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Sample records for general pediatrics certifying

  1. The use of office-based sedation and general anesthesia by board certified pediatric dentists practicing in the United States.

    Science.gov (United States)

    Olabi, Nassim F; Jones, James E; Saxen, Mark A; Sanders, Brian J; Walker, Laquia A; Weddell, James A; Schrader, Stuart M; Tomlin, Angela M

    2012-01-01

    The purpose of this study is to explore the use of office-based sedation by board-certified pediatric dentists practicing in the United States. Pediatric dentists have traditionally relied upon self-administered sedation techniques to provide office-based sedation. The use of dentist anesthesiologists to provide office-based sedation is an emerging trend. This study examines and compares these two models of office-based sedations. A survey evaluating office-based sedation of diplomates of the American Board of Pediatric Dentistry (ABPD) based on gender, age, years in practice, practice types, regions, and years as a diplomate of the ABPD was completed by 494 active members. The results were summarized using frequencies and percentages. Relationships of dentist age, gender, and number of years in practice with the use of intravenous (IV) sedation was completed using two-way contingency tables and Mantel-Haenszel tests for ordered categorical data. Relationships of office-based sedation use and the type of one's practice were examined using Pearson chi-square tests. Of the 1917 surveys e-mailed, 494 completed the survey for a response rate of 26%. Over 70% of board-certified US pediatric dentists use some form of sedation in their offices. Less than 20% administer IV sedation, 20 to 40% use a dentist anesthesiologist, and 60 to 70% would use dentist anesthesiologists if one were available.

  2. Core Competencies of the Certified Pediatric Doctor of Chiropractic

    DEFF Research Database (Denmark)

    Hewitt, Elise; Hestbaek, Lise; Pohlman, Katherine A

    2016-01-01

    An outline of the minimum core competencies expected from a certified pediatric doctor of chiropractic was developed using a Delphi consensus process. The initial set of seed statements and substatements was modeled on competency documents used by organizations that oversee chiropractic and medical...... education. These statements were distributed to the Delphi panel, reaching consensus when 80% of the panelists approved each segment. The panel consisted of 23 specialists in chiropractic pediatrics (14 females) from across the broad spectrum of the chiropractic profession. Sixty-one percent of panelists...... had postgraduate pediatric certifications or degrees, 39% had additional graduate degrees, and 74% were faculty at a chiropractic institution and/or in a postgraduate pediatrics program. The panel were initially given 10 statements with related substatements formulated by the study's steering...

  3. Certified first responder: a comprehensive model for pediatric training.

    Science.gov (United States)

    Markenson, D; Foltin, G; Tunik, M; Cooper, A; Treiber, M; Welborn, C; Clappin, J; Fitton, A; Giordano, L

    1997-04-01

    The purpose of this document is to present a general approach to educating the First Responder in Emergency Pediatric Care. The First Responder is especially important in the emergency care of the sick or injured child. The majority of mortality and morbidity associated with pediatric emergencies is a result of airway and ventilatory compromise. In addition, most airway and ventilation problems can be corrected with only basic life support interventions that are within the scope of practice of the First Responder. As a result, it is of paramount importance to assure that the First Responder is adequately trained in the initial care of the pediatric patient. This document will review some of the key objectives and topics which the First Responder needs to understand in order to adequately care for children until further emergency care arrives. Templates for lesson plans and suggested activities for training the First Responder are also presented.

  4. Core Competencies of the Certified Pediatric Doctor of Chiropractic: Results of a Delphi Consensus Process.

    Science.gov (United States)

    Hewitt, Elise; Hestbaek, Lise; Pohlman, Katherine A

    2016-04-01

    An outline of the minimum core competencies expected from a certified pediatric doctor of chiropractic was developed using a Delphi consensus process. The initial set of seed statements and substatements was modeled on competency documents used by organizations that oversee chiropractic and medical education. These statements were distributed to the Delphi panel, reaching consensus when 80% of the panelists approved each segment. The panel consisted of 23 specialists in chiropractic pediatrics (14 females) from across the broad spectrum of the chiropractic profession. Sixty-one percent of panelists had postgraduate pediatric certifications or degrees, 39% had additional graduate degrees, and 74% were faculty at a chiropractic institution and/or in a postgraduate pediatrics program. The panel were initially given 10 statements with related substatements formulated by the study's steering committee. On all 3 rounds of the Delphi process the panelists reached consensus; however, multiple rounds occurred to incorporate the valuable qualitative feedback received.

  5. Integration of pediatric mental health in general pediatrics in eritrea ...

    African Journals Online (AJOL)

    Integration of pediatric mental health in general pediatrics in eritrea: improving ... where integration of such services within the primary health care framework has not ... and 10% had behaviour disorders predominantly attention deficit disorder.

  6. Learning the ABC's Can Save a Life. Why Classroom Teachers Should Be Certified in CPR and Pediatric First Aid.

    Science.gov (United States)

    Delgado, Evelyn

    This paper explores the rationale for why classroom teachers should be certified in cardiopulmonary resuscitation and pediatric first aid. It begins by introducing a scenario of two fatal tragedies in a school setting. It also examines a study done of teachers and school aides in inclusive classrooms and their concerns about health and safety…

  7. Complications in common general pediatric surgery procedures.

    Science.gov (United States)

    Linnaus, Maria E; Ostlie, Daniel J

    2016-12-01

    Complications related to general pediatric surgery procedures are a major concern for pediatric surgeons and their patients. Although infrequent, when they occur the consequences can lead to significant morbidity and psychosocial stress. The purpose of this article is to discuss the common complications encountered during several common pediatric general surgery procedures including inguinal hernia repair (open and laparoscopic), umbilical hernia repair, laparoscopic pyloromyotomy, and laparoscopic appendectomy. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Certifying the quantumness of a generalized coherent control scenario.

    Science.gov (United States)

    Scholak, Torsten; Brumer, Paul

    2014-11-28

    We consider the role of quantum mechanics in a specific coherent control scenario, designing a "coherent control interferometer" as the essential tool that links coherent control to quantum fundamentals. Building upon this allows us to rigorously display the genuinely quantum nature of a generalized weak-field coherent control scenario (utilizing 1 vs. 2 photon excitation) via a Bell-CHSH test. Specifically, we propose an implementation of "quantum delayed-choice" in a bichromatic alkali atom photoionization experiment. The experimenter can choose between two complementary situations, which are characterized by a random photoelectron spin polarization with particle-like behavior on the one hand, and by spin controllability and wave-like nature on the other. Because these two choices are conditioned coherently on states of the driving fields, it becomes physically unknowable, prior to measurement, whether there is control over the spin or not.

  9. General anesthesia time for pediatric dental cases.

    Science.gov (United States)

    Forsyth, Anna R; Seminario, Ana Lucia; Scott, Joanna; Berg, Joel; Ivanova, Iskra; Lee, Helen

    2012-01-01

    The purpose of this study was to describe the use of operating room (OR) time for pediatric dental procedures performed under general anesthesia (GA) at a regional children's hospital over a 2-year period. A cross-sectional review of a pediatric dental GA records was performed at Seattle Children's Hospital. Data were collected for 709 0- to 21-year-old patients from January 2008 to December 2009. Demographic data, dental and anesthesia operator types, and procedures were recorded. Utilization of OR time was analyzed. The mean age of patients was 7.1 years (±4.2 SD), and 58% were male. Distribution by American Society of Anesthesiology (ASA) classifications were: ASA I 226 (32%); ASA II 316 (45%); ASA III 167 (24%). Cases finished earlier than the scheduled time by an average of 14 minutes (±28). Overrun time was significantly associated with: patient age (P=.01); ASA classification (P=.006); treatment type (Ppediatric dental procedures.

  10. [Induction of general anesthesia in pediatric patients].

    Science.gov (United States)

    Ota, Chiharu; Taniguchi, Akihiro

    2007-05-01

    The induction of general anesthesia is one of the most stressful procedures during the perioperative period for pediatric patients. Postoperative negative behavioral changes, such as nightmares or separation anxiety are reported in the children undergoing general anesthesia. To avoid these problems, the anesthesiologists have to pay more attention to the psychological needs of young patients as well as the technical aspects. Preoperative interview is important to identify the child who has extreme fear and anxiety. Premedication with sedatives and psychological preparation are effective for the smooth induction. In this article, preparation for the induction and practical skills of the induction in children, newborns, as well as patients with difficult airway and with full stomach are summarized.

  11. Global general pediatric surgery partnership: The UCLA-Mozambique experience.

    Science.gov (United States)

    Amado, Vanda; Martins, Deborah B; Karan, Abraar; Johnson, Brittni; Shekherdimian, Shant; Miller, Lee T; Taela, Atanasio; DeUgarte, Daniel A

    2017-09-01

    There has been increasing recognition of the disparities in surgical care throughout the world. Increasingly, efforts are being made to improve local infrastructure and training of surgeons in low-income settings. The purpose of this study was to review the first 5-years of a global academic pediatric general surgery partnership between UCLA and the Eduardo Mondlane University in Maputo, Mozambique. A mixed-methods approach was utilized to perform an ongoing needs assessment. A retrospective review of admission and operative logbooks was performed. Partnership activities were summarized. The needs assessment identified several challenges including limited operative time, personnel, equipment, and resources. Review of logbooks identified a high frequency of burn admissions and colorectal procedures. Partnership activities focused on providing educational resources, on-site proctoring, training opportunities, and research collaboration. This study highlights the spectrum of disease and operative case volume of a referral center for general pediatric surgery in sub-Saharan Africa, and it provides a context for academic partnership activities to facilitate training and improve the quality of pediatric general surgical care in limited-resource settings. Level IV. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Certified Schools

    Data.gov (United States)

    Department of Homeland Security — Certified schools must provide specific information regarding the school, the nature and requirements of the educational program, location and contact information,...

  13. Determinants for return to work among sickness certified patients in general practice

    Directory of Open Access Journals (Sweden)

    von Celsing Anna-Sophia

    2012-12-01

    Full Text Available Abstract Background Long-term sickness absence is one of the main risk factors for permanent exit out of the labour market. Early identification of the condition is essential to facilitate return to work. The aim of this study was to analyse possible determinants of return to work and their relative impact. Methods All 943 subjects aged 18 to 63 years, sickness certified at a Primary Health Care Centre in Sweden from 1 January until 31 August 2004, were followed up for three years. Baseline information on sex, age, sick leave diagnosis, employment status, extent of sick leave, and sickness absence during the year before baseline was obtained, as was information on all compensated days of sick leave, disability pension and death during follow-up. Results Slightly more than half the subjects were women, mean age was 39 years. Half of the study population returned to work within 14 days after baseline, and after three years only 15 subjects were still on sick leave. In multivariate proportional hazards regression analysis the extent of previous sick leave, age, being on part-time sick leave, and having a psychiatric, musculoskeletal, cardiovascular, nervous disease, digestive system, or injury or poisoning diagnosis decreased the return to work rate, while being employed increased it. Marital status, sex, being born in Sweden, citizenship, and annual salary had no influence. In logistic regression analyses across follow-up time these variables altogether explained 88-90% of return to work variation. Conclusions Return to work was positively or negatively associated by a number of variables easily accessible in the GP’s office. Track record data in the form of previous sick leave was the most influential variable.

  14. Practice patterns and outcomes of pediatric partial nephrectomy in the United States: Comparison between pediatric urology and general pediatric surgery.

    Science.gov (United States)

    Suson, Kristina D; Wolfe-Christensen, Cortney; Elder, Jack S; Lakshmanan, Yegappan

    2015-08-01

    In the United States, both pediatric urologists (PUROs) and general pediatric surgeons (GPSs) perform nephrectomies in children, with PUROs performing more nephrectomies overall, most commonly for benign causes. GPSs perform more nephrectomies for malignant causes. We questioned whether the same trends persisted for partial nephrectomy. We hypothesized that PUROs performed more partial nephrectomies for all causes, including malignancy. Our primary aim was to characterize the number of partial nephrectomies performed by PUROs and GPSs. We also compared short-term outcomes between subspecialties. We analyzed the Pediatric Health Information System (PHIS), a database encompassing data from 44 children's hospitals. Patients were ≤18 years old and had a partial nephrectomy (ICD-9 procedure code 554) carried out by PUROs or GPSs between 1 January, 2004 and June 30, 2013. Queried data points included surgeon subspecialty, age, gender, 3M™ All Patient Refined Diagnosis Related Groups (3M™ APR DRG) code, severity level, mortality risk, length of stay (LOS), and medical/surgical complication flags. Data points were compared in patients on whom PUROs and GPSs had operated. Statistical analysis included the Student t test, chi-square test, analysis of covariance, and logistic regression. Results are presented in the table. While PUROs performed the majority of partial nephrectomies, GPSs operated more commonly for malignancy. For surgeries performed for non-malignant indications, PURO patients had a shorter LOS and lower complication rate after controlling for statistically identified covariates. There was no difference in LOS or complication rate for patients with malignancy. A Pediatric Health Information System study of pediatric nephrectomy demonstrated PUROs performed more nephrectomies overall, but GPSs performed more surgeries for malignancy. The difference was less dramatic for partial nephrectomies (63% GPS, 37% PURO) than for radical nephrectomies (90% GPS, 10

  15. Management of Pediatric Skin Abscesses in Pediatric, General Academic and Community Emergency Departments

    Directory of Open Access Journals (Sweden)

    Baumann, Brigitte M

    2011-05-01

    Full Text Available Objectives: To compare the evaluation and management of pediatric cutaneous abscess patients at three different emergency department (ED settings.Method: We conducted a retrospective cohort study at two academic pediatric hospital EDs, a general academic ED and a community ED in 2007, with random sampling of 100 patients at the three academic EDs and inclusion of 92 patients from the community ED. Eligible patients were ≤18 years who had a cutaneous abscess. We recorded demographics, predisposing conditions, physical exam findings, incision and drainage procedures, therapeutics and final disposition. Laboratory data were reviewed for culture results and antimicrobial sensitivities. For subjects managed as outpatients from the ED, we determined where patients were instructed to follow up and, using electronic medical records, ascertained the proportion of patients who returned to the ED for further management.Result: Of 392 subjects, 59% were female and the median age was 7.7 years. Children at academic sites had larger abscesses compared to community patients, (3.5 versus 2.5 cm, p=0.02. Abscess incision and drainage occurred in 225 (57% children, with the lowest rate at the academic pediatric hospital EDs (51% despite the relatively larger abscess size. Procedural sedation and the collection of wound cultures were more frequent at the academic pediatric hospital and the general academic EDs. Methicillin-resistant Staphylococcus aureus (MRSA prevalence did not differ among sites; however, practitioners at the academic pediatric hospital EDs (92% and the general academic ED (86% were more likely to initiate empiric MRSA antibiotic therapy than the community site (71%, (p<0.0001. At discharge, children who received care at the community ED were more likely to be given a prescription for a narcotic (23% and told to return to the ED for ongoing wound care (65%. Of all sites, the community ED also had the highest percentage of follow-up visits (37

  16. National practice patterns and outcomes of pediatric nephrectomy: comparison between urology and general surgery.

    Science.gov (United States)

    Suson, Kristina D; Wolfe-Christensen, Cortney; Elder, Jack S; Lakshmanan, Yegappan

    2015-05-01

    In adults nephrectomy is under the purview of urologists, but pediatric urologists and pediatric general surgeons perform extirpative renal surgery in children. We compared the contemporary performance and outcome of all-cause nephrectomy at pediatric hospitals as performed by pediatric urologists and pediatric general surgeons. We queried the Pediatric Health Information System to identify patients 0 to 18 years old who were treated with nephrectomy between 2004 and 2013 by pediatric urologists and pediatric general surgeons. Data points included age, gender, severity level, mortality risk, complications and length of stay. Patients were compared by APR DRG codes 442 (kidney and urinary tract procedures for malignancy) and 443 (kidney and urinary tract procedures for nonmalignancy). Pediatric urologists performed more all-cause nephrectomies. While pediatric urologists were more likely to operate on patients with benign renal disease, pediatric general surgeons were more likely to operate on children with malignancy. Patients on whom pediatric general surgeons operated had a higher average severity level and were at greater risk for mortality. After controlling for differences patients without malignancy operated on by pediatric urologists had a shorter length of stay, and fewer medical and surgical complications. There was no difference in length of stay, or medical or surgical complications in patients with malignancy. Overall compared to pediatric general surgeons more nephrectomies are performed by pediatric urologists. Short-term outcomes, including length of stay and complication rates, appear better in this data set in patients without malignancy who undergo nephrectomy by pediatric urologists but there is no difference in outcomes when nephrectomy is performed for malignancy. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  17. Certifying quantumness: Benchmarks for the optimal processing of generalized coherent and squeezed states

    Science.gov (United States)

    Yang, Yuxiang; Chiribella, Giulio; Adesso, Gerardo

    2014-10-01

    Quantum technology promises revolutionary advantages in information processing and transmission compared to classical technology; however, determining which specific resources are needed to surpass the capabilities of classical machines often remains a nontrivial problem. To address such a problem, one first needs to establish the best classical solutions, which set benchmarks that must be beaten by any implementation claiming to harness quantum features for an enhanced performance. Here we introduce and develop a self-contained formalism to obtain the ultimate, generally probabilistic benchmarks for quantum information protocols including teleportation and approximate cloning, with arbitrary ensembles of input states generated by a group action, so-called Gilmore-Perelomov coherent states. This allows us to construct explicit fidelity thresholds for the transmission of multimode Gaussian and non-Gaussian states of continuous-variable systems, as well as qubit and qudit pure states drawn according to nonuniform distributions on the Bloch hypersphere, which accurately model the current laboratory facilities. The performance of deterministic classical procedures such as square-root measurement strategies is further compared with the optimal probabilistic benchmarks, and the state-of-the-art performance of experimental quantum implementations against our newly derived thresholds is discussed. This work provides a comprehensive collection of directly useful criteria for the reliable certification of quantum communication technologies.

  18. A prospective study on the attitude of post graduates in general pediatrics toward pediatric oncology subspeciality as a career.

    Science.gov (United States)

    Thirugnanasambandam, Ram Prakash; Latha, Magatha Sneha; Moorthy, Aravind; Kannan, Lakshminarayanan; Paramasivam, Venkataraman; Scott, Julius Xavier

    2014-01-01

    The health care scenario in India is experiencing an increase in the number of children affected with cancer and the number of pediatric oncologists available to treat these children are few and the awareness of childhood cancer is decimally low. Hence, the purpose of this study was to determine the attitude of post-graduate students of general pediatrics towards childhood cancer and to assess their interest in pursuing pediatric oncology as a specialty in their carrier. The study was conducted among 188 post-graduates hailing from various Medical colleges all over South India who were attending a 2 day workshop at Chennai. The survey was a 10 point questionnaire pertaining to their previous training, competence, interest toward the field of hematooncology. The data were analyzed by SPSS 18.V software. Among the post-graduates, 74.7% of them reported that they did not have a pediatric oncology unit in their institution. 63.3% reported that they never been posted in pediatric oncology clinical postings before. 62% were not interested in pursuing pediatric oncology as a sub-specialty at all. 45.3% felt that pediatric oncology was too depressing to take as a specialty. 46.7% felt that late diagnosis and referral was the main factor which contributed to the failure of effective treatment of childhood cancers. 52.7% had never attended a class on pediatric oncology. 61.3% felt that they did not have sufficient knowledge to suspect and refer a child with cancer. 92% felt that there was a need to improve pediatric oncology teaching in their curriculum. 56.7% felt that the best way to imprint awareness on childhood malignancies was to improve pediatric oncology teaching in their medical curriculum. The results show that majority of post-graduates in pediatrics were not interested in pursuing pediatric oncology as a sub-specialty. The main reasons may be lack of specialized Pediatric oncology units in the majority of the medical institutions, lack of opportunity of these

  19. Demand in pediatric dentistry for sedation and general anesthesia by dentist anesthesiologists: a survey of directors of dentist anesthesiologist and pediatric dentistry residencies

    National Research Council Canada - National Science Library

    Hicks, C Gray; Jones, James E; Saxen, Mark A; Maupome, Gerardo; Sanders, Brian J; Walker, Laquia A; Weddell, James A; Tomlin, Angela

    2012-01-01

    This study describes what training programs in pediatric dentistry and dental anesthesiology are doing to meet future needs for deep sedation/general anesthesia services required for pediatric dentistry...

  20. Different Aspects of General Anesthesia in Pediatric Dentistry: A Review.

    Science.gov (United States)

    Ramazani, Nahid

    2016-04-01

    Most child population is able to undergo dental treatment in the conventional setting. However, some children fail to cope with in-office conscious state and cannot respond to usual management modalities. This review aims to discuss the topic further. A computerized search in databases PubMed, MEDLINE, EMBASE, Google Scholar and Google were performed using dental general anesthesia related keywords. Original and review English-written articles that were limited to child population were retrieved without any limitation of publication date. The suitable papers were selected and carefully studied. A data form designed by author was used to write relevant findings. Preoperative oral examination and comprehensive evaluation of treatment needs is only possible after clinical and radiographic oral examination. Effective collaboration in dental GA team should be made to minimize psychological trauma of children who undergo dental GA. Before conducting comprehensive dental treatment under GA, the general health of the child and the success rate of procedures provided needs to be accurately evaluated. It is noteworthy that determination of the optimal timing for GA dental operation is of great importance. Providing safety with pediatric dental rehabilitation under GA is critical. Besides criteria for case selection of dental GA, some degree of dental practitioner's judgment is required to make decision. Pre- and post-operative instructions to parents or caregiver decrease the risk of complications. However, trained resuscitation providers, careful monitoring and advanced equipment minimize adverse outcomes.

  1. General anesthesia: as a challenge and treatment need option in pediatric dentistry

    OpenAIRE

    2005-01-01

    Objetive. The purpose of this study was to determine the type and characteristics of the interventions, indications of dental treatment and procedures performed to patients treated under general anesthesia (GA) by pediatric dentistry residents, during the 1997-1999 period. Method. a sample of 57 hospital records of patientes treated as part of the Special Pediatric course at the Puerto rico Pediatric hostpial were reviewed. statistical analysis was done using the chi-square test for infere...

  2. Training general surgery residents in pediatric surgery: educational value vs time and cost.

    Science.gov (United States)

    Lee, Steven L; Sydorak, Roman M; Applebaum, Harry

    2009-01-01

    This study evaluated the educational value of pediatric surgery rotations, the likelihood of performing pediatric operations upon completing general surgery (GS) residency, and time and cost of training GS residents in pediatric surgery. A survey was administered to GS residents that evaluated the pediatric surgery rotation and anticipated practice intentions. A retrospective analysis (2005-2006) of operative times for unilateral inguinal hernia repair, bilateral inguinal hernia repair, and umbilical hernia repair was also performed. Procedure times were compared for operations performed by a pediatric surgeon with and without GS residents. Cost analysis was based on time differences. General surgery residents (n = 19) considered the pediatric surgery rotation to have high educational value (4.7 +/- 0.6 of 5) with extensive teaching (4.6 +/- 0.7) and operative experience (4.4 +/- 0.8). Residents listed pediatric surgery exposure, operative technique, and observed work ethic as most valuable. Upon graduation, residents expect to perform pediatric operations 2 to 3 times annually. Thirty-seven percent of residents felt competent to perform appendectomy (patients >5 years), 32% appendectomy (3-5 years), 21% gastrostomy (>1 year), and 11% inguinal herniorrhaphy (>1 year). Operative times and costs were significantly higher in operative procedures performed with a GS resident. General surgery residents considered pediatric surgery as a valuable educational experience. Residents anticipate performing pediatric operations a few times annually. Training GS residents in pediatric surgery increased operative time and cost. This information may be useful in determining the appropriate setting for resident education as well as budget planning for pediatric surgical practices.

  3. Variables Affecting General Anesthesia Time for Pediatric Dental Cases.

    Science.gov (United States)

    Yi, Young; Lee, Joseph; Yi, Han; Asher, Sheetal; Feldman, Lauren; Rivas-Morello, Chiara; Haque, Mehedia; Ross, Elizabeth

    2015-01-01

    The purpose of this study was to identify variables affecting procedural times for dental treatments performed in the operating room (OR) under general anesthesia. A total of 2,264 OR cases at Boston Children's Hospital were included in the study. A series of patient, provider, and operational variables were studied, including: patient age, gender, American Society of Anesthesiologists (ASA) class, need for intraoperative radiographs, intubation type, provider type, referring provider type, referral date, waiting time between referral and OR, and symmetry of caries pattern. Analysis of variance, z test, t test, Pearson correlations, and regression modeling were used. Provider inexperience, need for obtaining radiographs, older age, higher ASA class, and oral intubation significantly increased surgical case times. Using the current OR case estimation resulted in an overestimation of 14.6 hours per month. Application of our regression model improved the accuracy of case time estimation by 7.9 hours per month. Overestimation of pediatric dental operating room cases exists, and identification of variables associated with these inaccuracies can aid providers in recapturing underutilized operating room times.

  4. Impact of implementation of a pediatric surgery fellowship on general surgery resident operative volume.

    Science.gov (United States)

    Snyder, Rebecca A; Phillips, Sharon E; Terhune, Kyla P

    2012-01-01

    The purpose of this study was to determine the impact of the initiation of a pediatric surgery fellowship on general surgery resident operative volume at 1 major academic institution. Retrospective review of operative records obtained from the Accreditation Council for Graduate Medical Education (ACGME) general surgery resident and pediatric surgery fellow case logs. Data collected included number and type of pediatric index cases per year, number of total pediatric surgery cases per year, and number of total cases logged as primary surgeon to date. Vanderbilt University School of Medicine Department of Surgery, which has an accredited general surgery program, finishes 7 chief residents per year during the study period, and instituted a new pediatric surgery fellowship in 2007. Case logs submitted by third and fourth year general surgery residents and first and second year pediatric surgery fellows were studied. The number of pediatric attending surgeons, relative value units (RVUs), and hospital admissions increased from 2003 to 2011. The median number of pediatric index cases performed by a resident decreased after the onset of fellowship from 34 cases to 23.5 cases per year (p pediatric surgery rotation also decreased from 74 to 53 cases per year after onset of the fellowship (p surgery resident index and overall case volume in pediatric surgery. Although operative volume is only 1 measure of surgical educational value, these findings suggest that the addition of surgical fellowships affects the educational experience of general surgery residents. We recommend that residency programs establish goals and calculate any potential impact on general surgery resident case volume before initiating a new surgical fellowship. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  5. Comparison of pediatric appendectomy outcomes between pediatric surgeons and general surgery residents.

    Science.gov (United States)

    Mizrahi, Ido; Mazeh, Haggi; Levy, Yair; Karavani, Gilad; Ghanem, Muhammad; Armon, Yaron; Vromen, Amos; Eid, Ahmed; Udassin, Raphael

    2013-04-01

    Appendectomy is the most common urgent procedure in children, and surgical outcomes may be affected by the surgeon's experience. This study's aim is to compare appendectomy outcomes performed by pediatric surgeons (PSs) and general surgery residents (GSRs). A retrospective review of all patients younger than 16y treated for appendicitis at two different campuses of the same institution during the years 2008-2009 was performed. Appendectomies were performed by PS in one campus and GSR in the other. Primary end points included postoperative morbidity and hospital length of stay. During the study period, 246 (61%) patients were operated by senior GSR (postgraduate year 5-7) versus 157 (39%) patients by PS. There was no significant difference in patients' characteristics at presentation to the emergency room and the rate of appendeceal perforation (11% versus 15%, P=0.32), and noninfectious appendicitis (5% versus 5% P=0.78) also was similar. Laparoscopic surgery was performed more commonly by GSR (16% versus 9%, P=0.02) with shorter operating time (54±1.5 versus 60±2.1, P=0.01). Interestingly, the emergency room to operating room time was shorter for GSR group (419±14 versus 529±24min, P<0.001). The hospital length of stay was shorter for the GSR group (4.0±0.2 versus 4.5±0.2, P=0.03), and broad-spectrum antibiotics were used less commonly (20% versus 53%, P<0.0001) and so was home antibiotics continuation (13% versus 30%, P<0.0001). Nevertheless, postoperative complication rate was similar (5% versus 7%, P=0.29) and so was the rate of readmissions (2% versus 5%, P=0.52). The results of this study suggest that the presence of a PS does not affect the outcomes of appendectomies. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. Innovation in Pediatric Surgical Education for General Surgery Residents: A Mobile Web Resource.

