Subgraph Mining on Large Evolving Graphs

    Abdelhamid, Ehab

    2017-08-22

    Frequent subgraph mining is a core graph operation used in many domains, such as graph data management and knowledge exploration, bioinformatics and security. Most existing techniques target static graphs. However, modern applications, such as social networks, utilize large evolving graphs. Mining these graphs using existing techniques is infeasible, due to the high computational cost. In this paper, we propose IncGM+, a fast incremental approach for continuous frequent subgraph mining problem on a single large evolving graph. We adapt the notion of “fringe” to the graph context, that is the set of subgraphs on the border between frequent and infrequent subgraphs. IncGM+ maintains fringe subgraphs and exploits them to prune the search space. To boost the efficiency, we propose an efficient index structure to maintain selected embeddings with minimal memory overhead. These embeddings are utilized to avoid redundant expensive subgraph isomorphism operations. Moreover, the proposed system supports batch updates. Using large real-world graphs, we experimentally verify that IncGM+ outperforms existing methods by up to three orders of magnitude, scales to much larger graphs and consumes less memory.

  13. Handling Dynamic Weights in Weighted Frequent Pattern Mining

    Ahmed, Chowdhury Farhan; Tanbeer, Syed Khairuzzaman; Jeong, Byeong-Soo; Lee, Young-Koo

    Even though weighted frequent pattern (WFP) mining is more effective than traditional frequent pattern mining because it can consider different semantic significances (weights) of items, existing WFP algorithms assume that each item has a fixed weight. But in real world scenarios, the weight (price or significance) of an item can vary with time. Reflecting these changes in item weight is necessary in several mining applications, such as retail market data analysis and web click stream analysis. In this paper, we introduce the concept of a dynamic weight for each item, and propose an algorithm, DWFPM (dynamic weighted frequent pattern mining), that makes use of this concept. Our algorithm can address situations where the weight (price or significance) of an item varies dynamically. It exploits a pattern growth mining technique to avoid the level-wise candidate set generation-and-test methodology. Furthermore, it requires only one database scan, so it is eligible for use in stream data mining. An extensive performance analysis shows that our algorithm is efficient and scalable for WFP mining using dynamic weights.

  14. Canine and feline obesity: frequently asked questions and their answers.

    Becvarova, Iveta

    2011-11-01

    The diagnosis of obesity is simple and warrants intervention because of the association between obesity and increased morbidity. Pet owner commitment, a proper feeding plan, and regular monitoring are the keys to a successful weight loss program. Treatment of obesity involves caloric restriction and/or diet change. Therapeutic weight loss diets differ in fiber, moisture, and digestible carbohydrate contents, and the diet choice should be tailored to the individual patient. Appropriate feeding management is equally important. To protect against the recurrence of obesity, owners should be educated on how to monitor body condition score and adjust the feeding program to maintain proper body condition.

  15. Embolic Signals during Routine Transcranial Doppler Ultrasonography in Aneurysmal Subarachnoid Hemorrhage

    Paschoal, Fernando Mendes; de Almeida Lins Ronconi, Karla; de Lima Oliveira, Marcelo; Nogueira, Ricardo de Carvalho; Paschoal, Eric Homero Albuquerque; Teixeira, Manoel Jacobsen; Figueiredo, Eberval Gadelha; Bor-Seng-Shu, Edson

    2015-01-01

    Introduction. Cerebral emboli may occur in subarachnoid hemorrhage (SAH) and intracranial aneurysm surgery. Although embolic signs (ES) have been reported in SAH, their origin remains unclear. The aim of this study was to report the detection of ES during routine TCD monitoring in patients with aneurysmal SAH. Methods. A total of 105 patients with aneurysmal SAH were submitted to TCD evaluation. Patients were monitored almost daily (5 times per week). In each monitoring session, one experienced operator performed TCD to detect or assess vasospasm and ES in arteries of the Willis polygon. Results. Four patients out of a total of 105 patients with aneurysmal SAH were found to present spontaneous cerebral embolization during routine TCD monitoring. The average age of the 4 patients (mean ± standard deviation) was 59.5 ± 8.34 years (range 49–68 ys); female patients predominated representing 75% (3/4) of subjects. Conclusion. Although detection of ES was relatively rare in this study, rates of emboli occurrence may be higher under systematic monitoring. The detection of ES after SAH surgery reinforces the need to study the role of embolus in this condition and may be an indicator for prophylactic antithrombotic treatment. PMID:25893190

  16. 40 CFR 143.4 - Monitoring.

    2010-07-01

    ... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Monitoring. 143.4 Section 143.4... SECONDARY DRINKING WATER REGULATIONS § 143.4 Monitoring. (a) It is recommended that the parameters in these regulations should be monitored at intervals no less frequent than the monitoring performed for inorganic...

  17. Development and Validation of the Pediatric Diabetes Routines Questionnaire for Adolescents.

    Pierce, Jessica S; Jordan, Sara S; Arnau, Randolph C

    2018-04-06

    This study describes the development and psychometric evaluation of an adolescent self-report version of the Pediatric Diabetes Routines Questionnaire (PDRQ:A), a measure of diabetes-specific routines for youth with type 1 diabetes, and further validation of the parent-version (PDRQ:P) in an adolescent sample. Participants included 120 parent-adolescent dyads (ages 12-17) and an additional 24 parents who completed measures of diabetes-specific adolescent routines, general adolescent routines, diabetes self-care, and family support of youth diabetes care. The PDRQ:P/A demonstrated good internal consistency, test-retest reliability, and parent-child agreement, and adequate validity coefficients. Confirmatory factor analysis supported a one-factor model. Promising results were obtained. The PDRQ:P/A is a clinically feasible parent- and self-report measure that can provide valuable information regarding how frequently adolescents engage in their diabetes management tasks in a consistent manner. Addition of an adolescent report format will enhance the utility of the measure for clinical and research use.

  18. Evaluation of macrocytosis in routine hemograms.

    Veda, P

    2013-03-01

    Macrocytosis, a condition in which erythrocytes are larger than normal manifests as an increase in mean corpuscular volume (MCV) more than 100 fl. The aim of this study was to identify the underlying causes of macrocytosis, detected in routine hemograms and to evaluate the hematological features in different etiologies. This study included 178 adult patients whose detailed medical history was recorded, and Vitamin B12 assay, folate assay, thyroid function tests, liver function tests, complete blood counts and peripheral smear evaluation was performed. Alcoholism was identified as the etiological factor in 65 cases (36.5%), Vitamin B12 deficiency in 43 cases (24.1%) and drug related in 23 cases (12.9%). These three conditions accounted for 73.6% of macrocytosis. Other causes identified were folate deficiency, liver disease, Myelodysplastic syndrome, chronic renal failure and Aplastic anemia. In 41 cases, the cause of macrocytosis could not be explained. Anemia was observed in 95 cases (53.3%) being most common in Vitamin B12 deficiency. 9 cases (20.9%) of Vitamin B12 deficiency presented with isolated macrocytosis without anemia. It was observed that mean hemoglobin was lower and red cell distribution width (RDW) higher in megaloblastic conditions. Peripheral smear revealed hypersegmented neutrophils in 86% and macro-ovalocytes in 72% of the megaloblastic cases. Complete medical history, red cell parameters and peripheral blood smear are simple, inexpensive tools which assist in identifying the underlying cause of macrocytosis, particularly in resource limited settings. Macrocytosis needs to be evaluated even in the absence of anemia, as it may be the first clue to an underlying pathology.

  19. Routine screening for fetal anomalies: expectations.

    Goldberg, James D

    2004-03-01

    Ultrasound has become a routine part of prenatal care. Despite this, the sensitivity and specificity of the procedure is unclear to many patients and healthcare providers. In a small study from Canada, 54.9% of women reported that they had received no information about ultrasound before their examination. In addition, 37.2% of women indicated that they were unaware of any fetal problems that ultrasound could not detect. Most centers that perform ultrasound do not have their own statistics regarding sensitivity and specificity; it is necessary to rely on large collaborative studies. Unfortunately, wide variations exist in these studies with detection rates for fetal anomalies between 13.3% and 82.4%. The Eurofetus study is the largest prospective study performed to date and because of the time and expense involved in this type of study, a similar study is not likely to be repeated. The overall fetal detection rate for anomalous fetuses was 64.1%. It is important to note that in this study, ultrasounds were performed in tertiary centers with significant experience in detecting fetal malformations. The RADIUS study also demonstrated a significantly improved detection rate of anomalies before 24 weeks in tertiary versus community centers (35% versus 13%). Two concepts seem to emerge from reviewing these data. First, patients must be made aware of the limitations of ultrasound in detecting fetal anomalies. This information is critical to allow them to make informed decisions whether to undergo ultrasound examination and to prepare them for potential outcomes.Second, to achieve the detection rates reported in the Eurofetus study, ultrasound examination must be performed in centers that have extensive experience in the detection of fetal anomalies.

  20. Children's expressions of negative emotions and adults' responses during routine cardiac consultations.

    Vatne, Torun M; Ruland, Cornelia M; Ørnes, Knut; Finset, Arnstein

    2012-03-01

    One function of expressing emotion is to receive support. The aim of this study was to assess how children with heart disease express negative emotions during routine consultations, and examine the interaction between children's expressions and adults' responses. Seventy children, aged 7-13 years, completed measures of anxiety and were videotaped during cardiology visits. Adult-child interactions were analyzed using the Verona Definitions of Emotional Sequences. Children expressed negative emotion, mainly in subtle ways; however, adults rarely recognized and responded to these expressions. The frequency of children's expressions and adults' responses were related to the child's age, level of anxiety, and verbal participation. Children do not openly express negative emotions frequently during routine cardiac consultations; they are more likely to provide subtle cues of negative emotion. When expression of negative emotions does occur, adults may consider using the opportunity to explore the child's emotional experiences.

  1. Brain perfusion SPECT in children with frequent fits

    Heiskala, H.; Launes, J.; Pihko, H.; Nikkinen, P.; Santavuori, P.

    1993-01-01

    We studied 14 children with frequent fits using 99m Tc-HM-PAO single photon emission computed tomography (SPECT). There were 11 patients with partial secondary generalized epilepsy (PSGE) and 3 with Lennox-Gastaut syndrome (LGS). The typical regional cerebral blood flow (rCBF) finding in PSGE was a single area of abnormally low perfused cortex, and that in LGS, multiple hypoperfused areas. Clinically, the LGS patients were more severely affected. SPECT was more sensitive in detecting abnormalities than EEG, CT or MRI. Extensive impairment of rCBF may thus indicate unfavourable development of intellectual performance and poor seizure control. (author)

  2. Managing for Old Growth in Frequent-fire Landscapes

    Carl E. Fiedler

    2007-12-01

    Full Text Available There is no one-size-fits-all approach to managing frequent-fire, old-growth forests. However, there are general guidelines to follow: 1 set objectives for both structure (tree density, diameter distribution, tree species composition, spatial arrangement, amount of coarse woody debris and function (nutrient cycling, desired tree species regeneration; 2 prioritize treatments according to ecological, economic, and social needs and risks; 3 identify the potential treatments (natural fire, prescribed fire, silvicultural cutting that best meet the objectives and scale of the project; and 4 implement the treatment(s. We discuss each of these guidelines in this article.

  3. Frequent hemodialysis with NxStage system in pediatric patients receiving maintenance hemodialysis.

    Goldstein, Stuart L; Silverstein, Douglas M; Leung, Jocelyn C; Feig, Daniel I; Soletsky, Beth; Knight, Cathy; Warady, Bradley A

    2008-01-01

    Recent evidence from adult hemodialysis (HD) patient studies reveal improved biochemical control and reported health-related quality of life after transition from conventional thrice weekly to daily home maintenance HD treatment. Published pediatric frequent dialysis experiences demonstrate similar improvement but all used conventional HD machines, which employ a treated municipal water supply, thereby frequently exposing patients to proinflammatory components. We report our pediatric experience with six-times-weekly HD using the NxStage system, which uses sterile dialysis fluid to provide dialysis in the home or center setting. Four patients (weight range 38-61.4 kg) completed the 16-week study. Patients exhibited progressive reductions in casual pretreatment systolic and diastolic blood pressures, discontinuation of antihypertensive medications, and decreased blood pressure load by ambulatory blood pressure monitoring. Mean serum phosphorus improved without change in phosphorus binder medication, and all three patients with a normalized protein catabolic rate 1.1 g/kg per day. Patients reported no adverse effects. Variable changes in proinflammatory cytokine levels were observed. We suggest that frequent HD with the NxStage system be considered for children who would benefit from home-based maintenance dialysis.

  4. The Endogenous Origins of Experience, Routines and Organizational Capabilities

    Foss, Nicolai Juul; Felin, Teppo

    2011-01-01

    In this paper we discuss the origins and emergence of organizational routines and capabilities. We first argue that there are theoretical and endogeneity-related concerns associated with the key antecedents and mechanisms specified by the extant routines and capabilities literature. Specifically,...... or rationalist, choice-based approach can provide a more fruitful (though preliminary) foundation for understanding organizational behavior and capabilities.......In this paper we discuss the origins and emergence of organizational routines and capabilities. We first argue that there are theoretical and endogeneity-related concerns associated with the key antecedents and mechanisms specified by the extant routines and capabilities literature. Specifically......, we explicate the behaviorist and empiricist foundations of the organizational routines and capabilities literature and the extant emphasis placed on experience, repetition, and observation as the key antecedents and mechanisms of routines and capabilities. Based on this discussion we highlight...

  5. Brain intrinsic network connectivity in individuals with frequent tanning behavior.

    Ketcherside, Ariel; Filbey, Francesca M; Aubert, Pamela M; Seibyl, John P; Price, Julianne L; Adinoff, Bryon

    2018-05-01

    Emergent studies suggest a bidirectional relationship between brain functioning and the skin. This neurocutaneous connection may be responsible for the reward response to tanning and, thus, may contribute to excessive tanning behavior. To date, however, this association has not yet been examined. To explore whether intrinsic brain functional connectivity within the default mode network (DMN) is related to indoor tanning behavior. Resting state functional connectivity (rsFC) was obtained in twenty adults (16 females) with a history of indoor tanning. Using a seed-based [(posterior cingulate cortex (PCC)] approach, the relationship between tanning severity and FC strength was assessed. Tanning severity was measured with symptom count from the Structured Clinical Interview for Tanning Abuse and Dependence (SITAD) and tanning intensity (lifetime indoor tanning episodes/years tanning). rsFC strength between the PCC and other DMN regions (left globus pallidus, left medial frontal gyrus, left superior frontal gyrus) is positively correlated with tanning symptom count. rsFC strength between the PCC and salience network regions (right anterior cingulate cortex, left inferior parietal lobe, left inferior temporal gyrus) is correlated with tanning intensity. Greater connectivity between tanning severity and DMN and salience network connectivity suggests that heightened self-awareness of salient stimuli may be a mechanism that underlies frequent tanning behavior. These findings add to the growing evidence of brain-skin connection and reflect dysregulation in the reward processing networks in those with frequent tanning.

  6. Cannabis consumption patterns among frequent consumers in Uruguay.

    Boidi, María Fernanda; Queirolo, Rosario; Cruz, José Miguel

    2016-08-01

    In 2013, Uruguay became the first country to fully regulate the cannabis market, which now operates under state control. Cannabis can be legally acquired in three ways: growing it for personal use (self-cultivation), cannabis club membership, and from pharmacies (not yet implemented). Users must be entered into a confidential official registry to gain access. This article presents findings of a Respondent Driven Sample survey of 294 high-frequency cannabis consumers in the Montevideo metropolitan area. Frequent consumers resort to more than one method for acquiring cannabis, with illegal means still predominating after 1 year of the new regulation law. Cannabis users overwhelmingly support the current regulation, but many of them are reluctant to register. Some of the attitudes and behaviors of the high-frequency consumers pose a challenge to the success of the cannabis law. Individuals relying on more than one method of access defy the single access clause, a prerequisite for legal use, while the maximum amount of cannabis individuals can access monthly seems too high even for most frequent consumers, which might promote the emergence of a grey market. Reluctance to register among a significant proportion of high-frequency consumers raises doubts about the law's ability to achieve its stated objectives. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. Finding Frequent Closed Itemsets in Sliding Window in Linear Time

    Chen, Junbo; Zhou, Bo; Chen, Lu; Wang, Xinyu; Ding, Yiqun

    One of the most well-studied problems in data mining is computing the collection of frequent itemsets in large transactional databases. Since the introduction of the famous Apriori algorithm [14], many others have been proposed to find the frequent itemsets. Among such algorithms, the approach of mining closed itemsets has raised much interest in data mining community. The algorithms taking this approach include TITANIC [8], CLOSET+[6], DCI-Closed [4], FCI-Stream [3], GC-Tree [15], TGC-Tree [16] etc. Among these algorithms, FCI-Stream, GC-Tree and TGC-Tree are online algorithms work under sliding window environments. By the performance evaluation in [16], GC-Tree [15] is the fastest one. In this paper, an improved algorithm based on GC-Tree is proposed, the computational complexity of which is proved to be a linear combination of the average transaction size and the average closed itemset size. The algorithm is based on the essential theorem presented in Sect. 4.2. Empirically, the new algorithm is several orders of magnitude faster than the state of art algorithm, GC-Tree.

  8. Promiscuous 2-aminothiazoles (PrATs): a frequent hitting scaffold.

    Devine, Shane M; Mulcair, Mark D; Debono, Cael O; Leung, Eleanor W W; Nissink, J Willem M; Lim, San Sui; Chandrashekaran, Indu R; Vazirani, Mansha; Mohanty, Biswaranjan; Simpson, Jamie S; Baell, Jonathan B; Scammells, Peter J; Norton, Raymond S; Scanlon, Martin J

    2015-02-12

    We have identified a class of molecules, known as 2-aminothiazoles (2-ATs), as frequent-hitting fragments in biophysical binding assays. This was exemplified by 4-phenylthiazol-2-amine being identified as a hit in 14/14 screens against a diverse range of protein targets, suggesting that this scaffold is a poor starting point for fragment-based drug discovery. This prompted us to analyze this scaffold in the context of an academic fragment library used for fragment-based drug discovery (FBDD) and two larger compound libraries used for high-throughput screening (HTS). This analysis revealed that such "promiscuous 2-aminothiazoles" (PrATs) behaved as frequent hitters under both FBDD and HTS settings, although the problem was more pronounced in the fragment-based studies. As 2-ATs are present in known drugs, they cannot necessarily be deemed undesirable, but the combination of their promiscuity and difficulties associated with optimizing them into a lead compound makes them, in our opinion, poor scaffolds for fragment libraries.

  9. Comparing childhood meal frequency to current meal frequency, routines, and expectations among parents.

    Friend, Sarah; Fulkerson, Jayne A; Neumark-Sztainer, Dianne; Garwick, Ann; Flattum, Colleen Freeh; Draxten, Michelle

    2015-02-01

    Little is known about the continuation of family meals from childhood to parenthood. This study aims to examine associations between parents' report of eating family meals while growing up and their current family meal frequency, routines, and expectations. Baseline data were used from the Healthy Home Offerings via the Mealtime Environment (HOME) Plus study, a randomized controlled trial with a program to promote healthful behaviors and family meals at home. Participants (160 parent/child dyads) completed data collection in 2011-2012 in the Minneapolis/St. Paul, MN metropolitan area. Parents were predominately female (95%) and white (77%) with a mean age of 41.3 years. General linear modeling examined relationships between parents' report of how often they ate family meals while growing up and their current family meal frequency, routines, and expectations as parents, controlling for parent age, education level, and race. Parental report of eating frequent family meals while growing up was positively and significantly associated with age, education, and self-identification as white (all p meals less than three times/week or four to five times/week, parents who ate six to seven family meals/week while growing up reported significantly more frequent family meals with their current family (4.0, 4.2 vs. 5.3 family meals/week, p = .001). Eating frequent family meals while growing up was also significantly and positively associated with having current regular meal routines and meal expectations about family members eating together (both p meals with children may have long-term benefits over generations. PsycINFO Database Record (c) 2015 APA, all rights reserved.

  10. Modeling Routinization in Games: An Information Theory Approach

    Wallner, Simon; Pichlmair, Martin; Hecher, Michael

    2015-01-01

    Routinization is the result of practicing until an action stops being a goal-directed process. This paper formulates a definition of routinization in games based on prior research in the fields of activity theory and practice theory. Routinization is analyzed using the formal model of discrete......-time, discrete-space Markov chains and information theory to measure the actual error between the dynamically trained models and the player interaction. Preliminary research supports the hypothesis that Markov chains can be effectively used to model routinization in games. A full study design is presented...