    Science.gov (United States)

    Rouch, Joshua D; Wagner, Justin P; Scott, Andrew; Sullins, Veronica F; Chen, David C; DeUgarte, Daniel A; Shew, Stephen B; Tillou, Areti; Dunn, James C Y; Lee, Steven L

    2015-01-01

    General surgery residents lack a standardized educational experience in pediatric surgery. We hypothesized that the development of a mobile educational interface would provide general surgery residents broader access to pediatric surgical education materials. We created an educational mobile website for general surgery residents rotating on pediatric surgery, which included a curriculum, multimedia resources, the Operative Performance Rating Scale (OPRS), and Twitter functionality. Residents were instructed to consult the curriculum. Residents and faculty posted media using the Twitter hashtag, #UCLAPedSurg, and following each surgical procedure reviewed performance via the OPRS. Site visits, Twitter posts, and OPRS submissions were quantified from September 2013 to July 2014. The pediatric surgery mobile website received 257 hits; 108 to the homepage, 107 to multimedia, 28 to the syllabus, and 19 to the OPRS. All eligible residents accessed the content. The Twitter hashtag, #UCLAPedSurg, was assigned to 20 posts; the overall audience reach was 85 individuals. Participants in the mobile OPRS included 11 general surgery residents and 4 pediatric surgery faculty. Pediatric surgical education resources and operative performance evaluations are effectively administered to general surgery residents via a structured mobile platform. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  7. Pediatric dentistry for the general practitioner: satisfying the need for additional education and training opportunities.

    Science.gov (United States)

    Stewart, Ray E; Sanger, Roger G

    2014-11-01

    The Pediatric Oral Health Access Program is a joint project of the California Dental Association and the California Society of Pediatric Dentistry. The results have been remarkable in terms of the number of underserved children who have received oral health services. What is less certain is the number of general dentists who, as a result of the training, have been able and willing to provide comprehensive care to more and younger children.

  8. General Anesthetic Versus Light Sedation: Effect on Pediatric Endoscopy Wait Times

    Directory of Open Access Journals (Sweden)

    Christine Edwards

    2013-01-01

    Full Text Available BACKGROUND: Wait times are an important measure of health care system effectiveness. There are no studies describing wait times in pediatric gastroenterology for either outpatient visits or endoscopy. Pediatric endoscopy is performed under light sedation or general anesthesia. The latter is hypothesized to be associated with a longer wait time due to practical limits on access to anesthesia in the Canadian health care system.

  9. Demand in Pediatric Dentistry for Sedation and General Anesthesia by Dentist Anesthesiologists: A Survey of Directors of Dentist Anesthesiologist and Pediatric Dentistry Residencies

    OpenAIRE

    Hicks, C. Gray; Jones, James E.; Saxen, Mark A.; Maupome,Gerardo; Sanders, Brian J.; Walker, LaQuia A.; James A. Weddell; Tomlin, Angela

    2012-01-01

    This study describes what training programs in pediatric dentistry and dental anesthesiology are doing to meet future needs for deep sedation/general anesthesia services required for pediatric dentistry. Residency directors from 10 dental anesthesiology training programs in North America and 79 directors from pediatric dentistry training programs in North America were asked to answer an 18-item and 22-item online survey, respectively, through an online survey tool. The response rate for the 1...

  10. Population-Based Pediatric Reference Intervals in General Clinical Chemistry: A Swedish Survey.

    Science.gov (United States)

    Ridefelt, Peter

    2015-01-01

    Very few high quality studies on pediatric reference intervals for general clinical chemistry and hematology analytes have been performed. Three recent prospective community-based projects utilising blood samples from healthy children in Sweden, Denmark and Canada have substantially improved the situation. The Swedish survey included 701 healthy children. Reference intervals for general clinical chemistry and hematology were defined.

  11. Usage and Attitudes Towards Natural Remedies and Homeopathy in General Pediatrics: A Cross-Country Overview.

    Science.gov (United States)

    Beer, André-Michael; Burlaka, Ievgeniia; Buskin, Stephen; Kamenov, Borislav; Pettenazzo, Andrea; Popova, Diana; Riveros Huckstadt, María Pilar; Sakalinskas, Virgilijus; Oberbaum, Menachem

    2016-01-01

    In order to better understand the global approach and country differences in physicians' usage, knowledge, and attitudes towards natural remedies and homeopathy in pediatric practice, an online survey involving 582 general pediatricians and general practitioners treating pediatric diseases was conducted in 6 countries. Overall, 17% of the pediatric prescriptions refer to phytotherapy and 15% refer to homeopathic preparations. Natural remedies and homeopathic preparations are more frequently used in upper respiratory tract infections, infant colic, sleep disturbances, and recurrent infections. In the majority of cases, they are used together with chemical drugs. Both treatment options are typically used if parents are concerned about side effects of conventional drugs or prefer natural remedies for themselves. Physicians express high interest in natural remedies and homeopathy; however, their knowledge is variable. Lack of proven efficacy, knowledge on mechanism of action, and information on indications are main factors that limit their usage.

  12. Usage and Attitudes Towards Natural Remedies and Homeopathy in General Pediatrics

    Directory of Open Access Journals (Sweden)

    André-Michael Beer MD, PhD

    2016-07-01

    Full Text Available In order to better understand the global approach and country differences in physicians’ usage, knowledge, and attitudes towards natural remedies and homeopathy in pediatric practice, an online survey involving 582 general pediatricians and general practitioners treating pediatric diseases was conducted in 6 countries. Overall, 17% of the pediatric prescriptions refer to phytotherapy and 15% refer to homeopathic preparations. Natural remedies and homeopathic preparations are more frequently used in upper respiratory tract infections, infant colic, sleep disturbances, and recurrent infections. In the majority of cases, they are used together with chemical drugs. Both treatment options are typically used if parents are concerned about side effects of conventional drugs or prefer natural remedies for themselves. Physicians express high interest in natural remedies and homeopathy; however, their knowledge is variable. Lack of proven efficacy, knowledge on mechanism of action, and information on indications are main factors that limit their usage.

  13. Pediatrics

    Science.gov (United States)

    Spackman, T. J.

    1978-01-01

    The utilization of the Lixiscope in pediatrics was investigated. The types of images that can presently be obtained are discussed along with the problems encountered. Speculative applications for the Lixiscope are also presented.

  14. Demand in pediatric dentistry for sedation and general anesthesia by dentist anesthesiologists: a survey of directors of dentist anesthesiologist and pediatric dentistry residencies.

    Science.gov (United States)

    Hicks, C Gray; Jones, James E; Saxen, Mark A; Maupome, Gerardo; Sanders, Brian J; Walker, Laquia A; Weddell, James A; Tomlin, Angela

    2012-01-01

    This study describes what training programs in pediatric dentistry and dental anesthesiology are doing to meet future needs for deep sedation/general anesthesia services required for pediatric dentistry. Residency directors from 10 dental anesthesiology training programs in North America and 79 directors from pediatric dentistry training programs in North America were asked to answer an 18-item and 22-item online survey, respectively, through an online survey tool. The response rate for the 10 anesthesiology training program directors was 9 of 10 or 90%. The response rate for the 79 pediatric dentistry training program directors was 46 of 79 or 58%. Thirty-seven percent of pediatric dentistry programs use clinic-based deep sedation/general anesthesia for dental treatment in addition to hospital-based deep sedation/general anesthesia. Eighty-eight percent of those programs use dentist anesthesiologists for administration of deep sedation/general anesthesia in a clinic-based setting. Pediatric dentistry residency directors perceive a future change in the need for deep sedation/general anesthesia services provided by dentist anesthesiologists to pediatric dentists: 64% anticipate an increase in need for dentist anesthesiologist services, while 36% anticipate no change. Dental anesthesiology directors compared to 2, 5, and 10 years ago have seen an increase in the requests for dentist anesthesiologist services by pediatric dentists reported by 56% of respondents (past 2 years), 63% of respondents (past 5 years), and 88% of respondents (past 10 years), respectively. Predicting the future need of dentist anesthesiologists is an uncertain task, but these results show pediatric dentistry directors and dental anesthesiology directors are considering the need, and they recognize a trend of increased need for dentist anesthesiologist services over the past decade.

  15. Pediatric generalized joint hypermobility with and without musculoskeletal complaints : A localized or systemic disorder?

    NARCIS (Netherlands)

    Engelbert, RHH; Bank, RA; Sakkers, RJB; Helders, PJM; Beemer, FA; Uiterwaal, CSPM

    2003-01-01

    Objectives. Children with generalized hypermobility of the joints and musculoskeletal complaints frequently visit pediatric clinics, but many show no currently known collagen or other possibly related diseases. Whether the symptoms are confined to the musculoskeletal system is unknown. We assessed w

  16. Different Aspects of General Anesthesia in Pediatric Dentistry: A Review

    National Research Council Canada - National Science Library

    Ramazani, Nahid

    2016-01-01

    .... This review aims to discuss the topic further. A computerized search in databases PubMed, MEDLINE, EMBASE, Google Scholar and Google were performed using dental general anesthesia related keyword...

  17. FDA Certified Mammography Facilities

    Science.gov (United States)

    ... Program Consumer Information (MQSA) Search for a Certified Facility Share Tweet Linkedin Pin it More sharing options ... Email Print This list of FDA Certified Mammography Facilities is updated weekly. If you click on Search ...

  18. Management of a pediatric patient with epidermolysis bullosa receiving comprehensive dental treatment under general anesthesia.

    Science.gov (United States)

    Yoon, Richard K; Ohkawa, Susumu

    2012-01-01

    The purpose of this report was to detail clinical considerations and a general anesthetic approach for a 3-year-old pediatric dental patient with epidermolysis bullosa, a group of rare genetic disorders characterized by blister development following minor trauma or traction to the skin or mucosal surfaces. Challenges in providing comprehensive dental treatment and care under general anesthesia are discussed. Early evaluation is vital to preventing the consequences of severe early childhood caries.

  19. Virtual Pediatric Hospital

    Science.gov (United States)

    ... Assistant™ Last revised on February 22, 2017 Related Digital Libraries Pediatric GeneralPediatrics.com - the general pediatrician's view of the Internet PediatricEducation.org - a pediatric digital library and learning collaboratory intended to serve as a ...

  20. Different Aspects of General Anesthesia in Pediatric Dentistry: A Review

    OpenAIRE

    Nahid Ramazani

    2016-01-01

    Context Most child population is able to undergo dental treatment in the conventional setting. However, some children fail to cope with in-office conscious state and cannot respond to usual management modalities. This review aims to discuss the topic further. Evidence Acquisition A computerized search in databases PubMed, MEDLINE, EMBASE, Google Scholar and Google were performed using dental general anesthesia related keywords. Or...

  1. Rates and risk factors of unplanned 30-day readmission following general and thoracic pediatric surgical procedures.

    Science.gov (United States)

    Polites, Stephanie F; Potter, Donald D; Glasgow, Amy E; Klinkner, Denise B; Moir, Christopher R; Ishitani, Michael B; Habermann, Elizabeth B

    2017-08-01

    Postoperative unplanned readmissions are costly and decrease patient satisfaction; however, little is known about this complication in pediatric surgery. The purpose of this study was to determine rates and predictors of unplanned readmission in a multi-institutional cohort of pediatric surgical patients. Unplanned 30-day readmissions following general and thoracic surgical procedures in children Pediatric. Time-dependent rates of readmission per 30 person-days were determined to account for varied postoperative length of stay (pLOS). Patients were randomly divided into 70% derivation and 30% validation cohorts which were used for creation and validation of a risk model for readmission. Readmission occurred in 1948 (3.6%) of 54,870 children for a rate of 4.3% per 30 person-days. Adjusted predictors of readmission included hepatobiliary procedures, increased wound class, operative duration, complications, and pLOS. The predictive model discriminated well in the derivation and validation cohorts (AUROC 0.710 and 0.701) with good calibration between observed and expected readmission events in both cohorts (p>.05). Unplanned readmission occurs less frequently in pediatric surgery than what is described in adults, calling into question its use as a quality indicator in this population. Factors that predict readmission including type of procedure, complications, and pLOS can be used to identify at-risk children and develop prevention strategies. III. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Receiving Providers' Perceptions on Information Transmission During Interfacility Transfers to General Pediatric Floors.

    Science.gov (United States)

    Rosenthal, Jennifer L; Romano, Patrick S; Kokroko, Jolene; Gu, Wendi; Okumura, Megumi J

    2017-06-01

    Pediatric patients can present to a medical facility and subsequently be transferred to a different hospital for definitive care. Interfacility transfers require a provider handoff across facilities, posing risks that may affect patient outcomes. The goal of this study was to describe the thoroughness of information transmission between providers during interfacility transfers, to describe perceived errors in care at the posttransfer facility, and to identify potential associations between thoroughness of information transmission and perceived errors in care. We performed an exploratory prospective cohort study on communication practices and patient outcomes during interfacility transfers to general pediatric floors. Data were collected from provider surveys and chart review. Descriptive statistics were used to summarize survey responses. Logistic regression was used to analyze the association of communication deficits with odds of having a perceived error in care. A total of 633 patient transfers were reviewed; 218 transport command physician surveys and 217 frontline provider surveys were completed. Transport command physicians reported higher proportions of key elements being included in the verbal handoff compared with frontline providers. The written key element transmitted with the lowest frequency was a summary document (65.2%), and 13% of transfers had at least 1 perceived error in care. Transfers with many deficits were associated with higher odds of having a perceived error in care. Information transmission during pediatric transfers is perceived to be inconsistently complete. Deficits in the verbal and written information transmission are associated with odds of having a perceived error in care. Copyright © 2017 by the American Academy of Pediatrics.

  3. Conscious sedation vs general anesthesia in pediatric dentistry – a review

    OpenAIRE

    Silva,Cátia Carvalho; Lavado, Carla; Areias, Cristina; Mourão, Joana; Andrade, David

    2015-01-01

    INTRODUCTION: Performing dental treatments on pediatric patients who present behavioral problems is usually a great clinical challenge. Depending on the patients’ emotional maturity and their physical, psychological and mental skills, the usual behavior control techniques may not offer adequate efficacy and safety when dental procedures are being carried out. In these circumstances, alternative and more invasive methods such as conscious sedation and general anesthesia may become necess...

  4. VT Certified Local Governments

    Data.gov (United States)

    Vermont Center for Geographic Information — Vermont established its Certified Local Government (CLG) program in 1985 to better help local governments integrate historic preservation concerns with planning and...

  5. Medical diagnoses of pediatric dental patients treated under general anesthesia: a 19 year review.

    Science.gov (United States)

    Roberts, Michael W; Milano, Michael; Lee, Jessica Y

    2009-01-01

    The objective of this study was to examine the records of pediatric dental patients treated under general anesthesia to determine if there had been any significant change in preoperative diagnoses between 1990-99 and 2000-08. The records of 3298 pediatric dental patients treated in the operating room under general anesthesia at the University of North Carolina (UNC) Children's Hospital were examined and medical diagnoses recorded. The number of cases treated by calendar year was obtained. The results of this study did not find any significant differences in percentage frequency of medical diagnoses between the years of 1990-99 and 2000-08. There has been a steady increase in the number of cases treated under general anesthesia over the period of the study. 1. Dental care under general anesthesia remains an important treatment option. 2. The medical diagnoses of children provided dental treatment under general anesthesia has not changed significantly over the past nineteen years at the UNC Children's Hospital. 3. The demand to provide dental care for children under general anesthesia has continued to increase.

  6. [Use of hypnosis in radiotherapy as an alternative to general anesthesia in pediatric radiation oncology].

    Science.gov (United States)

    Claude, Line; Morelle, Magali; Mancini, Sandrine; Duncan, Anita; Sebban, Henri; Carrie, Christian; Marec-Berard, Perrine

    2016-11-01

    General anesthesia (GA) is often needed for radiotherapy (RT) in young children. This study aimed to evaluate the place of the rituals and/or hypnosis in pediatric in a reference center in pediatric radiation oncology in Rhône-Alpes Auvergne. This observational study retrospectively collected data on AG in childrenhypnosis systematically. Explanatory analyses of AG were performed using logistic regression. One hundred and thirty-two children benefited from RT in that period and were included (70 patients until 2008, 62 after 2008). Fifty-three percent were irradiated under GA. There was significant reduction (Phypnosis can be used instead of GA in about half of patients under 5 years, even also with high-technicity RT requiring optimal immobilization. Copyright © 2016 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  7. [Minimally invasive surgery in pediatric patients within a general urology department].

    Science.gov (United States)

    Ríos, Jorge Subirá; Zalabardo, José Manuel Sánchez; Gil, Joaquín Navarro; Conejos, José Ignacio Hijazo; Alonso, Jesús García-Magariño; Calero, David García; López, José Antonio López; Uría, José Gabriel Valdivia

    2008-01-01

    The advances of minimally invasive surgery in urology over the last years have enabled a progressive and constant implementation of endourology and laparoscopy in pediatric patients. We perform a review of our experience, as a general hospital, with minimally invasive surgery performed in pediatric patients over the last ten years. We retrospectively analyzed the endourological and laparoscopic operations performed between 1997 and 2007 in children up to the age of 16 years, collecting data about patient's age and gender, type of disease, techniques, anesthesia, and perioperative events. seventy-two surgical operations were performed in patients with an age range between 28 days and 16 years, with a mean age of 6.8 years. 56% of the patients were boys and 44% girls. Indications for surgery was vesicoureteral reflux (VUR) in 28 cases (38.8%); lithiasis 17 cases (23.6%) which were distributed in 4 cystolithotripsies, 9 ureterorenoscopy with lithotripsy, one pure percutaneous nephrolithotomy and three mixed; ureterocele 9 cases (12.5%); urethral obstruction 7 cases (9.7%); 3 diagnostic laparoscopies for cryptorchidism (4. 1%), 2 laparoscopic procedures for cystic pathology (2.7%), another 2 laparoscopic renal biopsies (2.7%), and one laparoscopic repair of a ureteropyelic junction syndrome; 1 case of emergency percutaneous nephrostomy in the supine position after open pyeloplasty with subsequent reoperation with percutaneous resection of a granuloma; and 1 case of botulin toxin injection into the detrusor muscle. The consolidation of pediatric endourology in our department, and more recently laparoscopy, has contributed to improve the quality of care in pediatric patients; it has been achieved thanks to our previous know-how in general endourological techniques and the existence of adequate technical and human resources.

  8. Utilization of stainless steel crowns by general dentists and pediatric dental specialists in Indiana.

    Science.gov (United States)

    Kowolik, Joan; Kozlowski, Diana; Jones, James E

    2007-01-01

    The purpose of this study was to evaluate utilization of the stainless steel crown by both the general and pediatric dentists in Indiana. Although reports indicate that there has been a dramatic reduction in dental caries in the US, almost 20 percent of children have dental decay by age four, with almost 80 percent having a cavity by 17 years of age. After reviewing the literature, Seale has recommended that the stainless steel crown is the most successful restoration for children with a rate of high caries. All dental schools in North America teach the value of using stainless steel crowns and the method of tooth preparation. We hypothesized that greater use of the stainless steel crowns would be made by specialists than by general dentists. In this study, of the 200 questionnaires distributed, 62.5 percent were returned and analyzed. The results imply that stainless steel crowns are being significantly underutilized in general dental practice. It is interesting, and perhaps of concern, that the general dentists are not interested in continuing education courses about this subject. Over the next few years, with the aging of the pediatric dental community in Indiana, general (not specialty) dentists will treat most of the children. Because of this, pre-doctoral education needs to place more emphasis on preparation and utilization of the stainless steel crown.

  9. A survey of dental treatment under general anesthesia in a Korean university hospital pediatric dental clinic.

    Science.gov (United States)

    Shin, Bisol; Yoo, Seunghoon; Kim, Jongsoo; Kim, Seungoh; Kim, Jongbin

    2016-09-01

    In South Korea, the number of cases of dental treatment for the disabled is gradually increasing, primarily at regional dental clinics for the disabled. This study investigated pediatric patients at a treatment clinic for the disabled within a university hospital who received dental treatment under general anesthesia. This data could assist those that provide dental treatment for the disabled and guide future treatment directions and new policies. This study was a retrospective analysis of 263 cases in which patients received dental treatment under general anesthesia from January 2011 to May 2016. The variables examined were gender, age, reason for anesthesia, type of disability, time under anesthesia, duration of treatment, type of procedure, treatment details, and annual trends in the use of general anesthesia. Among pediatric patients with disabilities who received dental treatment under general anesthesia, the most prevalent age group was 5-8 years old (124 patients, 47.1%), and the primary reason for administering anesthesia was dental anxiety or phobia. The mean time under anesthesia was 132.7 ± 77.6 min, and the mean duration of treatment was 101.9 ± 71.2 min. The most common type of treatment was restoration, accounting for 158 of the 380 treatments performed. Due to increasing demand, the number of cases of dental treatment performed under general anesthesia is expected to continue increasing, and it can be a useful method of treatment in patients with dental anxiety or phobia.

  10. The ACGME case log: general surgery resident experience in pediatric surgery.

    Science.gov (United States)

    Gow, Kenneth W; Drake, F Thurston; Aarabi, Shahram; Waldhausen, John H

    2013-08-01

    General surgery (GS) residents in ACGME programs log cases performed during their residency. We reviewed designated pediatric surgery (PS) cases to assess for changes in performed cases over time. The ACGME case logs for graduating GS residents were reviewed from academic year (AY) 1989-1990 to 2010-2011 for designated pediatric cases. Overall and designated PS cases were analyzed. Data were combined into five blocks: Period I (AY1989-90 to AY1993-94), Period II (AY1994-95 to AY1998-99), Period III (AY1999-00 to AY2002-03), Period IV (AY2003-04 to AY2006-07), and Period V (AY2007-08 to AY2010-11). Periods IV and V were delineated by implementation of duty hour restrictions. Student t-tests compared averages among the time periods with significance at P pediatric cases declined for each period from an average of 47.7 in Period I to 33.8 in Period V. These changes are due to a decline in hernia repairs, which account for half of cases. All other cases contributed only minimally to the pediatric cases. The only laparoscopic cases in the database were anti-reflux procedures, which increased over time. GS residents perform a diminishing number of designated PS cases. This decline occurred before the onset of work-hour restrictions. These changes have implications on the capabilities of the current graduating workforce. However, the case log does not reflect all cases trainees may be exposed to, so revision of this list is recommended. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. General anesthesia: as a challenge and treatment need option in pediatric dentistry.

    Science.gov (United States)

    Del Machuca Portillo, María Carmen; Hanke Herrero, Rosana; del López Valle, Lydia; Machuca Portillo, Guillermo; Bullón Fernández, Pedro

    2005-12-01

    The purpose of this study was to determine the type and characteristics of the interventions, indications of dental treatment and procedures performed to patients treated under general anesthesia (GA) by pediatric dentistry residents, during the 1997-1999 period. A sample of 57 hospital records of patients treated as part of the Special Pediatric Course at the Puerto Rico Pediatric Hospital were reviewed. Statistical analysis was done using the chi-square test for inferences on proportions. MR patients made up 59.7% and NMR patients made up 40.3% of the sample studied. Ages ranged from 2 to 35 years with a mean age of 11 years (SD=8.54). MR patients were classified into 7 categories: mental retardation (38.2%), cerebral palsy (14.7%), epileptic (5.9%), mental syndromes (26.9%), hydrocephalic (5.9%), autism (5.9%) and others (2.9%). The NMR were classified into 5 categories: early childhood caries (65.2%), cardiac patients (8.7%), maxillofacial anomalies (4.3%), organic syndromes (13.1%) and others (8.7%). The dental procedures performed were: dental extractions 84%(MR) and 68% (NMR), restorative procedures 87.3%(MR) and 12.7%(NMR). Oral prophylaxis was performed in 76.8%, fissure sealants in 10.7% and topical fluoride applications in 21.8%. Dental extraction was a frequently performed procedure in both groups. The prevalence of exodontia and restorative procedures indicates the need to design and implement prevention programs for special pediatric patients.

  12. The ACGME case log: General surgery resident experience in pediatric surgery

    Science.gov (United States)

    Gow, Kenneth W.; Drake, F. Thurston; Aarabi, Shahram; Waldhausen, John H.

    2014-01-01

    Background General surgery (GS) residents in ACGME programs log cases performed during their residency. We reviewed designated pediatric surgery (PS) cases to assess for changes in performed cases over time. Methods The ACGME case logs for graduating GS residents were reviewed from academic year (AY) 1989–1990 to 2010–2011 for designated pediatric cases. Overall and designated PS cases were analyzed. Data were combined into five blocks: Period I (AY1989–90 to AY1993–94), Period II (AY1994–95 to AY1998–99), Period III (AY1999–00 to AY2002–03), Period IV (AY2003–04 to AY2006–07), and Period V (AY2007–08 to AY2010–11). Periods IV and V were delineated by implementation of duty hour restrictions. Student t-tests compared averages among the time periods with significance at P < .05. Results Overall GS case load remained relatively stable. Of total cases, PS cases accounted for 5.4% in Period I and 3.7% in Period V. Designated pediatric cases declined for each period from an average of 47.7 in Period I to 33.8 in Period V. These changes are due to a decline in hernia repairs, which account for half of cases. All other cases contributed only minimally to the pediatric cases. The only laparoscopic cases in the database were anti-reflux procedures, which increased over time. Conclusions GS residents perform a diminishing number of designated PS cases. This decline occurred before the onset of work-hour restrictions. These changes have implications on the capabilities of the current graduating workforce. However, the case log does not reflect all cases trainees may be exposed to, so revision of this list is recommended. PMID:23932601

  13. Pediatric patients on ketogenic diet undergoing general anesthesia-a medical record review.

    Science.gov (United States)

    Soysal, Elif; Gries, Heike; Wray, Carter

    2016-12-01

    To identify guidelines for anesthesia management and determine whether general anesthesia is safe for pediatric patients on ketogenic diet (KD). Retrospective medical record review. Postoperative recovery area. All pediatric patients who underwent general anesthesia while on KD between 2009 and 2014 were reviewed. We identified 24 patients who underwent a total of 33 procedures. All children were on KD due to intractable epilepsy. The age of patients ranged from 1 to 15 years. General anesthesia for the scheduled procedures. Patients' demographics, seizure history, type of procedure; perioperative blood chemistry, medications including the anesthesia administered, and postoperative complications. Twenty-four patients underwent a total of 33 procedures. The duration of KD treatment at the time of general anesthesia ranged from 4 days to 8 years. Among the 33 procedures, 3 patients had complications that could be attributable to KD and general anesthesia. A 9-year-old patient experienced increased seizures on postoperative day 0. An 8-year-old patient with hydropcephalus developed metabolic acidosis on postoperative day 1, and a 7-year-old patient's procedure was complicated by respiratory distress and increased seizure activity in the postanesthesia care unit. This study showed that it is relatively safe for children on KD to undergo general anesthesia. The 3 complications attributable to general anesthesia were mild, and the increased seizure frequencies in 2 patients returned back to baseline in 24 hours. Although normal saline is considered more beneficial than lactated Ringer's solution in patients on KD, normal saline should also be administered carefully because of the risk of exacerbating patients' metabolic acidosis. One should be aware of the potential change of the ketogenic status due to drugs given intraoperatively. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Certified Electronics Recyclers

    Science.gov (United States)

    Learn how EPA encourages all electronics recyclers become certified by demonstrating to an accredited, independent third-party auditor and that they meet specific standards to safely recycle and manage electronics.

  15. ENERGY STAR Certified Boilers

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 3.0 ENERGY STAR Program Requirements for Boilers that are effective as of October 1,...

  16. ENERGY STAR Certified Furnaces

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 4.0 ENERGY STAR Program Requirements for Furnaces that are effective as of February 1,...

  17. FDA Certified Mammography Facilities

    Science.gov (United States)

    ... Products Radiation-Emitting Products Home Radiation-Emitting Products Mammography Quality Standards Act and Program Consumer Information (MQSA) ... it Email Print This list of FDA Certified Mammography Facilities is updated weekly. If you click on ...

  18. ENERGY STAR Certified Computers

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 6.1 ENERGY STAR Program Requirements for Computers that are effective as of June 2, 2014....

  19. Extemporaneous Compounding of Oral Acitretin Suspension for Pediatric Patient with Generalized Pustular Psoriasis.

    Science.gov (United States)

    Choo, Winnie

    2016-01-01

    Generalized pustular psoriasis is rare in children, but it can occur and affect an extensive body surface area of a child. Treatment regimens can include medications that are not available in pediatric dosage form. Acitretin is considered one of the treatment options for acute generalized pustular psoriasis in children, but, in Singapore, it is only available as Neotigason capsules. Extemporaneous compounding of the powder content in the capsules was developed for formulating the oral acitretin suspension with a standardized formulation table and compounding process at National Skin Centre. An appropriate beyond-use date of the extemporaneous preparation was assigned after reviewing the photostability data of acitretin, compatibility of the active ingredient and excipients, and United States Pharmacopeia guidelines. It is deemed appropriate to assign a beyond-use date of 14 days when the extemporaneous preparation is stored in amber glass bottles at 2 degrees C to 8 degrees C.

  20. Stress system dysregulation in pediatric generalized anxiety disorder associated with comorbid depression.

    Science.gov (United States)

    Funke, R; Eichler, A; Distler, J; Golub, Y; Kratz, O; Moll, G H

    2016-12-16

    Because chronic stress is an important risk factor for anxiety states and depressive disorders, we studied hypothalamus-pituitary-adrenal (HPA) axis and sympathetic system activity via changes in cortisol and alpha amylase activity levels in pediatric generalized anxiety disorder (GAD) patients (n = 26) with comorbid depression and a healthy comparison group (n = 26). Morning plasma cortisol and diurnal profiles of salivary cortisol and salivary alpha amylase (sAA) activity were assessed, also reactivity of HPA-axis, sAA activity, and heart rate following a psychosocial stressor (Trier Social Stress Test for children). GAD patients with comorbid depression showed increased morning plasma and salivary cortisol levels, ameliorating throughout in-patient treatment, and higher sAA activity in their diurnal profile. Both HPA and sympathetic activity positively correlated with the severity of anxiety and depression. We also demonstrated a blunted HPA and sympathetic response to acute stress in patients. This pattern of neuroendocrine and sympathetic changes seems to be distinct from the one previously reported in pediatric patients with only social anxiety or depressive disorders. We propose morning plasma and saliva cortisol levels as potential physiological indicators for supporting the evaluation of symptoms' severity and treatment progress in children with GAD and comorbid depressive disorder.

  1. Levels of Stress among General Practitioners, Students and Specialists In Pediatric Dentistry during Dental Treatment.

    Science.gov (United States)

    Davidovich, E; Pessov, Y; Baniel, A; Ram, D

    2015-01-01

    To assess self-reported stress during the performance of different procedures in pediatric dentistry, according to the professional experience of the dentists. During the years 2010 to 2011, an anonymous survey was administered by means of an internet link, and by distribution at professional meetings of dentists . No statistically significant differences in stress were reported for maxilla and mandibular procedures. Placement of a rubber dam was rated as the most stressful procedure among dental students. For general practitioners and specialists, injection of local anesthesia to an anxious child was the most stressful procedure, regardless of age, sex, or years of professional experience. A negative correlation was found between years of experience and level of stress for all the procedures surveyed, but not for the use of nitrous oxide. No differences were found between male and female dentists in stress scores for any of the procedures. Higher rates of stress during operative procedures were reported among dental students than among experienced dentists. Anxiety of the pediatric patients, but not the location of the procedure: maxillary or mandibular, affected the dentists' reported level of stress.

  2. The Spectrum of General Surgery Interventions in Pediatric Patients with Ventricular Assist Devices.

    Science.gov (United States)

    Kamel, Fady; Buchholz, Holger; Dicken, Bryan; Conway, Jennifer

    2017-06-13

    Ventricular assist devices (VADs) have positively impacted the management of heart failure. However, they come with a range of complications. Although general surgical complications have been assessed in adults with VADs, there is no study to date that has assessed general surgery intervention in the pediatric population. Fifty-two patients who received VADs from 2005 to 2015 at the Stollery Children's Hospital were assessed for general surgery intervention and anticoagulation status at the time of intervention. Eighteen patients (35%) had general surgery intervention; there were 21 nonemergency procedures and six emergency procedures performed. For nonemergency procedures, 89% of patients had anticoagulation held within 24 hours of surgery and 84% had anticoagulation resumed within 4 hours postoperatively. Antiplatelet therapy was not held perioperatively. In both emergency and nonemergency procedures, anticoagulation status was not a factor in the success of the procedure. This study shows that it is safe to have general surgery intervention on the same admission as a VAD implant provided an appropriate interdisciplinary healthcare team is involved with the perioperative management of the patient.

  3. Knowledge and attitude of pediatric dentists, general dentists, postgraduates of pediatric dentistry, and dentists of other specialties toward the endodontic treatment of primary teeth

    Directory of Open Access Journals (Sweden)

    P Devendra Patil

    2016-01-01

    Full Text Available Background: Pediatric dentists (PDs play an important role in treating primary teeth and oral health care needs for children. Pulp therapy is widely used in the treatment of primary teeth. The choice of endodontic treatment modality changes among general dentist (GD and PD. Aim and Objectives: The aim of this study is to determine the attitudes of PDs, GDs, postgraduates (PGs of pediatric dentistry and dentists of other specialties toward endodontic treatment of primary teeth. Materials and Methods: A structured 20-item questionnaire was formulated in English and distributed to PD, GD's, PGs of pediatric dentistry, and dentist of other specialties. The filled questionnaire survey was statistically analyzed using simple descriptive analysis and inferential analysis was performed using Chi-square t- test. Results: Out of the 237 survey respondents, 27.43% were BDS (GD's, 16.88% were MDS (PD, 12.66% were PG's (pediatric dentistry, and 43.04% were MDS (other than PD. About 91.6% of the total respondents preferred endodontic procedures in primary teeth. Conclusion: The study concluded that the GD's, PD's, and dentist of other specialty differ in their treatment recommendations for primary teeth. The GDs and dentist of other specialty were regularly performing pulp therapy in primary teeth and should frequently update their knowledge about endodontic procedures in primary teeth.

  4. Comparison of Pediatric and General Orthopedic Surgeons? Approaches in Management of Developmental Dysplasia of the Hip and Flexible Flatfoot: the Road to Clinical Consensus

    OpenAIRE

    Ramin Haj Zargarbashi; Hirbod Nasiri Bonaki; Shayan Zadegan; Taghi Baghdadi; Mohammad Hossein Nabian; Mehdi Ramezan Shirazi

    2017-01-01

    Developmental dysplasia of the hip (DDH) and flatfoot are common pediatric orthopedic disorders, being referred to and managed by both general and pediatric orthopedic surgeons, through various modalities. Our study aimed to evaluate their consensus and perspective disagreements in terms of diagnostic and therapeutic approaches of the mentioned deformities. Forty participants in two groups of general orthopedic surgeons (GOS) (n=20) and pediatric orthopedic surgeons (POS) (n=20), were asked t...

  5. [Results of 30 children treated under dental general anesthesia in pediatric dentistry].

    Science.gov (United States)

    Chen, Xu; Liu, Yao; Jin, Shi-fu; Zhang, Qian; Jin, Xuan-yu

    2008-12-01

    To determine the age and sex characteristics of the children and type of dental procedures performed under dental general anesthesia (DGA) and to assess the results after six months to one year's follow-up. A sample of 30 patients treated under dental general anesthesia (DGA) during 2006-2007 in the Department of Pediatric Dentistry of China Medical University was reviewed. All the teeth were treated one time. The dental procedures performed included caries restoration, indirect pulp capping, pulpotomy, root canal therapy (RCT) and dental extraction. Oral prophylaxis and topical fluoride applications were performed on all teeth. Pit and fissure sealing was performed on all healthy premolars and molars. SPSS10.0 software package was used for statistical analysis. Chi-square test was used to analyze the difference of the sex distribution in different age group and the difference of dental procedures performed between the primary teeth and the permanent teeth. The age of the patients ranged from 19 months to 14 years. The mental retardation patients accounted for 10% and mental healthy patients accounted for 90% of the sample studied. Males were more than females with the ratio about 2 to 1 in each age group. The dental procedures performed were caries restoration (18.67%), indirect pulp capping (23.26%), pulpotomy (0.77%), RCT (29.16%), dental extractions (2.05%) and fissure sealants (26.09%). The percentage of RCT was higher than that of caries restoration in the primary teeth, whereas the result was opposite as for the permanent teeth as indicated by Chi-square test (X(2)=11.630, P=0.001). New dental caries was not found except 2 patients who suffered from dysnoesia and were not cooperative to have regular examination. Fillings were lost in 3 cases, with 3 anterior teeth and 2 posterior teeth after RCT. All the children could cooperate except two mental retardation patients during the follow-up visit. Caries restoration and RCT are the most frequently performed

  6. Pediatric information seeking behaviour, information needs, and information preferences of health care professionals in general emergency departments: Results from the Translating Emergency Knowledge for Kids (TREKK) Needs Assessment.

    Science.gov (United States)

    Scott, Shannon D; Albrecht, Lauren; Given, Lisa M; Hartling, Lisa; Johnson, David W; Jabbour, Mona; Klassen, Terry P

    2017-01-09

    The majority of children requiring emergency care are treated in general emergency departments (EDs) with variable levels of pediatric care expertise. The goal of the Translating Emergency Knowledge for Kids (TREKK) initiative is to implement the latest research in pediatric emergency medicine in general EDs to reduce clinical variation.

  7. A review of repeat general anesthesia for pediatric dental surgery in Alberta, Canada.

    Science.gov (United States)

    Schroth, Robert J; Smith, W F

    2007-01-01

    The purpose of this study was to review data from the province of Alberta, Canada for First Nations children who required more than 1 general anesthesia (GA) procedure for dental surgery from 1996 to 2005. This study was limited to First Nations and Inuit children younger than 18 years old in Alberta who received 2 or more GA procedures to facilitate dental treatment Data spanning 1996 to 2005 were provided from the Alberta Regional Office of First Nations & Inuit Health Branch, Health Canada. The entire database contained claims for 339 children who received repeat GA procedures for rehabilitative dental core. Seventy-six percent received 2 procedures, while the remainder underwent 3 or more surgeries. Twenty-four percent of First Nations children in this cohort were subjected to >2 GA procedures. Retreatment of previously restored teeth was a common observation. The majority of children were treated by general practitioners instead of pediatric dentists. Seventy-four percent who had 2 or more surgeries were treated by general dentists at the time of the first GA procedure. The mean age of children at the time of the first GA procedure was not associated with whether children received 2 or more GA procedures for dental care (P=.07). These data suggest that there may be on over-reliance on GA to treat dental caries for First Notions children in Alberta.

  8. Characteristics and Associated Comorbidities of Pediatric Dental Patients Treated under General Anesthesia.

    Science.gov (United States)

    Delfiner, Alexandra; Myers, Aaron; Lumsden, Christie; Chussid, Steve; Yoon, Richard

    2017-09-22

    To describe characteristics and identify common comorbidities of children receiving dental treatment under general anesthesia at Children's Hospital of New York-Presbyterian. Electronic medical records of all children that received dental treatment under general anesthesia through the Division of Pediatric Dentistry from 2012-2014 were reviewed. Data describing patient characteristics (age, sex, race/ethnicity, insurance carrier, and American Society of Anesthesiologists physical status classification system), medical history, and justification for treatment were collected. Descriptive statistics, including frequencies, percentages and t-tests, were calculated. A total of 298 electronic medical records were reviewed, of which 50 records were excluded due to missing information. Of the 248 electronic medical records included, the average age was 5-years-old and 58% were male. The most common reason for dental treatment under general anesthesia was extent and severity of dental disease (53%), followed by significant medical history (47%) and behavior/pre-cooperative age (39%). Those who were ASA III or IV were older (6.6-years) (ppediatric specialty services at Children's Hospital of NewYork-Presbyterian.

  9. Certified records manager exam

    Energy Technology Data Exchange (ETDEWEB)

    1990-01-01

    The Institute of Certified Records Managers (ICRM) is a non-profit, certifying organization of professional records managers and administrators. ICRM members are experienced in information requirements, records and information systems, and the related office systems and technologies. All members have met certification requirements and have received the Certified Records Manager (CRM) designation. As the field of information and records management moves toward standardization, and as the application of new technologies and technicalities complicate the measurement and demonstration of professional competence, the need for a means of identifying persons who have basic competency increases. The ICRM is providing such a means by testing and certifying basic knowledge. More and more job announcements are requiring this evidence of competency. Unfortunately, as an organization, NIRMA has a relatively small number of CRMs. The goal of the ICRM Development Group is two-fold; (1) to encourage NIRMA members to obtain their certification by providing basic information and support and; (2) to develop the Nuclear Specialist test module which will demonstrate that bearers have demonstrated expertise in nuclear records management as well as basic competencies. This report covers the examination process.

  10. Wound classification in pediatric general surgery: significant variation exists among providers.

    Science.gov (United States)

    Snyder, Rebecca A; Johnson, Lisa; Tice, Jamie; Wingo, Tammy; Williams, Dana; Wang, Li; Blakely, Martin L

    2013-11-01

    Risk-adjusted rates of surgical site infections (SSI) are used as a quality metric to facilitate improvement within a hospital system and allow comparison across institutions. The NSQIP-Pediatric, among others, uses surgical wound classification as a variable in models designed to predict risk-adjusted postoperative morbidity, including SSI rates. The purpose of this study was to measure the level of agreement in wound classification assignment among 3 providers: surgeons, operating room (OR) nurses, and NSQIP surgical clinical reviewers (SCR). An analysis was performed of pediatric general surgery operations from 2010 to 2011. Wound classification was assigned at the time of operation by the OR nurse and surgeon, and by the NSQIP SCR postoperatively, according to NSQIP methodology. Disagreement was defined as any discrepancy in classification among the 3 providers, and the level of agreement was determined using the kappa statistic. For the 374 procedures reviewed, there was an overall disagreement of 48% among all providers, kappa 0.48 (95% CI 0.43 to 0.53). When comparing wound classification by surgeon and NSQIP SCR, 23% of cases were in disagreement, kappa 0.74 (95% CI 0.68 to 0.78). Disagreement between OR nurse and either surgeon or NSQIP SCR was higher: 38%, kappa 0.45 (95% CI 0.38 to 0.53) and 40%, kappa 0.44 (95% CI 0.37 to 0.51). Fundoplication, appendectomy, and cholecystectomy demonstrated the highest overall disagreement (73%, 71%, and 60%, respectively). There is significant variation in assigning surgical wound classification among health care providers. For future SSI comparative analyses, it will be critical to improve uniformity and understanding of wound class assignment among providers and institutions. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Postoperative complications of pediatric dental general anesthesia procedure provided in Jeddah hospitals, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Almushayt Abdullah

    2009-02-01

    Full Text Available Abstract Background Review of post-operative morbidity reports for pediatric dental care under general anesthesia (GA show great variations. Until now, no morbidity data has been available to estimate the safety of pediatric patients under GA for dental rehabilitation in Saudi Arabia. The purposes of this study were to (1 investigate post-operative complications associated with dental care under GA and (2 correlate morbidity reports with patient's characteristics, dental procedures, and hospital protocol. Methods Study sample included 90 children attending GA for dental treatment at major governmental hospitals in Jeddah. Data were collected from every patient on three occasions, intra-operatively at the operating room, and post-operatively via phone calls in the first and third days after operation. Results Results showed that 99% of the children had one or more complaints in the first day in contrast to only 33% in the third day. Inability to eat (86%, sleepiness (71%, and pain (48% were the most common complaints in the first day, followed by bleeding (40%, drowsiness (39%, sore throat (34%, vomiting (26%, psychological changes (24%, fever (21%, cough (12%, and nausea (8%. A great significant complaints reduction was reported by the third post-operative day. Age, gender, admission type of the patients and GA duration were the factors that showed a significant relationship with post-operative complaints. Conclusion Post-operative morbidity was common, but mostly of mild severity and limited to the first day. Hospital staff efforts should be directed to control commonly reported postoperative complaints.

  12. Comparison of maternal anxiety scores in pediatric intensive care unit and general ward parents

    Directory of Open Access Journals (Sweden)

    Lie Affendi Kartikahadi

    2012-02-01

    Full Text Available Background Hospitalization of a child is known to be a dreadful and stressful situation for parents. One study reported that admitting a child to a general ward caused mild anxiety to mothers, while admitting a child to the pediatric intensive care unit (PICU caused moderate anxiety to mothers. Objective To compare Hamilton anxiety scores of mothers whose children were admitted to the PICU to those of mothers whose children were admitted to the general ward. Methods A cross-sectional study was done on mothers of children aged 1 month-12 years. Children were admitted to either the intensive care unit or the general ward from October 2010-January 2011. All subjects were assessed by Hamilton anxiety scores and questioned for risk factors and other causes of maternal anxiety. Consecutive sampling was used to allocate the subjects. Differences were considered statistically significant for P < 0.05. Results Of the 72 subjects, the median Hamilton anxiety score in mothers of children admitted to the PICU was 20.5 (interquartile range 14-29.75, higher than that of mothers of children admitted to the general ward (14, interquartile range 9-16.75. Mann-Whitney U test revealed a statistically significant difference in scores between the two groups (P = 0.001. Ancova multivariate analysis showed the admission location to be the only significant relationship to Hamilton anxiety score (P = 0.0001. Conclusion Hamilton anxiety scores were higher for mothers of children admitted to the PICU than that of mothers with children admitted to the general ward. [Paediatr Indones.2012;52:95-8].

  13. Pharmacotherapy for Pediatric Generalized Anxiety Disorder: A Systematic Evaluation of Efficacy, Safety and Tolerability

    Science.gov (United States)

    Dobson, Eric T.; Strawn, Jeffrey R.

    2016-01-01

    Background Randomized controlled trials consistently support the efficacy of antidepressants in treating youth with generalized anxiety disorder (GAD), although integrated examinations of efficacy, safety, and tolerability of psychotropic medications in GAD specifically are rare. With this in mind, we sought to describe the efficacy, safety and tolerability of psychopharmacologic interventions in youth with GAD. Methods Randomized, double-blind, placebo-controlled, prospective trials of psychopharmacologic interventions in youth with GAD were identified through a PubMed/Medline (1966–2015) search. Both authors manually reviewed trials and, to evaluate comparative efficacy and tolerability across medications, numbers needed to treat (NNT) (based on Pediatric Anxiety Rating Scale (PARS) remission criteria (PARS ≤8 [1]), and number needed to harm (NNH) for selected treatment-emergent adverse events (TEAEs) were calculated. Finally, treatment-emergent suicidality and taper-emergent/post-study adverse events are reported descriptively. Results Five trials that involved 1,186 patients and evaluated four medications were reviewed and efficacy data were extracted with regard to dimensional measures of anxiety. SSRI/SNRIs demonstrated efficacy in the reduction of anxiety symptoms with NNTs ranging from 2.8 to 9.3. TEAEs varied considerably between studies but tended to be mild and generally did not lead to discontinuation. Conclusions Data from five trials of SSRI/SNRI in youth with GAD, many of whom had co-occurring separation and social anxiety disorders, suggest superiority to placebo and favorable tolerability profiles. PMID:26660158

  14. ENERGY STAR Certified Displays - Deprecated

    Data.gov (United States)

    U.S. Environmental Protection Agency — This dataset is up-to-date but newer better data can be retrieved at: https://data.energystar.gov/dataset/ENERGY-STAR-Certified-Displays/xsyb-v8gs Certified models...

  15. Body temperature increases during pediatric full mouth rehabilitation surgery under general anesthesia

    Directory of Open Access Journals (Sweden)

    Yi-Shan Chuang

    2015-12-01

    Conclusion: Body temperature transiently increased during pediatric full mouth rehabilitation surgery. The increase in body temperature was associated with operation duration. The etiology is uncertain. Continuous body temperature monitoring and the application of both heating and cooling devices during pediatric full mouth rehabilitation surgery should be mandatory.

  16. Influence of sub-specialty surgical care on outcomes for pediatric emergency general surgery patients in a low-middle income country.

    Science.gov (United States)

    Shah, Adil A; Shakoor, Amarah; Zogg, Cheryl K; Oyetunji, Tolulope; Ashfaq, Awais; Garvey, Erin M; Latif, Asad; Riviello, Robert; Qureshi, Faisal G; Mateen, Arif; Haider, Adil H; Zafar, Hasnain

    2016-05-01

    Whether adult general surgeons should handle pediatric emergencies is controversial. In many resource-limited settings, pediatric surgeons are not available. The study examined differences in surgical outcomes among children/adolescents managed by pediatric and adult general surgery teams for emergency general surgical (EGS) conditions at a university-hospital in South Asia. Pediatric patients (pediatric surgical management team. Outcome measures included: length of stay (LOS), mortality, and occurrence of ≥1 complication(s). Descriptive statistics and multivariable regression analyses with propensity scores to account for potential confounding were used to compare outcomes between the two groups. Quasi-experimental counterfactual models further examined hypothetical outcomes, assuming that all patients had been treated by pediatric surgeons. A total of 2323 patients were included. Average age was 7.1y (±5.5 SD); most patients were male (77.7%). 1958 (84.3%) were managed by pediatric surgery. The overall probability of developing a complication was 1.8%; 0.9% died (all adult general surgery). Patients managed by adult general surgery had higher risk-adjusted odds of developing complications (OR [95%CI]: 5.42 [2.10-14.00]) and longer average LOS (7.98 vs. 5.61 days, p pediatric surgery. Pediatric patients had better post-operative outcomes under pediatric surgical supervision, suggesting that, where possible in resource-constrained settings, resources should be allocated to promote development and staffing of pediatric surgical specialties parallel to adult general surgical teams. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  17. Difficulties of Alternatively Certified Teachers

    Science.gov (United States)

    Schonfeld, Irvin Sam; Feinman, Samantha J.

    2012-01-01

    This daily diary study followed, over a 2-week period, 252 beginning New York City public school teachers. Seventy percent were alternatively certified (New York City Teaching Fellows) and the rest, traditionally certified teachers. Alternatively certified teachers were more likely to experience stressors such as violent incidents and classroom…

  18. Oral health-related quality of life in pediatric patients under general anesthesia

    Science.gov (United States)

    Li, Lanlan; Wang, Hongwei; Han, Xueping

    2017-01-01

    Abstract Our goal was to evaluate how dental treatments under general anesthesia (GA) affect the quality of life by a prospective pair-matched design. Pediatric patients, who had received dental treatments under GA, were enrolled and were asked to complete the Early Childhood Oral Health Impact Scale (ECOHIS) before the treatment and 1 month after the treatment. To shield the observed impacts, a pair-matched control group was performed. Patients in the control group were also required to complete the ECOHIS at these different points in time. In both groups, the items of troubled sleep and oral/dental pain scored highest, whereas avoiding smiling or laughing and avoiding talking scored lowest before the treatment. The total mean score in the 2 groups was 13.1 and 13.7, respectively, and there was no significant statistical difference (P > 0.05). However, the total mean score was 1.9 in the experimental group after the treatment and smaller compared with the control group (1.9 vs. 4.7, P < 0.001). The majority of the items in both groups had an apparent effect size and the total mean effect in the experimental group was greater than that in the control group (85.5% vs. 65.7%, P < 0.001). Therefore, dental treatment under GA could provide better quality of life restoration compared with treatment over multiple visits. PMID:28079793

  19. Differences in pediatric dental services under general anesthesia for Medicaid and military dependent children.

    Science.gov (United States)

    Johnson, M B; Cappelli, D P; Bradshaw, B S; Mabry, J C

    2010-01-01

    This study's purpose was to compare pediatric dental services provided for Medicaid and military dependent children to determine if differences in dental treatment choices exist based on site and payment method. Subjects included 120 Medicaid patients at the University of Texas Health Science Center at San Antonio and 120 military dependents at Lackland Air Force Base, Texas. Demographic data and treatment information were abstracted for children younger than 6 years old receiving dental treatment under general anesthesia between 2002 and 2006. Data was analyzed using Wilcoxon rank sum, Kruskal-Wallis, and Fisher's exact tests. The Medicaid recipients were younger (40.2 vs 49.8 months, P<.001) and more likely to be Hispanic (78% vs 30%, P<.001). The means of decayed teeth, fillings, and stainless steel crowns did not differ between sites. Medicaid children received more composite fillings (P<.001), fewer amalgam fillings (P<.001), fewer pulp therapies (P<.001), more extractions (P=.01), and fewer sealants (P<.001). Age and gender did not affect decay rates, but those of Hispanic ethnicity did experience more decay than non-Hispanics (9.5 vs 8.6, P=.02). This study found no difference in the number of less conservative, albeit more costly, procedures performed with Medicaid children at a university compared to military dependents at a military base.

  20. 31 CFR 306.45 - Certifying individuals.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Certifying individuals. 306.45 Section 306.45 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY BUREAU OF THE PUBLIC DEBT GENERAL REGULATIONS GOVERNING...

  1. Methemoglobin levels in generally anesthetized pediatric dental patients receiving prilocaine versus lidocaine.

    Science.gov (United States)

    Gutenberg, Lauren L; Chen, Jung-Wei; Trapp, Larry

    2013-01-01

    The purpose of this study was to measure and compare peak methemoglobin levels and times to peak methemoglobin levels following the use of prilocaine and lidocaine in precooperative children undergoing comprehensive dental rehabilitation under general anesthesia. Ninety children, 3-6 years of age, undergoing dental rehabilitation under general anesthesia were enrolled and randomly assigned into 3 equal groups: group 1, 4% prilocaine plain, 5 mg/kg; group 2, 2% lidocaine with 1:100,000 epinephrine, 2.5 mg/kg; and group 3, no local anesthetic. Subjects in groups 1 and 2 were administered local anesthetic prior to restorative dental treatment. Methemoglobin levels (SpMET) were measured and recorded throughout the procedure using a Masimo Radical-7 Pulse Co-Oximeter (Masimo Corporation, Irvine, Calif, RDS-1 with SET software with methemoglobin interface). Data were analyzed using chi-square, one-way analysis of variance (ANOVA), and Pearson correlation (significance of P < .05). Group 1 had a significantly higher mean peak SpMET level at 3.55% than groups 2 and 3 at 1.63 and 1.60%, respectively. The mean time to peak SpMET was significantly shorter for group 3 at 29.50 minutes than that of group 1 at 62.73 and group 2 at 57.50 minutes. Prilocaine, at 5 mg/kg in pediatric dental patients, resulted in significantly higher peak SpMET levels than lidocaine and no local anesthetic. In comparison to no local anesthetic, the administration of prilocaine and lidocaine caused peak SpMET levels to occur significantly later in the procedure.

  2. 47 CFR 15.202 - Certified operating frequency range.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Certified operating frequency range. 15.202 Section 15.202 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL RADIO FREQUENCY DEVICES Intentional Radiators § 15.202 Certified operating frequency range. Client devices that operate in a...

  3. Comparison of surgical outcomes among infants in neonatal intensive care units treated by pediatric surgeons versus general surgeons: The need for pediatric surgery specialists.

    Science.gov (United States)

    Boo, Yoon Jung; Lee, Eun Hee; Lee, Ji Sung

    2017-01-31

    This study compared the outcomes of infants who underwent surgery in neonatal intensive care units by pediatric surgeons and by general surgeons. This was a retrospective study of infants who underwent surgery in neonatal intensive care units between 2010 and 2014. A total of 227 patients were included. Of these patients, 116 were operated on by pediatric surgeons (PS) and 111 were operated on by general surgeons (GS). The outcome measures were the overall rate of operative complications, unplanned reoperation, mortality rate, length of stay, operative time, and number of total number of operative procedures. The overall operative complication rate was higher in the GS group compared with the PS group (18.7% vs. 7.0%, p=0.0091). The rate of unplanned reoperations was also higher in the GS group (10.8% vs. 3.5%, p=0.0331). The median operation time (90min vs. 75min, p=0.0474) and median length of stay (24days vs. 18days, p=0.0075) were significantly longer in the GS group. The adjusted odd ratios of postoperative complications for GS were 2.9 times higher than that of PS (OR 2.90, p=0.0352). The operative quality and patient outcomes of the PS group were superior to those of the GS group. III. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Evaluation of efficacy of restorative dental treatment provided under general anesthesia at hospitalized pediatric dental patients of Isfahan

    OpenAIRE

    Eshghi, Alireza; Samani, Mahdi Jafarzadeh; Najafi, Naghme Feyzi; Hajiahmadi, Maryam

    2012-01-01

    Background: General anesthesia (GA) allows dental treatment to be rendered under optimal conditions, theoretically ensuring ideal outcomes. The aim of this study was to determine the efficacy of restorative dental procedures performed under GA. Materials and Methods: In this cross-sectional retrospective study, 305 pediatric patients who had been treated under GA 6 to 24 months before our survey at Isfahan's hospitalized dentistry center were examined. The examination was performed on dental ...