  11. Widely applicable MATLAB routines for automated analysis of saccadic reaction times.

    Leppänen, Jukka M; Forssman, Linda; Kaatiala, Jussi; Yrttiaho, Santeri; Wass, Sam

    2015-06-01

    Saccadic reaction time (SRT) is a widely used dependent variable in eye-tracking studies of human cognition and its disorders. SRTs are also frequently measured in studies with special populations, such as infants and young children, who are limited in their ability to follow verbal instructions and remain in a stable position over time. In this article, we describe a library of MATLAB routines (Mathworks, Natick, MA) that are designed to (1) enable completely automated implementation of SRT analysis for multiple data sets and (2) cope with the unique challenges of analyzing SRTs from eye-tracking data collected from poorly cooperating participants. The library includes preprocessing and SRT analysis routines. The preprocessing routines (i.e., moving median filter and interpolation) are designed to remove technical artifacts and missing samples from raw eye-tracking data. The SRTs are detected by a simple algorithm that identifies the last point of gaze in the area of interest, but, critically, the extracted SRTs are further subjected to a number of postanalysis verification checks to exclude values contaminated by artifacts. Example analyses of data from 5- to 11-month-old infants demonstrated that SRTs extracted with the proposed routines were in high agreement with SRTs obtained manually from video records, robust against potential sources of artifact, and exhibited moderate to high test-retest stability. We propose that the present library has wide utility in standardizing and automating SRT-based cognitive testing in various populations. The MATLAB routines are open source and can be downloaded from http://www.uta.fi/med/icl/methods.html .

  12. Taking a new biomarker into routine use – A perspective from the routine clinical biochemistry laboratory

    Sturgeon, Catharine; Hill, Robert; Hortin, Glen L; Thompson, Douglas

    2010-01-01

    There is increasing pressure to provide cost-effective healthcare based on “best practice.” Consequently, new biomarkers are only likely to be introduced into routine clinical biochemistry departments if they are supported by a strong evidence base and if the results will improve patient management and outcome. This requires convincing evidence of the benefits of introducing the new test, ideally reflected in fewer hospital admissions, fewer additional investigations and/or fewer clinic visits. Carefully designed audit and cost-benefit studies in relevant patient groups must demonstrate that introducing the biomarker delivers an improved and more effective clinical pathway. From the laboratory perspective, pre-analytical requirements must be thoroughly investigated at an early stage. Good stability of the biomarker in relevant physiological matrices is essential to avoid the need for special processing. Absence of specific timing requirements for sampling and knowledge of the effect of medications that might be used to treat the patients in whom the biomarker will be measured is also highly desirable. Analytically, automation is essential in modern high-throughput clinical laboratories. Assays must therefore be robust, fulfilling standard requirements for linearity on dilution, precision and reproducibility, both within- and between-run. Provision of measurements by a limited number of specialized reference laboratories may be most appropriate, especially when a new biomarker is first introduced into routine practice. PMID:21137030

  13. Errorless (re)learning of daily living routines by a woman with impaired memory and initiation: transferrable to a new home?

    Ferland, Mark B; Larente, Johanne; Rowland, Julia; Davidson, Patrick S R

    2013-01-01

    To use errorless learning to train a memory- and initiation-impaired woman on two activities of daily living routines and then to transfer these routines to a new home. Single case quasi-experimental. Over 9 months, a young woman with an anterior cerebral haemorrhagic stroke (secondary to a ruptured arteriovenous malformation) was trained on routines of morning self-care and diabetes management, involving extensive practice on a structured series of steps with intervention as needed to prevent errors. Once routines were established, family members were trained in the supervision and rating of the routines at home. Following discharge, caregivers continued to monitor the routines daily for 3 months. Errorless learning of self-care and diabetes routines was successful. The routines were transferred to a new home environment and maintained at a near perfect level over a 3-month follow-up period. The patient remained severely memory-impaired, indicating that her functional gains were not attributable to any recovery of her memory abilities over time. This case offers evidence that even people with severe memory and initiation impairments can be trained on new routines using errorless learning and that, once learned, these routines can be carried out in novel contexts.

  14. Monitoring production target thickness

    Oothoudt, M.A.

    1993-01-01

    Pion and muon production targets at the Clinton P. Anderson Meson Physics Facility consist of rotating graphite wheels. The previous target thickness monitoring Procedure scanned the target across a reduced intensity beam to determine beam center. The fractional loss in current across the centered target gave a measure of target thickness. This procedure, however, required interruption of beam delivery to experiments and frequently indicated a different fractional loss than at normal beam currents. The new monitoring Procedure compares integrated ups and downs toroid current monitor readings. The current monitors are read once per minute and the integral of readings are logged once per eight-hour shift. Changes in the upstream to downstream fractional difference provide a nonintrusive continuous measurement of target thickness under nominal operational conditions. Target scans are now done only when new targets are installed or when unexplained changes in the current monitor data are observed

  15. Radiotherapy of the most frequent solid tumors in childhood

    Pfeiffer, J.; Kamprad, F.

    1980-01-01

    During the past decade the prognosis of malignant tumors in childhood could be clearly improved, realized by combining surgery, radiation therapy and chemotherapy. Recommendations for the use of radiotherapy for the most frequent solid tumors in childhood are represented basing on the experience of the study groups 'Pediatric Hematology and Oncology' of the Society for Pediatrics of the GDR and 'Tumors in Childhood' of the Section of Children's Surgery of the GDR. Besides general problems which have to be taken into consideration in the treatment of infantile tumors the radiotherapeutical measures for Wilms' tumors, neuroblastomas, cerebral tumors, embryonal sarcomas of the soft parts and bone tumors are discussed. The necessary close cooperation of the attending branches is pointed out and both the regional centralization of patients' care and a superregional cooperation are required. (author)

  16. Frequently Asked Questions in Fire Probabilistic Safety Assessment

    Kang, Dae Il; Kim, Kil Yoo; Park, Gee Yong

    2010-05-01

    The FAQs(Frequently Asked Questions) in the Fire Probabilistic Safety Assessment(FPSA) are the issues occurred during performing the engineering evaluation based on NFPA-805. In this report, the background and resolutions are reviewed and described for 17 FAQs related to FPSA among 57 FAQs. The current FAQs related to FPSA are the issues concerning to NUREG/CR-6850, and are almost resolved but for the some FAQ, the current resolutions would be changed depending on the results of the future or on-going research. Among FAQs related to FPSA, best estimate approaches are suggested concerning to the conservative method of NUREG/CR-6850. If these best estimate solutions are used in the FPSA of nuclear power plants, realistic evaluation results of fire risk would be obtained

  17. High prevalence of frequent attendance in the over 65s.

    McMahon, C Geraldine; Power Foley, Megan; Robinson, David; O'Donnell, Kate; Poulton, Miriam; Kenny, Rose A; Bennett, Kathleen

    2018-02-01

    Characteristics of older frequent users of Emergency Departments (EDs) are poorly understood. Our aim was to examine the characteristics of the ED frequent attenders (FAs) by age (under 65 and over 65 years). We examined the prevalence of FA attending the ED of an Urban Teaching Hospital in a cross-sectional study between 2009 and 2011. FA was defined as an individual who presented to the ED four or more times over a 12-month period. Randomly selected groups of FA and non-FA from two age groups (under 65 and over 65 years) were then examined to compare the characteristics between older FAs and non-FAs and older FAs and younger FAs. Logistic regression was used to calculate the odds ratio and 95% confidence intervals for 12-month mortality in FA compared with non-FA aged at least 65 years. Overall, 137 150 ED attendances were recorded between 2009 and 2011. A total of 21.6% were aged at least 65 years, 4.4% of whom were FAs, accounting for 18.4% of attendances by patients older than 65 years. There was a bimodal age distribution of FA (mean±SD; under 65 years 40±12.7; and over 65 years 76.9±7.4). Older FAs were five times more likely to present outside normal working hours and 5.5 times more likely to require admission. Cardiovascular emergencies were the most common complaint, in contrast with the younger FA group, where injury and psychosocial conditions dominated. The odds ratio for death at 12 months was 2.07 (95% confidence interval 0.93-4.63; P=0.07), adjusting for age and sex. One-in-five ED patients older than 65 years of age are FAs. Older FAs largely present with complex medical conditions. Enhanced access to expert gerontology assessment should be considered as part of effective intervention strategies for older ED users.

  18. A New Fast Vertical Method for Mining Frequent Patterns

    Zhihong Deng

    2010-12-01

    Full Text Available Vertical mining methods are very effective for mining frequent patterns and usually outperform horizontal mining methods. However, the vertical methods become ineffective since the intersection time starts to be costly when the cardinality of tidset (tid-list or diffset is very large or there are a very large number of transactions. In this paper, we propose a novel vertical algorithm called PPV for fast frequent pattern discovery. PPV works based on a data structure called Node-lists, which is obtained from a coding prefix-tree called PPC-tree. The efficiency of PPV is achieved with three techniques. First, the Node-list is much more compact compared with previous proposed vertical structure (such as tid-lists or diffsets since transactions with common prefixes share the same nodes of the PPC-tree. Second, the counting of support is transformed into the intersection of Node-lists and the complexity of intersecting two Node-lists can be reduced to O(m+n by an efficient strategy, where m and n are the cardinalities of the two Node-lists respectively. Third, the ancestor-descendant relationship of two nodes, which is the basic step of intersecting Node-lists, can be very efficiently verified by Pre-Post codes of nodes. We experimentally compare our algorithm with FP-growth, and two prominent vertical algorithms (Eclat and dEclat on a number of databases. The experimental results show that PPV is an efficient algorithm that outperforms FP-growth, Eclat, and dEclat.

  19. [Is nocturnal polyuria more frequent among patients with Parkinson's disease?].

    Romain, J; Torny, F; Dumas, J-P; Gamé, X; Descazeaud, A

    2015-05-01

    Nocturia is a frequent complaint in the population of idiopathic Parkinson's disease patients (IPD). The consequences of nocturia in the IPD population are at high importance as these patients have motor problems and therefore a risk of nocturnal fall. The aim of the study was to determine the mechanism of nocturia in patients with MPI, by determining the prevalence of nocturnal polyuria (NP) in this population. A prospective study by bladder diary was conducted on 70 consecutive IPD patients consulting for regular neurological follow-up at a non-severe stage. Nocturia was defined as 1 or more awakenings to urinate. Two definitions of NP were used: nocturnal diuresis 33% or higher of the total diuresis (NUV33), which is the ICS (International Continence Society) definition, and nocturnal diuresis 90 mL/h or higher (NUP90). The mean patient age was 71 years (45-86, sex ratio 33/30). On average, patients were diagnosed for IPD 6.76 years earlier. The prevalence of NP was 64.5% according to NUV33 definition, and 17.7% according to NUP90 definition. Among patients with nocturia, the prevalence of NP was 66% (NUV33) and 21.5% (NUP90). No association was observed between disease duration of the IPD and the prevalence of nocturia and NP. Patients 70 years and older were more likely to have NP as defined by NUV33 than those less than 70 years (72.7% versus 55.17%, P=0.015). Men had more frequently nocturia (33.3% versus 20.7%, P=0.027). The prevalence of NP and nocturia was analyzed in patients with IPD at a non-severe stage. This prevalence was not higher than in the general population of the same age. The mechanism of nocturia in patients with IPD is not unambiguous and therefore requires to be explored by a bladder diary. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  20. [Frequent attendance in a Primary Health Care District].

    Menéndez Granados, Nicolás; Vaquero Abellán, Manuel; Toledano Estepa, Manuel; Pérez Díaz, Manuel Modesto; Redondo Pedraza, Rosa

    2017-10-09

    To describe the distribution of frequent attenders (FA) through the different primary care practices in Cordoba-Guadalquivir Health District (Córdoba, Spain). An ecological study was performed, including data from 2011 to 2015. Defining FA as those subjects who made12 or more appointments per year; independently analysed for nursing, general practice and paediatrics. Prevalence of frequent attendance and FA/professional ratio were used as dependent variables. Demographic characteristics from district population, number of health professionals and use of general facilities were also examinated. Aiming to understand FA distribution, primary health settings were classified according to facility size and environmental location (urban, suburban and rural). The mean prevalence for FA was 10.86% (0.5 SE) for nursing; general practice 21.70% (0.7 SE) and for paediatrics 16.96% (0.7 SE). FA/professional ratios for the different professional categories were: 101.07 (5.0 SE) for nursing, 239.74 (9.0 SE) for general practice and 159.54 (9.8 SE) for paediatrics. A major part of primary health care users make a high number of consultations. From this group, women overuse nursing and general practitioner services more compared to men. A higher prevalence of FAs was observed in smaller settings, in rural areas. Although taking the FAs:professional ratio as the bar, medium-size practices are more highly overused. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. The etiological structure of diseases in frequently ill children depending on age

    A. S. Levina

    2017-01-01

    Full Text Available The urgency of the problem of frequently ill children is associated with a significant number of patients who can be assigned to this category. Objective: to present the nosological and etiological structure of diseases in frequently ill children depending on age.Subjects and methods. 243 children aged 1 to 17 years with recurrent respiratory infections were followed up. The children were examined using routine clinical, laboratory, and instrumental examinations. The etiological diagnosisincluded bacteriological examination of the upperrespiratory tract microflora; determination of IgM and IgG antibodies against Chlamydophila pneumoniae, Mycoplasma pneumoniae, Epstein–Barr virus(EBV, and cytomegalovirus(CMV in blood by enzyme immunoassay and that of Chlamydia and Mycoplasma DNA in pharyngealswabs and that of CMV, EBV and human herpesvirustype 6 DNA in blood by polymerase chain reaction.Results. Recurrentrespiratory diseases were found to be associated with herpesvirusinfection in 75% of the children aged 1 to 6 years, with Streptococcus, Mycoplasma, and Chlamydia infections in 16, 10, and 4% of those aged 3 to 6 years, respectively, and to be accompanied by abnormal lymphoid tissue proliferation in 84% of the children aged 3 to 6 years, with the abundant growth of bacterial opportunistic pathogensin one half of the patients. Despite the continuing importance of infectious agents(herpesviruses and streptococci in 29 and 20%, respectively, the chronically ill school-aged children displayed a high incidence of somatic diseases: chronic tonsillitis (43% and chronic sinusitis (14% in children aged older than 12 years and allergic rhinitis (23% in those aged 7 to 17 years. The symptoms of autonomic vascular dystonia were observed in 21% of the patients; cardiac arrhythmias were diagnosed in 14%. 

  2. A review of patient safety measures based on routinely collected hospital data.

    Tsang, Carmen; Palmer, William; Bottle, Alex; Majeed, Azeem; Aylin, Paul

    2012-01-01

    The literature on patient safety measures derived from routinely collected hospital data was reviewed to inform indicator development. MEDLINE and Embase databases and Web sites were searched. Of 1738 citations, 124 studies describing the application, evaluation, or validation of hospital-based medical error or complication of care measures were reviewed. Studies were frequently conducted in the United States (n = 88) between 2005 and 2009 (n = 77) using Agency for Healthcare Research and Quality patient safety indicators (PSIs; n = 79). The most frequently cited indicators included "postoperative hemorrhage or hematoma" and "accidental puncture and laceration." Indicator refinement is supported by international coding algorithm translations but is hampered by data issues, including coding inconsistencies. The validity of PSIs and similar adverse event screens beyond internal measurement and the effects of organizational factors on patient harm remain uncertain. Development of PSIs in ambulatory care settings, including general practice and psychiatric care, needs consideration.

  3. [Refeeding syndrome in geriatric patients : A frequently overlooked complication].

    Wirth, Rainer; Diekmann, Rebecca; Fleiter, Olga; Fricke, Leonhardt; Kreilkamp, Annika; Modreker, Mirja Katrin; Marburger, Christian; Nels, Stefan; Schaefer, Rolf; Willschrei, Heinz-Peter; Volkert, Dorothee

    2018-01-01

    The refeeding syndrome is a life-threatening complication that can occur after initiation of a nutrition therapy in malnourished patients. If the risk factors and pathophysiology are known, the refeeding syndrome can effectively be prevented and treated, if recognized early. A slow increase of food intake and the close monitoring of serum electrolyte levels play an important role. Because the refeeding syndrome is not well known and the symptoms may vary extremely, this complication is poorly recognized, especially against the background of geriatric multimorbidity. This overview is intended to increase the awareness of the refeeding syndrome in the risk group of geriatric patients.

  4. Literature Review Lifestyles and routine activities of South African ...

    Journal of Child and Adolescent Mental Health ... Lifestyles and routine activities of South African teenagers at risk of being trafficked for involuntary prostitution. Thozama ... Actual lifestyle and routine activities of South African teenagers and risky behaviours (substance abuse, intergenerational sex and child prostitution) are ...

  5. Factors for Radical Creativity, Incremental Creativity, and Routine, Noncreative Performance

    Madjar, Nora; Greenberg, Ellen; Chen, Zheng

    2011-01-01

    This study extends theory and research by differentiating between routine, noncreative performance and 2 distinct types of creativity: radical and incremental. We also use a sensemaking perspective to examine the interplay of social and personal factors that may influence a person's engagement in a certain level of creative action versus routine,…

  6. Endocarditis : Effects of routine echocardiography during Gram-positive bacteraemia

    Vos, F J; Bleeker-Rovers, C P; Sturm, P D; Krabbe, P F M; van Dijk, A P J; Oyen, W J G; Kullberg, B J

    2011-01-01

    BACKGROUND: Despite firm recommendations to perform echocardiography in high-risk patients with Gram-positive bacteraemia, routine echocardiography is not embedded in daily practice in many settings. The aim of this study was to evaluate whether a regime including routine echocardiography results in

  7. Thinking Routines: Replicating Classroom Practices within Museum Settings

    Wolberg, Rochelle Ibanez; Goff, Allison

    2012-01-01

    This article describes thinking routines as tools to guide and support young children's thinking. These learning strategies, developed by Harvard University's Project Zero Classroom, actively engage students in constructing meaning while also understanding their own thinking process. The authors discuss how thinking routines can be used in both…

  8. Understanding teachers’ routines to inform classroom technology design

    An, P.; Bakker, S.; Eggen, J.H.

    2017-01-01

    Secondary school teachers have quite busy and complex routines in their classrooms. However, present classroom technologies usually require focused attention from teachers while being interacted with, which restricts their use in teachers’ daily routines. Peripheral interaction is a human-computer

  9. Understanding Teachers' Routines to Inform Classroom Technology Design

    An, Pengcheng; Bakker, Saskia; Eggen, Berry

    2017-01-01

    Secondary school teachers have quite busy and complex routines in their classrooms. However, present classroom technologies usually require focused attention from teachers while being interacted with, which restricts their use in teachers' daily routines. Peripheral interaction is a human-computer interaction style that aims to enable interaction…

  10. An Element of Practical Knowledge in Education: Professional Routines

    Lacourse, France

    2011-01-01

    The question of practical knowledge and its teaching has arisen more perceptibly since the appearance of the aim to professionalize teachers. How can imperceptible knowledge such as professional routines be taught? To establish a social fabric and effective class management, it is essential to call on creative and adaptive professional routines.…

  11. See, Say, Write: A Writing Routine for the Preschool Classroom

    Copp, Stefanie B.; Cabell, Sonia Q.; Tortorelli, Laura S.

    2016-01-01

    See, Say, Write is an adaptable classroom writing routine that teachers can use across a range of activities in the preschool classroom. This preschool writing routine offers an opportunity for teachers to build on a shared experience through engagement in rich conversation and writing. After a shared experience, teachers will provide a visual…

  12. The emergence and change of management accounting routines

    van der Steen, M.P.

    2011-01-01

    Purpose - The purpose of this paper is to explore the dynamics involved in the emergence and change of management accounting routines. It seeks to provide an understanding of the ways in which these complex routines foster stability and change in management accounting practices.

  13. Family routines and rituals following separation: continuity and change

    Bakker, W.; Karsten, L.; Mulder, C.H.

    2015-01-01

    Separation always changes family life. The aim of this study is to gain insight into the everyday practices of ‘doing family’ after separation. We focus on two central elements of family life: routines and rituals. While in most families both parents are involved in family routines and rituals, this

  14. 42 CFR 493.1267 - Standard: Routine chemistry.

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Standard: Routine chemistry. 493.1267 Section 493.1267 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Systems § 493.1267 Standard: Routine chemistry. For blood gas analyses, the laboratory must perform the...