  5. Knowledge, Attitude and Practices of General Surgeons Regarding Pediatric Inguinal Hernia at Liaquat University Hospital Jamshoro Sindh

    OpenAIRE

    Pushpa Goswami; Samreen Memon; Nand Lal Kella

    2014-01-01

    Inguinal hernia is a most common surgical condition worldwide during infancy. In spite of significant improvements in pediatric surgery it still carries mortality and morbidity due to delay between diagnosis and surgical intervention. A delay in the treatment of inguinal hernia may lead to incarceration and strangulation. In developing countries like us the risk of incarceration and complications is much higher due to delay in seeking treatment due to lack of awareness among parents, general ...

  6. Knowledge, Attitude and Practices of General Surgeons Regarding Pediatric Inguinal Hernia at Liaquat University Hospital Jamshoro Sindh

    OpenAIRE

    Pushpa Goswami; Samreen Memon; Nand Lal Kella

    2014-01-01

    Inguinal hernia is a most common surgical condition worldwide during infancy. In spite of significant improvements in pediatric surgery it still carries mortality and morbidity due to delay between diagnosis and surgical intervention. A delay in the treatment of inguinal hernia may lead to incarceration and strangulation. In developing countries like us the risk of incarceration and complications is much higher due to delay in seeking treatment due to lack of awareness among parents, general ...

  7. Frequency of genetic diseases and health coverage of children requiring admission in a general pediatric clinic of northern Greece

    Directory of Open Access Journals (Sweden)

    Lialiaris Theodoros

    2010-01-01

    Full Text Available Abstract Background In order to estimate the causes of pediatric morbidity in our area, with particular emphasis on diseases with a genetic background, we retrospectively categorized the admissions of all children hospitalized in the Department of Pediatrics of the University General Hospital of Alexandroupolis, in the area of Evros, Thrace, Greece over the three year period 2005-2007. Finally, in order to guide health care administrators to improve the delivery of pediatric health care services, we estimated the percentage of hospitalized children who were uninsured and the type of health insurance of those who had medical coverage. Patients and Methods The causes of admission, as recorded in the medical records were categorized in terms of the major organ and/or system involved and/or the underlying pathology, with emphasis on diseases with a genetic background. Duplicate admissions, i.e., admissions of the same child for the same underlying disease were excluded. Additional information recorded was age, sex, and type of health insurance of all admitted children. Distribution of the causes of admission by study year was compared by chi-square. A p value Results Over the study period, there were 4,947 admissions in 2,818 boys and 2,129 girls. Respiratory diseases were the most common accounting for 30%, while infectious diseases followed with 26.4%. The frequency of chromosomal abnormalities among the hospitalized children was only 0.06%. However, if we consider diseases with an underlying genetic background, this percentage rises to 5%. Approximately 10.3% of the admitted children had no health insurance. Conclusions The percentage of children hospitalized in our area due to a disease with an underlying genetic background was 5%. This percentage pertains to a Department of Pediatrics that has no inpatient subspecialty units and which is located within a General hospital, because hospitalizations for genetic diseases are more frequent in

  8. Management of pediatric central nervous system emergencies: a review for general radiologists.

    Science.gov (United States)

    Rebollo Polo, M

    2016-05-01

    To review the most common and most important diseases and disorders of the central nervous system (CNS) in pediatric emergencies, discussing the indications for different imaging tests in each context. In pediatric patients, acute neurologic symptoms (seizures, deteriorating level of consciousness, focal neurologic deficits, etc.) can appear in diverse clinical situations (trauma, child abuse, meningoencephalitis, ischemia…). It is important to decide on the most appropriate neuroimaging diagnostic algorithm for each situation and age group, as well as to know the signs of the most typical lesions that help us in the etiological differential diagnosis. Pediatric patients' increased vulnerability to ionizing radiation and the possible need for sedation in studies that require more time are factors that should be taken into account when indicating an imaging test. It is essential to weigh the risks and benefits for the patient and to avoid unnecessary studies. Copyright © 2016 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  9. DGNB certified Healthcare Centres

    DEFF Research Database (Denmark)

    Brunsgaard, Camilla; Larsen, Tine Steen

    2015-01-01

    In recent years, research and the building industry greatly focused on lowering and optimising the energy use of buildings during operation. It has resulted in several pilot projects which illustrate how it can be achieved. At the same time voluntary sustainability certification schemes (BEAM, LEED...... interviews of key actors in each design team. Each interview is analysed individually and summarised in a report. Finally the four cases are analysed in a comparative study which draw a picture of what kind of DMaDP the DGNB certified HCC have had. At time of writing the analysis of the interviews....... At the same time it made the design teams work more conscious with sustainable initiatives. Nevertheless, different perceptions of when and how the DGNB consultant and engineers should be part of the initial sketching phases exist. Some believe there need be at first architectural idea. Others believe...

  10. Pediatric acute respiratory distress syndrome: Host factors in Down syndrome and the general population

    NARCIS (Netherlands)

    M. Bruijn

    2013-01-01

    We find that Down syndrome is an important risk factor for developing acute respiratory distress syndrome (ARDS) in children, but the reason why remains to be elucidated. In addition, we find several differences between adult and pediatric ARDS. The association between C-reactive protein (CRP) level

  11. [Pediatric traumatic brain injury due to civil gunshot wounds at a General Hospital in Cali, Colombia].

    Science.gov (United States)

    Parrado Sánchez, L; Gómez, C; Valderrama Chaparro, J A; Beltrán Osorio, L D; Sierra Ruiz, M; Enríquez Marulanda, A; Lobato Polo, J

    2017-01-25

    Traumatic brain injury (TBI) due to gunshot-wounds (GSW) is a critical situation in the pediatric population. The aim of this study is to characterize TBI in this population since there are few reports that describe it especially in Colombia where its incidence is high, also to determine which were the main mortality predictor within our population. We conducted a retrospective cross-sectional study in which we reviewed pediatric medical records of patients that had consulted at the Fundacion Valle del Lili pediatric Emergency Room between January of 2011 and December of 2015 because of TBI due to GSW. A descriptive statistical analysis was performed. In our sample of 32 patients the average age was of 13.3 (SD ± 5.4) and with 75% male patients. In our sample the Glasgow Coma Scale (GCS) at entry was less than 8 in 59.38%, a 15.6% needed craniotomy and 81.2% were admitted to the Intensive Care Unit (ICU). Death occurred in 43.75% of cases. The following mortality predictors were obtained: GCS at entry, pupillary exam and light reflexes, ISS, Marshal Score, absence of basal cisterns and presence of subarachnoid hemorrhage in CT scan, and APACHE II. TBI due to GSW is a devastating entity, especially in the pediatric population, they are responsible of high mortality and disability rates. There were no significant findings regarding infection rates and the use of surgery as a preventive method, therefore there's a chance it might not be indicated.

  12. Innovative Training in Pediatrics, General Psychiatry, and Child Psychiatry: Background, Outcomes, and Experiences

    Science.gov (United States)

    Gleason, Mary Margaret; Fritz, Gregory K.

    2009-01-01

    Objectives: The authors describe the history, rationale, and outcomes of combined training programs in pediatrics, psychiatry, and child psychiatry ("triple board"), including narrative feedback from graduates and reflections upon the important components of the program. Methods: This article reviews the background and experiences of triple board…

  13. Characterization of the age-dependent shape of the pediatric thoracic spine and vertebrae using generalized procrustes analysis.

    Science.gov (United States)

    Peters, James R; Campbell, Robert M; Balasubramanian, Sriram

    2017-08-11

    Generalized Procrustes Analysis (GPA) is a superimposition method used to generate size-invariant distributions of homologous landmark points. Several studies have used GPA to assess the three-dimensional (3D) shapes of or to evaluate sex-related differences in the human brain, skull, rib cage, pelvis and lower limbs. Previous studies of the pediatric thoracic vertebrae suggest that they may undergo changes in shape asa result of normative growth. This study uses GPA and second order polynomial equations to model growth and age- and sex-related changes in shape of the pediatric thoracic spine. We present a thorough analysis of the normative 3D shape, size, and orientation of the pediatric thoracic spine and vertebrae as well as equations which can be used to generate models of the thoracic spine and vertebrae for any age between 1 and 19years. Such models could be used to create more accurate 3D reconstructions of the thoracic spine, generate improved age-specific geometries for finite element models (FEMs) and used to assist clinicians with patient-specific planning and surgical interventions for spine deformity. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. 40 CFR 161.175 - Certified limits.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Certified limits. 161.175 Section 161... Certified limits. The applicant must propose certified limits for the ingredients in the product. Certified limits become legally binding limits upon approval of the application. Certified limits will apply to...

  15. General Hospital and Personal Use Devices: Renaming of Pediatric Hospital Bed Classification and Designation of Special Controls for Pediatric Medical Crib; Classification of Medical Bassinet. Final rule.

    Science.gov (United States)

    2016-12-19

    The Food and Drug Administration (FDA) is issuing a final rule to rename pediatric hospital beds as pediatric medical cribs and establish special controls for these devices. FDA is also establishing a separate classification regulation for medical bassinets, previously under the pediatric hospital bed classification regulation, as a class II (special controls) device. In addition, this rule continues to allow both devices to be exempt from premarket notification and use of the device in traditional health care settings and permits prescription use of pediatric medical cribs and bassinets outside of traditional health care settings.

  16. Pediatric referrals to psychiatry in a Tertiary Care General Hospital: A descriptive study

    Directory of Open Access Journals (Sweden)

    Bheemsain Tekkalaki

    2017-01-01

    Full Text Available Background: Children with chronic physical illnesses frequently have psychiatric comorbidities, which often go un-noticed and may lead to more resource utilization and morbidity. Pediatric liaison services can be effectively used to bridge this gap. Literature on pediatric liaison services is sparse. Aims: To study the referral patterns, reasons for referrals, psychiatric diagnoses and interventions in children and adolescents referred to psychiatry department in a tertiary care hospital. Materials and Methods: A retrospective chart analysis of all children and adolescents below 19 years of age, referred to psychiatry department from 2010 to 2015, was done. Data was collected and statistical analysis was done. Results: Two hundred and nine subjects were included in the study. Mean age of sample was 12.15 (±4.20 years, with about 66.02% being males. About 54.06% of the participants were referred from pediatricians. Almost three fourth (72.25% of children had no diagnosable physical illness. Intellectual disability (19.62% was the most common psychiatric diagnosis, followed by depressive disorders (14.35%, and dissociative disorders (12.92%. Conclusions: In our study, majority of the referrals were the adolescent males from pediatric department. Intellectual disability, depressive disorder, and stress-related disorders were the common diagnoses. The fact that three-fourth of the referred children had no physical illness implies lack of awareness, stigma toward mental illness, and pathway of care.

  17. Whole-body MRI in generalized cystic lymphangiomatosis in the pediatric population: diagnosis, differential diagnoses, and follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Herruela-Suffee, Cecile; Warin, Mathilde; Castier-Amouyel, Melody; Dallery, Florine; Bonnaire, Bruno; Constans, Jean-Marc [CHU Amiens-Picardie, Service de Radiologie, Amiens Cedex 1 (France)

    2016-02-15

    Generalized cystic lymphangiomatosis is a particularly rare disease with variable involvement of skeletal and extraskeletal sites. The key role of imaging in the diagnosis of this disease is no longer in doubt. The aim of our study was to demonstrate the contribution of whole-body magnetic resonance imaging (WB-MRI) at the diagnostic stage and during the follow-up in the pediatric population. Three children were included from 2008. The inclusion criteria were radiological images (conventional radiographs, computed tomography, and MRI) compatible with histological confirmation. Each child included received WB-MRI at the diagnosis stage and during follow-up. WB-MRI detected multiple hypointense T1 and hyperintense T2-STIR cystic bony lesions. One unnoticed mass in the retroperitoneum on computed tomography was easily detected by MRI. Mediastinal involvement was observed in one asymptomatic case. Histology was contributory in all cases. Preventive intramedullary nailings was done in one case. Follow-up WB-MRI detected new asymptomatic lesions in all cases. One child presented a third episode of lymphangitis of the right thigh during follow-up. Due to its high sensitivity to diagnose, ability to eliminate differential diagnoses and make exhaustive lesions assessment, and its non-radiating character for long-term follow-up, WB-MRI is highly recommended for generalized cystic lymphangiomatosis in the pediatric population. (orig.)

  18. ENERGY STAR Certified Imaging Equipment

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 2.0 ENERGY STAR Program Requirements for Imaging Equipment that are effective as of...

  19. ENERGY STAR Certified Water Coolers

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 2.0 ENERGY STAR Program Requirements for Water Coolers that are effective as of February...

  20. ENERGY STAR Certified Vending Machines

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 3.0 ENERGY STAR Program Requirements for Refrigerated Beverage Vending Machines that are...

  1. ENERGY STAR Certified Water Heaters

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 3.0 ENERGY STAR Program Requirements for Water Heaters that are effective April 16, 2015....

  2. ENERGY STAR Certified Commercial Dishwashers

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 2.0 ENERGY STAR Program Requirements for Commercial Dishwashers that are effective as of...

  3. ENERGY STAR Certified Audio Video

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 3.0 ENERGY STAR Program Requirements for Audio Video Equipment that are effective as of...

  4. ENERGY STAR Certified Residential Dishwashers

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 6.0 ENERGY STAR Program Requirements for Residential Dishwashers that are effective as of...

  5. ENERGY STAR Certified Commercial Fryers

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 3.0 ENERGY STAR Program Requirements for Commercial Fryers that are effective as of...

  6. Time and Cost Analysis: Pediatric Dental Rehabilitation with General Anesthesia in the Office and the Hospital Settings

    Science.gov (United States)

    Rashewsky, Stephanie; Parameswaran, Ashish; Sloane, Carole; Ferguson, Fred; Epstein, Ralph

    2012-01-01

    Pediatric dental patients who cannot receive dental care in the clinic due to uncooperative behavior are often referred to receive dental care under general anesthesia (GA). At Stony Brook Medicine, dental patients requiring treatment with GA receive dental care in our outpatient facility at the Stony Brook School of Dental Medicine (SDM) or in the Stony Brook University Hospital ambulatory setting (SBUH). This study investigates the time and cost for ambulatory American Society of Anesthesiologists (ASA) Class I pediatric patients receiving full-mouth dental rehabilitation using GA in these 2 locations, along with a descriptive analysis of the patients and dental services provided. In this institutional review board–approved cross-sectional retrospective study, ICD-9 codes for dental caries (521.00) were used to collect patient records between July 2009 and May 2011. Participants were limited to ASA I patients aged 36–60 months. Complete records from 96 patients were reviewed. There were significant differences in cost, total anesthesia time, and recovery room time (P anesthesia end time minus anesthesia start time) to treat a child at SBUH under GA was 222 ± 62.7 minutes, and recovery time (time of discharge minus anesthesia end time) was 157 ± 97.2 minutes; the average total cost was $7,303. At the SDM, the average total time was 175 ± 36.8 minutes, and recovery time was 25 ± 12.7 minutes; the average total cost was $414. After controlling for anesthesia time and procedures, we found that SBUH cost 13.2 times more than SDM. This study provides evidence that ASA I pediatric patients can receive full-mouth dental rehabilitation utilizing GA under the direction of dentist anesthesiologists in an office-based dental setting more quickly and at a lower cost. This is very promising for patients with the least access to care, including patients with special needs and lack of insurance. PMID:23241037

  7. 40 CFR 158.350 - Certified limits.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Certified limits. 158.350 Section 158... REQUIREMENTS FOR PESTICIDES Product Chemistry § 158.350 Certified limits. The applicant must propose certified limits for the ingredients in the product. Certified limits become legally binding limits upon...

  8. Intravenous midazolam sedation in pediatric diagnostic upper digestive endoscopy. A prospective study in a general hospital.

    Science.gov (United States)

    Verhage, Jan; Mulder, Chris J J; Willekens, Frans L A

    2003-12-01

    The positive role of benzodiazepines (Midazolam) in conscious sedation in pediatric patients is widely known. However, problems concerning the role of sedation in diagnostic upper endoscopy are a matter for debate as little is known about dosage and timing. We prospectively evaluated the efficacy, safety and optimal intravenous sedation dosage of midazolam in 257 consecutive patients, aged 2 months to 18 years old, who underwent upper endoscopy of the gastrointestinal tract. The initial midazolam dosage was 0.2 mg/kg Bw (Body weight) i.v. for 1 minute and, if necessary, another 0.1 mg/kg Bw was administered 5 minutes later. If sedation was sufficient, the procedure would be started 4-5 minutes later; if not, another 0.1 - 0.2 mg/kg Bw would be administered. All procedures were performed by a pediatrician together with a gastroenterologist. No serious complications occurred in any of the procedures. Oxygen saturation (OS) was maintained at over 90%, if necessary with blowby oxygen. Flumazenil was administered to 7 children (OS < 90%). Endoscopy could not be completed in 1 child. All endoscopies were completed within 10 minutes. No unexpected hospital admissions were necessary. The mean midazolam dosage was 0.4 mg/kg Bw in patients up to 6 years, for the over 6 years-olds the mean dosage was decreased to 0,2 mg/kg Bw. Particular attention was paid to the importance of informing patients before the procedure. Endoscopic diagnostic procedures can be performed safely and effectively in children with intravenous sedation in a well equipped pediatric endoscopy unit.

  9. Spectrum of digestive tract diseases 1985-1987 at the Pediatric Gastroenterology Outpatient Clinic of Dr. Pirngadi General Hospital, Medan.

    Science.gov (United States)

    Siregar, C D; Sinuhaji, A B; Sutanto, A H

    1990-01-01

    A retrospective study has been done on infants and children attending to the Pediatric Gastroenterology Outpatient Clinic of Dr. Pirngadi General Hospital in Medan, from 1985 through 1987. During the study there were 874 patients, 477 (54.58%) suffered from diarrhea, 209 (23.91%) had bloody stool, 20 (2.99%) jaundice, 57 (6.52%) abdominal pain, 48 (5.49%) abdominal distention, 30 (3.43%) vomiting, 13 (1.49%) constipation, and 20 (2.29%) others. Of all cases with diarrhoea, watery diarrhoea were found in only 319 (66.88%), diarrhoea with vomiting 84 (17.61%), and bloody diarrhoea 74 (15.51%). Stool examination in patients with diarrhoea revealed 144 (30.19%) cases with Candida albicans, while 16 (3.35%) of them with steatorrhoea. Of 63 patients with diarrhoea on which the clinitest had been performed, sugar intolerance were found in 30 (47.62%) cases.

  10. Is expertise in pediatric surgery necessary to perform laparoscopic splenectomy in children? An experience from a department of general surgery.

    Science.gov (United States)

    Guaglio, Marcello; Romano, Fabrizio; Garancini, Mattia; Degrate, Luca; Luperto, Margherita; Uggeri, Fabio; Scotti, Mauro; Uggeri, Franco

    2012-06-01

    Splenectomy is frequently required in children for various hematologic pathologic findings. Because of progress in minimally invasive techniques, laparoscopic splenectomy (LS) has become feasible. The objective of this report is to present a monocentric experience and to evaluate the efficacy of and complications observed after laparoscopic splenic procedures in a department of general surgery. 57 consecutive LSs have been performed in a pediatric population between January 2000 and October 2010. There were 33 females and 24 males with a median age of 12 years (range 4-17). Indications were: hereditary spherocytosis 38 cases, idiopathic thrombocytopenic purpura 10, sickle cell disease (SCD) 6, thrombocytopenic thrombotic purpura 2 and non-hodgkin lymphoma 1 case. Patients were operated on using right semilateral position, employing Atlas Ligasure vessel sealing system in 49 cases (86%) and Harmonic Scalpel + EndoGIA in 8. In 24 patients (42.1%), a cholecystectomy was associated. Two patients required conversion to open splenectomy (3.5%). In three cases, a minilaparotomy was performed for spleen removal (5.2%). Accessory spleens were identified in three patients (5.2%). Complications (8.8%) included bleeding (two), abdominal collection (one) and pleural effusion (two). There was no mortality. Average operative time was 128 min (range 80-220). Average length of stay was 3 days (range 2-7). Mean blood loss was 80 ml (range 30-500) with a transfusion rate of 1.7% (one patient). Laparoscopic spleen surgery is safe, reliable and effective in the pediatric population with hematologic disorders and is associated with minimal morbidity, zero mortality, and a short length of stay. Ligasure vessel sealing system shortened operative time and blood loss. On the basis of the results, we consider laparoscopic approach the gold standard for the treatment of these patients even in a department of general surgery.

  11. Seeking Coalitions between Certified and Non-Certified Art Educators

    Science.gov (United States)

    Lackey, Lara M.; Chou, Chun-Ming; Hsu, Pei-Lan

    2010-01-01

    This article explores the following question, posed in the call for submissions to this special issue, dealing with significant 21st-century debates for art education: "How can art educators embrace non-certified individuals who teach art in various settings such as craft stores, after-school programs, and community centers?" While the question…

  12. Certifiable Java for Embedded Systems

    DEFF Research Database (Denmark)

    Schoeberl, Martin; Dalsgaard, Andreas Engelbredt; Hansen, Rene Rydhof

    2014-01-01

    The Certifiable Java for Embedded Systems (CJ4ES) project aimed to develop a prototype development environment and platform for safety-critical software for embedded applications. There are three core constituents: A profile of the Java programming language that is tailored for safety...

  13. Ways of Improving the Training of Interns Pediatricians and General Practitioners — Family Physicians in «Pediatrics» Discipline

    Directory of Open Access Journals (Sweden)

    S.A. Mokiia-Serbina

    2015-10-01

    Full Text Available Graduates of medical schools having sufficient theoretical and practical skills often have difficulty in communicating with patients — children and their parents, as well as with colleagues. Objective: improving the efficiency of the educational process in the training of interns pediatricians and general practitioners — family physicians in «Pediatrics» course. Methods of the study: theoretical analysis of gathered experience. Results and discussion. During internship at the department, there are used seminars-discussions, seminars — training conferences, seminars — round tables that allows you to work out the tactics of speech, methods of discussion, reasoning of judgments, review, assessment, analysis. Interns most of the time must participate in the examination of a sick child, discussions of the results, conversations with parents. Clinical analysis of patients should be carried out using the method of structured group discussion when each intern can express his views. Interns are involved in scientific work, speak at scientific conferences. The department created a series of ambulatory pediatrics, -during which the intern talks to a child, his parents and he must to conciliate them, to inspire confidence and to prove himself as a specialist. During this course, special attention is paid to the psychological component of medical trai-ning. Clas-ses are conducted by assistant pediatrician, a graduate majoring in «Practical Psychology». Conclusions. The use of interactive teaching methods at different stages of the educational process contributes not only to improvement of theoretical activity, but also the formation in interns of professional qualities of clinical and scientific thinking, competence in the construction and development of interpersonal relations, humanism.

  14. Advanced general dentistry program directors' attitudes on physician involvement in pediatric oral health care.

    Science.gov (United States)

    Raybould, Ted P; Wrightson, A Stevens; Massey, Christi Sporl; Smith, Tim A; Skelton, Judith

    2009-01-01

    Childhood oral disease is a significant health problem, particularly for vulnerable populations. Since a major focus of General Dentistry Program directors is the management of vulnerable populations, we wanted to assess their attitudes regarding the inclusion of physicians in the prevention, assessment, and treatment of childhood oral disease. A survey was mailed to all General Practice Residency and Advanced Education in General Dentistry program directors (accessed through the ADA website) to gather data. Spearman's rho was used to determine correlation among variables due to nonnormal distributions. Overall, Advanced General Dentistry directors were supportive of physicians' involvement in basic aspects of oral health care for children, with the exception of applying fluoride varnish. The large majority of directors agreed with physicians' assessing children's oral health and counseling patients on the prevention of dental problems. Directors who treated larger numbers of children from vulnerable populations tended to strongly support physician assistance with early assessment and preventive counseling.

  15. [A case of a pediatric patient with tuberous sclerosis (Bourneville-Pringle disease) and frequent epileptic seizure for intensive dental treatment under general anesthesia].

    Science.gov (United States)

    Mimura, Shinichiro; Kikura, Mutsuhito; Itagaki, Taiga; Inokuma, Mie; Iwamoto, Tatsuaki; Kawakubo, Atsushi; Hirano, Kazuhiro; Sato, Shigehito

    2006-04-01

    Tuberous sclerosis (Bourneville-Pringle disease) is a rare disease with a triad of mental retardation, epilepsy, and facial spot. Management of the patients with tuberous sclerosis under general anesthesia has been previously reported. However, there are few case reports about management under general anesthesia of a pediatric patient with tuberous sclerosis with frequent epileptic seizure. Here, we report a case of a pediatric patient with tuberous sclerosis and frequent epileptic seizure who underwent intensive dental treatment under general anesthesia with careful management of epilepsy. The patient was discharged on the day of surgery without any complications. In this case report, we discussed the appropriate assessment of the complications of tuberous sclerosis; such as, of central nervous, circulatory, respiratory, endocrine, and urinary systems including the management of general anesthesia.

  16. Information Resources in Clinical Medicine: Family Practice, Pediatrics, Obstetrics and Gynecology, General Surgery, Internal Medicine.

    Science.gov (United States)

    Schwank, Jean; Allen, Joyce

    Designed for beginning health science librarians, this continuing education course syllabus presents a guide to information resources for answering physicians' questions about patient care. Sources from standard core lists, such as the Alfred Brandon list, are highlighted and described, along with additional titles. General resources covered…

  17. 7 CFR 983.7 - Certified pistachios.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Certified pistachios. 983.7 Section 983.7 Agriculture... and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE PISTACHIOS GROWN IN CALIFORNIA, ARIZONA, AND NEW MEXICO Definitions § 983.7 Certified pistachios. Certified pistachios are those that...

  18. 7 CFR 1221.4 - Certified organization.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Certified organization. 1221.4 Section 1221.4 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING... organization. Certified organization means any organization that has been certified by the Secretary...

  19. 7 CFR 1280.103 - Certified organization.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Certified organization. 1280.103 Section 1280.103 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING... organization. Certified organization means any organization which has been certified by the Secretary...

  20. Effect of Oral Midazolam Premedication on Children's Co-operation Before General Anesthesia in Pediatric Dentistry.

    Science.gov (United States)

    Kaviani, Nasser; Shahtusi, Mina; Haj Norousali Tehrani, Maryam; Nazari, Sara

    2014-09-01

    Premedication is expedient in reducing the psychological trauma from recalling the unpleasant pre-anesthetic phases, hence, inducing a trouble-free anesthesia. This study aimed to determine the effectiveness of oral midazolam in co-operation of the subjects before general anesthesia and in recalling the pre-anesthetic phases, performed on children candidate for dental treatment under general anesthesia. In this prospective clinical trial study, 62 healthy non-cooperative children, candidate for dental treatment under general anesthesia, were randomly divided into study and control groups. The children received 20ml orange juice, 20 minutes before starting the anesthesia. The juice of the test group contained 0.5mg/kg of midazolam and that of the control group included no medication. The induction and the maintenance process of anesthesia were similar in both groups. The manner of subjects when separated from parents, their cooperation during intravenous catheterization, and recalling the pre-anesthetic events were recorded. Data were analyzed by adopting chi-square and Mann-Whitney tests. Most of the children in the test group had a comfortable separation from parents, restful IV catheterization and 90% of the subjects did not recall the pre-anesthetic events. Under the circumstances of this study, it could be concluded that 0.5mg/kg oral midazolam premedication is effective for comfortable separation of children from parents and restful IV catheterization and also forgetting the pre-anesthetic events.

  1. The use of general anesthesia in pediatric dental care of children at multi-dental centers in Saudi Arabia.

    Science.gov (United States)

    Ba'akdah, Rania; Farsi, Najat; Boker, Abdulaziz; Al Mushayt, Abdullah

    2008-01-01

    High caries reports in young Saudi children strongly suggest the need occasionally for general anesthesia to provide quality dental work. The purpose of this study was to investigate the characteristics of patients, dental procedures and hospital protocols for Pediatric Dental General Anesthesia (PDGA) procedure at multi-dental centers in Jeddah, Saudi Arabia. Study sample included 90 children attending PDGA treatment at three governmental hospitals in Jeddah. Collected data included patient's demographics, medical condition, admission type, intra-operative protocols, and dental procedures. Results showed the mean age of treated children was 5 +/- 2 years and the majority of them (93%) were treated for the first time under general anesthesia (GA). Long waiting duration for PDGA procedure was reported regardless of the patient age and medical status. Being very young with extensive caries was the major indication for GA (58%). Children mean preoperative fasting times were 10 +/- 2 hours. Hospitals were significantly different in some protocols for PDGA procedures. Child behavior during GA induction was significantly related to child's age, premedication use, and hospital admission type. The mean number of treated teeth per child was 14 +/- 3.8 and the treatment mostly included restorations. Age was found to significantly affect the type of dental treatment, while gender and medical status did not. PDGA procedure is used mostly for young children with extensive dental caries. Children treated under GA received a comprehensive dental care in Saudi hospitals. Efforts should be directed to improve some of the existing hospitals protocols with PDGA procedure. The long waiting period for PDGA operation indicated the need to improve available facilities in the three hospitals.

  2. The effects of the addition of a pediatric surgery fellow on the operative experience of the general surgery resident.

    Science.gov (United States)

    Raines, Alexander; Garwe, Tabitha; Adeseye, Ademola; Ruiz-Elizalde, Alejandro; Churchill, Warren; Tuggle, David; Mantor, Cameron; Lees, Jason

    2015-06-01

    Adding fellows to surgical departments with residency programs can affect resident education. Our specific aim was to evaluate the effect of adding a pediatric surgery (PS) fellow on the number of index PS cases logged by the general surgery (GS) residents. At a single institution with both PS and GS programs, we examined the number of logged cases for the fellows and residents over 10 years [5 years before (Time 1) and 5 years after (Time 2) the addition of a PS fellow]. Additionally, the procedure related relative value units (RVUs) recorded by the faculty were evaluated. The fellows averaged 752 and 703 cases during Times 1 and 2, respectively, decreasing by 49 (P = 0.2303). The residents averaged 172 and 161 cases annually during Time 1 and Time 2, respectively, decreasing by 11 (P = 0.7340). The total number of procedure related RVUs was 4627 and 6000 during Times 1 and 2, respectively. The number of cases logged by the PS fellows and GS residents decreased after the addition of a PS fellow; however, the decrease was not significant. Programs can reasonably add an additional PS fellow, but care should be taken especially in programs that are otherwise static in size.

  3. Comparative study of postoperative morbidity in dental treatment under general anesthesia in pediatric patients with and without an underlying disease.

    Science.gov (United States)

    Escanilla-Casal, Alejandro; Ausucua-Ibáñez, Martina; Aznar-Gómez, Mireia; Viaño-García, José M; Sentís-Vilalta, Joan; Rivera-Baró, Alejandro

    2016-03-01

    To identify and quantify the variables and their influence on postoperative morbidity in dental treatment under general anesthesia (GA) in pediatric patients with and without an underlying disease. A prospective, descriptive, and comparative analysis was conducted of healthy (n = 49) and disabled/medically compromised (n = 81) children treated under GA. Intra-/post-surgical, clinical epidemiology, technical, care-related, and pharmacologic data were gathered, as were postoperative complications. The average age of ASA I patients (6.7 ± 4.4 years) was younger than that of ASA II-III patients (9.0 ± 4.5 years). Average hospitalization time was 4.27 ± 6.5 h in ASA I and 7.41 ± 6.8 h in ASA II-III. Significant differences were found between the two groups in fillings, pulpotomies, oral surgery, and scaling. Postoperative morbidity in ASA I and ASA II-III was similar both in frequency and severity and decreased during the first 72 h. The most common complication in both groups was toothache. Postoperative morbidity is high after dental treatment under GA, but it is not higher in disabled/medically compromised patients. © 2015 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. General dentists', pediatric dentists', and endodontists' diagnostic assessment and treatment strategies for deep carious lesions: A comparative analysis.

    Science.gov (United States)

    Koopaeei, Mahshid Majlessi; Inglehart, Marita R; McDonald, Neville; Fontana, Margherita

    2017-02-01

    There is a large variation among clinicians when managing deep carious lesions (DCLs). The purpose of this study was to assess general dentists' (GDs), pediatric dentists' (PDs), and endodontists' (EDs) diagnostic methods, clinical decision-making considerations, treatment strategies, and knowledge, behavior, and attitudes related to the diagnosis and treatment of DCLs. A total of 175 GDs, 511 PDs, and 377 EDs responded to a nationwide Web-based survey. Most EDs (68%) and GDs (47%) practiced complete caries removal. PDs (31%) were more likely than GDs (12%) and EDs (4%) to remove carious tissues partially. Dentin hardness was the most important diagnostic criterion used during caries excavation (GDs, 90%; PDs, 72%; EDs, 88%). Only 30% of GDs, 17% of PDs, and 90% of EDs used diagnostic tests (for example, a cold test) when assessing pupal health. A substantial percentage of respondents considered endodontic treatment as a choice for treating DCLs in asymptomatic teeth in young patients (GDs, 40%; PDs, 30%; EDs, 40%). GDs rarely used a rubber dam when treating these lesions. Most respondents practiced complete caries removal until hard dentin was felt, using hardness as the primary excavation criterion, and did not use pulp diagnostic tests routinely before making decisions about treatment of teeth with DCLs. Efforts should be made to translate the growing body of evidence supporting the use of conservative caries removal criteria to preserve pulpal health and tooth structure integrity when managing DCLs. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.

  5. The epidemiological profile of pediatric patients admitted to the general intensive care unit in an Ethiopian university hospital

    Directory of Open Access Journals (Sweden)

    Abebe T

    2015-01-01

    Full Text Available Teshome Abebe, Mullu Girmay, Girma G/Michael, Million Tesfaye Department of Anesthesia, Jimma University, Jimma, Ethiopia Background: In least developing countries, there are few data on children's critical care. This makes the provision of aid and improvement of outcome difficult. Objectives: To describe admission and outcome patterns of children managed in a general intensive care unit at Jimma University Specialized Hospital (JUSH, Ethiopia, over a 5-year period. Methods: A retrospective cross-sectional study design was used. All children from birth to 14 years of age who were admitted to the general ICU of the hospital from 2009–2013 were included. Patient charts and ICU documentation log were reviewed. Results: A total of 170 children were admitted to the ICU of JUSH over the study period. The greater share was taken by males (54.7%, with a male-to-female ratio of 1.2:1. The overall mortality rate was 40%. The majority of the children were in the age range of 10–14 years (38.8%. Of the total number of patients admitted, 34.7% were trauma cases, 45.8% of whom died. The highest percentage, 69.5%, of trauma patients were admitted for head injuries. Among the trauma cases, burn and polytrauma were the second and third leading causes (15.3% of admission. Postoperative patients and medical patients accounted for the rest of the admitted cases (28.2% and 27.6% of the cases respectively. Conclusion: The leading cause of admission and death was trauma. Postoperative and medical causes of admission were also significant. The mortality rate in the ICU was very high, and this could be due to various factors. Further research benchmarking and interventions are highly recommended. Keywords: trauma, critical care, pediatric, ICU, ventilation, oxygenation

  6. The Presenting Feature and Role of General Practitioners and Non-neurosurgeon Physicians in Recognizing Pediatric Brain Tumors

    Directory of Open Access Journals (Sweden)

    Wihasto Suryaningtyas

    2010-04-01

    Full Text Available AIM: To determine the presenting features and role of non-neurosurgeon physician in recognizing the signs and symptoms of brain tumours in children. METHOD: Medical records of 31 pediatric brain tumor patients treated in Department of Neurosurgery, Soetomo General Hospital, Airlangga University Faculty of Medicine, Surabaya from August 2005 to September 2006 were reviewed. RESULTS: Thirty five percents f parents went to pediatrician as their first contact physician, 25% to general practitioner, 20% neurologist, 20% to neurosurgeon. Neurosurgeon was the second and third contact physician receiving refferal from non-neurosurgeon physician. The most common symptoms were headache (71%, vomiting (61%, motor weakness (48%, visual disturbance (45%, decrease level of consciousness (45% and seizures (38%, unsteadiness (35%. The most common symptoms that led the parents to find medical help at any time were motor disturbance (48%, vomiting (48%, visual disturbance (45%, unsteadiness (35%, decrease level of consciousness (32%, seizures (32%, headache (32%. All patients had neurological signs at diagnosis; 58% had papilloedema, 48% cranial nerve abnormalities, 35% cerebellar signs, 32% motor disturbance, 29% a reduced level of consciousness, 12% cranial enlargement. Duration of symptoms at admission was 1 months (32%, 2 months (42%, 3-6 months (19%, more than 6 months (7%. A short symptom interval was significantly associated with high grade tumours and patient age 3 years or younger. CONCLUSION: The symptoms and signs are often nonspecific, mimicking more common diseases. Therefore, the possibility of a brain neoplasm should always be considered, it materializes very rarely. Benign neurologic symptoms such as headache, which last for 2 months or more, should indicate the need of additional studies. Our results higlighted the neurologic impairments which might facilitate early recognition of a brain neoplasm. Neurologic problems as the only symptom of brain

  7. [Clinical and epidemiological characteristics of humeral supracondylar fractures in pediatric patients in a Regional General Hospital].

    Science.gov (United States)

    Barrón-Torres, Erika Alejandrina; Sánchez-Cruz, Juan Francisco; Cruz-Meléndez, José Ramses

    2015-01-01

    Supracondylar humerus fractures are common in children between 5-7 years of age and more frequent in the males, 90-95% of these fractures are in extension mechanism, the urgency of immediate attention is to prevent complications and sequelae. To establish the clinical and epidemiological profile of supracondylar humerus fractures, in a General Regional Hospital from the Instituto Mexicano del Seguro Social in Yucatan Mexico, during 2011-2013. A cross-sectional study. Strength association was measured by odds ratios and statistical significance with chi(2) test, p value was considered in < 0.05 RESULTS: 56 cases were analyzed, the mean age was 2.6 ± 5.33 years, the mechanism of injury was falling over at home, male gender is associated with extent injure mechanism (OR 5.6, 95% CI 1.0-30.1, p = 0.03), we observed that at most time elapsed between injury and medical means more hospital days (r = 0.40; p = 0.002), surgical treatment was established in 44 cases (78.6%), 18 (40.9%) with closed technique and placement of cloves and 26 (59.1%) with open reduction, in 100% cross configuration was used, ten complications were reported. Supracondylar humerus fractures are a common injury in children, males are more likely to be injured by extension, and the speed in medical treatment is an important issue. Copyright © 2015. Published by Masson Doyma México S.A.

  8. Pediatric Specialists

    Science.gov (United States)

    ... Healthy Children > Family Life > Medical Home > Pediatric Specialists Pediatric Specialists Article Body ​Your pediatrician may refer your child to a pediatric specialist for further evaluation and treatment. Pediatric specialists ...

  9. Certified randomness in quantum physics.

    Science.gov (United States)

    Acín, Antonio; Masanes, Lluis

    2016-12-07

    The concept of randomness plays an important part in many disciplines. On the one hand, the question of whether random processes exist is fundamental for our understanding of nature. On the other, randomness is a resource for cryptography, algorithms and simulations. Standard methods for generating randomness rely on assumptions about the devices that are often not valid in practice. However, quantum technologies enable new methods for generating certified randomness, based on the violation of Bell inequalities. These methods are referred to as device-independent because they do not rely on any modelling of the devices. Here we review efforts to design device-independent randomness generators and the associated challenges.

  10. Certifiable Java for Embedded Systems

    DEFF Research Database (Denmark)

    Schoeberl, Martin; Dalsgaard, Andreas Engelbredt; Hansen, Rene Rydhof

    2014-01-01

    The Certifiable Java for Embedded Systems (CJ4ES) project aimed to develop a prototype development environment and platform for safety-critical software for embedded applications. There are three core constituents: A profile of the Java programming language that is tailored for safety......-critical applications, a predictable Java processor built with FPGA technology, and an Eclipse based application development environment that binds the profile and the platform together and provides analyses that help to provide evidence that can be used as part of a safety case. This paper summarizes key contributions...

  11. Certified randomness in quantum physics

    Science.gov (United States)

    Acín, Antonio; Masanes, Lluis

    2016-12-01

    The concept of randomness plays an important part in many disciplines. On the one hand, the question of whether random processes exist is fundamental for our understanding of nature. On the other, randomness is a resource for cryptography, algorithms and simulations. Standard methods for generating randomness rely on assumptions about the devices that are often not valid in practice. However, quantum technologies enable new methods for generating certified randomness, based on the violation of Bell inequalities. These methods are referred to as device-independent because they do not rely on any modelling of the devices. Here we review efforts to design device-independent randomness generators and the associated challenges.

  12. Certifiable Java for Embedded Systems

    DEFF Research Database (Denmark)

    Schoeberl, Martin; Hansen, René Rydhof; Ravn, Anders P.;

    2014-01-01

    The Certifiable Java for Embedded Systems (CJ4ES) project aimed to develop a prototype development environment and platform for safety-critical software for embedded applications. There are three core constituents: A profile of the Java programming language that is tailored for safety......-critical applications, a predictable Java processor built with FPGA technology, and an Eclipse based application development environment that binds the profile and the platform together and provides analyses that help to provide evidence that can be used as part of a safety case. This paper summarizes key contributions...

  13. Evaluation of efficacy of restorative dental treatment provided under general anesthesia at hospitalized pediatric dental patients of Isfahan

    Science.gov (United States)

    Eshghi, Alireza; Samani, Mahdi Jafarzadeh; Najafi, Naghme Feyzi; Hajiahmadi, Maryam

    2012-01-01

    Background: General anesthesia (GA) allows dental treatment to be rendered under optimal conditions, theoretically ensuring ideal outcomes. The aim of this study was to determine the efficacy of restorative dental procedures performed under GA. Materials and Methods: In this cross-sectional retrospective study, 305 pediatric patients who had been treated under GA 6 to 24 months before our survey at Isfahan's hospitalized dentistry center were examined. The examination was performed on dental chair with oral mirror and dental probe. The results were recorded in a special form for each patient for statistical analysis and evaluation of restorations to be successful or failed. Statistical analysis was performed by chi-square and fisher exact tests for comparison between success rates of restorations and Kendall's tau-b test for evaluating the effect of time on success rates of them (P < 0.05). Results: Stainless steel crown restorations had significantly better results vs class I and class II amalgam and class I and class II tooth color restorations. All types of posterior tooth color restorations had statistically same results with amalgam restorations. Anterior composite resin build-up represented significantly low success rates. The failure rates of stainless steel crown and anterior composite resin build-up restorations did not correlate with the time of follow-up (P = 0.344 and P = 0.091, respectively). Conclusion: Stainless steel crown restorations had significantly better results vs other posterior restorations. The failure rates of stainless steel crown and anterior composite resin build-up restorations did not correlate with the time of follow-up in comparison of other restorations. PMID:23162592

  14. Development of the 24/7 Nurse Practitioner Model on the Inpatient Pediatric General Surgery Service at a Large Tertiary Care Children's Hospital and Associated Outcomes.

    Science.gov (United States)

    Rejtar, Marketa; Ranstrom, Lee; Allcox, Christina

    Nurse practitioners (NPs) have been providing high-quality and safe patient care for a few decades, and evidence showing the extent of their impact is emerging. This article describes the implementation of a 24/7 NP patient care model on an inpatient pediatric general surgery service in a tertiary free-standing Children's Hospital in the Northeastern United States. The literature shows that there is limited evidence regarding NP models of care and their effect on patient outcomes. In response to policy changes leading to reduction of resident work hours and a more acute and complex inpatient pediatric general surgery patient population, our existing NP model evolved into a 24/7 NP Model in June 2011. The results from two quality improvement projects showed positive registered nurse and attending surgeon staff satisfaction with the 24/7 NP Model of care and a decreased trend of unplanned intensive care unit patient transfers after the 24/7 NP Model implementation. These findings further support the evidence in the literature that NPs provide safe and quality patient care. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  15. Comparison of Pediatric and General Orthopedic Surgeons’ Approaches in Management of Developmental Dysplasia of the Hip and Flexible Flatfoot: the Road to Clinical Consensus

    Directory of Open Access Journals (Sweden)

    Ramin Haj Zargarbashi

    2017-01-01

    Full Text Available Developmental dysplasia of the hip (DDH and flatfoot are common pediatric orthopedic disorders, being referred to and managed by both general and pediatric orthopedic surgeons, through various modalities. Our study aimed to evaluate their consensus and perspective disagreements in terms of diagnostic and therapeutic approaches of the mentioned deformities. Forty participants in two groups of general orthopedic surgeons (GOS (n=20 and pediatric orthopedic surgeons (POS (n=20, were asked to answer an 8-item questionnaire on DDH and flexible flatfoot. The questions were provided with two- or multiple choices and a single choice was accepted for each one. Chi-square and Fisher’s exact tests was performed to compare the responses. For a neonate with limited hip abduction, hip ultrasonography was the agreed-upon approach in both groups (100% POS vs 71% GOS, and for its interpretation 79% of POS relied on their own whereas 73% of GOS relied on radiologist’s report (P=0.002. In failure of a 3-week application of the Pavlik harness, ending it and closed reduction (57% POS vs. 41% GOS followed by surgery quality assessment with CT scan (64% POS vs. 47% GOS and without the necessity for avascular necrosis evaluation (79% POS vs. 73% GOS were the choice measures. In case of closed reduction failure, open reduction via medial approach was the favorite next step in both groups (62% POS and 80% GOS. For the patient with flexible flat foot, reassurance was the choice plan of 79% of pediatric orthopedists. Our findings demonstrated significant disagreements among the orthopedic surgeons. This proposes insufficiency of high-level evidence.

  16. Comparison of Pediatric and General Orthopedic Surgeons' Approaches in Management of Developmental Dysplasia of the Hip and Flexible Flatfoot: the Road to Clinical Consensus.

    Science.gov (United States)

    Zargarbashi, Ramin Haj; Bonaki, Hirbod Nasiri; Zadegan, Shayan Abdollah; Baghdadi, Taghi; Nabian, Mohammad Hossein; Shirazi, Mehdi Ramezan

    2017-01-01

    Developmental dysplasia of the hip (DDH) and flatfoot are common pediatric orthopedic disorders, being referred to and managed by both general and pediatric orthopedic surgeons, through various modalities. Our study aimed to evaluate their consensus and perspective disagreements in terms of diagnostic and therapeutic approaches of the mentioned deformities. Forty participants in two groups of general orthopedic surgeons (GOS) (n=20) and pediatric orthopedic surgeons (POS) (n=20), were asked to answer an 8-item questionnaire on DDH and flexible flatfoot. The questions were provided with two- or multiple choices and a single choice was accepted for each one. Chi-square and Fisher's exact tests was performed to compare the responses. For a neonate with limited hip abduction, hip ultrasonography was the agreed-upon approach in both groups (100% POS vs 71% GOS), and for its interpretation 79% of POS relied on their own whereas 73% of GOS relied on radiologist's report (P=0.002). In failure of a 3-week application of the Pavlik harness, ending it and closed reduction (57% POS vs. 41% GOS) followed by surgery quality assessment with CT scan (64% POS vs. 47% GOS) and without the necessity for avascular necrosis evaluation (79% POS vs. 73% GOS) were the choice measures. In case of closed reduction failure, open reduction via medial approach was the favorite next step in both groups (62% POS and 80% GOS). For the patient with flexible flat foot, reassurance was the choice plan of 79% of pediatric orthopedists. Our findings demonstrated significant disagreements among the orthopedic surgeons. This proposes insufficiency of high-level evidence.

  17. Regional anesthesia for pediatrics

    OpenAIRE

    Türk, Hacer Şebnem; Işıl, Canan Tülay; Açık, Mehmet Eren; Ediz, Naim; Sayın, Pınar; Tombul, Merih; Oba, Sibel

    2015-01-01

    Objectives: Relevancy to regional anesthesia in pediatrics has increased, because it is complementary to general anesthesia, allows conscious postoperative analgesia without respiratory depression, technical difficulties have been defeated and new local anesthetics have been improved. Therefore we reported data of patients who underwent pediatric surgery and received regional anesthesia.Patients and methods: We retrospectively analyzed data of all patients, who were operated in the pediatric ...

  18. Supply and demand of board-certified emergency physicians by U.S. state, 2005.

    Science.gov (United States)

    Sullivan, Ashley F; Ginde, Adit A; Espinola, Janice A; Camargo, Carlos A

    2009-10-01

    The objective was to estimate the emergency medicine (EM) board-certified emergency physician (EP) workforce supply and demand by U.S. state. The 2005 National Emergency Department Inventories-USA provided annual visit volumes for U.S. emergency departments (EDs). We estimated full-time equivalent (FTE) EP demand at each ED by dividing the actual number of visits by the estimated average EP visit volume (3,548 visits/year) and then summing FTEs by state. Our model assumed that at least one EP should be present 24/7 in each ED. The number of EM board-certified EPs per state was provided by the American Board of Medical Specialties (American Board of Emergency Medicine, American Board of Pediatrics) and the American Osteopathic Board of Emergency Medicine. We used U.S. Census Bureau civilian population estimates to calculate EP population density by state. The supply of EM board-certified EPs was 58% of required FTEs to staff all EDs nationally and ranged from 10% in South Dakota to 104% in Hawai'i (i.e., there were more EPs than the estimated need). Texas and Florida had the largest absolute shortages of EM board-certified EPs (2,069 and 1,146, respectively). The number of EM board-certified EPs per 100,000 U.S. civilian population ranged from 3.6 in South Dakota to 13.8 in Washington, DC. States with a higher population density of EM board-certified EPs had higher percent high school graduates and a lower percent rural population and whites. The supply and demand of EM board-certified EPs varies by state. Only one state had an adequate supply of EM board-certified EPs to fully staff its EDs.

  19. 24 CFR 1710.504 - Cooperation among certified states and between certified states and the Secretary.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Cooperation among certified states....504 Cooperation among certified states and between certified states and the Secretary. (a) By filing... exceed the federal standard provided that such requirements are not in conflict with the Act or...

  20. Digital radiography: a survey of pediatric dentists.

    Science.gov (United States)

    Russo, Julie M; Russo, James A; Guelmann, Marcio

    2006-01-01

    The purpose of this study was to: (1) determine the popularity of digital radiography among members of the American Academy of Pediatric Dentistry (AAPD); and (2) report the most common systems in use. An AAPD-approved, voluntary, and anonymous electronic survey was developed and sent to 923 board certified pediatric dentists. Years in practice and in-office x-ray technology (digital or conventional) were inquired about initially. If negative for the use of digital radiography, future consideration for converting to digital radiography was ascertained. For positive responses, more in-depth information was requested. Information on type of system (sensor or phosphor plate), user friendliness, diagnostic ability, patient's comfort, general costs, durability, and parental and overall satisfaction was collected. For most of the questions, a 5-point assessment scale was used. Opportunity for additional comments was provided upon survey completion. Data was analyzed using descriptive statistics. A 32% (296/923) response rate was obtained. Twenty-six percent of practitioners (78/296) implemented digital radiography in their practices, whereas 71% considered future acquisition. Similar distribution for sensor and phosphor plate users was found. Sensor technology was reported to produce faster images, but was less tolerable by young children due to size and thickness. Phosphor plates were considered more children friendly, less expensive, and less durable. Parental satisfaction was very high with great marketing value. Picture quality was comparable to conventional film. Overall, digital radiography users would recommend it to other pediatric dentists. Digital radiography is not yet popular among pediatric dentists. Cost reduction and technology advancement may enhance utilization.

  1. Pediatric tracheostomy.

    Science.gov (United States)

    Campisi, Paolo; Forte, Vito

    2016-06-01

    Tracheotomy refers to a surgical incision made into a trachea. Tracheostomy, on the other hand, refers to a surgical procedure whereby the tracheal lumen is positioned in close proximity to the skin surface. Tracheostomy is an uncommon procedure in the pediatric population. When required tracheostomy is typically performed as an open surgical procedure under general anesthesia with the patient intubated. However, it may need to be performed under local anesthesia or over a rigid bronchoscope in the patient with a precarious airway. Over the past half century, the primary indication for pediatric tracheostomy has shifted from acute infectious airway compromise to the need for prolonged ventilatory support in neurologically compromised children. The surgical technique, choice of tracheostomy tube, and post-operative care requires a nuanced approach in infants and young children. This article will review these topics in a comprehensive fashion. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Certifying qubit operations below the fault tolerance threshold

    CERN Document Server

    Blume-Kohout, Robin; Nielsen, Erik; Rudinger, Kenneth; Mizrahi, Jonathan; Fortier, Kevin; Maunz, Peter

    2016-01-01

    Quantum information processors promise fast algorithms for problems inaccessible to classical computers. But since qubits are noisy and error-prone, they will depend on fault-tolerant quantum error correction (FTQEC) to compute reliably. Quantum error correction can protect against general noise if -- and only if -- the error in each physical qubit operation is smaller than a certain threshold. The threshold for general errors is quantified by their diamond norm. Until now, qubits have been assessed primarily by randomized benchmarking (RB), which reports a different "error rate" that is not sensitive to all errors, cannot be compared directly to diamond norm thresholds, and cannot efficiently certify a qubit for FTQEC. We use gate set tomography (GST) to completely characterize the performance of a trapped-Yb$^+$-ion qubit and certify it rigorously as suitable for FTQEC by establishing that its diamond norm error rate is less than $6.7\\times10^{-4}$ with $95\\%$ confidence.

  3. Pediatric Asthma

    Science.gov (United States)

    ... Science Education & Training Home Conditions Asthma (Pediatric) Asthma (Pediatric) Make an Appointment Refer a Patient Ask a ... meet the rising demand for asthma care. Our pediatric asthma team brings together physicians, nurses, dietitians, physical ...

  4. Pediatric Ophthalmologist

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Ophthalmologist? Page Content Article Body If your child ... treat your child. What Kind of Training Do Pediatric Ophthalmologists Have? Pediatric ophthalmologists are medical doctors who ...

  5. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... jaundice in newborns and older children. epilepsy . location, anatomy and function of the thyroid gland. top of ... full size with caption Related Articles and Media General Nuclear Medicine Children's (Pediatric) CT (Computed Tomography) Epilepsy ...

  6. ENERGY STAR Certified Geothermal Heat Pumps

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 3.0 ENERGY STAR Program Requirements for Geothermal Heat Pumps that are effective as of...

  7. ENERGY STAR Certified Commercial Refrigerators and Freezers

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 3.0 ENERGY STAR Program Requirements for Commercial Refrigerators and Freezers that are...

  8. ENERGY STAR Certified Data Center Storage

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 1.0 ENERGY STAR Program Requirements for Data Center Storage that are effective as of...

  9. ENERGY STAR Certified Light Commercial HVAC

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 2.0 ENERGY STAR Program Requirements for Light Commercial HVAC that are effective as of...

  10. ENERGY STAR Certified Commercial Clothes Washers

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 7.0 ENERGY STAR Program Requirements for Clothes Washers that are effective as of March...

  11. ENERGY STAR Certified Uninterruptible Power Supplies

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 1.0 ENERGY STAR Program Requirements for Uninterruptible Power Supplies that are...

  12. ENERGY STAR Certified Electric Vehicle Supply Equipment

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 1.0 ENERGY STAR Program Requirements for Electric Vehicle Supply Equipment that are...

  13. ENERGY STAR Certified Residential Clothes Dryers

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 1.0 ENERGY STAR Program Requirements for Clothes Dryers that are effective as of January...

  14. HISTORIC ENERGY STAR Certified Room Air Cleaners

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 1.2 ENERGY STAR Program Requirements for Room Air Cleaners that are effective as of July...