  15. 42 CFR 493.841 - Standard; Routine chemistry.

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Standard; Routine chemistry. 493.841 Section 493.841 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... These Tests § 493.841 Standard; Routine chemistry. (a) Failure to attain a score of at least 80 percent...

  16. Epidemiology of frequent attenders: a 3-year historic cohort study comparing attendance, morbidity and prescriptions of one-year and persistent frequent attenders

    ter Riet Gerben

    2009-01-01

    Full Text Available Abstract Background General Practitioners spend a disproportionate amount of time on frequent attenders. So far, trials on the effect of interventions on frequent attenders have shown negative results. However, these trials were conducted in short-term frequent attenders. It would be more reasonable to target intervention at persistent frequent attenders. Typical characteristics of persistent frequent attenders, as opposed to 1-year frequent attenders and non-frequent attenders, may generate hypotheses regarding modifiable factors on which new randomized trials may be designed. Methods We used the data of all 28,860 adult patients from 5 primary healthcare centers. Frequent attenders were patients whose attendance rate ranked in the (age and sex adjusted top 10 percent during 1 year (1-year frequent attenders or 3 years (persistent frequent attenders. All other patients on the register over the 3-year period were referred to as non-frequent attenders. The lists of medical problems coded by the GP using the International Classification of Primary Care (ICPC were used to assess morbidity. First, we determined which proportion of 1-year frequent attenders was still a frequent attender during the next two consecutive years and calculated the GPs' workload for these patients. Second, we compared morbidity and number of prescriptions for non-frequent attenders, 1-year frequent attenders and persistent frequent attenders. Results Of all 1-year frequent attenders, 15.4% became a persistent frequent attender equal to 1.6% of all patients. The 1-year frequent attenders (3,045; 10.6% were responsible for 39% of the face-to-face consultations; the 470 patients who would become persistent frequent attenders (1.6% were responsible for 8% of all consultations in 2003. Persistent frequent attenders presented more social problems, more psychiatric problems and medically unexplained physical symptoms, but also more chronic somatic diseases (especially diabetes

  17. User manual for two simple postscript output FORTRAN plotting routines

    Nguyen, T. X.

    1991-01-01

    Graphics is one of the important tools in engineering analysis and design. However, plotting routines that generate output on high quality laser printers normally come in graphics packages, which tend to be expensive and system dependent. These factors become important for small computer systems or desktop computers, especially when only some form of a simple plotting routine is sufficient. With the Postscript language becoming popular, there are more and more Postscript laser printers now available. Simple, versatile, low cost plotting routines that can generate output on high quality laser printers are needed and standard FORTRAN language plotting routines using output in Postscript language seems logical. The purpose here is to explain two simple FORTRAN plotting routines that generate output in Postscript language.

  18. An intelligent stochastic optimization routine for nuclear fuel cycle design

    Parks, G.T.

    1990-01-01

    A simulated annealing (Metropolis algorithm) optimization routine named AMETROP, which has been developed for use on realistic nuclear fuel cycle problems, is introduced. Each stage of the algorithm is described and the means by which it overcomes or avoids the difficulties posed to conventional optimization routines by such problems are explained. Special attention is given to innovations that enhance AMETROP's performance both through artificial intelligence features, in which the routine uses the accumulation of data to influence its future actions, and through a family of simple performance aids, which allow the designer to use his heuristic knowledge to guide the routine's essentially random search. Using examples from a typical fuel cycle optimization problem, the performance of the stochastic Metropolis algorithm is compared to that of the only suitable deterministic routine in a standard software library, showing AMETROP to have many advantages

  19. DMBT1 is frequently downregulated in well-differentiated gastric carcinoma but more frequently upregulated across various gastric cancer types

    Conde, Ana R; Martins, Ana P; Brito, Miguel

    2007-01-01

    in cell differentiation and protection and has been proposed as a candidate tumour suppressor for brain and epithelial cancer. One study reported a loss of DMBT1 expression in 12.5% (5/40) of gastric cancer samples. Here, we examined in more detail DMBT1 protein and mRNA expression in 78 primary gastric...... preferentially take place in well-differentiated gastric carcinoma. However, an upregulation of DMBT1 expression is more frequently found across all gastric cancer types.......Well-differentiated gastric carcinomas are considered to represent a distinct entity emerging via specific molecular changes different from those found in other gastric carcinoma types. The gene deleted in malignant brain tumours 1 (DMBT1) at 10q25.3-q26.1 codes for a protein presumably involved...

  20. Incidence of ischemic lesions by diffusion-weighted imaging after carotid endarterectomy with routine shunt usage

    Inoue, Tomohiro; Tsutsumi, Kazuo; Adachi, Shinobu; Tanaka, Shota; Yako, Kyoko; Saito, Kuniaki; Kunii, Naoto; Maeda, Keiitirou

    2006-01-01

    Temporary intraluminal shunt was used during 72 consecutive carotid endarterectomies (CEAs) in 61 patients (bilateral CEA in 11 patients) during October 2001 and September 2005. The medical records of these patients were retrospectively reviewed. All procedures were performed with routine shunt insertion without monitoring such as electroencephalography. Pre- and postoperative diffusion-weighted magnetic resonance (MR) imaging was used to detect ischemic complications. Postoperative angiography was performed in 70 cases to detect abnormalities such as major stenosis or dissection of the distal end. Symptomatic ischemic complication occurred in one patient at 1 month. Postoperative diffusion-weighted MR imaging detected new hyperintense lesions in three patients including the symptomatic patient. Postoperative angiography confirmed that the distal end was satisfactory in all cases. The incidence of ischemic lesions of embolic origin after CEA with routine shunt usage is acceptably low if the procedure of shunt device insertion and removal is meticulously conducted. (author)

  1. Chest Pain: The Need to Consider Less Frequent Diagnosis

    Pedro Magalhães

    2016-01-01

    Full Text Available Chest pain is one of the most frequent patient’s complaints. The commonest underlying causes are well known, but, sometimes, in some clinical scenarios, it is necessary to consider other diagnoses. We report a case of a 68-year-old Caucasian male, chronically hypertensive, who complained of recurrent episodes of chest pain and fever with elevated acute phase reactants. The first investigation was negative for some of the most likely diagnosis and he quickly improved with anti-inflammatory drugs. Over a few months, his symptoms continued to recur periodically, his hypertension was aggravated, and he developed headaches and lower limbs claudication. After a temporal artery biopsy that was negative for vasculitis, he underwent a positron emission tomography suggestive of Takayasu Arteritis. Takayasu Arteritis is a rare chronic granulomatous vasculitis of the aorta and its first-order branches affecting mostly females up to 50 years old. Chest pain is experienced by >40% of the patients and results from the inflammation of the aorta, pulmonary artery, or coronaries.

  2. [Loyal frequent users of hospital emergency departments: the FIDUR project].

    Fernández Alonso, Cesáreo; Romero Pareja, Rodolfo; Rivas García, Aristides; Jiménez Gallego, Rosa; Majo Carbajo, Yolanda; Aguilar Mulet, Juan Mariano

    2016-02-01

    To describe the characteristics of frequent users of hospital emergency departments and analyze whether characteristics varied in relation to how revisits were distributed over the course of the year studied. Retrospective study of patients over the age of 14 years who were treated in a hospital emergency department at least 10 times in 2013. Patients were identified in 17 public hospitals in the Spanish autonomous community of Madrid. Data related to the first and successive visits were gathered and analyzed by quarter year. We included 2340 patients with a mean (SD) age of 54 (21) years. A total of 1361 (58.%) were women, 1160 (50%) had no concomitant diseases, 1366 (58.2%) were substance abusers, and 25 (1.1%) were homeless. During the first visit, 2038 (87.1%) complained of a recent health problem, and 289 (12.4%) were admitted. Sixty (2.6%) patients concentrated their revisits in a single quarters 335 (14.3%) in 2 quarters, 914 (39.1%) in 3, and 1005 (42.9%) in 4. Patients whose revisits were distributed over more quarters were older (> 65 years), had more concomitant conditions, were on more medications (P women (P = .012) and more likely to have a specific diagnosis (P loyally comes to the same emergency department over the course of a year. Patients whose revisits are dispersed over a longer period have more complex problems and use more resources during their initial visit.

  3. The semiology of febrile seizures: Focal features are frequent.

    Takasu, Michihiko; Kubota, Tetsuo; Tsuji, Takeshi; Kurahashi, Hirokazu; Numoto, Shingo; Watanabe, Kazuyoshi; Okumura, Akihisa

    2017-08-01

    To clarify the semiology of febrile seizures (FS) and to determine the frequency of FS with symptoms suggestive of focal onset. FS symptoms in children were reported within 24h of seizure onset by the parents using a structured questionnaire consisting principally of closed-ended questions. We focused on events at seizure commencement, including changes in behavior and facial expression, and ocular and oral symptoms. We also investigated the autonomic and motor symptoms developing during seizures. The presence or absence of focal and limbic features was determined for each patient. The associations of certain focal and limbic features with patient characteristics were assessed. Information was obtained on FS in 106 children. Various events were recorded at seizure commencement. Behavioral changes were observed in 35 children, changes in facial expression in 53, ocular symptoms in 78, and oral symptoms in 90. In terms of events during seizures, autonomic symptoms were recognized in 78, and convulsive motor symptoms were recognized in 68 children. Focal features were evident in 81 children; 38 children had two or more such features. Limbic features were observed in 44 children, 9 of whom had two or more such features. There was no significant relationship between any patient characteristic and the numbers of focal or limbic features. The semiology of FS varied widely among children, and symptoms suggestive of focal onset were frequent. FS of focal onset may be more common than is generally thought. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Lichenoid keratosis is frequently misdiagnosed as basal cell carcinoma.

    Maor, D; Ondhia, C; Yu, L L; Chan, J J

    2017-08-01

    Lichenoid keratosis (LK), also known as benign lichenoid keratosis or lichen planus-like keratosis, is a solitary, pink to red-brown scaly plaque representing a host immunological response to a variety of precursor lesions. LK is often misdiagnosed as a dermatological malignancy owing to its clinical resemblance to basal cell carcinoma (BCC) or Bowen disease. We performed a retrospective analysis of the pathology records of a series of LK lesions with reference to the demographic features and accuracy of clinical diagnosis. The pathology records from 2008 to 2009 of 263 consecutive patients with a histological diagnosis of LK from a specialized skin laboratory were retrieved. Data relating to clinical diagnosis, age, sex, anatomical location, time of year of presentation and any coexistent pathological lesions adjacent to the LK were recorded. Mean age at presentation was 64 years (range 34-96), and 58% of patients were female. The most common anatomical site was the chest/anterior torso, followed by the back and legs. The most common coexisting lesion was solar keratosis at 14%, followed by seborrhoeic keratosis (SK) at 7.8%. The correct clinical diagnosis of LK was made in 29.5% of cases. The most common clinical diagnosis was BCC (47%), while SK was the preferred diagnosis in 18%. A clinical diagnosis was not given in 5.5% of cases. In conclusion, it appears that LK is frequently misdiagnosed, with misdiagnosis occurring in > 70% of cases in this study. © 2017 British Association of Dermatologists.

  5. Smartphone gaming and frequent use pattern associated with smartphone addiction.

    Liu, Chun-Hao; Lin, Sheng-Hsuan; Pan, Yuan-Chien; Lin, Yu-Hsuan

    2016-07-01

    The aim of this study was to investigate the risk factors of smartphone addiction in high school students.A total of 880 adolescents were recruited from a vocational high school in Taiwan in January 2014 to complete a set of questionnaires, including the 10-item Smartphone Addiction Inventory, Chen Internet Addiction Scale, and a survey of content and patterns of personal smartphone use. Of those recruited, 689 students (646 male) aged 14 to 21 and who owned a smartphone completed the questionnaire. Multiple linear regression models were used to determine the variables associated with smartphone addiction.Smartphone gaming and frequent smartphone use were associated with smartphone addiction. Furthermore, both the smartphone gaming-predominant and gaming with multiple-applications groups showed a similar association with smartphone addiction. Gender, duration of owning a smartphone, and substance use were not associated with smartphone addiction.Our findings suggest that smartphone use patterns should be part of specific measures to prevent and intervene in cases of excessive smartphone use.

  6. Frequently Occurring Reconnection Jets from Sunspot Light Bridges

    Tian, Hui; Yurchyshyn, Vasyl; Peter, Hardi; Solanki, Sami K.; Young, Peter R.; Ni, Lei; Cao, Wenda; Ji, Kaifan; Zhu, Yingjie; Zhang, Jingwen; Samanta, Tanmoy; Song, Yongliang; He, Jiansen; Wang, Linghua; Chen, Yajie

    2018-02-01

    Solid evidence of magnetic reconnection is rarely reported within sunspots, the darkest regions with the strongest magnetic fields and lowest temperatures in the solar atmosphere. Using the world’s largest solar telescope, the 1.6 m Goode Solar Telescope, we detect prevalent reconnection through frequently occurring fine-scale jets in the Hα line wings at light bridges, the bright lanes that may divide the dark sunspot core into multiple parts. Many jets have an inverted Y-shape, shown by models to be typical of reconnection in a unipolar field environment. Simultaneous spectral imaging data from the Interface Region Imaging Spectrograph show that the reconnection drives bidirectional flows up to 200 km s‑1, and that the weakly ionized plasma is heated by at least an order of magnitude up to ∼80,000 K. Such highly dynamic reconnection jets and efficient heating should be properly accounted for in future modeling efforts of sunspots. Our observations also reveal that the surge-like activity previously reported above light bridges in some chromospheric passbands such as the Hα core has two components: the ever-present short surges likely to be related to the upward leakage of magnetoacoustic waves from the photosphere, and the occasionally occurring long and fast surges that are obviously caused by the intermittent reconnection jets.

  7. [Usefulness of continuous glucose monitoring system (CGMS) in monitoring glycaemic profile in small children with diabetes type 1].

    Głowińska-Olszewska, Barbara; Urban, Mirosława; Peczyńska, Jadwiga; Florys, Bozena; Kowalewski, Marek

    2005-01-01

    Improved methods of diabetes therapy result in a near normoglycaemic state in many patients. This leads however unfortunately to more frequent hypoglycaemic incidents. Particularly small children, whose nervous system is not fully mature, are at high risk of central nervous system damage in case of hypoglycaemia. A new method of detail monitoring of glycaemia provides CGMS system. The aim of the study was to compare the glycaemic profile, with high attention to hypoglycaemia in groups of young and older children with diabetes type 1, using CGMS and routine glucose meter. We studied 32 children with diabetes type 1. Children were divided into groups: group I--small children, n=17 (10 years of age), mean age--12 years, with disease duration--3 years, with HbA1c level--7,21%. Continuous glucose monitoring system (CGMS), by MiniMed, was applied in outpatient or hospital conditions, after short training of patient and parents; together with routine glucose meter measurements, 4-8 times/24 hours. In 9 patients from small children group CGMS was repeated after 2 months. Hypoglycaemic incidents detected with CGMS were similar in both groups: 4,6 in I group vs. 4,2 in II group (ns). Hypoglycaemic incidents found with meter were lower in I group--1,6 vs. 2,3 in II group (ns). Mean hypoglycaemic time/24 hour was longer in small children group: 101 min vs. 74 min in group II (p<00,05). In I group we found higher number of hypoglycaemic incidents during the night compared to group II--1,7 vs. 0,8 (p<00,05) and longer duration of night hypoglycaemia: in I group--56 min vs. 32 min in group II (p<00,05). Repeated CGMS study in 9 children from I group revealed decreased mean time of hypoglycaemia/24 hours from 134 min/24 h to 90 min/24 h (p<00,05) and decreased time of night hypoglycaemia from 65 min to 40 min (p<00,05), with a comparable number of hypoglycaemic incidents. Hypoglycaemic incidents found with routine meter measurements in small children were 1,6 vs. 4,6 hypoglycaemia

  8. Monitor update: 1979

    Grisham, D.L.; Ekberg, E.L.; Lambert, J.E.; Meyer, R.E.; Stroik, P.J.; Wickham, M.D.

    1980-01-01

    The Clinton P. Anderson Meson Physics Facility (LAMPF) has developed an advanced remote-handling system (Monitor) that is routinely used to perform complex tasks required to maintain, replace, and improve highly radioactive experimental facilities and components. This advanced system is based on the use of first-generation, force-reflecting servomanipulators that are placed at the remote-task site by a commercial hydraulic crane. A number of television cameras provide the viewing for the operations. Although LAMPF is now able to perform all the maintenance necessary on our main experimental beam line, advancements in manipulator dexterity and capacity, television viewing, and master-slave control links are required to develop the speed and dexterity necessary for general use. These developments should be undertaken as soon as possible to provide a means of routine handling of toxic and dangerous materials, as well as a capability to respond to disasters

  9. Answers to frequently asked questions about cleanup activities at Three Mile Island, Unit 2

    1984-03-01

    This question-and-answer report provides answers in nontechnical language to frequently asked questions about the status of cleanup activities at Three Mile Island, Unit 2. The answers update information first prepared in 1981, shortly after the cleanup got under way. Since then, a variety of important developments in the cleanup has occurred. The information in the report should be read in conjunction with NUREG 1060, a discussion of increased occupational exposure estimates for the cleanup. The questions and answers in this report cover purpose and community involvement, decontamination of water and reactor, fuel removal, radwaste transport, environmental impact, social and economic effects, worker exposures and safety, radiation monitoring, potential for accidents, and schedule and funding

  10. Protein-energy malnutrition is frequent and precocious in children with cri du chat syndrome.

    Lefranc, Violaine; de Luca, Arnaud; Hankard, Régis

    2016-05-01

    Protein-energy malnutrition (PEM) is poorly reported in cri du chat syndrome (CDCS) (OMIM #123450), a genetic disease that causes developmental delay and global growth retardation. The objective was to determine the nutritional status at different ages in children with CDCS and factors associated with PEM. A questionnaire focused on growth and nutritional care was sent to 190 families. Among 36 analyzable questionnaires, growth and nutritional indices compatible with PEM occurred in 47% of patients: 19% before 6 months of age, 24% between 6-12 months and 34% after 12 months. Eight patients received enteral feeding. Speech therapy for swallowing education was performed more often in malnourished children (63% vs. 22%, P < 0.02). PEM is frequent and occurs early in this disease, requiring closed nutritional monitoring. © 2016 Wiley Periodicals, Inc.

  11. Which Triggers Produce the Most Erosive, Frequent, and Longest Runout Turbidity Currents on Deltas?

    Hizzett, J. L.; Hughes Clarke, J. E.; Sumner, E. J.; Cartigny, M. J. B.; Talling, P. J.; Clare, M. A.

    2018-01-01

    Subaerial rivers and turbidity currents are the two most voluminous sediment transport processes on our planet, and it is important to understand how they are linked offshore from river mouths. Previously, it was thought that slope failures or direct plunging of river floodwater (hyperpycnal flow) dominated the triggering of turbidity currents on delta fronts. Here we reanalyze the most detailed time-lapse monitoring yet of a submerged delta; comprising 93 surveys of the Squamish Delta in British Columbia, Canada. We show that most turbidity currents are triggered by settling of sediment from dilute surface river plumes, rather than landslides or hyperpycnal flows. Turbidity currents triggered by settling plumes occur frequently, run out as far as landslide-triggered events, and cause the greatest changes to delta and lobe morphology. For the first time, we show that settling from surface plumes can dominate the triggering of hazardous submarine flows and offshore sediment fluxes.

  12. The Quality of Clinical Maternal and Neonatal Healthcare – A Strategy for Identifying ‘Routine Care Signal Functions’

    Brenner, Stephan; De Allegri, Manuela; Gabrysch, Sabine; Chinkhumba, Jobiba; Sarker, Malabika; Muula, Adamson S.