  15. Certified metamodels for sensitivity indices estimation

    Directory of Open Access Journals (Sweden)

    Prieur Clémentine

    2012-04-01

    Full Text Available Global sensitivity analysis of a numerical code, more specifically estimation of Sobol indices associated with input variables, generally requires a large number of model runs. When those demand too much computation time, it is necessary to use a reduced model (metamodel to perform sensitivity analysis, whose outputs are numerically close to the ones of the original model, while being much faster to run. In this case, estimated indices are subject to two kinds of errors: sampling error, caused by the computation of the integrals appearing in the definition of the Sobol indices by a Monte-Carlo method, and metamodel error, caused by the replacement of the original model by the metamodel. In cases where we have certified bounds for the metamodel error, we propose a method to quantify both types of error, and we compute confidence intervals for first-order Sobol indices. L’analyse de sensibilité globale d’un modèle numérique, plus précisément l’estimation des indices de Sobol associés aux variables d’entrée, nécessite généralement un nombre important d’exécutions du modèle à analyser. Lorsque celles-ci requièrent un temps de calcul important, il est judicieux d’effectuer l’analyse de sensibilité sur un modèle réduit (ou métamodèle, fournissant des sorties numériquement proches du modèle original mais pour un coût nettement inférieur. Les indices estimés sont alors entâchés de deux sortes d’erreur : l’erreur d’échantillonnage, causée par l’estimation des intégrales définissant les indices de Sobol par une méthode de Monte-Carlo, et l’erreur de métamodèle, liée au remplacement du modèle original par le métamodèle. Lorsque nous disposons de bornes d’erreurs certifiées pour le métamodèle, nous proposons une méthode pour quantifier les deux types d’erreurs et fournir des intervalles de confiance pour les indices de Sobol du premier ordre.

  16. [Certified occupational physician system of Japan Society for Occupational Health].

    Science.gov (United States)

    Ogami, Akira; Higashi, Toshiaki

    2013-10-01

    Certified Occupational Physician System (COPS) of Japan Society for Occupational Health has been in existence for 21 years, since 1992. UOEH has supported this system as a secretary general. In this report, we review the 2012 revision of COPS. With the new title of Certified Associate Occupational Physician (CAOP), this revision was established to produce well-educated and experienced occupational physicians. The title of COP is not competitive but independent to other titles such as occupational physician, medical advisor in industrial health or industrial health consultant. In addition, the aim of COPS is not the replacement to these existing systems. Furthermore, the COP should be active in industrial and occupational health, and should cooperate with existing systems through the sharing of experience and knowledge.

  17. Pediatric keratoconus and iontophoretic corneal crosslinking: refractive and topographic evidence in patients underwent general and topical anesthesia, 18 months of follow-up.

    Science.gov (United States)

    Magli, Adriano; Chiariello Vecchio, Elisabetta; Carelli, Roberta; Piozzi, Elena; Di Landro, Felicia; Troisi, Salvatore

    2016-08-01

    To evaluate the efficiency and safety of iontophoretic transepithelial corneal crosslinking in pediatric patients with progressive keratoconus underwent general or topical anesthesia in 18 months follow-up. 13 patients (13 eyes) diagnosed with progressive keratoconus underwent corneal CXL with iontophoresis (I-CXL). Riboflavin solution was administered by iontophoresis for 5 min, and then UV-A irradiation (10 mW/cm) was performed for 9 min. Preoperative and post-operative visits at 1, 6, 12, and 18 months assessed the following parameters: uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), slit-lamp biomicroscopy, corneal topography, optical tomography, and pachymetry with Pentacam (Oculus Optikgeräte GmbH, Wetzlar, Germany), endothelial biomicroscopy (Konan Specular Microscope; Konan Medical, Inc., Hyogo, Japan). The paired Student t test was used to compare data during the follow-up. 10 males and 3 females with a mean age of 15.4 ± 1.7 years (range 11-18 years) were included. The results showed a stabilization of the refractive UCVA and BCVA as early as the first post-operative month, with a slight improvement over time. The Kmax remained stable throughout follow-up (p = 0.04). Transepithelial collagen crosslinking by iontophoresis, unlike other transepithelial techniques seems to halt pediatric keratoconus progression over 18 months. This is the second study evaluating CXL with iontophoresis in pediatric patients with progressive keratoconus with 18 months of follow-up using two different ways of anesthesia.

  18. A pointer logic and certifying compiler

    Institute of Scientific and Technical Information of China (English)

    CHEN Yiyun; GE Lin; HUA Baojian; LI Zhaopeng; LIU Cheng; WANG Zhifang

    2007-01-01

    Proof-Carrying Code brings two big challenges to the research field of programming languages.One is to seek more expressive logics or type systems to specify or reason about the properties of low-level or high-level programs.The other is to study the technology of certifying compilation in which the compiler generates proofs for programs with annotations.This paper presents our progress in the above two aspects.A pointer logic was designed for PointerC (a C-like programming language) in our research.As an extension of Hoare logic,our pointer logic expresses the change of pointer information for each statement in its inference rules to support program verification.Meanwhile,based on the ideas from CAP (Certified Assembly Programming) and SCAP (Stack-based Certified Assembly Programming),a reasoning framework was built to verify the properties of object code in a Hoare style.And a certifying compiler prototype for PointerC was implemented based on this framework.The main contribution of this paper is the design of the pointer logic and the implementation of the certifying compiler prototype.In our certifying compiler,the source language contains rich pointer types and operations and also supports dynamic storage allocation and deallocation.

  19. Pediatric vitiligo.

    Science.gov (United States)

    Silverberg, Nanette B

    2014-04-01

    Vitiligo is a disease of pigment loss. Most investigators currently consider vitiligo to be a disorder that occurs as a result of autoimmune destruction of melanocytes, supported by identification of antimelanocyte antibodies in many patients, and the presence of comorbid autoimmune disease in patients with and family members of individuals with vitiligo. One-half of vitiligo cases are of childhood onset. This article presents a current overview of pediatric vitiligo including comorbidities of general health, psychological factors, therapeutic options, and long-term health considerations.

  20. 48 CFR 5215.804-3 - Exemptions from or waiver of submission of certified cost or pricing data.

    Science.gov (United States)

    2010-10-01

    ... of submission of certified cost or pricing data. 5215.804-3 Section 5215.804-3 Federal Acquisition... 5215.804-3 Exemptions from or waiver of submission of certified cost or pricing data. (a) General. As explained in 5215.402, cost or pricing data would not normally be obtained because the predominant...

  1. Inhalation Conscious Sedation with Nitrous Oxide and Oxygen as Alternative to General Anesthesia in Precooperative, Fearful, and Disabled Pediatric Dental Patients: A Large Survey on 688 Working Sessions

    Directory of Open Access Journals (Sweden)

    Angela Galeotti

    2016-01-01

    Full Text Available Aim. To evaluate the effectiveness and the tolerability of the nitrous oxide sedation for dental treatment on a large pediatric sample constituting precooperative, fearful, and disabled patients. Methods. 472 noncooperating patients (aged 4 to 17 were treated under conscious sedation. The following data were calculated: average age; gender distribution; success/failure; adverse effects; number of treatments; kind of dental procedure undertaken; number of dental procedures for each working session; number of working sessions for each patient; differences between males and females and between healthy and disabled patients in relation to success; success in relation to age; and level of cooperation using Venham score. Results. 688 conscious sedations were carried out. The success was 86.3%. Adverse effects occurred in 2.5%. 1317 dental procedures were performed. In relation to the success, there was a statistically significant difference between healthy and disabled patients. Sex and age were not significant factors for the success. Venham score was higher at the first contact with the dentist than during the treatment. Conclusions. Inhalation conscious sedation represented an effective and safe method to obtain cooperation, even in very young patients, and it could reduce the number of pediatric patients referred to hospitals for general anesthesia.

  2. Clinical Effectiveness of Family Therapeutic Interventions Embedded in General Pediatric Primary Care Settings for Parental Mental Health: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Cluxton-Keller, Fallon; Riley, Anne W; Noazin, Sassan; Umoren, Mfon Valencia

    2015-12-01

    The aim of this systematic review and meta-analysis was to synthesize the available evidence on embedded family therapy interventions in pediatrics and impacts on parental mental health and family functioning outcomes. The Cochrane Collaboration guidelines for systematic reviews and meta-analysis were used for this study. Six electronic databases were searched for randomized controlled trials and cluster randomized trials. The Cochrane Collaboration's Risk of Bias Tool and GRADE system were used to rate the quality of evidence of the included studies. The primary outcomes included parental distress, parental depressive symptoms, and dysfunctional parent-child interaction. Fixed effects models showed statistically significant reductions in parental distress at 6-month and 12-month post-intervention in favor of the intervention group. Family therapy model, intervention level, delivery modality, and dosage moderated intervention impacts on parental distress. Fixed effects models showed statistically significant reductions in parental depressive symptoms and in dysfunctional parent-child interaction in favor of the intervention group. Family therapy interventions can be successfully embedded in general pediatric primary care, and intended outcomes are achieved in this setting. Recommendations for future research and implications for policy development are discussed.

  3. 7 CFR 201.69 - Classes of certified seed.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Classes of certified seed. 201.69 Section 201.69..., Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) FEDERAL SEED ACT FEDERAL SEED ACT REGULATIONS Certified Seed § 201.69 Classes of certified seed. (a) Classes of certified seed are as...

  4. 7 CFR 945.7 - Certified seed potatoes.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Certified seed potatoes. 945.7 Section 945.7... Certified seed potatoes. Certified seed potatoes means and includes all potatoes officially certified and tagged, marked, or otherwise appropriately identified, under the supervision of the official seed...

  5. A COMPARATIVE STUDY OF PEDIATRIC CARDIAC CATHETERIZATION PROCEDURE UNDER GENERAL ANESTHESIA WITH OR WITHOUT FEMORAL NERVE BLOCK

    Directory of Open Access Journals (Sweden)

    Jigisha

    2016-02-01

    Full Text Available OBJECTIVE Anesthetic management for interventional cardiac procedures/cardiac catheterization in pediatric patients is challenging. Cardiac anomalies vary from simple to complex congenital cardiac anomalies, shunts may be present at multiple levels and patients may be profoundly cyanotic, may be with ventricular dysfunction. They usually require sedation and analgesia to maintain steady stable state. In adults, such type of procedures can be well managed with local anesthesia. METHODS Fifty patients were included in the study. They were randomly divided into two groups- Group A (n=25 patients received femoral N. block along with IV sedation and analgesia while group B (n=25 patients received only IV sedation and analgesia. Both groups were compared for hemodynamics, pain score and requirement of IV anesthetic agents and any complications if come up. RESULTS Group A patients required IV ketamine 3.24mg/kg (±0.31SD as compared to 5.58mg/kg (±1.6SD in group B, which suggests significantly reduced requirement of IV anesthetic agents in group where femoral nerve block has been given. Hemodynamic parameters remained stable and comparable (no statistically significant variation Pain score was less in group A patients than group B. CONCLUSION It has been observed that Group A patients required less dosages of IV anesthetic agents, with stable hemodynamics and less pain score and sedation score as compared to group B patients.

  6. Etiology, extended-spectrum β-lactamase rates and antimicrobial susceptibility of gram-negative bacilli causing intra-abdominal infections in patients in general pediatric and pediatric intensive care units--global data from the Study for Monitoring Antimicrobial Resistance Trends 2008 to 2010.

    Science.gov (United States)

    Badal, Robert E; Bouchillon, Samuel K; Lob, Sibylle H; Hackel, Meredith A; Hawser, Stephen P; Hoban, Daryl J

    2013-06-01

    Antimicrobial resistance has been increasing for several years and is often higher in intensive care units (ICUs) than in other facilities. The spread of extended-spectrum β-lactamases (ESBLs) in particular has profoundly impacted antimicrobial efficacy and usage. The Study for Monitoring Antimicrobial Resistance Trends has monitored the in vitro activity of ertapenem and several comparators against aerobic gram-negative bacteria from intra-abdominal infections (IAIs) for many years. This report summarizes susceptibility levels and epidemiology for key IAI pathogens cultured from general pediatric medical wards and pediatric ICUs globally. 1248 gram-negative bacteria were collected from pediatric IAIs by 113 labs in 40 countries from 2008 to 2010. Susceptibility was determined by Clinical and Laboratory Standards Institute broth microdilution. Susceptibility rates (%S) were determined for species with ≥10 isolates. Sixty-two percent of isolates came from general pediatric wards and 38% from pediatric ICUs. The overall ESBL-positive rate was 11.0% for Escherichia coli and 38.9% for Klebsiella pneumoniae; the ESBL-positive rate for E. coli was twice as high in ICU as non-ICU. Most study drugs inhibited >90% of ESBL-negative isolates, but only the carbapenems inhibited >90% of ESBL-positive E. coli and only imipenem inhibited >90% of ESBL-positive K. pneumoniae. Amikacin, imipenem and ertapenem were the most active against gram-negative bacteria from pediatric IAIs, followed closely by the fluoroquinolones and cefepime. Other cephalosporins were often <90% active. ESBL rates were 38.9% for K. pneumoniae and 11.0% for E. coli. Therapy for pediatric IAIs should take into consideration local ESBL rates because only carbapenems inhibited most of these pathogens.

  7. Myocarditis - pediatric

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007307.htm Myocarditis - pediatric To use the sharing features on this page, please enable JavaScript. Pediatric myocarditis is inflammation of the heart muscle in ...

  8. 12 CFR 327.2 - Certified statements.

    Science.gov (United States)

    2010-01-01

    ... the FDIC's e-business Web site FDICconnect a quarterly certified statement invoice each assessment... of the Assessments Section. (4) Each assessment period, the FDIC will provide courtesy e-mail... available and may be accessed on FDICconnect. E-mail notification will be sent to all individuals with...

  9. EU ENERGY STAR Certified Uninterruptible Power Supplies

    Science.gov (United States)

    Certified models meet all ENERGY STAR requirements as listed in the Version 1.0 ENERGY STAR Program Requirements for Uninterruptible Power Supplies that are effective as of August 1, 2012. A detailed listing of key efficiency criteria are available at http://www.energystar.gov/index.cfm?c=uninterruptible_power_supplies.pr_crit_uninterruptible_power_supplies

  10. ENERGY STAR Certified Uninterruptible Power Supplies

    Science.gov (United States)

    Certified models meet all ENERGY STAR requirements as listed in the Version 1.0 ENERGY STAR Program Requirements for Uninterruptible Power Supplies that are effective as of August 1, 2012. A detailed listing of key efficiency criteria are available at http://www.energystar.gov/index.cfm?c=uninterruptible_power_supplies.pr_crit_uninterruptible_power_supplies

  11. ENERGY STAR Certified Geothermal Heat Pumps

    Science.gov (United States)

    Certified models meet all ENERGY STAR requirements as listed in the Version 3.0 ENERGY STAR Program Requirements for Geothermal Heat Pumps that are effective as of January 1, 2012. A detailed listing of key efficiency criteria are available at http://www.energystar.gov/index.cfm?c=geo_heat.pr_crit_geo_heat_pumps

  12. Comparing Techniques for Certified Static Analysis

    Science.gov (United States)

    Cachera, David; Pichardie, David

    2009-01-01

    A certified static analysis is an analysis whose semantic validity has been formally proved correct with a proof assistant. The recent increasing interest in using proof assistants for mechanizing programming language metatheory has given rise to several approaches for certification of static analysis. We propose a panorama of these techniques and compare their respective strengths and weaknesses.

  13. 31 CFR 346.14 - Certifying officers.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Certifying officers. 346.14 Section 346.14 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL... imprint of the corporate seal, or, where the institution is an authorized issuing agent for United States...

  14. 31 CFR 341.14 - Certifying officers.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Certifying officers. 341.14 Section 341.14 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL... imprint of the corporate seal, or, where the institution is an authorized issuing agent for United States...

  15. 31 CFR 357.31 - Certifying individuals.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Certifying individuals. 357.31 Section 357.31 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL... institutions, corporate central credit unions, and institutions that are members of Treasury-recognized...

  16. General Ultrasound Imaging

    Medline Plus

    Full Text Available ... General ultrasound procedure View full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes child-specific content. ...

  17. 76 FR 19310 - Information Collection; Certified State Mediation Program

    Science.gov (United States)

    2011-04-07

    ... Farm Service Agency Information Collection; Certified State Mediation Program AGENCY: Farm Service... Mediation Program. The information collection is necessary to ensure the grant program is being administered... following methods: Mail: Carol Wagner, Certified State Mediation Program Manager, USDA, FSA, Appeals...

  18. 7 CFR 205.662 - Noncompliance procedure for certified operations.

    Science.gov (United States)

    2010-01-01

    ... MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) ORGANIC FOODS PRODUCTION ACT PROVISIONS NATIONAL ORGANIC PROGRAM Administrative Compliance § 205.662... of a certified operation by a certifying agent or a State organic program's governing State...

  19. Effect of Oral Midazolam Premedication on Children’s Co-operation Before General Anesthesia in Pediatric Dentistry

    Science.gov (United States)

    Kaviani, Nasser; Shahtusi, Mina; Haj Norousali Tehrani, Maryam; Nazari, Sara

    2014-01-01

    Statement of the Problem: Premedication is expedient in reducing the psychological trauma from recalling the unpleasant pre-anesthetic phases, hence, inducing a trouble-free anesthesia. Purpose: This study aimed to determine the effectiveness of oral midazolam in co-operation of the subjects before general anesthesia and in recalling the pre-anesthetic phases, performed on children candidate for dental treatment under general anesthesia. Materials and Method: In this prospective clinical trial study, 62 healthy non-cooperative children, candidate for dental treatment under general anesthesia, were randomly divided into study and control groups. The children received 20ml orange juice, 20 minutes before starting the anesthesia. The juice of the test group contained 0.5mg/kg of midazolam and that of the control group included no medication. The induction and the maintenance process of anesthesia were similar in both groups. The manner of subjects when separated from parents, their cooperation during intravenous catheterization, and recalling the pre-anesthetic events were recorded. Data were analyzed by adopting chi-square and Mann-Whitney tests. Results: Most of the children in the test group had a comfortable separation from parents, restful IV catheterization and 90% of the subjects did not recall the pre-anesthetic events. Conclusion: Under the circumstances of this study, it could be concluded that 0.5mg/kg oral midazolam premedication is effective for comfortable separation of children from parents and restful IV catheterization and also forgetting the pre-anesthetic events. PMID:25191661

  20. 33 CFR 159.17 - Changes to certified devices.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Changes to certified devices. 159... (CONTINUED) POLLUTION MARINE SANITATION DEVICES Certification Procedures § 159.17 Changes to certified devices. (a) The manufacturer of a device that is certified under this part shall notify the...

  1. 30 CFR 71.202 - Certified person; sampling.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Certified person; sampling. 71.202 Section 71... Sampling Procedures § 71.202 Certified person; sampling. (a) The respirable dust sampling required by this... on sampling of respirable coal mine dust. (c) A person may be temporarily certified by MSHA to...

  2. 30 CFR 70.202 - Certified person; sampling.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Certified person; sampling. 70.202 Section 70... HEALTH MANDATORY HEALTH STANDARDS-UNDERGROUND COAL MINES Sampling Procedures § 70.202 Certified person; sampling. (a) The respirable dust sampling required by this part shall be done by a certified person....

  3. 30 CFR 90.202 - Certified person; sampling.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Certified person; sampling. 90.202 Section 90... Sampling Procedures § 90.202 Certified person; sampling. (a) The respirable dust sampling required by this... on sampling of respirable coal mine dust. (c) A person may be temporarily certified by MSHA to...

  4. Effect of Oral Midazolam Premedication on Children’s Co-operation Before General Anesthesia in Pediatric Dentistry

    Directory of Open Access Journals (Sweden)

    Nasser Kaviani

    2014-09-01

    Full Text Available Statement of the Problem: Premedication is expedient in reducing the psychological trauma from recalling the unpleasant pre-anesthetic phases, hence, inducing a trouble-free anesthesia. Purpose: This study aimed to determine the effectiveness of oral midazolam in co-operation of the subjects before general anesthesia and in recalling the pre-anesthetic phases, performed on children candidate for dental treatment under general anesthesia. Materials and Method: In this prospective clinical trial study, 62 healthy non-cooperative children, candidate for dental treatment under general anesthesia, were randomly divided into study and control groups. The children received 20ml orange juice, 20 minutes before starting the anesthesia. The juice of the test group contained 0.5mg/kg of midazolam and that of the control group included no medication. The induction and the maintenance process of anesthesia were similar in both groups. The manner of subjects when separated from parents, their cooperation during intravenous catheterization, and recalling the pre-anesthetic events were recorded. Data were analyzed by adopting chi-square and Mann-Whitney tests. Results: Most of the children in the test group had a comfortable separation from parents, restful IV catheterization and 90% of the subjects did not recall the pre-anesthetic events. Conclusion: Under the circumstances of this study, it could be concluded that 0.5mg/kg oral midazolam premedication is effective for comfortable separation of children from parents and restful IV catheterization and also forgetting the pre-anesthetic events.

  5. Pediatric Dentistese

    Directory of Open Access Journals (Sweden)

    Sharath Asokan

    2017-01-01

    Full Text Available Successful practice of pediatric dentistry depends on the establishment of a good relationship between the dentist and the child. Such a relationship is possible only through effective communication. Pediatric dentistry includes both an art and a science component. The focus has been mostly on the technical aspects of our science, and the soft skills we need to develop are often forgotten or neglected. This paper throws light on the communication skills we need to imbibe to be a successful pediatric dentist. A new terminology “Pediatric Dentistese” has been coined similar to motherese, parentese, or baby talk. Since baby talk cannot be applied to all age groups of children, pediatric dentistese has been defined as “the proactive development-based individualized communication between the pediatric dentist and the child which helps to build trust, allay fear, and treat the child effectively and efficiently.”

  6. Advanced Development of Certified OS Kernels

    Science.gov (United States)

    2015-06-01

    software , like a C com- piler [Leroy 2009] and an OS microkernel [Klein et al. 2009], as well as complicated mathematical proofs [Gonthier 2008...Jagannathan, and P. Sewell. CompCertTSO: A Verified Compiler for Relaxed-Memory Concur- rency. J. ACM , 60(3), 2013. [33] Z. Shao. Certified software ...Publication rights licensed to ACM . ACM 978-1-4503-3468-6/15/06. . . $15.00. http://dx.doi.org/10.1145/2737924.2737955 1. Introduction In software

  7. Pediatric Sepsis.

    Science.gov (United States)

    Prusakowski, Melanie K; Chen, Audrey P

    2017-02-01

    Pediatric sepsis is distinct from adult sepsis in its definitions, clinical presentations, and management. Recognition of pediatric sepsis is complicated by the various pediatric-specific comorbidities that contribute to its mortality and the age- and development-specific vital sign and clinical parameters that obscure its recognition. This article outlines the clinical presentation and management of sepsis in neonates, infants, and children, and highlights some key populations who require specialized care. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Effects of parental gender and level of education on the quality of life and general health of pediatric patients with epilepsy: An outpatient cross-sectional survey.

    Science.gov (United States)

    Iqbal, Meisam; Amirsalari, Susan; Radfar, Shokofeh; Haidari, Mohsen Reza

    2016-07-01

    The quality of life (QOL) of children with epilepsy has been widely studied, and several problems related to cognition, behavior, social lives, and physical activity among these children have been reported. Family life and parental care are important aspects of the lives of these patients. The impact of parental education on the QOL of pediatric patients with epilepsy is an understudied topic, especially in developing countries. In this study, we investigated the QOL and general health (GH) of patients with epilepsy presenting at the pediatric neurology clinic at Baqiyatallah Hospital and a private clinic. The Quality of Life in Childhood Epilepsy (QOLCE) questionnaire, which is a 92-item epilepsy-specific questionnaire covering physical activity, well-being, cognition, behavior, social activity, overall QOL, and GH, was used for interviewing parents. A total of 106 patients (m=61, 57.5% and f=45, 42.5%) aged 5-17years (mean: 10.31±2.91) participated in the study. Overall, there was no significant difference between the QOL and GH results of male and female patients. However, the maternal education level had a significant impact on the overall QOL (high school: 3.02±0.85 vs. B.Sc.: 3.67±0.61, peducation had no significant effect. A multiple linear regression showed that the maternal education level had an independently significant association with the physical activity of the patients (p=0.02, CI: 1.4-6.25), and the paternal education level had an independently significant association with the well-being of the patients (p=0.02, CI: 0.43-5.36). In addition, the maternal education level (high school vs. B.Sc.) had a significant effect on physical activity, well-being, cognition, and behavior for all of the patients (peducation level (high school vs. B.Sc.) had no significant impact. However, in a comparison of high school vs. higher education, paternal education had a significant effect on patients' physical activity and well-being (peducation play a significant

  9. Psychometric Properties of the Physical Activity Questionnaire for Older Children in Italy: Testing the Validity among a General and Clinical Pediatric Population.

    Directory of Open Access Journals (Sweden)

    Erica Gobbi

    Full Text Available The purpose of this research was to assess an Italian version of the Physical Activity Questionnaire for Older Children (PAQ-C-It. Three separate studies were conducted, whereby testing general psychometric properties, construct validity, concurrent validity and the factor structure of the PAQ-C-It among general and clinical pediatric population. Study 1 (n = 1170 examined the psychometric properties, internal consistency, factor structure (exploratory factor analysis, EFA and construct validity with enjoyment perception during physical activity. Study 2 (n = 59 reported on reliability, construct validity with enjoyment and BMI, and on cross-sectional concurrent validity with objectively measured MVPA (tri-axial accelerometry over the span of seven consecutive days. Study 3 (n = 58 examined the PAQ-C-It reliability, construct validity with BMI and VO2max as the objective measurement among a population of children with congenital heart defects (CHD. In study 2 and 3, the factor structure of the PAQ-C-It was then re-examined with an EFA. The PAQ-C-It showed acceptable to good reliability (alpha .70 to .83. Results on construct validity showed moderate but significant association with enjoyment perception (r = .30 and .36, with BMI (r = -.30 and -.79 for CHD simple form, and with the VO2max (r = .55 for CHD simple form. Significant concurrent validity with the objectively measured MVPA was reported (rho = .30, p < .05. Findings of the EFA suggested a two-factor structure for the PAQ-C-It, with items 2, 3, and 4 contributing little to the total score. This study supports the PAQ-C-It as an appropriate instrument to assess the MVPA levels of Italian children, including children with simple forms of CHD. Support is given to the possible instrument effectiveness on a large international perspective in order to level out data gathering across the globe.

  10. Psychometric Properties of the Physical Activity Questionnaire for Older Children in Italy: Testing the Validity among a General and Clinical Pediatric Population.

    Science.gov (United States)

    Gobbi, Erica; Elliot, Catherine; Varnier, Maurizio; Carraro, Attilio

    2016-01-01

    The purpose of this research was to assess an Italian version of the Physical Activity Questionnaire for Older Children (PAQ-C-It). Three separate studies were conducted, whereby testing general psychometric properties, construct validity, concurrent validity and the factor structure of the PAQ-C-It among general and clinical pediatric population. Study 1 (n = 1170) examined the psychometric properties, internal consistency, factor structure (exploratory factor analysis, EFA) and construct validity with enjoyment perception during physical activity. Study 2 (n = 59) reported on reliability, construct validity with enjoyment and BMI, and on cross-sectional concurrent validity with objectively measured MVPA (tri-axial accelerometry) over the span of seven consecutive days. Study 3 (n = 58) examined the PAQ-C-It reliability, construct validity with BMI and VO2max as the objective measurement among a population of children with congenital heart defects (CHD). In study 2 and 3, the factor structure of the PAQ-C-It was then re-examined with an EFA. The PAQ-C-It showed acceptable to good reliability (alpha .70 to .83). Results on construct validity showed moderate but significant association with enjoyment perception (r = .30 and .36), with BMI (r = -.30 and -.79 for CHD simple form), and with the VO2max (r = .55 for CHD simple form). Significant concurrent validity with the objectively measured MVPA was reported (rho = .30, p PAQ-C-It, with items 2, 3, and 4 contributing little to the total score. This study supports the PAQ-C-It as an appropriate instrument to assess the MVPA levels of Italian children, including children with simple forms of CHD. Support is given to the possible instrument effectiveness on a large international perspective in order to level out data gathering across the globe.

  11. Integrating Implicit Induction Proofs into Certified Proof Environments

    Science.gov (United States)

    Stratulat, Sorin

    We give evidence of the direct integration and automated checking of implicit induction-based proofs inside certified reasoning environments, as that provided by the Coq proof assistant. This is the first step of a long term project focused on 1) mechanically certifying implicit induction proofs generated by automated provers like Spike, and 2) narrowing the gap between automated and interactive proof techniques inside proof assistants such that multiple induction steps can be executed completely automatically and mutual induction can be treated more conveniently. Contrary to the current approaches of reconstructing implicit induction proofs into scripts based on explicit induction tactics that integrate the usual proof assistants, our checking methodology is simpler and fits better for automation. The underlying implicit induction principles are separated and validated independently from the proof scripts that consist in a bunch of one-to-one translations of implicit induction proof steps. The translated steps can be checked independently, too, so the validation process fits well for parallelisation and for the management of large proof scripts. Moreover, our approach is more general; any kind of implicit induction proof can be considered because the limitations imposed by the proof reconstruction techniques no longer exist. An implementation that integrates automatic translators for generating fully checkable Coq scripts from Spike proofs is reported.

  12. Efficacy and utility of phone call follow-up after pediatric general surgery versus traditional clinic follow-up.

    Science.gov (United States)

    Fischer, Kevin; Hogan, Virginia; Jager, Alesha; von Allmen, Daniel

    2015-01-01

    Typical follow-up for surgical procedures consists of an interim history and brief focused physical examination. These appointments occupy clinic resources, require a time investment by the family, and rarely identify problems. Previous studies have demonstrated the safety of a postoperative phone call. Compare a traditional in-person clinic postoperative visit with postoperative phone call follow-up regarding patient satisfaction, rate of successful follow-up, and clinic resource utilization in a large academic practice. A retrospective review of charts of patients who underwent select surgical procedures, along with a review of the clinic schedule for the same time period. Efficacy, patient/family satisfaction, and impact on the clinic. Families were contacted by telephone two weeks after select surgical procedures to assess for complications and questions. Cohorts of patients six months before and six months after implementation were assessed for main outcome measures. Before implementation, 55.5% of patients (427/769) who had one of the select surgical procedures were seen in the clinic postoperatively, and 62.6% (435/695) had a successful postoperative phone call follow-up. There were also 1090 overall scheduled postoperative appointments. Six months after implementation, overall postoperative appointments decreased 35.5% to 703. Overall, postoperative-scheduled visits decreased by 6% compared with new visits and other general follow-up visits, which each increased by 3%. A satisfaction survey revealed that 93% of patients (n = 231) were highly satisfied with the process. A hospital cost analysis suggested an 89% cost savings ($101.75 per patient for clinic visit vs $12.50 per patient for phone call follow-up). Postoperative phone call follow-up is an effective tool that improves patient and physician efficiency and satisfaction.

  13. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... the body area being examined, and the child's size. Radiologists generally attempt to use the lowest radiation ... being prepared for a CT scan. View full size with caption Pediatric Content Some imaging tests and ...

  14. Kerala Pioneering Pediatric Surgery in India

    Directory of Open Access Journals (Sweden)

    TP Joseph

    2014-04-01

    Full Text Available Pediatric surgeons of Kerala are very proud to have led the development of superspeciality in any branch of medicine in Kerala and also superspeciality of Pediatric surgery in whole of India. Late Prof. Raman Nair returned in 1954 after training under Dr. Everett Koop in US. Same year, in his far-sighted vision for future development of the speciality, he moved to SATH, Medical College, Trivandrum and started Pediatric surgery as a speciality attached to Paediatrics department; this was the beginning of Pediatric surgery in India. He opted for Pediatric surgery as a full time job and did not do any general surgery work in adults. He was the first full time Pediatric surgeon of India; during the next few years, 2 surgeons, one in Calcutta, Prof. UC Chakraboty and Prof. D Anjaneyulu in Hyderabad started working as full time Pediatric surgeons. In Mumbai, Delhi and Chennai, Pediatric surgery developed much later and then all over the country.

  15. Pediatric allergy and immunology in Spain.

    Science.gov (United States)

    Nieto, Antonio; Mazon, Angel; Martin-Mateos, Maria Anunciacion; Plaza, Ana-Maria; Garde, Jesus; Alonso, Elena; Martorell, Antonio; Boquete, Manuel; Lorente, Felix; Ibero, Marcel; Bone, Javier; Pamies, Rafael; Garcia, Juan Miguel; Echeverria, Luis; Nevot, Santiago; Martinez-Cañavate, Ana; Fernandez-Benitez, Margarita; Garcia-Marcos, Luis

    2011-11-01

    The data of the ISAAC project in Spain show a prevalence of childhood asthma ranging from 7.1% to 15.3%, with regional differences; a higher prevalence, 22.6% to 35.8%, is described for rhinitis, and atopic dermatitis is found in 4.1% to 7.6% of children. The prevalence of food allergy is 3%. All children in Spain have the right to be visited in the National Health System. The medical care at the primary level is provided by pediatricians, who have obtained their titles through a 4-yr medical residency training program. The education on pediatric allergy during that period is not compulsory and thus very variable. There are currently 112 certified European pediatric allergists in Spain, who have obtained the accreditation of the European Union of Medical Specialist for proven skills and experience in pediatric allergy. Future specialists in pediatric allergy should obtain their titles through a specific education program to be developed in one of the four accredited training units on pediatric allergy, after obtaining the title on pediatrics. The Spanish Society of Pediatric Allergy and Clinical Immunology (SEICAP) gathers over 350 pediatric allergists and pediatricians working in this field. SEICAP has a growing activity including yearly congresses, continued education courses, elaboration of technical clinical documents and protocols, education of patients, and collaboration with other scientific societies and associations of patients. The official journal of SEICAP is Allergologia et Immunophatologia, published every 2 months since 1972. The web site of SEICAP, http://www.seicap.es, open since 2004, offers information for professionals and extensive information on pediatric allergic and immunologic disorders for the lay public; the web site is receiving 750 daily visits during 2011. The pediatric allergy units are very active in clinical work, procedures as immunotherapy or induction of oral tolerance in food allergy, contribution to scientific literature, and

  16. Update on pediatric hyperhidrosis.

    Science.gov (United States)

    Gordon, Jennifer R S; Hill, Samantha E

    2013-01-01

    Hyperhidrosis is a common and under-recognized disease in the pediatric population that has a significant impact on quality of life. Focal and generalized forms of hyperhidrosis exist, which can be idiopathic or secondary to underlying medical conditions or medications. Treatment is tailored to the specific patient needs, characteristics and goals. These include topical preparations, iontophoresis, botulinum toxin and anticholinergic medications.

  17. Pharmacotherapy of Pediatric Insomnia

    Science.gov (United States)

    Owens, Judith A.

    2009-01-01

    General guidelines for the use of medication to treat pediatric insomnia are presented. It should be noted that medication is not the first treatment choice and should be viewed within the context of a more comprehensive treatment plan. The pharmacological and clinical properties of over the counter medications and FDA-approved insomnia drugs are…

  18. CISA Certified Information Systems Auditor : study guide

    CERN Document Server

    Cannon, David L

    2011-01-01

    The industry-leading study guide for the CISA exam, fully updated. More than 27,000 IT professionals take the Certified Information Systems Auditor exam each year. SC Magazine lists the CISA as the top certification for security professionals. Compliances, regulations, and best practices for IS auditing are updated twice a year, and this is the most up-to-date book available to prepare aspiring CISAs for the next exam.: CISAs are among the five highest-paid IT security professionals; more than 27,000 take the exam each year and the numbers are growing; Standards are updated twice a year, and t

  19. Going the distance for certified cancer registrars.

    Science.gov (United States)

    Backus, Amanda; Kolender, Ellen R

    2009-01-01

    Cancer registry departments are using electronic technology to solve the local and national Certified Tumor Registrar (CTR) shortages. As demand for CTRs continues to increase without an accompanied increase in the supply of qualified personnel, cancer registry departments are looking for new solutions to this growing local and national trend. In order to solve this problem, some cancer registries have started using telecommunication to fill the empty positions within their departments. This is the case at Roper St. Francis Healthcare (RSFH) in Charleston, SC, where Cancer Registry Manager, Ellen Kolender, RHIA, CTR, used telecommuting to fill one full-time and one part-time CTR position.

  20. CEH Certified Ethical Hacker Study Guide

    CERN Document Server

    Graves, Kimberly

    2010-01-01

    Prepare for the new version of CEH certification with this advanced guide. Once you learn the thought processes of unethical hackers, you can figure out how to secure your computer systems to defend against them. That's the philosophy behind ethical hacking, and it's a growing field. Prepare for certification in this important area with this advanced study guide that covers all exam objectives for the challenging CEH Certified Ethical Hackers exam. The book provides full coverage of exam topics, real-world examples, and a CD with additional materials for extra review and practice.:; Covers eth

  1. Self-reported Occupational Skin Exposure and Risk of Physician-certified Long-term Sick Leave

    DEFF Research Database (Denmark)

    Alfonso, Jose Hernan; Tynes, Tore; Thyssen, Jacob P;

    2016-01-01

    Little is known about the contribution of occupational skin exposure as a risk factor for physician-certified long-term sick leave in the general working population of Norway. This study drew a cohort (n = 12,255; response at baseline 69.9%) randomly from the general population of Norway. Occupat......Little is known about the contribution of occupational skin exposure as a risk factor for physician-certified long-term sick leave in the general working population of Norway. This study drew a cohort (n = 12,255; response at baseline 69.9%) randomly from the general population of Norway...

  2. Drug repurposing in pediatrics and pediatric hematology oncology.

    Science.gov (United States)

    Blatt, Julie; Corey, Seth J

    2013-01-01

    Drug 'repurposing', that is, using old drugs for new indications, has been proposed as a more efficient strategy for drug development than the current standard of beginning with novel agents. In this review, we explore the scope of drug repurposing in pediatric hematology oncology and in pediatrics in general. Drugs commonly used in children were identified using the Harriet Lane Handbook (HLH) and searched in PubMed for different uses. Additional drugs were identified by searching PubMed and Google.com for 'drug repurposing' or 'drug repositioning'. Almost 10% of drugs with primary uses in pediatrics have been repurposed in pediatric hematology oncology or pediatrics. The observant clinician, pharmacologist and translational bioinformatician, as well as structural targeting, will have a role in discovering new repurposing opportunities.

  3. Pediatric Cardiomyopathies.

    Science.gov (United States)

    Lee, Teresa M; Hsu, Daphne T; Kantor, Paul; Towbin, Jeffrey A; Ware, Stephanie M; Colan, Steven D; Chung, Wendy K; Jefferies, John L; Rossano, Joseph W; Castleberry, Chesney D; Addonizio, Linda J; Lal, Ashwin K; Lamour, Jacqueline M; Miller, Erin M; Thrush, Philip T; Czachor, Jason D; Razoky, Hiedy; Hill, Ashley; Lipshultz, Steven E

    2017-09-15

    Pediatric cardiomyopathies are rare diseases with an annual incidence of 1.1 to 1.5 per 100 000. Dilated and hypertrophic cardiomyopathies are the most common; restrictive, noncompaction, and mixed cardiomyopathies occur infrequently; and arrhythmogenic right ventricular cardiomyopathy is rare. Pediatric cardiomyopathies can result from coronary artery abnormalities, tachyarrhythmias, exposure to infection or toxins, or secondary to other underlying disorders. Increasingly, the importance of genetic mutations in the pathogenesis of isolated or syndromic pediatric cardiomyopathies is becoming apparent. Pediatric cardiomyopathies often occur in the absence of comorbidities, such as atherosclerosis, hypertension, renal dysfunction, and diabetes mellitus; as a result, they offer insights into the primary pathogenesis of myocardial dysfunction. Large international registries have characterized the epidemiology, cause, and outcomes of pediatric cardiomyopathies. Although adult and pediatric cardiomyopathies have similar morphological and clinical manifestations, their outcomes differ significantly. Within 2 years of presentation, normalization of function occurs in 20% of children with dilated cardiomyopathy, and 40% die or undergo transplantation. Infants with hypertrophic cardiomyopathy have a 2-year mortality of 30%, whereas death is rare in older children. Sudden death is rare. Molecular evidence indicates that gene expression differs between adult and pediatric cardiomyopathies, suggesting that treatment response may differ as well. Clinical trials to support evidence-based treatments and the development of disease-specific therapies for pediatric cardiomyopathies are in their infancy. This compendium summarizes current knowledge of the genetic and molecular origins, clinical course, and outcomes of the most common phenotypic presentations of pediatric cardiomyopathies and highlights key areas where additional research is required. URL: http

  4. Certified quantum non-demolition measurement of material systems

    Science.gov (United States)

    Mitchell, M. W.; Koschorreck, M.; Kubasik, M.; Napolitano, M.; Sewell, R. J.

    2012-08-01

    An extensive debate on quantum non-demolition (QND) measurement, reviewed in Grangier et al (1998 Nature 396 537), finds that true QND measurements must have both non-classical state-preparation capability and non-classical information-damage tradeoff. Existing figures of merit for these non-classicality criteria require direct measurement of the signal variable and are thus difficult to apply to optically-probed material systems. Here we describe a method to demonstrate both criteria without need for to direct signal measurements. Using a covariance matrix formalism and a general noise model, we compute meter observables for QND measurement triples, which suffice to compute all QND figures of merit. The result will allow certified QND measurement of atomic spin ensembles using existing techniques.

  5. Certified quantum non-demolition measurement of material systems

    CERN Document Server

    Mitchell, Morgan W; Kubasik, Marcin; Napolitano, Mario; Sewell, Robert J

    2012-01-01

    An extensive debate on quantum non-demolition (QND) measurement, reviewed in Grangier et al. [Nature, {\\bf 396}, 537 (1998)], finds that true QND measurements must have both non-classical state-preparation capability and non-classical information-damage tradeoff. Existing figures of merit for these non-classicality criteria require direct measurement of the signal variable and are thus difficult to apply to optically-probed material systems. Here we describe a method to demonstrate both criteria without need for to direct signal measurements. Using a covariance matrix formalism and a general noise model, we compute meter observables for QND measurement triples, which suffice to compute all QND figures of merit. The result will allow certified QND measurement of atomic spin ensembles using existing techniques.

  6. 77 FR 5415 - National Organic Program: Notice of Draft Guidance for Accredited Certifying Agents, Certified...

    Science.gov (United States)

    2012-02-03

    ...; ] DEPARTMENT OF AGRICULTURE Agricultural Marketing Service 7 CFR Part 205 National Organic Program: Notice of... Certified Organic Products AGENCY: Agricultural Marketing Service, USDA. ACTION: Notice of availability with..., Agricultural Marketing Specialist, National Organic Program, USDA-AMS- NOP, 1400 Independence Ave. SW.,...

  7. Training and Certification Program for Certified Energy Auditors (CEA) and Certified Building Commissioning Professionals (CBCP)

    Energy Technology Data Exchange (ETDEWEB)

    Kent, Bill

    2012-08-24

    The Association of Energy Engineers (AEE) has offered energy efficiency training and certification programs for over 30 years. During that time AEE has certified more than 22,000 professionals. All of our certification programs are the result of extensive industry research and program development and oversight by certification boards. For this project award, AEE proposed to work with the Department of Energy to utilize and extend existing industry recognized Certified Energy Auditor (CEA) and Certified Building Commissioning Professional (CBCP) programs under this Training Program Development Announcement. These expanded training programs will have significant impact in training professionals for building commissioning and energy auditing to achieve the goal of bringing existing buildings up to their optimal energy performance potential and ensuring that new buildings maintain their expected optimal level of performance. The goals and objectives of the training development project were achieved with the development of new training programs that are now being offered as self-sustaining commercial training and certification programs. These new programs are training and certifying professionals who are accomplishing the goal of increasing building energy performance in both existing and new buildings.

  8. Random numbers certified by Bell's theorem.

    Science.gov (United States)

    Pironio, S; Acín, A; Massar, S; de la Giroday, A Boyer; Matsukevich, D N; Maunz, P; Olmschenk, S; Hayes, D; Luo, L; Manning, T A; Monroe, C

    2010-04-15

    Randomness is a fundamental feature of nature and a valuable resource for applications ranging from cryptography and gambling to numerical simulation of physical and biological systems. Random numbers, however, are difficult to characterize mathematically, and their generation must rely on an unpredictable physical process. Inaccuracies in the theoretical modelling of such processes or failures of the devices, possibly due to adversarial attacks, limit the reliability of random number generators in ways that are difficult to control and detect. Here, inspired by earlier work on non-locality-based and device-independent quantum information processing, we show that the non-local correlations of entangled quantum particles can be used to certify the presence of genuine randomness. It is thereby possible to design a cryptographically secure random number generator that does not require any assumption about the internal working of the device. Such a strong form of randomness generation is impossible classically and possible in quantum systems only if certified by a Bell inequality violation. We carry out a proof-of-concept demonstration of this proposal in a system of two entangled atoms separated by approximately one metre. The observed Bell inequality violation, featuring near perfect detection efficiency, guarantees that 42 new random numbers are generated with 99 per cent confidence. Our results lay the groundwork for future device-independent quantum information experiments and for addressing fundamental issues raised by the intrinsic randomness of quantum theory.

  9. [Treatment of pediatric epilepsy].

    Science.gov (United States)

    Ito, Susumu; Oguni, Hirokazu

    2014-05-01

    Recently, the treatment strategy for pediatric epilepsy has been dramatically changed in Japan, because of the approval of new-generation antiepileptic drugs. Since 2006, a total of 6 new antiepileptic drugs, including gabapentin (GBP; adults/pediatric patients: 2006/2011 [year of approval]), topiramate (TPM; 2007/2013), lamotrigine (LTG; 2008/2008), levetiracetam (LEV; 2010/2013), stiripentol (STP; 2012/2012), and rufinamide (RUF; 2013/2013), have been introduced. Thus far, valproate (VPA) and carbamazepine (CBZ) have been first indicated for "generalized" epilepsy and "focal" epilepsy syndromes/types, respectively, in Japan. However, the approval of these new drugs could allow us to choose more effective and less toxic ones at an early stage of treatment. In this chapter, we describe the latest domestic and foreign guidelines for the treatment of pediatric epilepsy.

  10. Pediatric MRI

    Data.gov (United States)

    U.S. Department of Health & Human Services — The NIH Study of Normal Brain Development is a longitudinal study using anatomical MRI, diffusion tensor imaging (DTI), and MR spectroscopy (MRS) to map pediatric...

  11. Pediatric Terminology

    Science.gov (United States)

    The National Institute of Child Health and Human Development (NICHD) is working with NCI Enterprise Vocabulary Services (EVS) to provide standardized terminology for coding pediatric clinical trials and other resea

  12. Pediatric melanoma.

    Science.gov (United States)

    Tracy, Elisabeth T; Aldrink, Jennifer H

    2016-10-01

    Childhood melanoma is a rare pediatric malignancy, with fewer than 500 new diagnoses annually. The incidence is increasing, particularly in the adolescent population. This review highlights the epidemiology, clinical presentation, and histopathologic challenges of pediatric melanoma. Surgical resection remains the cornerstone for localized and regionally advanced disease. Adjuvant therapies, including current options and potential novel therapeutics for this unique population will be discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Pediatric Dentistese

    OpenAIRE

    Sharath Asokan; Sivakumar Nuvvula

    2017-01-01

    Successful practice of pediatric dentistry depends on the establishment of a good relationship between the dentist and the child. Such a relationship is possible only through effective communication. Pediatric dentistry includes both an art and a science component. The focus has been mostly on the technical aspects of our science, and the soft skills we need to develop are often forgotten or neglected. This paper throws light on the communication skills we need to imbibe to be a successful pe...

  14. Pediatric Anthropometry

    Science.gov (United States)

    Klinich, Kathleen D.; Reed, Matthew P.

    Anthropometry is the measurement of human size, shape, and physical capabilities. Most pediatric anthropometry data are gathered to describe child growth patterns, but data on body size, mass distribution, range of motion, and posture are used to develop crash test dummies and computational models of child occupants. Pediatric anthropometry data are also used to determine child restraint dimensions, so they will accommodate the applicable population of child occupants.

  15. 21 CFR 880.5140 - Pediatric hospital bed.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Pediatric hospital bed. 880.5140 Section 880.5140...) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Therapeutic Devices § 880.5140 Pediatric hospital bed. (a) Identification. A pediatric hospital bed is a device...

  16. Development studies of captopril certified reference material

    Directory of Open Access Journals (Sweden)

    Raquel Nogueira

    2011-06-01

    Full Text Available This paper describes the studies performed with the candidate Certified Reference Material (CRM of captopril, the first CRM of an active pharmaceutical ingredient (API in Brazil, including determination of impurities (organic, inorganic and volatiles, homogeneity testing, short- and long-term stability studies, calculation of captopril content using the mass balance approach, and estimation of the associated measurement uncertainty.Este artigo descreve os estudos realizados com o candidato a Material de Referência Certificado (MRC de captopril, primeiro MRC de fármacos no Brasil, incluindo a determinação de impurezas (orgânicas, inorgânicas e voláteis, testes de homogeneidade, testes de estabilidade de curta e longa duração, cálculo do teor de captopril por balanço de massa e estimativa da incerteza de medição associada ao valor certificado.

  17. Random Numbers Certified by Bell's Theorem

    CERN Document Server

    Pironio, S; Massar, S; de la Giroday, A Boyer; Matsukevich, D N; Maunz, P; Olmschenk, S; Hayes, D; Luo, L; Manning, T A; Monroe, C

    2009-01-01

    Randomness is difficult to characterize mathematically, and its generation must rely on an unpredictable physical process. Inaccuracies in the theoretical modelling of such processes or failures of the devices, possibly due to adversarial attacks, limit the reliability of random number generators in ways that are difficult to control and detect. Here, we show that the nonlocal correlations of entangled quantum particles can be used to design a new type of cryptographically secure random number generator without the need for any assumptions on the internal working of the devices. This strong form of randomness generation is impossible classically and possible in quantum systems only if certified by a Bell inequality violation. We demonstrate this proposal in a system of two entangled atoms separated by approximately 1 meter. The observed Bell inequality violation, featuring near-perfect detection efficiency, guarantees that 42 new random numbers are generated with 99% confidence. Our results lay the groundwork...

  18. Educational practices and exploration of the clinical teaching of general Pediatrics%普通儿科临床实习教学实践

    Institute of Scientific and Technical Information of China (English)

    胡晓红; 孙婧; 李乔俊

    2016-01-01

    After years of general Pediatrics medicine clinical practice teaching, we have dis-covered that there exist some problems such as teachers’ job burnout, teachers’ low professional knowledge level of clinical teaching and lack of teaching ability, medical students fear, low self-esteem, psychological fear and emotional weariness breeding as well as the children patients and their parents refusal of practice because of their worrying about being a test and so on. To solve these problems, we have put forward some proposals such as to implement the management system, recognizing and rewarding teachers to affirm their teaching levels, organizing teachers to participate in academic con-ferences, seminars, and to expand their professional knowledge in order to improve their overall quality. Meanwhile, we have adopted some new teaching ways to instead of traditional ways, such as applied multimedia technology and network platforms, put emphasis on basic skills training, the im-provement of departmental rotation assessment, and other ways to improve clinical teaching quality and develop interns’ clinical thinking ability to help them transit to clinicians.%综合医院普通儿科实习教学中长期存在医生教学时间有限、意识有限和能力有限,患儿哭闹不配合,家长不信任,实习生陌生、惶恐、厌学问题。针对这3方面问题,解放军总医院第一附属医院儿科通过健全管理制度,培训带教医生理论知识和教学技巧,加强学生操作技能训练、完善出科考核等探索和实践,提高带教医生的教学能力,激发学生学习热情,提高学生临床思维、操作和解决临床问题的能力,取得了良好的教学效果。

  19. [Evaluation and characterization of the certified reference materials for coagulation factor Ⅷ and Ⅸ activity testing].

    Science.gov (United States)

    Zhang, H P; Zhou, W B; Li, C B; Du, Z L; Peng, M T

    2016-05-31

    To evaluate and characterize the certified reference materials for coagulation factor Ⅷ (FⅧ) and factor Ⅸ (FⅨ) activity testing. The homogeneity and stability of three lots of certified reference materials (F01-F03) with different factor concentrations were evaluated according to guidelines"Reference materials-general and statistical principles for certification","Guidance on evaluating the homogeneity and stability of samples used for proficiency testing"and"Technical Norm of Primary Reference Material". The certified reference materials were characterized by eight laboratories using one-stage method, which were calibrated by the coagulation standard provided by the National Institute for Biological Standards and Control (NIBSC) in UK. The Coefficient of Variation (CV) of homogeneity test of FⅧ activity of three lots of certified reference materials were 3.9%, 3.3% and 3.4%, respectively. While that of FⅨ activity were 3.7%, 3.0% and 1.8%, respectively. The results of one-way ANOVA showed that all certified reference materials had good homogeneity (P>0.05), and the between-bottle homogeneity uncertainties (ubb) of FⅧ and FⅨ activity were 0.5%-2.9% and 0.1%-3.9%, respectively. All certified reference materials stored in -80 ℃ remained stable in 9 months by trend analysis, and the long-term stability uncertainties(ults) of FⅧ and FⅨ activity were 0.5%-5.1% and 1.3%-4.4%, respectively. The characterization uncertainties (uchar) of FⅧ and FⅨ activity testing were 0.9%-2.4% and 1.1%-2.4%, respectively. The combined uncertainties and extended uncertainties (coverage factor k=2) were calculated. The assigned values of each lot of certified reference materials for FⅧ activity were (85±13)%, (36.0±3.4)% and (20.5±2.3)%, and that were (102±13)%, (47.8±6.9)% and (29.3±3.8)% for FⅨ activity, respectively. The certified reference materials for FⅧ and FⅨ activity testing have good homogeneity and stability. The results of the

  20. 27 CFR 478.95 - Certified copy of license.

    Science.gov (United States)

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 3 2010-04-01 2010-04-01 false Certified copy of license... Conduct of Business § 478.95 Certified copy of license. The license furnished to each person licensed... the licensee desires an additional copy of the license for certification (instead of making a...

  1. 36 CFR 61.7 - Subgrants to certified local governments.

    Science.gov (United States)

    2010-07-01

    ... INTERIOR PROCEDURES FOR STATE, TRIBAL, AND LOCAL GOVERNMENT HISTORIC PRESERVATION PROGRAMS § 61.7 Subgrants to certified local governments. (a) Each SHPO must transfer at least 10 percent of its annual... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Subgrants to certified...

  2. 36 CFR 61.6 - Certified local government programs.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Certified local government... INTERIOR PROCEDURES FOR STATE, TRIBAL, AND LOCAL GOVERNMENT HISTORIC PRESERVATION PROGRAMS § 61.6 Certified local government programs. (a) Each approved State program must provide a mechanism for...

  3. 19 CFR 159.36 - Multiple certified rates.

    Science.gov (United States)

    2010-04-01

    ... TREASURY (CONTINUED) LIQUIDATION OF DUTIES Conversion of Foreign Currency § 159.36 Multiple certified rates... rates of exchange (e.g., official and free) for a foreign currency: (a) Rates to be published. When the... multiple rates have been certified for a foreign currency, the rate to be used for Customs purposes...

  4. 19 CFR 159.35 - Certified daily rate.

    Science.gov (United States)

    2010-04-01

    ... TREASURY (CONTINUED) LIQUIDATION OF DUTIES Conversion of Foreign Currency § 159.35 Certified daily rate. The daily buying rate of foreign currency which is determined by the Federal Reserve Bank of New York... the conversion of foreign currency whenever a proclaimed rate or certified quarterly rate is...

  5. 7 CFR 97.143 - Certified seed only.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Certified seed only. 97.143 Section 97.143 Agriculture... PLANT VARIETY AND PROTECTION Marking Or Labeling Provisions § 97.143 Certified seed only. (a) Upon filing an application, or amendment thereto, specifying seed of the variety is to be sold by variety...