    2015-01-01

    Background A variety of clinical process indicators exists to measure the quality of care provided by maternal and neonatal health (MNH) programs. To allow comparison across MNH programs in low- and middle-income countries (LMICs), a core set of essential process indicators is needed. Although such a core set is available for emergency obstetric care (EmOC), the ‘EmOC signal functions’, a similar approach is currently missing for MNH routine care evaluation. We describe a strategy for identifying core process indicators for routine care and illustrate their usefulness in a field example. Methods We first developed an indicator selection strategy by combining epidemiological and programmatic aspects relevant to MNH in LMICs. We then identified routine care process indicators meeting our selection criteria by reviewing existing quality of care assessment protocols. We grouped these indicators into three categories based on their main function in addressing risk factors of maternal or neonatal complications. We then tested this indicator set in a study assessing MNH quality of clinical care in 33 health facilities in Malawi. Results Our strategy identified 51 routine care processes: 23 related to initial patient risk assessment, 17 to risk monitoring, 11 to risk prevention. During the clinical performance assessment a total of 82 cases were observed. Birth attendants’ adherence to clinical standards was lowest in relation to risk monitoring processes. In relation to major complications, routine care processes addressing fetal and newborn distress were performed relatively consistently, but there were major gaps in the performance of routine care processes addressing bleeding, infection, and pre-eclampsia risks. Conclusion The identified set of process indicators could identify major gaps in the quality of obstetric and neonatal care provided during the intra- and immediate postpartum period. We hope our suggested indicators for essential routine care processes

  13. Development and validation of MyLifeTracker: a routine outcome measure for youth mental health

    Kwan B

    2018-04-01

    Full Text Available Benjamin Kwan,1 Debra J Rickwood,1,2 Nic R Telford2 1Faculty of Health, University of Canberra, Bruce, ACT, 2headspace National Youth Mental Health Foundation, Melbourne, VIC, Australia Purpose: Routine outcome measures are now being designed for session-by-session use, with emphasis on clinically meaningful items and sensitivity to change. Despite an increasing mental health service focus for young people aged 12–25 years, there is a lack of outcome measures that are designed to be used across this age group. Consequently, MyLifeTracker (MLT was developed as a brief mental health outcome measure designed for young people for routine use. It consists of the following five items targeting areas of importance to young people: general well-being, day-to-day activities, relationships with friends, relationships with family, and general coping. Participants and methods: The measure was tested with 75,893 young people aged 12–25 years attending headspace centers across Australia for mental health-related issues. Results: MLT showed a robust unidimensional factor structure and appropriate reliability. It exhibited good concurrent validity against well-validated measures of psychological distress, well-being, functioning, and life satisfaction. The measure was further demonstrated to be sensitive to change. Conclusion: MLT provides a psychometrically sound mental health outcome measure for young people. The measure taps into items that are meaningful to young people and provides an additional clinical support tool for clinicians and clients during therapy. The measure is brief and easy to use and has been incorporated into an electronic system that routinely tracks session-by-session change and produces time-series charts for the ease of use and interpretation. Keywords: MyLifeTracker, youth mental health, routine outcome measure, routine outcome monitoring, adolescent and young adult

  14. Frequent food insecurity among injection drug users: correlates and concerns

    Strike Carol

    2012-12-01

    Full Text Available Abstract Background Food insecurity and nutrition are two topics that are under-researched among injection drug users (IDUs. Our study examined the extent and correlates of food insecurity among a sample of IDUs and explored whether there is an association between food insecurity and injection-related HIV risk. Methods A cross-sectional survey was conducted using interviewer-administered questionnaires. Data were collected at a needle exchange program in London, Ontario, Canada between September 2006 and January 2007. Participants included 144 English-speaking IDUs who had injected drugs in the past 30 days. Participants were asked about their socio-demographic characteristics, HIV risk behaviours, food insecurity, and health/social service use. Results In the past 6 months, 54.5% of participants reported that on a daily/weekly basis they did not have enough to eat because of a lack of money, while 22.1% reported this type of food insecurity on a monthly basis. Moreover, 60.4% and 24.3% reported that they did not eat the quality or quantity of food they wanted on a daily/weekly or a monthly basis, respectively. Participants reported re-using someone else’s injection equipment: 21% re-used a needle, 19% re-used water, and 37.3% re-used a cooker. The odds of sharing injection equipment were increased for food insecure individuals. Conclusions Findings show that IDUs have frequent and variable experiences of food insecurity and these experiences are strongly correlated with sharing of injection-related equipment. Such behaviours may increase the likelihood of HIV and HCV transmission in this population. Addressing food-related needs among IDUs is urgently needed.

  15. Children with Crohn's Disease Frequently Consume Select Food Additives.

    Lee, Dale; Swan, C Kaiulani; Suskind, David; Wahbeh, Ghassan; Vanamala, Jairam; Baldassano, Robert N; Leonard, Mary B; Lampe, Johanna W

    2018-06-04

    Certain food additives may promote the pathogenesis of Crohn's disease (CD), but thus far the evaluation of food additive exposures in humans has been limited. The objective of this study was to quantify food additive exposures in children with CD. In a trial for bone health in CD, children were followed over 24 months with evaluation of disease characteristics, dietary intake, and body composition. At baseline, participants completed three 24-h dietary recalls. Foods were categorized, and the ingredient list for each item was evaluated for the presence of select food additives: polysorbate-80, carboxymethylcellulose, xanthan gum, soy lecithin, titanium dioxide, carrageenan, maltodextrin, and aluminosilicates. The frequency of exposures to these food additives was described for study participants and for food categories. At study baseline, 138 participants, mean age 14.2 ± 2.8 years, 95% having inactive or mild disease, were enrolled and dietary recalls were collected. A total of 1325 unique foods were recorded. Mean exposures per day for xanthan gum was 0.96 ± 0.72, carrageenan 0.58 ± 0.63, maltodextrin 0.95 ± 0.77, and soy lecithin 0.90 ± 0.74. The other additives had less than 0.1 exposures per day. For the 8 examined food additives, participants were exposed to a mean (SD) of 3.6 ± 2.1 total additives per recall day and a mean (SD) of 2.4 ± 1.0 different additives per day. Children with CD frequently consume food additives, and the impact on disease course needs further study.

  16. A Case of Frequent Arousal Following Nocturnal Dyspnea Caused by Gastroesophageal Reflux Disease

    Dae Wui Yoon

    2013-06-01

    Full Text Available Gastroesophageal reflux disease (GERD is a common disorder that is associated with many esophageal syndromes and complications. Most cases of reflux event occur during the day, but reflux during sleep can cause not only esophageal problems, but also sleep problems, such as arousal and poor sleep quality. We report the case of a 17-year-old man who had been referred to us with frequent arousal following sudden dyspnea. On polysomnography, no respiratory disturbances and periodic limb movements were found during the sleep study, but frequent events of arousal were reported (arousal index: 12.3/h. On a 24-hr esophageal pH monitoring test, his DeMeester score was 176.43 and the total reflux time was 1120.9 min (76.9%, indicating the presence of significant acid reflux. After treatment with a proton-pump inhibitor, the arousals following nocturnal dyspnea and fatigue in the morning disappeared in the patient. GERD should be considered as a cause of spontaneous arousal or awakening not accompanying respiratory disturbances.

  17. Monitoring Active Volcanos Using Aerial Images and the Orthoview Tool

    Maria Marsella

    2014-12-01

    Full Text Available In volcanic areas, where it can be difficult to perform direct surveys, digital photogrammetry techniques are rarely adopted for routine volcano monitoring. Nevertheless, they have remarkable potentialities for observing active volcanic features (e.g., fissures, lava flows and the connected deformation processes. The ability to obtain accurate quantitative data of definite accuracy in short time spans makes digital photogrammetry a suitable method for controlling the evolution of rapidly changing large-area volcanic phenomena. The systematic acquisition of airborne photogrammetric datasets can be adopted for implementing a more effective procedure aimed at long-term volcano monitoring and hazard assessment. In addition, during the volcanic crisis, the frequent acquisition of oblique digital images from helicopter allows for quasi-real-time monitoring to support mitigation actions by civil protection. These images are commonly used to update existing maps through a photo-interpretation approach that provide data of unknown accuracy. This work presents a scientific tool (Orthoview that implements a straightforward photogrammetric approach to generate digital orthophotos from single-view oblique images provided that at least four Ground Control Points (GCP and current Digital Elevation Models (DEM are available. The influence of the view geometry, of sparse and not-signalized GCP and DEM inaccuracies is analyzed for evaluating the performance of the developed tool in comparison with other remote sensing techniques. Results obtained with datasets from Etna and Stromboli volcanoes demonstrate that 2D features measured on the produced orthophotos can reach sub-meter-level accuracy.

  18. FREQUENT SUBGRAPH MINING OF PERSONALIZED SIGNALING PATHWAY NETWORKS GROUPS PATIENTS WITH FREQUENTLY DYSREGULATED DISEASE PATHWAYS AND PREDICTS PROGNOSIS.

    Durmaz, Arda; Henderson, Tim A D; Brubaker, Douglas; Bebek, Gurkan

    2017-01-01

    Large scale genomics studies have generated comprehensive molecular characterization of numerous cancer types. Subtypes for many tumor types have been established; however, these classifications are based on molecular characteristics of a small gene sets with limited power to detect dysregulation at the patient level. We hypothesize that frequent graph mining of pathways to gather pathways functionally relevant to tumors can characterize tumor types and provide opportunities for personalized therapies. In this study we present an integrative omics approach to group patients based on their altered pathway characteristics and show prognostic differences within breast cancer (p network-based classifier algorithms and showed that our unsupervised approach generates more robust and biologically relevant clustering whereas previous approaches failed to report specific functions for similar patient groups or classify patients into prognostic groups. These results could serve as a means to improve prognosis for future cancer patients, and to provide opportunities for improved treatment options and personalized interventions. The proposed novel graph mining approach is able to integrate PPI networks with gene expression in a biologically sound approach and cluster patients in to clinically distinct groups. We have utilized breast cancer and glioblastoma multiforme datasets from microarray and RNA-Seq platforms and identified disease mechanisms differentiating samples. Supplementary methods, figures, tables and code are available at https://github.com/bebeklab/dysprog.

  19. Autonomous profiling device to monitor remote water bodies

    Madhan, R.; Dabholkar, N.A.; Navelkar, G.S.; Desa, E.; Afzulpurkar, S.; Mascarenhas, A.A.M.Q.; Prabhudesai, S.P.

    implications to human health, and requires frequent and effective monitoring, particularly during summer months (March–May) when water consumption is highest. These water bodies are frequently located in remote areas away from human habitation, making...

  20. Insomnia is a frequent finding in adults with Asperger syndrome

    von Wendt Lennart

    2003-10-01

    Full Text Available Abstract Background Asperger syndrome (AS is a neurodevelopmental disorder belonging to autism spectrum disorders with prevalence rate of 0,35% in school-age children. It has been most extensively studied in childhood while there is scarcity of reports concerning adulthood of AS subjects despite the lifelong nature of this syndrome. In children with Asperger syndrome the initiation and continuity of sleep is disturbed because of the neuropsychiatric deficits inherent of AS. It is probable that sleep difficulties are present in adulthood as well. Our hypothesis was that adults with AS suffer from difficulty in initiating and maintaining sleep and nonrestorative sleep (insomnia. Methods 20 AS without medication were compared with 10 healthy controls devoid of neuropsychiatric anamnesis. Clinical examination, blood test battery and head MRI excluded confounding somatic illnesses. Structured psychiatric interview for axis-I and axis-II disorders were given to both groups as well as Beck Depression Inventory and Wechsler adult intelligence scale, revised version. Sleep quality was assessed with sleep questionnaire, sleep diary during 6 consecutive days and description of possible sleep problems by the participants own words was requested. Results compared with controls and with normative values of good sleep, AS adults had frequent insomnia. In sleep questionnaire 90% (18/20, in sleep diary 75% (15/20 and in free description 85% (17/20 displayed insomnia. There was a substantial psychiatric comorbidity with only 4 AS subject devoid of other axis-I or axis-II disorders besides AS. Also these persons displayed insomnia. It can be noted that the distribution of psychiatric diagnoses in AS subjects was virtually similar to that found among patient with chronic insomnia. Conclusions the neuropsychiatric deficits inherent of AS predispose both to insomnia and to anxiety and mood disorders. Therefore a careful assessment of sleep quality should be an

  1. Radiation monitoring

    Larsson, L.Eh.; B'yuli, D.K.; Karmikel, Dzh.Kh.E.

    1985-01-01

    Recommendations on radiation monitoring of personnel, used medical ionizing radiation source, are given. The necessity to carry out radiation monitoring of situation at medical personnel's positions and personnel dosimetry is marked. It is convenient to subdivide radiation monitoring into 3 types: usual, surgical and special. Usual monitoring is connected with current work; surgical monitoring is carried out to receive information during a concrete operation; special monitoring is used to detect possible deviation from standard conditions of work or when suspecting them

  2. Analyzing Effectiveness of Routine Pleural Drainage After Nuss Procedure: A Randomized Study.

    Pawlak, Krystian; Gąsiorowski, Łukasz; Gabryel, Piotr; Smoliński, Szymon; Dyszkiewicz, Wojciech

    2017-12-01

    The routine use of postoperative pleural cavity drainage after the Nuss procedure is not widely accepted, and its limited use depends on experience. This study analyzed the influence of pleural drainage in the surgical treatment of patients with pectus excavatum on the prevention of pneumothorax and the efficacy of using drainage after a corrective operation. From November 2013 to May 2015, 103 consecutive patients with pectus excavatum, aged 11 to 39 years, underwent surgical treatment by the Nuss procedure. Patients were prospectively randomized into two groups. In 58 patients, a 28F chest tube was routinely introduced into the right pleural cavity during procedure for 2 consecutive days (group I). In the remaining 45 patients, the drain was not inserted (group II). No statistically significant differences were found between the study groups, including sex, age, body mass index, or clinical subjective and objective factors in the preoperative evaluation. Group II manifested more complications in the early postoperative period; however, this was not statistically significant (group I vs group II; p = 0.0725). Pneumothorax requiring additional chest tube placement was statistically significant (group I vs group II; p = 0.0230). Other complications were also more frequent among patients from group II, although this did not reach statistical significance. Follow up was 22.9 ± 6.4 months. Routine drainage of the pleural cavity during the Nuss procedure significantly reduces the incidence of postoperative pneumothorax and should be considered as a routine procedure. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Detection time for THC in oral fluid after frequent cannabis smoking.

    Andås, Hilde T; Krabseth, Hege-Merete; Enger, Asle; Marcussen, Bjarne N; Haneborg, An-Magritt; Christophersen, Asbjørg S; Vindenes, Vigdis; Øiestad, Elisabeth L

    2014-12-01

    The use of oral fluid for detecting drugs of abuse has become increasingly more frequent. Few studies have, however, investigated the detection times for drugs of abuse in oral fluid, compared with that of in urine or in blood. Cannabis is the world's most widely used drug of abuse, and the detection times for cannabis, in different types of matrixes, are therefore important information to the laboratories or institutions performing and evaluating drugs of abuse analyses. It is well known that frequent use of high dosages of cannabis, for longer periods of time, might lead to prolonged detection times for THC-COOH in urine. Cannabis intake is detected in oral fluid as THC, and a positive finding is considered to be a result of recent smoking, although some studies have already reported longer detection times. The aim of this study was to investigate the detection time for THC in oral fluid, collected from drug addicts admitted for detoxification. Findings in oral fluid were compared with findings in urine, among 26 patients admitted to a closed detoxification unit. The study, being the first in doing so, describes the concentration-time profiles for THC in oral fluid among chronic cannabis users, during monitored abstinence, using the Intercept collection kit. The study also includes the concentration-time profiles for creatinine-corrected THC-COOH ratios in urine samples, included to monitor for the possibility of new intakes. THC was detected in oral fluid collected from 11 of the 26 patients in the study. The elimination curves for THC in oral fluid revealed that negative samples could be interspersed among positive samples several days after cessation, whereas the THC-COOH concentrations in urine were decreasing. THC was, in this study, detected in oral fluid for up to 8 days after admission. The study shows that frequent use of high dosages of cannabis may lead to prolonged detection times, and that positive samples can be interspersed among negative samples

  4. Ordinary and partial differential equation routines in C, C++, Fortran, Java, Maple, and Matlab

    Lee, HJ

    2003-01-01

    This book provides a set of ODE/PDE integration routines in the six most widely used computer languages, enabling scientists and engineers to apply ODE/PDE analysis toward solving complex problems. This text concisely reviews integration algorithms and then analyzes the widely used Runge-Kutta method. It first presents a complete code before discussing its components in detail, focusing on integration concepts such as error monitoring and control. The format allows readers to understand the basics of ODE/PDE integration, and then calculate sample numerical solutions within the targeted program

  5. Verification and quality control of routine hematology analyzers

    Vis, J Y; Huisman, A

    2016-01-01

    Verification of hematology analyzers (automated blood cell counters) is mandatory before new hematology analyzers may be used in routine clinical care. The verification process consists of several items which comprise among others: precision, accuracy, comparability, carryover, background and

  6. ORGANIZATIONAL ROUTINES IN RUSSIAN COMPANIES: REVIEW OF PRACTICES

    Olga Valieva

    2014-10-01

    Full Text Available Results of the first stage of the researches conducted in 2012-2013 are presented in article. Researches are connected with studying of transformational processes intra corporate of managemetn practices in the Russian companies and their subsequent institutionalization. Preliminary results showed that in the companies there is a standard set of organizational routines which part are information, and administrative routines, routines of the power of the founder, genetic, institutional and development routines. During research statistically significant connection between types of organizational structures, the sizes of the organization, information processing and administrative practices is established. It is revealed as change of approaches to management of the organization can affect a corruption component.

  7. Pharmaceutical care and the use of routine diagnostic tools by ...

    Purpose: To evaluate the use of routine diagnostic tools among community pharmacists in Ibadan,. Nigeria. ... measurement, and tests for serum cholesterol, capillary .... Development .... Duweijua M, Dodoo A, Plange R. Quality Counseling on.

  8. Evaluation of Eigenvalue Routines for Large Scale Applications

    V.A. Tischler

    1994-01-01

    Full Text Available The NASA structural analysis (NASTRAN∗ program is one of the most extensively used engineering applications software in the world. It contains a wealth of matrix operations and numerical solution techniques, and they were used to construct efficient eigenvalue routines. The purpose of this article is to examine the current eigenvalue routines in NASTRAN and to make efficiency comparisons with a more recent implementation of the block Lanczos aLgorithm. This eigenvalue routine is now availabLe in several mathematics libraries as well as in severaL commerciaL versions of NASTRAN. In addition, the eRA Y library maintains a modified version of this routine on their network. Several example problems, with a varying number of degrees of freedom, were selected primarily for efficiency bench-marking. Accuracy is not an issue, because they all gave comparable results. The block Lanczos algorithm was found to be extremely efficient, particularly for very large problems.

  9. Routine hemoglobin electrophoresis for pediatric surgery day case ...

    2015-09-25

    Sep 25, 2015 ... 2016 Nigerian Journal of Clinical Practice | Published by Wolters Kluwer - Medknow ... surgery day case in at-risk populations: Suggested algorithm for screening .... HBE is a routine preoperative investigation before a surgical ...

  10. User's Manual: Routines for Radiative Heat Transfer and Thermometry

    Risch, Timothy K.

    2016-01-01

    Determining the intensity and spectral distribution of radiation emanating from a heated surface has applications in many areas of science and engineering. Areas of research in which the quantification of spectral radiation is used routinely include thermal radiation heat transfer, infrared signature analysis, and radiation thermometry. In the analysis of radiation, it is helpful to be able to predict the radiative intensity and the spectral distribution of the emitted energy. Presented in this report is a set of routines written in Microsoft Visual Basic for Applications (VBA) (Microsoft Corporation, Redmond, Washington) and incorporating functions specific to Microsoft Excel (Microsoft Corporation, Redmond, Washington) that are useful for predicting the radiative behavior of heated surfaces. These routines include functions for calculating quantities of primary importance to engineers and scientists. In addition, the routines also provide the capability to use such information to determine surface temperatures from spectral intensities and for calculating the sensitivity of the surface temperature measurements to unknowns in the input parameters.

  11. Use of WGS in Mycobacterium tuberculosis routine diagnosis

    Daniela M Cirillo

    2016-01-01

    Conclusion: WGS is a rapid, cost-effective technique that promises to integrate and replace the other tests in routine laboratories for an accurate diagnosis of DR-TB, although it is suitable nowadays for cultured samples only.

  12. The clinical value of daily routine chest radiographs in a mixed medical-surgical intensive care unit is low.

    Graat, Marleen E; Choi, Goda; Wolthuis, Esther K; Korevaar, Johanna C; Spronk, Peter E; Stoker, Jaap; Vroom, Margreeth B; Schultz, Marcus J

    2006-02-01

    The clinical value of daily routine chest radiographs (CXRs) in critically ill patients is unknown. We conducted this study to evaluate how frequently unexpected predefined major abnormalities are identified with daily routine CXRs, and how often these findings lead to a change in care for intensive care unit (ICU) patients. This was a prospective observational study conducted in a 28-bed, mixed medical-surgical ICU of a university hospital. Over a 5-month period, 2,457 daily routine CXRs were done in 754 consecutive ICU patients. The majority of these CXRs did not reveal any new predefined major finding. In only 5.8% of daily routine CXRs (14.3% of patients) was one or more new and unexpected abnormality encountered, including large atelectases (24 times in 20 patients), large infiltrates (23 in 22), severe pulmonary congestion (29 in 25), severe pleural effusion (13 in 13), pneumothorax/pneumomediastinum (14 in 13), and malposition of the orotracheal tube (32 in 26). Fewer than half of the CXRs with a new and unexpected finding were ultimately clinically relevant; in only 2.2% of all daily routine CXRs (6.4% of patients) did these radiologic abnormalities result in a change to therapy. Subgroup analysis revealed no differences between medical and surgical patients with regard to the incidence of new and unexpected findings on daily routine CXRs and the effect of new and unexpected CXR findings on daily care. In the ICU, daily routine CXRs seldom reveal unexpected, clinically relevant abnormalities, and they rarely prompt action. We propose that this diagnostic examination be abandoned in ICU patients.

  13. Cost of nursing most frequent procedures performed on severely burned patients

    Talita de Oliveira Melo

    Full Text Available ABSTRACT Objective: to identify the mean direct cost (MDC of the most frequent procedures performed by nursing professionals on severely burned patients in an Intensive Care Unit. Method: exploratory-descriptive quantitative single-case study. The MDC was calculated by multiplying time (timed spent by nursing professionals in the performance of the procedures by the unit cost of direct labor, and adding the costs of material and medicine/solutions. Results: a MDC of US$ 0.65 (SD=0.36 was obtained for "vital signs monitoring"; US$ 10.00 (SD=24.23 for "intravenous drug administration"; US$ 5.90 (SD=2.75 for "measurement of diuresis"; US$ 0.93 (SD=0.42 for "capillary blood glucose monitoring"; and US$ 99.75 (SD=129.55 for "bandaging". Conclusion: the knowledge developed can support managerial decision-making, contribute to the efficiency distribution of the resources involved and, when possible, provide cost-containment or cost-minimization strategies without impairing the quality of nursing care.

  14. Radioprotective shield - an adequate radioprotective device for routine stomatological radiodiagnosis

    Wiltschke, F [Ernst-Moritz-Arndt-Univ., Greifswald (German Democratic Republic); Taschner, P; Koenig, W; Menzel, B [Staatliches Amt fuer Atomsicherheit und Strahlenschutz, Berlin (German Democratic Republic)

    1975-01-01

    Starting from the shortcomings of the radioprotective devices at present used in routine stomatological radiodiagnosis, the authors describe the advantages of a radioprotective shield which has been produced in the Greifswald University Stomatological Clinic. On the basis of dosimetric studies, the National Board for Nuclear Safety and Radiological Protection of the GDR (Staatliches Amt fuer Atomsicherheit und Strahlenschutz der DDR) could demonstrate the suitability of this shield as a radioprotective device for routine stomatological radiodiagnosis.

  15. Equipment recommendations for uniform work places for routine stomatological radiodiagnosis

    Rother, U [Rostock Univ. (German Democratic Republic). Radiologische Klinik; Taschner, P [Staatliches Amt fuer Atomsicherheit und Strahlenschutz, Berlin (German Democratic Republic); Wiltschke, F; Tonne, E; Kuehling, U; Nenning, K

    1977-03-01

    Corresponding to the different objectives, the Working Group on Radiology of the Stomatological Society has designed 6 standardized work places for routine radiodiagnosis in stomatology. Apart from the objectives, the problems related to the division of rooms, equipment, radioprotection and film processing are dealt with separately and specifically. The work places for routine stomatological radiodiagnosis are intended for achieving an improvement in a sector of stomatological care.

  16. Novel structuring routines of titania films for application in photovoltaics

    Niedermeier, Martin A.

    2014-01-01

    Novel routines to structure titania thin films on various length scales are investigated regarding photovoltaic applications. The main focus of the investigations lies on the custom-tailoring of the morphologies of the titania films using sol-gel chemistry in combination with block copolymer templating. Additionally, a low-temperature routine for functional hybrid films as well as the growth of gold as electrode material on top of an organic hole-conductor are investigated. Im Hinblick auf...

  17. Non-routine activities in RP Group in 1995

    Hoefert, M.; Stevenson, G.R.

    1996-01-01

    The activities not directly concerned with the daily routine, but nevertheless essential to ensure a steady progress in radiation protection at CERN, concern mostly tests and intercomparisons of existing methods (quality control), development of new ideas, methods, and instruments. New projects, another non-routine activity, require in most cases profound studies to prove their feasibility with respect to radiation protection requirements. All these activities are documented in Divisional Reports, Internal Reports and Technical Memoranda, and are listed

  18. Cyclotrons, radionuclides, precursors, and demands for routine versus research compounds

    Wolf, A.P.

    1984-01-01

    Accelerators for producing commonly used short-lived positron emitters for positron emission tomography are addressed in the context of their use for the preparation of labeled compounds for research and routine biomedical applications. Progress and direction in the preparation and use of radiotracers for studies of the brain are discussed. Advancement to complete automation is stressed as an important factor for the eventual use of positron emission tomography as a routine clinical tool in universities and major medical centers

  19. IONEOS: a fast, analytic, ion equation-of-state routine

    Cranfill, C.W.; More, R.

    1978-10-01

    A routine IONEOS has been developed to compute ion pressure and specific energy along with their derivatives. The theoretical model used is due to R.D. Cowan and includes non-ideal-gas behavior. The routine is designed for use in large hydrodynamics codes as an improved procedure for splitting the total pressure and specific energy (which are usually tabulated) into ion and electron components

  20. Understanding teachers’ routines to inform classroom technology design

    An, P.; Bakker, S.; Eggen, J.H.

    2017-01-01

    Secondary school teachers have quite busy and complex routines in their classrooms. However, present classroom technologies usually require focused attention from teachers while being interacted with, which restricts their use in teachers’ daily routines. Peripheral interaction is a human-computer interaction style that aims to enable interaction to take place both in the center and periphery of users’ attention and naturally shift between the two. We believe that classroom technologies emplo...

  1. Adoption of routine telemedicine in Norway: the current picture

    Zanaboni, Paolo; Knarvik, Undine; Wootton, Richard

    2014-01-01

    Background Telemedicine appears to be ready for wider adoption. Although existing research evidence is useful, the adoption of routine telemedicine in healthcare systems has been slow. Objective We conducted a study to explore the current use of routine telemedicine in Norway, at national, regional, and local levels, to provide objective and up-to-date information and to estimate the potential for wider adoption of telemedicine. Design A top-down approach was used to collect official data on the national use of telemedicine from the Norwegian Patient Register. A bottom-up approach was used to collect complementary information on the routine use of telemedicine through a survey conducted at the five largest publicly funded hospitals. Results Results show that routine telemedicine has been adopted in all health regions in Norway and in 68% of hospitals. Despite being widely adopted, the current level of use of telemedicine is low compared to the number of face-to-face visits. Examples of routine telemedicine can be found in several clinical specialties. Most services connect different hospitals in secondary care, and they are mostly delivered as teleconsultations via videoconference. Conclusions Routine telemedicine in Norway has been widely adopted, probably for geographical reasons, as in other settings. However, the level of use of telemedicine in Norway is rather low, and it has significant potential for further development as an alternative to face-to-face outpatient visits. This study is a first attempt to map routine telemedicine at regional, institutional, and clinical levels, and it provides useful information to understand the adoption of telemedicine in routine healthcare and to measure change in future updates. PMID:24433942

  2. Monitoring in traumatic brain injury.

    Matz, P G; Pitts, L

    1997-01-01

    part of routine monitoring in TBI.

  3. Design of the FemCure study: prospective multicentre study on the transmission of genital and extra-genital Chlamydia trachomatis infections in women receiving routine care

    Dukers-Muijrers, Nicole H. T. M.; Wolffs, Petra F. G.; Eppings, Lisanne; Götz, Hannelore M.; Bruisten, Sylvia M.; Schim van der Loeff, Maarten F.; Janssen, Kevin; Lucchesi, Mayk; Heijman, Titia; van Benthem, Birgit H.; van Bergen, Jan E.; Morre, Servaas A.; Herbergs, Jos; Kok, Gerjo; Steenbakkers, Mieke; Hogewoning, Arjan A.; de Vries, Henry J.; Hoebe, Christian J. P. A.

    2016-01-01

    In women, anorectal infections with Chlamydia trachomatis (CT) are about as common as genital CT, yet the anorectal site remains largely untested in routine care. Anorectal CT frequently co-occurs with genital CT and may thus often be treated co-incidentally. Nevertheless, post-treatment detection

  4. Microbiological Standardization in Small Laboratory Animals and Recommendations for the Monitoring

    Meral Karaman

    2014-03-01

    Full Text Available Microbiological standardization in laboratory animal breeding is based on the classification according to the microorganisms that the animals host and consequently their upbringing environment, as well as the certification of their microbiological status and the protection of their properties. Although there are many different classifications for microbiological standardization of laboratory animals, they can be basically classified as; gnotobiotic animals, animals bred with a complete barrier system (Germ free, GF, with Colonization-Resistant Flora; CRF, animals bred with a partial barrier system (Specified Pathogen Free, SPF, and animals bred by conventional methods in units without barriers (Conventional; CV. Monitoring of microbiological standardization is carried out in two ways. One is controlling barrier systems (process control and the other is controlling laboratory animals (product control. In controlling barrier systems samples are taken routinely from ambient air, surfaces, base plate materials of animals, foods and waters, and microbiological tests are carried out. FELASA guidelines are frequently used in monitoring laboratory animals. These guidelines where the monitoring frequency, sample size, micro-organisms to be tested, vary according to the microbiological quality of the animals, and test methods and are frequently updated by FELASA and shared in their web pages. In our country, in general, laboratory animals used for experimental studies present no microbiological standardization, and follow-up protocols are not implemented. Therefore, construction of facilities for the production of microbiologically standard animals and establishment of backup laboratories testing microbiological quality should be established.

  5. ERMS - Environmental Radiation Monitoring System

    Vax, Eran; Sarusi, Benny; Sheinfeld, Mati; Levinson, Shmuel; Brandys, Irad; Sattinger, Danny; Wengrowicz, Udi; Tshuva, Avi; Tirosh, Dan

    2008-01-01

    A new Environmental Radiation Monitoring System (ERMS) has been developed in the NRCN as an extensive tool to be applied in case of nuclear malfunction or Nuclear Disposal Device (NDD) incident, as well as for routine radiation monitoring of the reactor's vicinity. The system collects real-time environmental data such as: gamma radiation, wind speed, wind direction, and temperature for monitoring purposes. The ERMS consists of a main Control Center and an array of monitoring stations. Fixed, environmental, gamma radiation monitoring stations are installed at the reactor's surroundings while portable stations can be posted rapidly along the wind direction, enhancing the spatial sampling of the radiation measurements and providing better hazard assessment at an emergency event. The presented ERMS, based on industrial standards for hardware and network protocols, is a reliable standalone system which upgrades the readiness to face a nuclear emergency event by supplying real-time, integrated meteorological and radiation data. (author)

  6. Special monitoring in nuclear medicine

    Beltran, C.C.; Puerta, J.A.; Morales, J.

    2006-01-01

    Colombia counts with around 56 centers of Nuclear Medicine, 70 Nuclear Doctors and more of 100 Technologists in this area. The radioisotopes more used are the 131 I and the 99m Tc. The radiological surveillance singular in the country is carried out for external dosimetry, being the surveillance by incorporation of radioactive materials very sporadic in our media. Given the necessity to implement monitoring programs in the incorporation of radionuclides of the occupationally exposed personnel, in the routine practice them routine of Nuclear Medicine, it was implemented a pilot program of Special Monitoring with two centers of importance in the city of Medellin. This program it was carried out with the purpose of educating, to stimulate and to establish a program of reference monitoring with base in the National Program of Monitoring in the radionuclides Incorporation that serves like base for its application at level of all the services of Nuclear Medicine in the country. This monitoring type was carried out with the purpose of obtaining information on the work routine in these centers, form of manipulation and dosage of the radionuclides, as well as the administration to the patient. The application of the program was carried out to define the frequency of Monitoring and analysis technique for the implementation of a program of routine monitoring, following the recommendations of the International Commission of Radiological Protection. For their application methods of activity evaluation were used in urine and in 7 workers thyroid, of those which only two deserve an analysis because they presented important activities. The measures were carried out during one month, every day by means in urine samples and to the most critic case is practiced two thyroid measures, one in the middle of the period and another when concluding the monitoring. To the other guy is practiced an activity count in thyroid when concluding the monitoring period. The obtained result of the

  7. CEMs turn monitoring giant

    White, J.R.

    1993-01-01

    Crucial to complying with environmental regulations is selecting appropriate pollution control equipment to capture or destroy regulated pollutants. But just as important is selecting a continuous emissions monitoring system (CEM). CEMs play a dual role in an overall compliance strategy. On one hand, they identify the type and quantity of emissions at a source as a first step for determining which regulatory requirements and control technologies are applicable. They also provide ongoing emissions data to demonstrate compliance with air and other environmental regulations. Facilities are required to monitor their processes with CEMs, or a comparable technology, under several titles of the Clean Air Act Amendments of 1990. CEMs meet regulatory requirements if they include a SO 2 concentration monitor, nitrogen oxides (NO x ) concentration monitor, volumetric flow monitor, opacity monitor, diluent gas monitor and data acquisition and handling system. The entire system and each subsystem has to be installed and certified before it can be used for compliance. A written quality assurance/quality control (QA/QC) plan for the CEMs must accompany the permit application. The acid rain rules also impose performance standards and frequent calibration checks to ensure the integrity of CEMs data

  8. Wide area monitoring study

    Wogman, N.A.; Holdren, G.R. Jr.

    1999-01-01

    Environmental sampling can be used to complement the safeguarding of nuclear material, especially in the detection of undeclared nuclear activities. Routine monitoring of nuclear installations has provided valuable information about the fate of key signature materials within different environmental settings. The approach collates information regarding the generation of individual radiochemical signatures within different nuclear processes, the potential for release of these signatures to the environment and, the chemical form and mobility of the signatures in environmental media along which the material could migrate. Meteorological, geological and hydrological information is used to determine where to sample, what to sample, and how often to sample to provide the greatest likelihood for detection. Multiple strategies can be used to implement wide area monitoring for safeguards purposes. The most complex, and expensive of these, involves establishing extensive networks of fixed location sampling sites. The sites would be operated continuously, and would be instrumented with automated sampling, analysis, and communication equipment to relay information regarding potential anomalies to control centers in near-real time. Alternative strategies can be used to supplement fixed location monitoring equipment, especially in regions that cannot support (financially or logistically) the fixed stations. Through combinations of these various strategies, using a variety of environmental media to monitor a region, we believe that a competent network, one with a quantifiable probability for detecting undeclared nuclear activities, can be designed. While this approach cannot and should not replace other inspection and monitoring activities, it can potentially contribute valuable information to an international safeguards system. (author)

  9. The patient perspective: Quality of life in advanced heart failure with frequent hospitalisations.

    Nieminen, Markku S; Dickstein, Kenneth; Fonseca, Cândida; Serrano, Jose Magaña; Parissis, John; Fedele, Francesco; Wikström, Gerhard; Agostoni, Piergiuseppe; Atar, Shaul; Baholli, Loant; Brito, Dulce; Colet, Josep Comín; Édes, István; Gómez Mesa, Juan E; Gorjup, Vojka; Garza, Eduardo Herrera; González Juanatey, José R; Karanovic, Nenad; Karavidas, Apostolos; Katsytadze, Igor; Kivikko, Matti; Matskeplishvili, Simon; Merkely, Béla; Morandi, Fabrizio; Novoa, Angel; Oliva, Fabrizio; Ostadal, Petr; Pereira-Barretto, Antonio; Pollesello, Piero; Rudiger, Alain; Schwinger, Robert H G; Wieser, Manfred; Yavelov, Igor; Zymliński, Robert

    2015-07-15

    End of life is an unfortunate but inevitable phase of the heart failure patients' journey. It is often preceded by a stage in the progression of heart failure defined as advanced heart failure, and characterised by poor quality of life and frequent hospitalisations. In clinical practice, the efficacy of treatments for advanced heart failure is often assessed by parameters such as clinical status, haemodynamics, neurohormonal status, and echo/MRI indices. From the patients' perspective, however, quality-of-life-related parameters, such as functional capacity, exercise performance, psychological status, and frequency of re-hospitalisations, are more significant. The effects of therapies and interventions on these parameters are, however, underrepresented in clinical trials targeted to assess advanced heart failure treatment efficacy, and data are overall scarce. This is possibly due to a non-universal definition of the quality-of-life-related endpoints, and to the difficult standardisation of the data collection. These uncertainties also lead to difficulties in handling trade-off decisions between quality of life and survival by patients, families and healthcare providers. A panel of 34 experts in the field of cardiology and intensive cardiac care from 21 countries around the world convened for reviewing the existing data on quality-of-life in patients with advanced heart failure, discussing and reaching a consensus on the validity and significance of quality-of-life assessment methods. Gaps in routine care and research, which should be addressed, were identified. Finally, published data on the effects of current i.v. vasoactive therapies such as inotropes, inodilators, and vasodilators on quality-of-life in advanced heart failure patients were analysed. Copyright © 2015. Published by Elsevier Ireland Ltd.

  10. Femoral head avascular necrosis: a frequently missed incidental finding on multidetector CT

    Barille, M.F.; Wu, Jim S.; McMahon, Colm J.

    2014-01-01

    Aim: To determine the incidence of missed femoral head avascular necrosis (AVN) on pelvic computed tomography (CT) performed for clinical indications other than assessment for AVN. Materials and methods: The study was a Health Insurance Portability and Accountability Act (HIPAA)-compliant retrospective study. The picture archiving and communication system (PACS) database was queried for patients with diagnosis of femoral head AVN on magnetic resonance imaging (MRI), who also underwent pelvic multidetector CT after or <30 days before the MRI examination. The MRI and CT images of 144 hips of 72 patients (39 patients with reported AVN on MRI and 33 age-matched controls; mean age = 60 years, 28 male, 44 female), were reviewed in consensus by two readers in a randomized, blinded manner. Using MRI-proven CT-visible AVN as a reference standard, the incidence of missed AVN on initial CT interpretation was determined. Results: Readers confirmed AVN in 33 patients on the MRI images. Nine hips with AVN underwent joint replacement of the affected joint(s) prior to subsequent CT and were excluded. Forty-three MRI-proven AVN cases in 28 patients (15 bilateral, 13 unilateral) were available for analysis. The study readers diagnosed 35/43 (81%) MRI-proven AVN cases in 22/28 (79%) patients. Four of the 35 (11%) cases of MRI-proven, CT-visible AVN were prospectively reported in 3/22 (14%) patients at initial clinical interpretation, with a miss rate of 89% per hip and 86% per patient. Conclusion: Multidetector CT has high accuracy for detection of AVN; however, this is frequently missed as an incidental finding (89% missed in the present study). Assessment for signs of femoral AVN should be part of routine search pattern in interpretation of pelvic CT

  11. Femoral head avascular necrosis: a frequently missed incidental finding on multidetector CT.

    Barille, M F; Wu, Jim S; McMahon, Colm J

    2014-03-01

    To determine the incidence of missed femoral head avascular necrosis (AVN) on pelvic computed tomography (CT) performed for clinical indications other than assessment for AVN. The study was a Health Insurance Portability and Accountability Act (HIPAA)-compliant retrospective study. The picture archiving and communication system (PACS) database was queried for patients with diagnosis of femoral head AVN on magnetic resonance imaging (MRI), who also underwent pelvic multidetector CT after or AVN on MRI and 33 age-matched controls; mean age = 60 years, 28 male, 44 female), were reviewed in consensus by two readers in a randomized, blinded manner. Using MRI-proven CT-visible AVN as a reference standard, the incidence of missed AVN on initial CT interpretation was determined. Readers confirmed AVN in 33 patients on the MRI images. Nine hips with AVN underwent joint replacement of the affected joint(s) prior to subsequent CT and were excluded. Forty-three MRI-proven AVN cases in 28 patients (15 bilateral, 13 unilateral) were available for analysis. The study readers diagnosed 35/43 (81%) MRI-proven AVN cases in 22/28 (79%) patients. Four of the 35 (11%) cases of MRI-proven, CT-visible AVN were prospectively reported in 3/22 (14%) patients at initial clinical interpretation, with a miss rate of 89% per hip and 86% per patient. Multidetector CT has high accuracy for detection of AVN; however, this is frequently missed as an incidental finding (89% missed in the present study). Assessment for signs of femoral AVN should be part of routine search pattern in interpretation of pelvic CT. Copyright © 2013 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  12. Evaluation of work routines in PET/CT service with and individual tool in real time

    Moreira, Maryana N.; Oliveira, Fernanda R. de; Fischer, Andreia C.F.S.; Bacelar, Alexandre

    2016-01-01

    This study used a direct monitoring system (RemoteDose) that presents the individual dose and dose rate measurements, plotted instantly, as a tool to evaluate work routines of Individuals Occupationally Exposed (IOE) of a PET/CT Service. With this evaluation was possible to identify the critical tasks performed by each work team (Pharmaceutical/Nursing/Radiology Technician team) for subsequent optimization of patient care processes. It was also possible to assess whether these tasks are properly distributed among this teams. The RemoteDose system proved to be able to assist the optimization of radiation protection of a PET/CT Service, proving to be an important ally of the Radiation Protection Supervisor in this process, since it allows the display of real-time monitoring. (author)

  13. Very poor agreement between routine outpatient clinic office and ambulatory blood pressure: time to improve an old hospital outpatient clinic routine?

    Reinhard, Mark; Poulsen, Per L; Christensen, Kent L

    2016-12-01

    We investigated the agreement between elevated outpatient clinic office blood pressure (OC-OBP) as measured in the daily routine in our University Hospital Cardiology Outpatient Clinic and subsequent awake ambulatory blood pressure (AABP). In all patients referred for ambulatory blood pressure monitoring from our Cardiology Outpatient Clinic, we identified OC-OBP and changes in medication in the period from 1 January 2014 to 15 September 2015. The AABP was used as a reference measurement for the OC-OBP. A total of 183 patients were included in the study. Their mean age was 62.1±14.0 years and 49% were women. The mean systolic OC-OBP was 166.8±17.9 mmHg and the difference between the mean systolic OC-OBP and AABP was 28.0±19.5 mmHg (Pclinic agrees poorly with AABP and may lead to unnecessary treatment and pharmacologically induced symptomatic hypotension, particularly in elderly patients. The results of this study urgently call for alternative solutions to routine OC-OBP in hospital outpatient clinics.

  14. Remote monitoring demonstration

    Caskey, Susan; Olsen, John

    2006-01-01

    The recently upgraded remote monitoring system at the Joyo Experimental Reactor uses a DCM-14 camera module and GEMINI software. The final data is compatible both with the IAEA-approved GARS review software and the ALIS software that was used for this demonstration. Features of the remote monitoring upgrade emphasized compatibility with IAEA practice. This presentation gives particular attention to the selection process for meeting network security considerations at the O'arai site. The Joyo system is different from the NNCA's ACPF system, in that it emphasizes use of IAEA standard camera technology and data acquisition and transmission software. In the demonstration itself, a temporary virtual private network (VPN) between the meeting room and the server at Sandia in Albuquerque allowed attendees to observe data stored from routine transmissions from the Joyo Fresh Fuel Storage to Sandia. Image files from a fuel movement earlier in the month showed Joyo workers and IAEA inspectors carrying out a transfer. (author)

  15. Functional connectivity experiments reflect routine movement behavior of a tropical hummingbird species.

    Volpe, Noelia L; Hadley, Adam S; Robinson, W Douglas; Betts, Matthew G

    Translocation experiments, in which researchers displace animals and then monitor their movements to return home, are commonly used as tools to assess functional connectivity of fragmented landscapes. Such experiments are purported to have important advantages of being time efficient and of standardizing “motivation” to move across individuals. Yet, we lack tests of whether movement behavior of translocated birds reflects natural behavior of unmanipulated birds. We compared the routine movement behavior of a tropical hummingbird, the Green Hermit (Phaethornis guy), to that of experimentally translocated individuals. We tested for differences in site selection patterns during movement at two spatial scales (point and path levels). We also compared movement rates between treatments. Behaviors documented during translocation experiments reflected those observed during routine movements. At the point level, both translocated and non-translocated birds showed similar levels of preference for mature tropical forest. At the path level, step selection functions showed both translocated and non-translocated hummingbirds avoiding movement across non-forested matrix and selecting streams as movement corridors. Movement rates were generally higher during translocation experiments. However, the negative influence of forest cover on movement rates was proportionately similar in translocation and routine movement treatments. We report the first evidence showing that movement behavior of birds during translocation experiments is similar to their natural movement behavior. Therefore, translocation experiments may be reliable tools to address effects of landscape structure on animal movement. We observed consistent selection of landscape elements between translocated and non-translocated birds, indicating that both routine and translocation movement studies lead to similar conclusions regarding the effect of landscape structure and forest composition on functional connectivity

  16. Cyclophosphamide administration routine in autoimmune rheumatic diseases: a review

    Kaian Amorim Teles

    Full Text Available Abstract Cyclophosphamide is an alkylating agent widely used for the treatment of malignant neoplasia and which can be used in the treatment of multiple rheumatic diseases. Medication administration errors may lead to its reduced efficacy or increased drug toxicity. Many errors occur in the administration of injectable drugs. The present study aimed at structuring a routine for cyclophosphamide use, as well as creating a document with pharmacotherapeutic guidelines for the patient. The routine is schematized in three phases: pre-chemotherapy, administration of cyclophosphamide, and post-chemotherapy, taking into account the drugs to be administered before and after cyclophosphamide in order to prevent adverse effects, including nausea and hemorrhagic cystitis. Adverse reactions can alter laboratory tests; thus, this routine included clinical management for changes in white blood cells, platelets, neutrophils, and sodium, including cyclophosphamide dose adjustment in the case of kidney disease. Cyclophosphamide is responsible for other rare - but serious - side effects, for instance, hepatotoxicity, severe hyponatremia and heart failure. Other adverse reactions include hair loss, amenorrhea and menopause. In this routine, we also entered guidelines to post-chemotherapy patients. The compatibility of injectable drugs with the vehicle used has been described, as well as stability and infusion times. The routine aimed at the rational use of cyclophosphamide, with prevention of adverse events and relapse episodes, factors that may burden the health care system.

  17. Improving Automation Routines for Automatic Heating Load Detection in Buildings

    Stephen Timlin

    2012-11-01

    Full Text Available Energy managers use weather compensation data and heating system cut off routines to reduce heating energy consumption in buildings and improve user comfort. These routines are traditionally based on the calculation of an estimated building load that is inferred from the external dry bulb temperature at any point in time. While this method does reduce heating energy consumption and accidental overheating, it can be inaccurate under some weather conditions and therefore has limited effectiveness. There remains considerable scope to improve on the accuracy and relevance of the traditional method by expanding the calculations used to include a larger range of environmental metrics. It is proposed that weather compensation and automatic shut off routines that are commonly used could be improved notably with little additional cost by the inclusion of additional weather metrics. This paper examines the theoretical relationship between various external metrics and building heating loads. Results of the application of an advanced routine to a recently constructed building are examined, and estimates are made of the potential savings that can be achieved through the use of the routines proposed.

  18. Experimental evaluation of the exposure level onboard Czech Airlines aircraft - measurements verified the routine method

    Ploc, O.; Spurny, F.; Turek, K.; Kovar, I.

    2008-01-01

    Air-crew members are exposed to ionizing radiation due to their work on board of air-crafts. The International Commission on Radiological Protection (ICRP) in 1990 recommends that exposure to cosmic radiation in the operation of jet aircraft should be recognised as occupational exposure. Czech air transport operators are therefore obliged to ensure: - Air-crew members to be well informed about the exposure level and health risks; - An analysis of complete exposure level of aircraft crew and its continuing monitoring in cases of exceeding the informative value 1 mSv; - A compliance of limit 1 mSv during pregnancy Since 1998, after receiving a proper accreditation, the Department of Radiation Dosimetry of Nuclear Physics Institute of Czech Academy of Sciences (DRD) is the competent dosimetric service realized requirements of Notice No.307 of the State Office for Nuclear Safety concerning air-crew exposure (paragraphs 87-90). The DRD has developed routine method of personal dosimetry of aircraft crew in 1998 which has been applied after receiving a proper accreditation in the same year. DRD therefore helps Czech airlines a.s. (CSA) with their legislative obligations mentioned above, and in return, once per four years, in terms of business contract, CSA allows scientific measurements performed by DRD onboard its air-crafts with the aim to verify the method of routine individual monitoring of aircraft crew exposure. (authors)

  19. Environmental monitoring program to NUCLEMON deposits in Botuxim - Itu

    1980-01-01

    An Environmental monitoring program to be executed in routine as caution against a possible contamination in adjacents regions of Radioactive Materials deposits sites of Santo Amaro (USAM)/NUCLEMON is presented. (author) [pt

  20. Mining Frequent Item Sets in Asynchronous Transactional Data Streams over Time Sensitive Sliding Windows Model

    Javaid, Q.; Memon, F.; Talpur, S.; Arif, M.; Awan, M.D.

    2016-01-01

    EPs (Extracting Frequent Patterns) from the continuous transactional data streams is a challenging and critical task in some of the applications, such as web mining, data analysis and retail market, prediction and network monitoring, or analysis of stock market exchange data. Many algorithms have been developed previously for mining FPs (Frequent Patterns) from a data stream. Such algorithms are currently highly required to develop new solutions and approaches to the precise handling of data streams. New techniques, solutions, or approaches are developed to address unbounded, ordered, and continuous sequences of data and for the generation of data at a rapid speed from data streams. Hence, extracting FPs using fresh or recent data involves the high-level analysis of data streams. We have suggested an efficient technique for the window sliding model; this technique extracts new and fresh FPs from high-speed data streams. In this study, a CPILT (Compacted Tree Compact Pattern Tree) is developed to capture the latest contents in the stream and to efficiently remove outdated contents from the data stream. The main concept introduced in this work on CPILT is the dynamic restructuring of a tree, which is helpful in producing a compacted tree and the frequency descending structure of a tree on runtime. With the help of the mining technique of FP growth, a complete list of new and fresh FPs is obtained from a CPILT using an existing window. The memory usage and time complexity of the latest FPs in high-speed data streams can efficiently be determined through proper experimentation and analysis. (author)

  1. Cannabis withdrawal in chronic, frequent cannabis smokers during sustained abstinence within a closed residential environment.

    Lee, Dayong; Schroeder, Jennifer R; Karschner, Erin L; Goodwin, Robert S; Hirvonen, Jussi; Gorelick, David A; Huestis, Marilyn A

    2014-01-01

    Chronic, frequent cannabis smokers may experience residual and offset effects, withdrawal, and craving when abstaining from the drug. We characterized the prevalence, duration, and intensity of these effects in chronic frequent cannabis smokers during abstinence on a closed research unit. Non-treatment-seeking participants (N = 29 on admission, 66% and 34% remaining after 2 and 4 weeks) provided subjective effects data. A battery of five instruments was computer-administered daily to measure psychological, sensory, and physical symptoms associated with cannabinoid intoxication and withdrawal. Plasma and oral fluid specimens were concurrently collected and analyzed for cannabinoids. Outcome variables were evaluated as change from admission (Day 0) with regression models. Most abstinence effects, including irritability and anxiety were greatest on Days 0-3 and decreased thereafter. Cannabis craving significantly decreased over time, whereas decreased appetite began to normalize on Day 4. Strange dreams and difficulty getting to sleep increased over time, suggesting intrinsic sleep problems in chronic cannabis smokers. Symptoms likely induced by residual drug effects were at maximum intensity on admission and positively correlated with plasma and oral fluid cannabinoid concentrations on admission but not afterward; these symptoms showed overall prevalence higher than cannabis withdrawal symptoms. The combined influence of residual/offset drug effects, withdrawal, and craving was observed in chronic cannabis smokers during monitored abstinence. Abstinence symptoms were generally more intense in the initial phase, implying importance of early intervention in cannabis quit attempts. Sleep disturbance persisting for an extended period suggests that hypnotic medications could be beneficial in treating cannabis dependence. © American Academy of Addiction Psychiatry.

  2. Older adults' personal routine at time of hospitalization.

    Zisberg, Anna; Gur-Yaish, Nurit

    This study is the first to explore whether hospitalization disrupts the daily routines of dependent and independent older adults. Data were collected as part of a prospectively designed study from 330 hospitalized older adults age 70+. Patients reported prehospitalization frequency, duration, and timing of basic activities of daily living and leisure activities at hospital admission. Hospital routine was assessed on day of discharge. Results indicated that frequency and duration of most basic activities decreased during hospitalization; the sharpest decrease was in frequency of getting dressed. Showering occurred 2 h earlier in the hospital setting, and getting dressed occurred an hour and a half later. For dependent respondents, the greatest change was in duration; for independent respondents, the greatest change was in frequency. Given the importance of routine maintenance to health and well-being, understanding the dynamics of its disruption in the hospital setting is imperative. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Master schedule for CY-1982 Hanford environmental surveillance routine program

    Blumer, P.J.; Sula, M.J.; Eddy, P.A.

    1981-12-01

    This report provides the current schedule of data collection for the routine environmental surveillance program at the Hanford Site. The environmental surveillance program objectives are to evaluate and report the levels of radioactive and nonradioactive pollutants in the Hanford environs, as required in DOE Order 5484.1. The routine sampling schedule provided does not include samples which are planned to be collected during FY-1982 in support of special studies or for quality control purposes. In addition, the routine program outlined in this schedule is subject to modification during the year in response to changes in Site operations, program requirements, or unusual sample results. Sampling schedules are presented for the following: air; Columbia River; sanitary water; surface water; ground water; foodstuffs; wildlife; soil and vegetation; external radiation measurements; portable instrument surveys; and surveillance of waste disposal sites

  4. Pulse processing routines for neutron time-of-flight data

    Žugec, P; Guerrero, C; Gunsing, F; Vlachoudis, V; Sabate-Gilarte, M; Stamatopoulos, A; Wright, T; Lerendegui-Marco, J; Mingrone, F; Ryan, J A; Warren, S G; Tsinganis, A; Barbagallo, M

    2016-01-01

    A pulse shape analysis framework is described, which was developed for n_TOF-Phase3, the third phase in the operation of the n_TOF facility at CERN. The most notable feature of this new framework is the adoption of generic pulse shape analysis routines, characterized by a minimal number of explicit assumptions about the nature of pulses. The aim of these routines is to be applicable to a wide variety of detectors, thus facilitating the introduction of the new detectors or types of detectors into the analysis framework. The operational details of the routines are suited to the specific requirements of particular detectors by adjusting the set of external input parameters. Pulse recognition, baseline calculation and the pulse shape fitting procedure are described. Special emphasis is put on their computational efficiency, since the most basic implementations of these conceptually simple methods are often computationally inefficient.

  5. Columbia River water quality monitoring

    Anon.

    1983-01-01

    Waste water from Hanford activities is discharged at eight points along the Hanford reach of the Columbia River. These discharges consist of backwash water from water intake screens, cooling water, river bank springs, water storage tank overflow, and fish laboratory waste water. Each discharge point is identified in an existing National Pollutant Discharge Elimination System (NPDES) permit issued by the EPA. Effluents from each of these outfalls are routinely monitored and reported by the operating contractors as required by their NPDES permits. Measurements of several Columbia River water quality parameters were conducted routinely during 1982 both upstream and downstream of the Hanford Site to monitor any effects on the river that may be attributable to Hanford discharges and to determine compliance with the Class A designation requirements. The measurements indicated that Hanford operations had a minimal, if any, impact on the quality of the Columbia River water

  6. Establishing a National Maternal Morbidity Outcome Indicator in England: A Population-Based Study Using Routine Hospital Data.

    Manisha Nair

    Full Text Available As maternal deaths become rarer, monitoring near-miss or severe maternal morbidity becomes important as a tool to measure changes in care quality. Many calls have been made to use routinely available hospital administration data to monitor the quality of maternity care. We investigated 1 the feasibility of developing an English Maternal Morbidity Outcome Indicator (EMMOI by reproducing an Australian indicator using routinely available hospital data, 2 the impact of modifications to the indicator to address potential data quality issues, 3 the reliability of the indicator.We used data from 6,389,066 women giving birth in England from April 2003 to March 2013 available in the Hospital Episode Statistics (HES database of the Health and Social care Information centre (HSCIC. A composite indicator, EMMOI, was generated from the diagnoses and procedure codes. Rates of individual morbid events included in the EMMOI were compared with the rates in the UK reported by population-based studies.EMMOI included 26 morbid events (17 diagnosis and 9 procedures. Selection of the individual morbid events was guided by the Australian indicator and published literature for conditions associated with maternal morbidity and mortality in the UK, but was mainly driven by the quality of the routine hospital data. Comparing the rates of individual morbid events of the indicator with figures from population-based studies showed that the possibility of false positive and false negative cases cannot be ruled out.While routine English hospital data can be used to generate a composite indicator to monitor trends in maternal morbidity during childbirth, the quality and reliability of this monitoring indicator depends on the quality of the hospital data, which is currently inadequate.

  7. Legal provisions governing gaseous effluents radiological monitoring

    Winkelmann, I.

    1985-01-01

    This contribution explains the main provisions governing radiological monitoring of gaseous effluents from LWR type nuclear power plants. KTA rule 1503.1 defines the measuring methods and tasks to be fulfilled by reactor operators in order to safeguard due monitoring and accounting of radioactive substances in the plants' gaseous effluents. The routine measurements are checked by a supervisory programme by an independent expert. The routine controls include analysis of filter samples, comparative measurement of radioactive noble gases, interlaboratory comparisons, and comparative evaluation of measured values. (DG) [de

  8. Cost-effectiveness of duloxetine versus routine treatment for U.S. patients with diabetic peripheral neuropathic pain.

    Wu, Eric Q; Birnbaum, Howard G; Mareva, Milena N; Le, T Kim; Robinson, Rebecca L; Rosen, Amy; Gelwicks, Steve

    2006-06-01

    The purpose of this study was to compare the cost-effectiveness of duloxetine versus routine treatment in management of diabetic peripheral neuropathic pain (DPNP). Two hundred thirty-three patients with DPNP who completed a 12-week, double-blind, placebo-controlled, randomized, multicenter duloxetine trial were re-randomized into a 52-week, open-label trial of duloxetine 60 mg twice daily versus routine treatment. Routine treatment included pain management therapies. Effectiveness was measured by using the bodily pain domain (BP) of the Medical Outcomes Study Short Form 36 (SF-36). Costs were analyzed from 3 perspectives: third party payer (direct medical costs), employer (direct and indirect medical costs), and societal (patient's out-of-pocket costs and total medical costs). Costs of study medications were not included because of limited data. Bootstrap method was applied to calculate statistical inference of the incremental cost-effectiveness ratio (ICER). Routine treatment most frequently used included gabapentin (56%), venlafaxine (36%), and amitripytline (15%). From employer and societal perspectives, duloxetine was cost-effective (ICER= -342 dollars and -429 dollars, respectively, per unit of SF-36 BP; both P routine DPNP treatment (both P < .05). From payer perspective, duloxetine trended toward cost-effectiveness (ICER= -249 dollars per unit of SF-36 BP; P routine treatment in management of DPNP.

  9. Monitoring of Individual Needs in Diabetes (MIND)-2

    Snoek, Frank J; Kersch, Nancy Y A; Eldrup, Ebbe

    2012-01-01

    To test the effects of implementing computer-assisted Monitoring of Individual Needs in Diabetes (MIND) in routine diabetes care on psychological status and glycemic control, identify predictors of poor psychological outcomes, and evaluate care providers' experiences.......To test the effects of implementing computer-assisted Monitoring of Individual Needs in Diabetes (MIND) in routine diabetes care on psychological status and glycemic control, identify predictors of poor psychological outcomes, and evaluate care providers' experiences....

  10. Teaching Early Readers to Self-Monitor and Self-Correct

    Pratt, Sharon M.; Urbanowski, Melena

    2016-01-01

    Proficient readers self-monitor and self-correct to derive meaning from text. This article reviews research on how students learn to self-monitor and self-correct and describes a Reciprocal Teaching (RT) instructional routine that was successfully used with early readers to build their metacognitive processes. The RT routine included teacher…

  11. Marshalling embedded routines in support of firm creation

    Houman Andersen, Poul; Norus, Jesper

    2003-01-01

    The paper has a dual purpose. First, we suggest that entrepreneurs in their establishment of new businesses draw on a range of pre-existing socially embedded routines for creating acceptance by their environment. Also they draw upon external resources that are used in patterning specific practices....... This ability is treated as entrepreneurial assets. Secondly, we argue that the existence and patterning of these socially embedded routines used in new business development are contingent on the institutional context. We see the institutional context as complex and fragmented, composed and shaped by different...

  12. The Emergence of Routines: Entrepreneurship, Organization, and Business History

    Lubinski, Christina

    2018-01-01

    Book review of: The Emergence of Routines: Entrepreneurship, Organization, and Business History. Edited by Daniel M. G. Raff and Philip Scranton. Oxford: Oxford University Press, 2017. xii + 358 pp. Figures, notes, index. Cloth, $90.00. ISBN: 978-0-19-878776-1.......Book review of: The Emergence of Routines: Entrepreneurship, Organization, and Business History. Edited by Daniel M. G. Raff and Philip Scranton. Oxford: Oxford University Press, 2017. xii + 358 pp. Figures, notes, index. Cloth, $90.00. ISBN: 978-0-19-878776-1....

  13. Linking child travel routes and routine health data

    Amy Mizen

    2017-04-01

    Depending on modelled accuracy, a GIS and data linkage approach may allow the investigation of natural experiments and intervention evaluation at the scale of the total population. This is the first step towards anonymously modelling part of the daily exposure environment using routine data. A limitation is the lack of routinely collected BMI data for older children and teenagers an age when they are more likely to have the option to choose to buy food on the school route. This work will have many potential applications, including the delivery and evaluation of multiple school and workplace commuting interventions.

  14. Interest Rate Demands and Television Viewing-Is a Single Exposure More Influential Than Routine Viewing?

    Hetsroni, Amir; Reizer, Abira; Ben Zion, Uri

    2017-04-01

    This study examined the impact of media consumption, and particularly exposure to television, on decisions regarding interest rate demands. One hundred and fifty-four participants were randomly divided into two groups: in the manipulation group, participants were exposed to a news clip about an Iranian nuclear attack on Israel, whereas in the control group, the participants were not exposed to the film. Both groups filled a questionnaires regarding their interest rate requirements in different situations, their media conception behaviors, and demographic questionnaires. Frequent routine viewing increased the interest rate demands only among participants in the manipulation group, but the manipulation itself did not have a significant effect on interest rate demands. The results are explained in terms of cultivation theory.

  15. Building a Conceptual Model of Routines, Capabilities, and Absorptive Capacity Interplay

    Ivan Stefanovic

    2014-05-01

    Full Text Available Researchers have often used constructs such as routines, operational capability, dynamic capability, absorptive capacity, etc., to explain various organizational phenomena, especially a competitive advantage of firms. As a consequence of their frequent use in different contexts, these constructs have become extremely broad and blurred, thus making a void in strategic management literature. In this paper we attempt to bring a sense of holistic perspective on these constructs by briefly reviewing the current state of the research and presenting a conceptual model that provides an explanation for the causal relationships between them. The final section of the paper sheds some light on this topic from the econophysics perspective. Authors hope that findings in this paper may serve as a foundation for other research endeavours related to the topic of how firms achieve competitive advantage and thrive in their environments.

  16. Mobile environmental radiation monitoring station

    Assido, H.; Shemesh, Y.; Mazor, T.; Tal, N.; Barak, D.

    1997-01-01

    A mobile environmental radiation monitoring station has been developed and established for the Israeli Ministry of Environment. The radiation monitoring station is ready for immediate placing in any required location, or can be operated from a vehicle. The station collects data Tom the detector and transfers it via cellular communication network to a Computerized Control Center for data storage, processing, and display . The mobile station is fully controlled from the. Routinely, the mobile station responses to the data request accumulated since the last communication session. In case of fault or alarm condition in the mobile station, a local claim is activated and immediately initiates communication with the via cellular communication network. (authors)

  17. Frequent IgE sensitization to latex, cow's milk, and egg in children with short bowel syndrome.

    Mazon, Angel; Solera, Eva; Alentado, Noemi; Oliver, Fernando; Pamies, Rafael; Caballero, Luis; Nieto, Antonio; Dalmau, Jaime

    2008-03-01

    Children with short bowel syndrome (SBS) undergo frequent operations, so they are at risk for sensitizing to latex. There have been isolated reports of sensitization to food in these children. In a cross-sectional study, we assessed sensitization to latex, cow's milk, and egg with skin prick tests (SPT) and serum-specific immunoglobulin E (IgE) in 14 children with SBS. Data were collected about the number of operations with latex devices, serum total IgE, and history of feeding with milk formula. Ten children were sensitized to latex (specific IgE median: 6.7 kU/l, range: 0.5-33). Compared with those non-sensitized, sensitized children had significantly (p range: 0.5-21.1 kU/l), and five to egg (specific IgE median: 0.68, range: 0.58-2.17 kU/l). Except for some isolated days with cow's milk formula, the children had been initially fed with a diet without intact cow's milk proteins. Sensitization to latex, cow's milk, and egg is very frequent in children with SBS. They should be treated in a latex-free environment since the very early stages of the disease, and should be routinely studied regarding food sensitization, as this might contribute as an added factor in the chronic diarrhea of these patients.

  18. Improved quality of patient care through routine second review of histopathology specimens prior to multidisciplinary meetings.

    Kuijpers, Chantal C H J; Burger, Gerard; Al-Janabi, Shaimaa; Willems, Stefan M; van Diest, Paul J; Jiwa, Mehdi

    2016-10-01

    Double reading may be a valuable tool for improving quality of patient care by identifying diagnostic errors before final sign-out, but standard double reading would significantly increase costs of pathology. We assessed the added value of intradepartmental routine double reading of histopathology specimens prior to multidisciplinary meetings. Diagnoses, treatment plans and prognoses of patients are often discussed at multidisciplinary meetings. As part of the daily routine, all pathology specimens to be discussed at upcoming multidisciplinary meetings undergo prior intradepartmental double reading. We identified all histopathology specimens from 2013 that underwent such double reading and determined major and minor discordance rates based on clinical relevance between the initial and consensus sign-out diagnoses. We included 6796 histopathology specimens that underwent double reading, representing approximately 8% of all histopathology cases at our institution in 2013. Double reading diagnoses were concordant in 6566 specimens (96.6%). Major and minor discordances were observed in 60 (0.9%) and 170 (2.5%) specimens, respectively. Urology specimens had significantly more discordances than other tissues of origin, Gleason grading of prostate cancer biopsies being the most frequent diagnostic problem. Furthermore, premalignant and malignant cases showed significantly higher discordance rates than the rest. The vast majority (90%) of discordances represented changes within the same diagnostic category (eg, malignant to malignant). Routine double reading of histopathology specimens prior to multidisciplinary meetings prevents diagnostic errors. It resulted in about 1% discordant diagnoses of potential clinical significance, indicating that second review is worthwhile in terms of patient safety and quality of patient care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. Venous variants and anomalies on routine abdominal multi-detector row CT

    Koc, Zafer; Ulusan, Serife; Oguzkurt, Levent; Tokmak, Naime

    2007-01-01

    Objective: This study aims to determine the types and prevalence rates of anatomic variations of the hepatic veins, portal vein, inferior vena cava and renal veins, and to establish statistical correlations between various anomalies and frequency differences between male and female using multi-detector row computed tomography (CT). Materials and methods: One thousand one hundred and twenty patients (588 men, 532 women) were evaluated with routine abdominal CT. Frequencies of different variants were noted and compared, and correlations between three categories of variation were tested. Results: In total, 1261 abdominal vein variants and anomalies were identified in 756 (67.5%) of 1120 patients. Six hundred and forty-two hepatic vein variants were detected in 468 (41.8%) patients. One or more inferior right hepatic veins were identified in 356 (31.8%) individuals, and tributary hepatic veins were detected in 147 (13.1%) patients. Portal vein variations and anomalies were observed in 307 (27.4%) cases. The most frequent of these was trifurcation (139 patients, 12.4%). A total of 311 inferior vena cava and renal vein variants were identified in 258 (23%) cases. Six patients (0.5%) exhibited inferior vena cava anomalies, 62 (5.5%) had circumaortic renal veins, 53 (4.7%) had retroaortic renal veins, and 210 (18.8%) had multiple renal veins. Conclusion: The prevalence of abdominal vein variations is high, and routine abdominal CT demonstrates these abnormalities very well. The data suggest that hepatic vein variants and multiple right renal veins are more frequent in women than in men, and that hepatic vein variation is correlated with portal vein variation

  20. Venous variants and anomalies on routine abdominal multi-detector row CT

    Koc, Zafer [Baskent University, School of Medicine, Department of Radiology, Adana (Turkey)]. E-mail: koczafer@gmail.com; Ulusan, Serife [Baskent University, School of Medicine, Department of Radiology, Adana (Turkey); Oguzkurt, Levent [Baskent University, School of Medicine, Department of Radiology, Adana (Turkey); Tokmak, Naime [Baskent University, School of Medicine, Department of Radiology, Adana (Turkey)

    2007-02-15

    Objective: This study aims to determine the types and prevalence rates of anatomic variations of the hepatic veins, portal vein, inferior vena cava and renal veins, and to establish statistical correlations between various anomalies and frequency differences between male and female using multi-detector row computed tomography (CT). Materials and methods: One thousand one hundred and twenty patients (588 men, 532 women) were evaluated with routine abdominal CT. Frequencies of different variants were noted and compared, and correlations between three categories of variation were tested. Results: In total, 1261 abdominal vein variants and anomalies were identified in 756 (67.5%) of 1120 patients. Six hundred and forty-two hepatic vein variants were detected in 468 (41.8%) patients. One or more inferior right hepatic veins were identified in 356 (31.8%) individuals, and tributary hepatic veins were detected in 147 (13.1%) patients. Portal vein variations and anomalies were observed in 307 (27.4%) cases. The most frequent of these was trifurcation (139 patients, 12.4%). A total of 311 inferior vena cava and renal vein variants were identified in 258 (23%) cases. Six patients (0.5%) exhibited inferior vena cava anomalies, 62 (5.5%) had circumaortic renal veins, 53 (4.7%) had retroaortic renal veins, and 210 (18.8%) had multiple renal veins. Conclusion: The prevalence of abdominal vein variations is high, and routine abdominal CT demonstrates these abnormalities very well. The data suggest that hepatic vein variants and multiple right renal veins are more frequent in women than in men, and that hepatic vein variation is correlated with portal vein variation.

  1. Tennessee's East Fork Poplar Creek: A biological monitoring and abatement program

    Halbrook, R.S.; Loar, J.M.; Adams, S.M.; Black, M.C.; Boston, H.L.; Greeley, M.S. Jr.; Hill, W.R.; Hinzman, R.L.; McCarthy, J.F.; Peterson, M.J.; Ryon, M.G.; Schilling, E.M.; Smith, J.G.; Southworth, G.R.; Stewart, A.J.; Gatz, A.J.

    1991-01-01

    On May 1985, a Biological Monitoring Program was developed for East Fork Poplar Creek (EFPC) in eastern Tennessee, United States. This stream originates within the Oak Ridge Y-12 Plant that produces nuclear weapons components for the Department of Energy. Water and sediment in the stream contain metals, organic chemicals, and radionuclides from releases that have occurred over the past 45 years. The creek also receives urban and some agricultural runoff and effluent from the City of Oak Ridge's Wastewater Treatment Facility (WTF). The biological monitoring program includes four major tasks: (1) ambient toxicity testing: (2) bioaccumulation studies; (3) biological indicator studies; and (4) ecological monitoring of stream communities, including periphyton, benthic macroinvertebrates, and fish. Biological conditions are monitored at six sites on EFPC ranging from kilometer 24.4 near the headwaters to kilometer 6.3 near the month. A site on Brushy Fork, A stream just north of Oak Ridge, is used as reference. Ambient (instream) toxicity was monitored through the use of 7-day static-renewal tests that measured the survival and growth of fathead minnow (Pimephales promelas) larvae and the survival and reproduction of a microstrustacean (Ceriodaphnia dubia). Full-strength water from EFPC within the Y-12 Plant boundary was frequently toxic to Ceriodaphnia, but less frequently toxic to the minnow larvae. Chlorine has been identified as an important toxicant in upper EFPC. Water samples from six sites in EFPC downstream from the Y-12 Plant boundary were tested eight times with both species during a 2-year period (October, 1986 through October, 1988). These sites were ranked by the number of times they were ''best'' or ''worst'' for each species. Water samples collected for use in the ambient toxicity tests were routinely analyzed for conductivity, pH, alkalinity, hardness, total residual and free chlorine, and temperature

  2. Proton (1H) MR spectroscopy for routine diagnostic evaluation of brain lesions

    Burtscher, I.M.; Holtaas, S.; Staahlberg, F.; Univ. Hospital, Lund

    1997-01-01

    Purpose: To describe the introduction and performance of proton MR spectroscopy ( 1 H-MRS) in the daily routine of a modern standard MR unit. Material and Methods: Over an 8-month period, 52 patients with brain lesions were studied with 1 H-MRS, using SE and STEAM sequences for chemical-shift imaging and single-volume spectroscopy. The quality of the spectra was graded from 1 (best) to 3, and the main factors influencing the quality of the spectra were evaluated. Results: Of the measurements: 85% were graded as 1; 12% as 2; and 3% as 3. The main reasons for poor spectral quality were: the unfortunate positioning of the VOI; hemorrhage; and/or postoperative changes within the VOI. Of 40 patients with a final diagnosis: MRS provided an increased confidence in MR diagnosis in 18 cases; MRS contributed significantly to preoperative diagnosis in 3 cases; and the spectra were not specific (n=10) or were difficult to evaluate (n=9) owing to reduced quality (grade 2 or 3) in 19 cases. Conclusion: MRS of the brain can provide a high percentage of interpretable spectra and frequently can increase confidence in the MR diagnosis of brain lesions in clinical routine. (orig.)

  3. Radiation detectors as surveillance monitors

    Fehlau, P.E.; Dowdy, E.J.

    1981-01-01

    The International Atomic Energy Agency (IAEA) proposes to use personnel dosimetry radiation detectors as surveillance monitors for safeguards purposes. It plans to place these YES/NO monitors at barrier penetration points declared closed under IAEA safeguards to detect the passage of plutonium-bearing nuclear material, usually spent fuel. For this application, commercially available dosimeters were surveyed as well as other radiation detectors that appeared suitable and likely to be marketed in the near future. No primary advantage was found in a particular detector type because in this application backgrounds vary during long counting intervals. Secondary considerations specify that the monitor be inexpensive and easy to tamper-proof, interrogate, and maintain. On this basis radiophotoluminescent, thermoluminescent, and electronic dosimeters were selected as possible routine monitors; the latter two may prove useful for data-base acquisition

  4. Interval of Routine Maintenance and Maintenance Performance: A Literature Review

    Au-Yong Cheong Peng

    2016-01-01

    Full Text Available In high-rise residential buildings, the quality of facilities management services is significant to the normal operation of the facilities. Unfortunately, lack of concern towards building maintenance, especially preventive maintenance, happens in domestic housing industry in Malaysia. Majority of the maintenance operations of condominiums suffer from lack of planning, lack of proactive maintenance plan, and lack of proper implementation. Thus, this paper reviews the implementation of preventive maintenance strategy, routine maintenance in specific. An extensive review of literature published in 1987 to 2014 is performed for the purpose of this research. The publications are sourced from journal articles, conference proceedings and books. The literature analysis confirms that the routine maintenance of facilities and building services is vital and it can be influential towards the maintenance performance. Subsequently, a theoretical framework is developed, which shows the relationship between routine maintenance of building facilities & services and maintenance performance. The building facilities & services are divided into two categories. They are essential facilities & services that ensure the safety, health, habitability, and operability of buildings; while value-added facilities & services deal with property value, return on investment, and quality living of buildings. Based on the findings, a future research is proposed, which aims to identify the appropriate routine of maintenance for the facilities and services in high-rise residential buildings to improve the maintenance performance.

  5. A problem-solving routine for improving hospital operations.

    Ghosh, Manimay; Sobek Ii, Durward K

    2015-01-01

    The purpose of this paper is to examine empirically why a systematic problem-solving routine can play an important role in the process improvement efforts of hospitals. Data on 18 process improvement cases were collected through semi-structured interviews, reports and other documents, and artifacts associated with the cases. The data were analyzed using a grounded theory approach. Adherence to all the steps of the problem-solving routine correlated to greater degrees of improvement across the sample. Analysis resulted in two models. The first partially explains why hospital workers tended to enact short-term solutions when faced with process-related problems; and tended not seek longer-term solutions that prevent problems from recurring. The second model highlights a set of self-reinforcing behaviors that are more likely to address problem recurrence and result in sustained process improvement. The study was conducted in one hospital setting. Hospital managers can improve patient care and increase operational efficiency by adopting and diffusing problem-solving routines that embody three key characteristics. This paper offers new insights on why caregivers adopt short-term approaches to problem solving. Three characteristics of an effective problem-solving routine in a healthcare setting are proposed.

  6. A Sudden Total Loss of Vision After Routine Cataract Surgery ...

    We share our experience of a 50-year-old controlled hypertensive woman who had routine cataract surgery in her left eye. She was given retrobulbar Xylocaine with adrenalin and postoperative gentamycin. She subsequently became blind in the operated eye after developing macular infarction by the first day post ...

  7. Glogs as Non-Routine Problem Solving Tools in Mathematics

    Devine, Matthew T.

    2013-01-01

    In mathematical problem solving, American students are falling behind their global peers because of a lack of foundational and reasoning skills. A specific area of difficulty with problem solving is working non-routine, heuristic-based problems. Many students are not provided with effective instruction and often grow frustrated and dislike math.…

  8. Collaborative Referencing between Individuals with Aphasia and Routine Communication Partners.

    Hengst, Julie A.

    2003-01-01

    This study examined how four adults with aphasia collaborated with routine communication partners. Overall, these pairs completed the referencing task trials with accuracy and displayed referencing processes that conformed to the collaborative referencing model of communication. However, the pairs also used diverse verbal and nonverbal resources,…

  9. Diagnostic accuracy of routine postoperative body temperature measurements

    Vermeulen, Hester; Storm-Versloot, Marja N.; Goossens, Astrid; Speelman, Peter; Legemate, Dink A.

    2005-01-01

    BACKGROUND: On surgical wards, body temperature is routinely measured, but there is no proof that this is useful for detecting postoperative infection. The aim of this study was to compare temperature measurements (the test) with the confirmed absence or presence of a postoperative infection (the

  10. Radiographic demonstration of small intestinal villi on routine clinical studies

    Gelfand, D.W.; Ott, D.J.

    1981-01-01

    The radiographic demonstration of the small intestinal villi is reported. The villi were demonstrable with both single- and double-contrast methods on routine clinical studies. The primary requirement for their delineation appears to be employment of a high-resolution radiographic system. (orig.) [de

  11. Pitfalls in the routine diagnosis of Staphylococcus aureus | Bello ...

    Two hundred isolates of Presumed Staphylococcus aureus from routine clinical specimens, collected from two government hospitals in Abha, Saudi Arabia, had their identity verified. We used the tube coagulase test as our gold standard. Twenty (10%) of the isolates were mis-identified. Reliance by the two laboratories on ...

  12. 32 CFR 318.14 - Blanket routine uses.

    2010-07-01

    ... interest of simplicity, economy and to avoid redundancy. (b) Routine Use—Law Enforcement. If a system of... to the OMB in connection with the review of private relief legislation as set forth in OMB Circular A-19 at any stage of the legislative coordination and clearance process as set forth in that Circular...

  13. Types of and reasons for postoperative complications after routine ...

    Tooth extraction also called exodontia is one of the most common surgical procedures. This study was to assess the reasons and the types of wound healing complications arising after routine (intra alveolar dental extraction) in a General hospital in Lagos. Consecutive recruitment (convenient sampling) method was used to ...

  14. Modeling the Structure and Complexity of Engineering Routine Design Problems

    Jauregui Becker, Juan Manuel; Wits, Wessel Willems; van Houten, Frederikus J.A.M.

    2011-01-01

    This paper proposes a model to structure routine design problems as well as a model of its design complexity. The idea is that having a proper model of the structure of such problems enables understanding its complexity, and likewise, a proper understanding of its complexity enables the development

  15. Routine Activities and Sexual Harassment in the Workplace.

    De Coster, Stacy; Estes, Sarah Beth; Mueller, Charles W.

    1999-01-01

    In criminology, routine activities of potential victims can be used to predict victimization. Application to organizational sexual harassment data shows that organizational features (proximity in job location, supervisor or work group guardianship) and individual characteristics (target attractiveness) can predict sexual harassment victimization,…

  16. Perspex in the verification routines for accelerator beam

    Paredes G, L.; Genis S, R.

    1998-01-01

    It is analyzed the use of a perspex solid phantom, adequately referred to a water phantom, as an auxiliary alternative for the daily stability verification routines or constance of radiation beam, as an option in the case of radiotherapy installations with high charge of accelerator working and with basic dosimetry equipment. (Author)

  17. Antibody response to routine measles vaccination among a ...

    owner

    2013-02-08

    Feb 8, 2013 ... Abstract Background: Despite a global decline in mortality and morbidity from measles in the last decade, outbreaks continue to occur in some parts of the world including Nigeria. Objective: To determine antibody response to routine measles vacci- nation in Nigerian children and evaluate vaccine potency.

  18. Circulating tumor cell isolation and diagnostics: toward routine clinical use

    Stolpe, van de A.; Pantel, K.; Sleijfer, S.; Terstappen, L.W.; Toonder, den J.M.J.

    2011-01-01

    From February 7–11, 2011, the multidisciplinary Lorentz Workshop Circulating Tumor Cell (CTC) Isolation and Diagnostics: Toward Routine Clinical Use was held in Leiden (The Netherlands) to discuss progress and define challenges and potential solutions for development of clinically useful circulating

  19. Practising Homelessness: A Typology Approach to Young People's Daily Routines

    Mallett, Shelley; Rosenthal, Doreen; Myers, Paul; Milburn, Norweeta; Rotheram-Borus, Mary Jane

    2004-01-01

    In a study exploring the relationship between typology and risk, we investigated the daily routines of a heterogeneous sample of young men and women from two sites who had been homeless for varying periods (N=1289). Cluster analysis yielded four groups--"Partnered", "Socially engaged", "Service connected-harm avoidant", and "Transgressive"--based…

  20. Predictors of routine episiotomy in primigravida women in Oman.

    Al-Ghammari, Khadija; Al-Riyami, Zainab; Al-Moqbali, Moza; Al-Marjabi, Fatma; Al-Mahrouqi, Basma; Al-Khatri, Amal; Al-Khasawneh, Esra M

    2016-02-01

    Episiotomy is still the most common surgical procedure performed on women, despite the evidence against its routine use. This cross-sectional study was conducted to determine the practice and predictors of routine episiotomy on primigravidae in Oman. Demographic data, reasons for and rate of performing routine episiotomies, and perceptions of 269 obstetricians, midwives and nurses from 11 hospitals in Oman regarding the procedure were recorded and analyzed. The rate of episiotomies was 66%. In terms of performing routine episiotomies (p<0.05): non-Omanis were 4.49 times more likely than Omanis; bachelor's degree-holders were 2.26 more likely than diploma-holders; and regional hospitals were 2.36 times more likely than tertiary hospitals. The majority perceived episiotomies "reduce spontaneous perineal tearing risk", "reduce shoulder dystocia complications", and allow for "easier suturing". The rate of episiotomies was higher than other similar contexts. An urgent intervention is necessary to curb this excessive practice, and create a culture of evidence-based practice to deal with misleading perceptions. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  1. POLAND' SYNDROME: An Incidental findings on routine medical ...

    Dr Hamidu

    SM is a 20 year, old young man who came for routine medical check for recruitment into a local football club. Born to a 45 ... mimicking a radical mastectomy. A dense ascending line as a result of the absence of the ... centered around reconstructive surgical procedures on the hand. They may however be some functional.

  2. A new generation videokymography for routine clinical vocal fold examination

    Qiu, Qingjun; Schutte, Harm K.

    2006-01-01

    Objective. This study aims to introduce a new-generation videokymographic system, which provides simultaneous laryngoscopic and kymographic image, for routine clinical vocal fold examination. Study Design: The authors explored a new imaging method for diagnosis and evaluation of voice disorders.

  3. Introducing routine enquiry about domestic violence in a paediatric setting.

    Asiegbunam, Nkiru

    2018-02-01

    Implementation of routine enquiry (RE) about domestic abuse in the multidisciplinary Evelina London Guys and St. Thomas Trust (GSTT) Community Health Services (CHS). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. Validating soil phosphorus routines in the SWAT model

    Phosphorus transfer from agricultural soils to surface waters is an important environmental issue. Commonly used models like SWAT have not always been updated to reflect improved understanding of soil P transformations and transfer to runoff. Our objective was to validate the ability of the P routin...

  5. The birth and routinization of IVF in China

    Wahlberg, Ayo

    2016-01-01

    How can it be that China today is home to some of the world’s largest IVF clinics, carrying out as many as 30,000 cycles annually? In this article, I address how IVF was developed in China during the early 1980s only to be routinized during the exact same period that one of the world’s most compr...

  6. ORIGINAL ARTICLES Acceptability, feasibility and impact of routine ...

    programme, leading to the identification of children with previously undiagnosed HIV ... We explored the acceptability and feasibility of routine HIV screening in ... proportion of previously undiagnosed HIV-positive children aged ..... primary healthcare facilities in South Africa: Attitudes of nurses and child caregivers. Soc Sci ...

  7. Good Quality - the Routinization of Sperm Banking in China

    Wahlberg, Ayo

    Good Quality is an assemblage ethnography of how sperm banking came to be routinized in China. Based on 8 years of episodic fieldwork at China’s oldest and largest sperm bank in Changsha, Hunan province, the book meticulously chronicles how, beginning in the early 1980s, a unique style of sperm b...

  8. Routine antenatal syphilis screening in South West Nigeria - a ...

    Background: Untreated maternal syphilis is strongly associated with adverse birth outcomes, especially in women with high titre syphilis. The WHO recommends routine serological screening in pregnancy. Some workers have advised a reappraisal of this practice, having demonstrated low sero-prevalence in their antenatal ...

  9. Creating Masterpieces: How Course Structures and Routines Enable Student Performance

    Dean, Kathy Lund; Fornaciari, Charles J.

    2014-01-01

    Over a five-year period, we made a persistent observation: Course structures and routines, such as assignment parameters, student group process rules, and grading schemes were being consistently ignored. As a result, we got distracted by correcting these structural issues and were spending less time on student assignment performance. In this…

  10. Routine hemoglobin electrophoresis for pediatric surgery day case ...

    Background: Hemoglobin electrophoresis (HBE) is a part of the preoperative routine requested by anesthetists. However, the prevalence of hemoglobinopathy in the population is low. This study aims to determine the clinical risk factors for hemoglobinopathies and propose clinical guidelines for preoperative screening of ...

  11. Frequently updated noise threat maps created with use of supercomputing grid

    Szczodrak Maciej

    2014-09-01

    Full Text Available An innovative supercomputing grid services devoted to noise threat evaluation were presented. The services described in this paper concern two issues, first is related to the noise mapping, while the second one focuses on assessment of the noise dose and its influence on the human hearing system. The discussed serviceswere developed within the PL-Grid Plus Infrastructure which accumulates Polish academic supercomputer centers. Selected experimental results achieved by the usage of the services proposed were presented. The assessment of the environmental noise threats includes creation of the noise maps using either ofline or online data, acquired through a grid of the monitoring stations. A concept of estimation of the source model parameters based on the measured sound level for the purpose of creating frequently updated noise maps was presented. Connecting the noise mapping grid service with a distributed sensor network enables to automatically update noise maps for a specified time period. Moreover, a unique attribute of the developed software is the estimation of the auditory effects evoked by the exposure to noise. The estimation method uses a modified psychoacoustic model of hearing and is based on the calculated noise level values and on the given exposure period. Potential use scenarios of the grid services for research or educational purpose were introduced. Presentation of the results of predicted hearing threshold shift caused by exposure to excessive noise can raise the public awareness of the noise threats.

  12. Advanced core monitoring technology for WWER reactors

    Nguyen, T.Q.; Casadei, A.L.; Doshi, P.K.

    1993-01-01

    The Westinghouse BEACON online monitoring system has been developed to provide continuous core monitoring and operational support for pressurized water reactor using movable detectors (fission chamber) and core thermocouples. The basic BEACON core monitoring methodology is described. Traditional WWER reactors use rhodium fixed in-core detectors as the means to provide detailed core power distribution for surveillance purposes. An adapted version of the BEACON advanced core monitoring and support system is described which seems to be, due to the different demand/response requirements, the optimal solution (for routine surveillance and anomaly detection) for WWER reactors with existing fixed in-core detectors. (Z.S.) 4 refs

  13. Gastric Reflux on Routine Tc-99m DISIDA hepatobiliary Scintigraphy

    Lee, Kang Wook; Lee, Heon Young [Chungnam National University College of Medicine, Daejeon (Korea, Republic of)

    1995-06-15

    Reflux of bile and digestive enzymes from the small bowel and duodenum into stomach has been observed in patients with various gastroduodenal diseases. Tc-99m iminodiacetic acid derivatives hepatobiliary scan has been used as a noninvasive method to detect duodenogastric reflux. Sometimes, gastric reflux can be observed incidentally on routine Tc-99m DISA hepatobiliary scintigraphy. To evaluate the clinical meaning of gastric reflux on routine Tc-99m DISIDA hepatobiliary scan, we analyzed 36 patients showed gastric reflux incidentally on the routine Tc-99m-DISIDA hepatobiliary scintigraphy from December 1991 to June 1995 in Chungnam National University Hospital. The results were as follows: 1) The gastric reflux was observed in 2.3% of 1,553 cases of routine Tc-99m DISIDA Hepatobiliary scintigraphy for 43 months. 2) Nineteen percent of patients with gastric reflux had the past medical history of operations on stomach or biliary system. And that history was more prevalent in patients with reflux than those without reflux, significantly (p<0.01). 3) On fiberoptic gastroduodenpscopic examination, 87% of the patients with gastric reflux had the gastroduodenal diseases such as gastritis, gastric ulcer, duodenal ulcer, gastric cancer, duodenal cancer and ampullary diverticulosis. We thought that the gastric reflux can be observed considerably in patients without any operation history on stomach or duodenum, although the operation history is more prevalent in patients with gastric reflux than those without reflux, significantly and most of patients with gastric reflux on routine Tc-99m DISIDA scan has various gastroduodenal diseases.

  14. Benchmarking routine psychological services: a discussion of challenges and methods.

    Delgadillo, Jaime; McMillan, Dean; Leach, Chris; Lucock, Mike; Gilbody, Simon; Wood, Nick

    2014-01-01

    Policy developments in recent years have led to important changes in the level of access to evidence-based psychological treatments. Several methods have been used to investigate the effectiveness of these treatments in routine care, with different approaches to outcome definition and data analysis. To present a review of challenges and methods for the evaluation of evidence-based treatments delivered in routine mental healthcare. This is followed by a case example of a benchmarking method applied in primary care. High, average and poor performance benchmarks were calculated through a meta-analysis of published data from services working under the Improving Access to Psychological Therapies (IAPT) Programme in England. Pre-post treatment effect sizes (ES) and confidence intervals were estimated to illustrate a benchmarking method enabling services to evaluate routine clinical outcomes. High, average and poor performance ES for routine IAPT services were estimated to be 0.91, 0.73 and 0.46 for depression (using PHQ-9) and 1.02, 0.78 and 0.52 for anxiety (using GAD-7). Data from one specific IAPT service exemplify how to evaluate and contextualize routine clinical performance against these benchmarks. The main contribution of this report is to summarize key recommendations for the selection of an adequate set of psychometric measures, the operational definition of outcomes, and the statistical evaluation of clinical performance. A benchmarking method is also presented, which may enable a robust evaluation of clinical performance against national benchmarks. Some limitations concerned significant heterogeneity among data sources, and wide variations in ES and data completeness.

  15. Examining the cost of delivering routine immunization in Honduras.

    Janusz, Cara Bess; Castañeda-Orjuela, Carlos; Molina Aguilera, Ida Berenice; Felix Garcia, Ana Gabriela; Mendoza, Lourdes; Díaz, Iris Yolanda; Resch, Stephen C

    2015-05-07

    Many countries have introduced new vaccines and expanded their immunization programs to protect additional risk groups, thus raising the cost of routine immunization delivery. Honduras recently adopted two new vaccines, and the country continues to broaden the reach of its program to adolescents and adults. In this article, we estimate and examine the economic cost of the Honduran routine immunization program for the year 2011. The data were gathered from a probability sample of 71 health facilities delivering routine immunization, as well as 8 regional and 1 central office of the national immunization program. Data were collected on vaccinations delivered, staff time dedicated to the program, cold chain equipment and upkeep, vehicle use, infrastructure, and other recurrent and capital costs at each health facility and administrative office. Annualized economic costs were estimated from a modified societal perspective and reported in 2011 US dollars. With the addition of rotavirus and pneumococcal conjugate vaccines, the total cost for routine immunization delivery in Honduras for 2011 was US$ 32.5 million. Vaccines and related supplies accounted for 23% of the costs. Labor, cold chain, and vehicles represented 54%, 4%, and 1%, respectively. At the facility level, the non-vaccine system costs per dose ranged widely, from US$ 25.55 in facilities delivering fewer than 500 doses per year to US$ 2.84 in facilities with volume exceeding 10,000 doses per year. Cost per dose was higher in rural facilities despite somewhat lower wage rates for health workers in these settings; this appears to be driven by lower demand for services per health worker in sparsely populated areas, rather than increased cost of outreach. These more-precise estimates of the operational costs to deliver routine immunizations provide program managers with important information for mobilizing resources to help sustain the program and for improving annual planning and budgeting as well as longer

  16. Gastric Reflux on Routine Tc-99m DISIDA hepatobiliary Scintigraphy

    Lee, Kang Wook; Lee, Heon Young

    1995-01-01

    Reflux of bile and digestive enzymes from the small bowel and duodenum into stomach has been observed in patients with various gastroduodenal diseases. Tc-99m iminodiacetic acid derivatives hepatobiliary scan has been used as a noninvasive method to detect duodenogastric reflux. Sometimes, gastric reflux can be observed incidentally on routine Tc-99m DISA hepatobiliary scintigraphy. To evaluate the clinical meaning of gastric reflux on routine Tc-99m DISIDA hepatobiliary scan, we analyzed 36 patients showed gastric reflux incidentally on the routine Tc-99m-DISIDA hepatobiliary scintigraphy from December 1991 to June 1995 in Chungnam National University Hospital. The results were as follows: 1) The gastric reflux was observed in 2.3% of 1,553 cases of routine Tc-99m DISIDA Hepatobiliary scintigraphy for 43 months. 2) Nineteen percent of patients with gastric reflux had the past medical history of operations on stomach or biliary system. And that history was more prevalent in patients with reflux than those without reflux, significantly (p<0.01). 3) On fiberoptic gastroduodenpscopic examination, 87% of the patients with gastric reflux had the gastroduodenal diseases such as gastritis, gastric ulcer, duodenal ulcer, gastric cancer, duodenal cancer and ampullary diverticulosis. We thought that the gastric reflux can be observed considerably in patients without any operation history on stomach or duodenum, although the operation history is more prevalent in patients with gastric reflux than those without reflux, significantly and most of patients with gastric reflux on routine Tc-99m DISIDA scan has various gastroduodenal diseases.

  17. Reverse iontophoresis of urea in health and chronic kidney disease: a potential diagnostic and monitoring tool?

    Ebah, Leonard M; Read, Ian; Sayce, Andrew; Morgan, Jane; Chaloner, Christopher; Brenchley, Paul; Mitra, Sandip

    2012-01-01

    Background Patients with chronic kidney disease (CKD) need regular monitoring, usually by blood urea and creatinine measurements, needing venepuncture, frequent attendances and a healthcare professional, with significant inconvenience. Noninvasive monitoring will potentially simplify and improve monitoring. We tested the potential of transdermal reverse iontophoresis of urea in patients with CKD and healthy controls. Methods Using a MIC 2® Iontophoresis Controller, reverse iontophoresis was applied on the forearm of five healthy subjects (controls) and 18 patients with CKD for 3–5 h. Urea extracted at the cathode was measured and compared with plasma urea. Results Reverse iontophoresis at 250 μA was entirely safe for the duration. Cathodal buffer urea linearly correlated with plasma urea after 2 h (r = 0·82, P urea (y) from cathodal urea after 2 and 3 h, respectively. Cathodal urea concentration in controls was significantly lower than in patients with CKD after a minimum current application of 2 h (P urea cut-off of 30 μM gave a sensitivity of 83·3% and positive predictive value of 87% CKD. During haemodialysis, the fall in cathodal urea was able to track that of blood urea. Conclusion Reverse iontophoresis is safe, can potentially discriminate patients with CKD and healthy subjects and is able to track blood urea changes on dialysis. Further development of the technology for routine use can lead to an exciting opportunity for its use in diagnostics and monitoring. PMID:22409780

  18. GRAMI: Frequent subgraph and pattern mining in a single large graph

    Elseidy, M.; Abdelhamid, Ehab; Skiadopoulos, S.; Kalnis, Panos

    2014-01-01

    Mining frequent subgraphs is an important operation on graphs; it is defined as finding all subgraphs that appear frequently in a database according to a given frequency threshold. Most existing work assumes a database of many small graphs

  19. Routine HIV testing in Botswana: a population-based study on attitudes, practices, and human rights concerns.

    Sheri D Weiser

    2006-07-01

    Full Text Available The Botswana government recently implemented a policy of routine or "opt-out" HIV testing in response to the high prevalence of HIV infection, estimated at 37% of adults.We conducted a cross-sectional, population-based study of 1,268 adults from five districts in Botswana to assess knowledge of and attitudes toward routine testing, correlates of HIV testing, and barriers and facilitators to testing, 11 months after the introduction of this policy. Most participants (81% reported being extremely or very much in favor of routine testing. The majority believed that this policy would decrease barriers to testing (89%, HIV-related stigma (60%, and violence toward women (55%, and would increase access to antiretroviral treatment (93%. At the same time, 43% of participants believed that routine testing would lead people to avoid going to the doctor for fear of testing, and 14% believed that this policy could increase gender-based violence related to testing. The prevalence of self-reported HIV testing was 48%. Adjusted correlates of testing included female gender (AOR = 1.5, 95% CI = 1.1-1.9, higher education (AOR = 2.0, 95% CI = 1.5-2.7, more frequent healthcare visits (AOR = 1.9, 95% CI = 1.3-2.7, perceived access to HIV testing (AOR = 1.6, 95% CI = 1.1-2.5, and inconsistent condom use (AOR = 1.6, 95% CI = 1.2-2.1. Individuals with stigmatizing attitudes toward people living with HIV and AIDS were less likely to have been tested for HIV/AIDS (AOR = 0.7, 95% CI = 0.5-0.9 or to have heard of routine testing (AOR = 0.59, 95% CI = 0.45-0.76. While experiences with voluntary and routine testing overall were positive, 68% felt that they could not refuse the HIV test. Key barriers to testing included fear of learning one's status (49%, lack of perceived HIV risk (43%, and fear of having to change sexual practices with a positive HIV test (33%.Routine testing appears to be widely supported and may reduce barriers to testing in Botswana. As routine testing is

  20. Neutrons individual monitoring: 18 years of experience

    Goncalves, Sergio Alves; Mauricio, Claudia Lucia de Pinho; Moura Junior, Jose; Martins, Marcelo Marques; Meira, Nilton Ferreira; Diz, Ricardo; Seda, Rosangela Pinto Guimaraes

    2002-01-01

    The Thermoluminescent Dosimetry Laboratory of the Departamento de Monitoracao Individual of the Instituto de Radioprotecao e Dosimetria (LDT/DEMIN/IRD) is the only one in Brazil that operates routinely a whole body external individual monitoring service for neutrons. An albedo type monitor is used with thermoluminescent detectors pairs of 6 LiF:Mg,Ti and 7 LiF:Mg,Ti, made by Harshaw/Bicron and named, respectively, TLD-600 and TLD-700. In its 18 years of activities, the laboratory has ever made a great effort to be continuously updated. Equipment and procedures have been updated and optimized in order to guarantee the quality of all measurements. Nowadays, the neutron individual monitoring service evaluates doses of about 300 workers occupationally exposed to neutrons in several facilities of different areas of Brazil. The system history and the results obtained by the service in international intercomparisons and in its routine monitoring are presented in this work. (author)