  6. 178名儿童口腔医生对笑气镇静及全麻的认知调查%Investigation of the cognition of 178 pediatric dentists about nitrous oxide sedation and general anesthesia

    Institute of Scientific and Technical Information of China (English)

    陈静涛; 周志斐; 邬礼政; 王小竞

    2013-01-01

    目的:了解儿童口腔医生对笑气镇静及全麻的认知情况.方法:2012-06对参加第七次全国儿童口腔医学会议的178名医生进行笑气镇静及全麻认知情况问卷调查,并对相关因素进行分析.结果:178名医生中有25人(14%)独立开展过笑气镇静;42人(23.6%)在麻醉医生的合作下开展过全麻技术;38人(21.3%)接受过不同程度的笑气镇静专科培训.医师工作所在省市GDP位于全国前10位的92名医生中有30人(32.6%)在麻醉医师合作下开展全麻技术,位于10位以后的86名医生中仅有12人(13.9%)开展过全麻技术.笑气镇静和全麻的优点,85人(47.8%)选择了避免患儿产生心理阴影;笑气镇静和全麻的缺点,选择医疗费用高,操作难度大,会出现麻醉意外分别为33.7%,29.2%,27.5%;175名(98.3%)医生在以后的工作中会建议病人使用笑气镇静或全麻.结论:目前国内开展笑气镇静及全麻技术的程度较低,可能与国内经济教育发展水平相对不高有关.%AIM: To investigate the general cognition situation of chinese pediatric dentists about the use of nitrous oxide (NO) sedation and general anesthesia. METHODS: In June, 2012 during the 7 th National Congress of Pediatric Dentistry a questionnaire was delivered to delegates on the acceptance level of NO sedation and general anesthesia and effective replies with a sample size of 178 were received. Then the related factors based on the questionnaires were further assessed. RESULTS: 25 out of the 178 investigated pediatric dentists(14% ) had carried out NO sedation independently and 42 (23. 6% ) had taken general anesthesia by anesthesiologists in the treating procedure. 38 (21. 3% ) had received professional training in the field of NO sedation. 30 out of the 92 (32. 6% ) from the provinces or cities ranking top 10 of GDP in China had carried out general anesthesia with the cooperation of anesthesiologists while those from the other

  7. What is in a label? Rainforest-Alliance certified banana production versus non-certified conventional banana production

    Directory of Open Access Journals (Sweden)

    Angelina Sanderson Bellamy

    2016-07-01

    Full Text Available Export banana production in Latin America is pesticide intensive, receiving much negative publicity regarding human health problems and environmental degradation. The Rainforest Alliance (RA certification scheme was established to certify farms that met a number of social, occupation health and environmental standards set by RA and their certifying body, the Sustainable Agriculture Network (SAN. This study was one of the first, independent studies of the environmental impact of some of the principles set by RA and SAN. The study focuses on insect and bird diversity as an indicator of ecosystem health. Five RA certified farms, six non-RA certified farms, and five organic certified farms were sampled. The data was analyzed with RDA multivariate analyses and Monte Carlo permutation tests. The results showed that RA certified farms had less insect diversity compared to non-RA certified farms and that both farm types had less insect diversity than organic farms. There was little difference between RA and non-RA certified farms with regards bird community composition. Thus, organic farming conserves biodiversity, while alternative environmental labels (e.g. a Rainforest alliance seal may not have any visible positive effect on in-farm biodiversity. This study points to the need for improvements in SAN certification standards to achieve improved environmental conditions.

  8. Teacher quality: a comparison of National Board-certified and non-Board-certified teachers of deaf students.

    Science.gov (United States)

    Scheetz, Nanci A; Martin, David S

    2006-01-01

    THE STUDY was designed to identify specific components of teacher excellence, focusing initially on the characteristics of the small number of teachers of the deaf who are certified by the National Board for Professional Teaching Standards (NBPTS), then comparing those with the characteristics of other teachers identified as master teachers by university faculty in teacher preparation in deafness. Classroom observation, written lesson plans, teacher questionnaires on beliefs, and content analysis of interactive electronic focus groups were used to compare the two groups of teachers. Results indicated similarities between Board-certified and non-Board-certified master teachers in regard to teacher behaviors and commitment to well-founded pedagogical principles. Differences were found in classroom priorities and in the greater level of interconnectivity expressed by Board-certified teachers as the result of becoming Board certified. Recommendations are made for preparing teachers of deaf students.

  9. Injuries in the Iowa Certified Safe Farm Study.

    Science.gov (United States)

    Rautiainen, R H; Lange, J L; Hodne, C J; Schneiders, S; Donham, K J

    2004-01-01

    The aims of this article are to assess injury characteristics and risk factors in the Iowa Certified Safe Farm (CSF) program and to evaluate the effectiveness of CSF for reducing injuries. This intervention program includes a health screening, on-farm safety review, education, and monetary incentives. Cohorts of farmers in an intervention group (n = 152) and control group (n = 164) in northwestern Iowa were followed for a three-year period. During the follow-up, there were 318 injuries (42/100 person-years), of which 112 (15/100 person-years) required professional medical care. The monetary cost of injuries was $51,764 ($68 per farm per year). There were no differences in the self-reported injury rates and costs between the intervention and control groups. Raising livestock, poor general health, and exposures to dust and gas, noise, chemicals and pesticides, and lifting were among risk factors for injury. Most injuries in this study were related to animals, falls from elevation, slips/trips/falls, being struck by or struck against objects, lifting, and overexertion. Machinery was less prominent than generally reported in the literature. Hurry, fatigue, or stress were mentioned as the primary contributing factor in most injuries. These findings illustrate the need for new interventions to address a multitude of hazards in the farm work environment as well as management and organization of farm work.

  10. Certifying floating-point implementations using Gappa

    CERN Document Server

    De Dinechin, Florent; Melquiond, Guillaume

    2008-01-01

    High confidence in floating-point programs requires proving numerical properties of final and intermediate values. One may need to guarantee that a value stays within some range, or that the error relative to some ideal value is well bounded. Such work may require several lines of proof for each line of code, and will usually be broken by the smallest change to the code (e.g. for maintenance or optimization purpose). Certifying these programs by hand is therefore very tedious and error-prone. This article discusses the use of the Gappa proof assistant in this context. Gappa has two main advantages over previous approaches: Its input format is very close to the actual C code to validate, and it automates error evaluation and propagation using interval arithmetic. Besides, it can be used to incrementally prove complex mathematical properties pertaining to the C code. Yet it does not require any specific knowledge about automatic theorem proving, and thus is accessible to a wide community. Moreover, Gappa may ge...

  11. Environmental impact of non-certified versus certified (ASC) intensive Pangasius aquaculture in Vietnam, a comparison based on a statistically supported LCA.

    Science.gov (United States)

    Nhu, Trang T; Schaubroeck, Thomas; Henriksson, Patrik J G; Bosma, Roel; Sorgeloos, Patrick; Dewulf, Jo

    2016-12-01

    Pangasius production in Vietnam is widely known as a success story in aquaculture, the fastest growing global food system because of its tremendous expansion by volume, value and the number of international markets to which Pangasius has been exported in recent years. While certification schemes are becoming significant features of international fish trade and marketing, an increasing number of Pangasius producers have followed at least one of the certification schemes recognised by international markets to incorporate environmental and social sustainability practices in aquaculture, typically the Pangasius Aquaculture Dialogue (PAD) scheme certified by the Aquaculture Stewardship Council (ASC). An assessment of the environmental benefit of applying certification schemes on Pangasius production, however, is still needed. This article compared the environmental impact of ASC-certified versus non-ASC certified intensive Pangasius aquaculture, using a statistically supported LCA. We focused on both resource-related (water, land and total resources) and emissions-related (global warming, acidification, freshwater and marine eutrophication) categories. The ASC certification scheme was shown to be a good approach for determining adequate environmental sustainability, especially concerning emissions-related categories, in Pangasius production. However, the non-ASC certified farms, due to the large spread, the impact (e.g., water resources and freshwater eutrophication) was possibly lower for a certain farm. However, this result was not generally prominent. Further improvements in intensive Pangasius production to inspire certification schemes are proposed, e.g., making the implementation of certification schemes more affordable, well-oriented and facilitated; reducing consumed feed amounts and of the incorporated share in fishmeal, especially domestic fishmeal, etc. However, their implementation should be vetted with key stakeholders to assess their feasibility. Copyright

  12. Pediatric vasculitis.

    Science.gov (United States)

    Barut, Kenan; Sahin, Sezgin; Kasapcopur, Ozgur

    2016-01-01

    The aim of this review is to define childhood vasculitis and to highlight new causative factors and treatment modalities under the guidance of recently published studies. Childhood vasculitis is difficult to diagnose because of the wide variation in the symptoms and signs. New nomenclature and classification criteria were proposed for the diagnosis of pediatric vasculitis. Recently, progress has been made toward understanding the genetic susceptibility to pediatric vasculitis as it was in other diseases. Various radiological techniques provide great opportunities in establishing the diagnosis of pediatric vasculitis. Mild central nervous system disease can accompany Henoch-Schonlein purpura and can go unnoticed. Antineutrophilic cytoplasmic antibody-associated vasculitis is rare in children. Increased severity of the disease, subglottic stenosis, and renal disease are described more frequently among children. Biological therapies are used with success in children as in adults. Future studies, whose aims are to evaluate treatment responses, prognosis and to design guidelines for activity, and damage index of vasculitis for children are required. Henoch-Schonlein purpura and Kawasaki disease are the most frequent vasculitides of children. Experience from adult studies for treatment and prognosis are usually used because of low incidence of other vasculitides in children. Multicenter studies of pediatric vasculitis should be conducted to detail treatment responses and prognosis in children.

  13. Childhood Obesity for Pediatric Gastroenterologists

    Science.gov (United States)

    Huang, Jeannie S.; Barlow, Sarah E.; Quiros-Tejeira, Ruben E.; Scheimann, Ann; Skelton, Joseph; Suskind, David; Tsai, Patrika; Uko, Victor; Warolin, Joshua P.; Xanthakos, Stavra A.

    2014-01-01

    Obesity in childhood is one of the major health issues in pediatric health care today. As expected, the prevalence of obesity-related comorbidities has risen in parallel with that of obesity. Consultation regarding these concomitant diseases and subsequent management by subspecialists, including pediatric gastroenterologists, is now common and has resulted in obesity being recognized as a chronic disease requiring coordination of care. Although medications and even surgery may provide effective, though often temporary, treatments for obesity and its comorbidities, behavioral interventions addressing healthy dietary and physical activity habits remain a mainstay in the obesity treatment paradigm. Therefore, the issue of weight management must be addressed by both general practitioner and subspecialist alike. In this report, we review select aspects of pediatric obesity and obesity-related management issues because it relates in particular to the field of pediatric gastroenterology and hepatology. PMID:23282941

  14. Nonparametric decision tree: The impact of ISO 9000 on certified and non certified companies Nonparametric decision tree: The impact of ISO 9000 on certified and non certified companies Nonparametric decision tree: The impact of ISO 9000 on certified and non certified companies

    Directory of Open Access Journals (Sweden)

    Joaquín Texeira Quirós

    2013-09-01

    Full Text Available Purpose: This empirical study analyzes a questionnaire answered by a sample of ISO 9000 certified companies and a control sample of companies which have not been certified, using a multivariate predictive model. With this approach, we assess which quality practices are associated to the likelihood of the firm being certified. Design/methodology/approach: We implemented nonparametric decision trees, in order to see which variables influence more the fact that the company be certified or not, i.e., the motivations that lead companies to make sure. Findings: The results show that only four questionnaire items are sufficient to predict if a firm is certified or not. It is shown that companies in which the respondent manifests greater concern with respect to customers relations; motivations of the employees and strategic planning have higher likelihood of being certified. Research implications: the reader should note that this study is based on data from a single country and, of course, these results capture many idiosyncrasies if its economic and corporate environment. It would be of interest to understand if this type of analysis reveals some regularities across different countries. Practical implications: companies should look for a set of practices congruent with total quality management and ISO 9000 certified. Originality/value: This study contributes to the literature on the internal motivation of companies to achieve certification under the ISO 9000 standard, by performing a comparative analysis of questionnaires answered by a sample of certified companies and a control sample of companies which have not been certified. In particular, we assess how the manager’s perception on the intensity in which quality practices are deployed in their firms is associated to the likelihood of the firm being certified.Purpose: This empirical study analyzes a questionnaire answered by a sample of ISO 9000 certified companies and a control sample of companies

  15. Optimization of electronic prescribing in pediatric patients

    NARCIS (Netherlands)

    Maat, B.

    2014-01-01

    Improving pediatric patient safety by preventing medication errors that may result in adverse drug events and consequent healthcare expenditure,is a worldwide challenge to healthcare. In pediatrics, reported medication error rates in general, and prescribing error rates in particular, vary between s

  16. Survey of Educational Preparation in Pediatric Audiology: A Decade Later.

    Science.gov (United States)

    Oyler, Robert F.; Gross, Shannon R.

    2000-01-01

    This study surveyed audiology program directors (N=46) and audiologists (N=70) concerning preparation in pediatric audiology, specifically general program characteristics, education and training in pediatric audiology, affiliation with a pediatric medical facility, affiliation with school systems, and perceived adequacy of preparation. Comparison…

  17. Child Neurology Education for Pediatric Residents.

    Science.gov (United States)

    Albert, Dara V F; Patel, Anup D; Behnam-Terneus, Maria; Sautu, Beatriz Cunill-De; Verbeck, Nicole; McQueen, Alisa; Fromme, H Barrett; Mahan, John D

    2017-03-01

    The aim of this study was to evaluate whether the current state of child neurology education during pediatric residency provides adequate preparation for pediatric practice. A survey was sent to recent graduates from 3 pediatric residency programs to assess graduate experience, perceived level of competence, and desire for further education in child neurology. Responses from generalists versus subspecialists were compared. The response rate was 32%, half in general pediatric practice. Only 22% feel very confident in approaching patients with neurologic problems. This may represent the best-case scenario as graduates from these programs had required neurology experiences, whereas review of Accreditation Council of Graduate Medical Education-accredited residency curricula revealed that the majority of residencies do not. Pediatric neurologic problems are common, and pediatric residency graduates do encounter such problems in practice. The majority of pediatricians report some degree of confidence; however, some clear areas for improvement are apparent.

  18. Imaging in the diagnosis of pediatric urolithiasis

    Energy Technology Data Exchange (ETDEWEB)

    Colleran, Gabrielle C.; Callahan, Michael J.; Paltiel, Harriet J.; Chow, Jeanne S. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Nelson, Caleb P.; Cilento, Bartley G. [Boston Children' s Hospital, Department of Urology, Boston, MA (United States); Baum, Michelle A. [Boston Children' s Hospital, Department of Nephrology, Boston, MA (United States)

    2017-01-15

    Pediatric urolithiasis is an important and increasingly prevalent cause of pediatric morbidity and hospital admission. Ultrasound (US) is the recommended primary imaging modality for suspected urolithiasis in children. There is, however, widespread use of CT as a first-line study for abdominal pain in many institutions involved in pediatric care. The objective of this review is to outline state-of-the-art imaging modalities and methods for diagnosing urolithiasis in children. The pediatric radiologist plays a key role in ensuring that the appropriate imaging modality is performed in the setting of suspected pediatric urolithiasis. Our proposed imaging algorithm starts with US, and describes the optimal technique and indications for the use of CT. We emphasize the importance of improved communication with a greater collaborative approach between pediatric and general radiology departments so children undergo the appropriate imaging evaluation. (orig.)

  19. 7 CFR 205.100 - What has to be certified.

    Science.gov (United States)

    2010-01-01

    ... Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) ORGANIC FOODS PRODUCTION ACT PROVISIONS NATIONAL ORGANIC PROGRAM Applicability § 205.100 What has to be certified. (a) Except...

  20. 19 CFR 159.34 - Certified quarterly rate.

    Science.gov (United States)

    2010-04-01

    ..., Denmark, Finland, France, Germany, Hong Kong, India, Iran, Ireland, Italy, Japan, Malaysia, Mexico... Customs purposes in connection with merchandise exported on such date. (2) Certified daily rate. If the... merchandise exported on such day. ...

  1. Water Well Locations - MO 2012 Certified Wells (SHP)

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This data set provides information about wells that are certified by the State of Missouri. The parent data set is the Wellhead Information Management System (WIMS)...

  2. ENERGY STAR Certified Water Heaters (V3.1)

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 3.0 ENERGY STAR Program Requirements for Water Heaters that are effective April 16, 2015....

  3. ENERGY STAR Certified Commercial Hot Food Holding Cabinet

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 2.0 ENERGY STAR Program Requirements for Commercial Hot Food Holding Cabinets that are...

  4. Smartphones in the Operating Room: Distraction or Diagnostic Aid? A Case of Newly Diagnosed Wolff-Parkinson White in a Pediatric Patient Having Bronchoscopy Under General Anesthesia.

    Science.gov (United States)

    Esenther, Brandon; Ko, Riva

    2015-08-01

    A 4-year-old boy presented for elective bronchoscopy after years of pharmacologically unresponsive reactive airway disease that limited physical activity. After mask induction with nitrous oxide and sevoflurane, the patient was noted to be intermittently in a hemodynamically stable tachyarrhythmia. The anesthesia machine, though equipped with electrocardiogram (ECG) recording capabilities, malfunctioned during the case and was not able to print a rhythm strip. As a substitute, a smartphone picture and video were recorded. In the recovery room, initial 12-lead ECG showed sinus tachycardia. Shortly after, a presumptive diagnosis of Wolff-Parkinson White was given upon review of the smartphone recordings by the pediatric cardiologist on service. Twelve lead ECG was repeated which showed intermittent Wolff-Parkinson White. This case highlights 2 points. First, any prolonged or sustained pediatric dysrhythmia revealed during anesthesia warrants further investigation and should not be assumed secondary to an anesthetic drug. Second, ubiquitous smartphones are an excellent tool for capturing data that the monitor is unable to capture.

  5. Do LEED-certified buildings save energy? Yes, but...

    Energy Technology Data Exchange (ETDEWEB)

    Newsham, Guy R.; Mancini, Sandra; Birt, Benjamin J. [National Research Council Canada - Institute for Research in Construction, Ottawa (Canada)

    2009-08-15

    We conducted a re-analysis of data supplied by the New Buildings Institute and the US Green Buildings Council on measured energy use data from 100 LEED-certified commercial and institutional buildings. These data were compared to the energy use of the general US commercial building stock. We also examined energy use by LEED certification level, and by energy-related credits achieved in the certification process. On average, LEED buildings used 18-39% less energy per floor area than their conventional counterparts. However, 28-35% of LEED buildings used more energy than their conventional counterparts. Further, the measured energy performance of LEED buildings had little correlation with certification level of the building, or the number of energy credits achieved by the building at design time. Therefore, at a societal level, green buildings can contribute substantial energy savings, but further work needs to be done to define green building rating schemes to ensure more consistent success at the individual building level. Note, these findings should be considered as preliminary, and the analyses should be repeated when longer data histories from a larger sample of green buildings are available. (author)

  6. Certified safe farm: identifying and removing hazards on the farm.

    Science.gov (United States)

    Rautiainen, R H; Grafft, L J; Kline, A K; Madsen, M D; Lange, J L; Donham, K J

    2010-04-01

    This article describes the development of the Certified Safe Farm (CSF) on-farm safety review tools, characterizes the safety improvements among participating farms during the study period, and evaluates differences in background variables between low and high scoring farms. Average farm review scores on 185 study farms improved from 82 to 96 during the five-year study (0-100 scale, 85 required for CSF certification). A total of 1292 safety improvements were reported at an estimated cost of $650 per farm. A wide range of improvements were made, including adding 9 rollover protective structures (ROPS), 59 power take-off (PTO) master shields, and 207 slow-moving vehicle (SMV) emblems; improving lighting on 72 machines: placing 171 warning decals on machinery; shielding 77 moving parts; locking up 17 chemical storage areas, adding 83 lockout/tagout improvements; and making general housekeeping upgrades in 62 farm buildings. The local, trained farm reviewers and the CSF review process overall were well received by participating farmers. In addition to our earlier findings where higher farm review scores were associated with lower self-reported health outcome costs, we found that those with higher farm work hours, younger age, pork production in confinement, beef production, poultry production, and reported exposure to agrichemicals had higher farm review scores than those who did not have these characteristics. Overall, the farm review process functioned as expected. encouraging physical improvements in the farm environment, and contributing to the multi-faceted CSF intervention program.

  7. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small ... of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical ...

  8. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging ... the limitations of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch ...

  9. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small ... of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical ...

  10. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses ... limitations of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of ...

  11. Pediatric heart surgery - discharge

    Science.gov (United States)

    ... discharge; Heart valve surgery - children - discharge; Heart surgery - pediatric - discharge; Heart transplant - pediatric - discharge ... Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 434. ...

  12. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts ... Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  13. Pediatric sleep apnea

    Science.gov (United States)

    Sleep apnea - pediatric; Apnea - pediatric sleep apnea syndrome; Sleep-disordered breathing - pediatric ... During sleep, all of the muscles in the body become more relaxed. This includes the muscles that help keep ...

  14. Children's (Pediatric) Nuclear Medicine

    Science.gov (United States)

    ... Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts ... Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  15. A PCC Architecture based on Certified Abstract Interpretation

    OpenAIRE

    Besson, Frédéric; Jensen, Thomas; Pichardie, David

    2005-01-01

    Proof Carrying Code (PCC) is a technique for downloading mobile code on a host machine while ensuring that the code adheres to the host's security policy. We show how certified abstract interpretation can be used to build a PCC architecture where the code producer can produce program certificates automatically. Code consumers use proof checkers derived from certified analysers to check certificates. Proof checkers carry their own correctness proofs and accepting a new proof checker amounts to...

  16. Certified Satisfiability Module Theories (SMT) Solving for System Verification

    Science.gov (United States)

    2017-01-01

    CERTIFIED SATISFIABILITY MODULO THEORIES (SMT) SOLVING FOR SYSTEM VERIFICATION NEW YORK UNIVERSITY JANUARY 2017 FINAL TECHNICAL REPORT APPROVED...COVERED (From - To) AUG 2013 – JUL 2016 4. TITLE AND SUBTITLE CERTIFIED SATISFIABILITY MODULO THEORIES (SMT) SOLVING FOR SYSTEM VERIFICATION 5a...describes the results of efforts to do exactly this. CVC4, a modern, open - source solver for Satisfiability Modulo Theories (SMT), has been instrumented

  17. Pediatric biobanking

    DEFF Research Database (Denmark)

    Salvaterra, Elena; Giorda, Roberto; Bassi, Maria T

    2012-01-01

    and data handling, and return of results as faced in 10 European countries. Because of the lack of comparative analyses of these topics, a pilot study was designed. Following a qualitative methodology, a questionnaire draft mostly including open-ended queries was developed, tested, and sent by e...... their own choices (n=26). Based on the collected data, dedicated recommendations are needed to govern unique ethical and regulatory issues surrounding pediatric biobanking.......Ethical, legal, and social issues related to the collection, storage, and use of biospecimens and data derived from children raise critical concerns in the international debate. So far, a number of studies have considered a variety of the individual issues crucial to pediatric biobanking...

  18. Pediatric parasomnias.

    Science.gov (United States)

    Mason, Thornton B A; Pack, Allan I

    2007-02-01

    Parasomnias in childhood are common, and often more frequent than in adults. The large number of parasomnias underscore that sleep is not simply a quiescent state, but can involve complex episodes of movement, ranging from subtle to dramatic and complex. Clinicians should be aware that many pediatric parasomnias are benign, self-limited, and may not persist into late childhood or adolescence. Importantly, parasomnias in childhood often differ in type from adults. Nevertheless, parasomnias across ages can be classified as: 1) disorders of arousal (from non-rapid eye movement, or NREM, sleep); 2) parasomnias usually associated with REM sleep; and 3) other parasomnias. We detail here issues in the clinical diagosis, evaluation, and management of multiple pediatric parasomnias. The further study of parasomnias in children may help elucidate the multi-factorial etiologies of these fascinating conditions, shedding light on the potential genetic bases as well as environmental contributions.

  19. Evolution of nutritional status of pediatric in patients of a tertiary care general hospital in Brazil Evolución del estado nutritivo de pacientes pediátricos ingresados en hospital general terciario de Brasil

    Directory of Open Access Journals (Sweden)

    C. R. De Moraes Silveira

    2008-12-01

    Full Text Available Justification and objective: Identify changes in the nutritional status of hospitalized children is fundamental for the early establishment of interventions. This study aims at describing the prevalence of undernutrition at admission and over the weeks of in-hospital stay in pediatric patients and evaluate the association between nutritional status and length of in-hospital stay. Materials and methods: A cohort study was carried out. It followed all the in-patients admitted to the general pediatric unit, composed of 72 beds, in the Hospital de Clínicas de Porto Alegre (HCPA, in the south of Brazil, from 20 march to 20 october in 2004. Patients who were between 1 month and 12 years of age and who had been admitted for clinical or/and surgical reasons were included. Those with Down Syndrome or without clinical condition and/or stature for weight measurement were excluded. Anthropometric data were collected up to 48 hours after admission and, weekly, up to hospital discharge (at admission, on 7th, 14th, and 21st day after admission. In children below 5 years of age, the standard defined by the World Heath Organization (WHO/2006 for the classification of the z-score for the stature/age (S/A, weight/age (W/A and weight/stature (W/S scores was used. In children from 5 to 10 years of age, the standards of the National Center for Health Statistics (NCHS, 1977 were used to classify the same rates as reference values. In children above 10 years of age, the classification of the Body Mass Index (BMI was used (OMS/1995. In order to compare the z-scores over the four evaluation moments, analysis of variance (ANOVA was used for repeated measurements, with Bonferroni's Post-Hoc test, and, for the evaluation of the in-hospital stay length, according to the nutritional status, Kaplan-Meier's survival curve, in the SPSS program, version 12.0, was used. Results: 426 patients were included in the study. 57% of them were male and 50.7% were below one year of age

  20. Pediatric fibromyalgia

    Directory of Open Access Journals (Sweden)

    J. Ablin

    2012-09-01

    Full Text Available Fibromyalgia (FM is currently defined as chronic widespread pain (CWP with allodynia or hyperalgesia to pressure pain. It is classified as one of the large group of soft-tissue pain syndromes. Pain is the cardinal symptom of FM; however, most patients also experience additional symptoms such as debilitating fatigue, disrupted or non-restorative sleep, functional bowel disturbances, and a variety of neuropsychiatric problems, including cognitive dysfunction, anxiety and depressive symptoms. Its pathogenesis is not entirely understood, although it is currently believed to be the result of a central nervous system (CNS malfunction that increases pain transmission and perception. FMS usually involves females, and in these patients it often makes its first appearance during menopause. But it is often diagnosed both in young as well as elderly individuals. Pediatric FMS is a frustrating condition affecting children and adolescents at a crucial stage of their physical and emotional development. Pediatric FMS is an important differential diagnosis to be considered in the evaluation of children suffering from widespread musculoskeletal pain, and must be differentiated from a spectrum of inflammatory joint disorders such as juvenile idiopathic arthritis (JIA, juvenile ankylosing spondylitis, etc. The management of pediatric FMS is centered on the issues of education, behavioral and cognitive change (with a strong emphasis on physical exercise, and a relatively minor role for pharmacological treatment with medications such as muscle relaxants, analgesics and tricyclic agents.

  1. 地佐辛对小儿耳鼻喉手术全身麻醉苏醒期躁动的影响%Effect of Dezocine General Anesthesia in Pediatric ENT Surgery Restlessness

    Institute of Scientific and Technical Information of China (English)

    曾春红

    2015-01-01

    目的:探讨地佐辛对减轻小儿耳鼻喉手术全身麻醉苏醒期躁动的作用。方法:选取我院收治的行全身麻醉耳鼻喉手术的小儿患者作为研究对象,并随机分为对照组和观察组,所有患者术前接受相同的治疗,使用东莨菪碱、芬太尼、异丙酚和罗库溴铵诱导麻醉,微量泵入异丙酚、瑞芬太尼维持麻醉。手术结束前观察组静脉滴注地佐辛,对照组滴注生理盐水。结果:两组小儿患者手术时间、麻醉时间及拔管时间差异无统计学意义(P>0.05),拔管后15min时,观察组患者的平均动脉压(79.0±6.9) mmHg和心率(98.0±15.5)次/min均低于对照组的平均动脉压(94.2±8.3)mmHg和心率(115.1±17.2)次/min,差异有统计学意义(P<0.05);观察组小儿患者躁动情况控制率显著(80.0%)高于对照组(26.7%),且观察组平均躁得分(0.67±0.11)低于对照组(1.96±0.46),差异有统计学意义(P<0.05)。结论:地佐辛对减轻小儿耳鼻喉手术全身麻醉苏醒期躁动效果显著。%Objective: To investigate the Dezocine pediatric ENT surgery to relieve restlessness general anesthesia role. Methods:Our hospital ENT surgery under general anesthesia in pediatric patients for the study and randomly divided into control group and observation group,all patients received the same treatment,the use of scopolamine,fontanel,protocol and rocuronium-induced anesthesia,micro-pump protocol remifentanil anesthesia was maintained.Before the end of surgery,intravenous Dezocine observation group and control group with normal saline infusion.Results:The two groups of pediatric patients operative time,anesthesia time and estuation time was no significant difference (P>0.05),15min after estuation,observe the group of patients with mean arterial pressure (79.0±6.9)mmHg and heart rate (98.0±15.5)times / min were lower than the control group, mean arterial pressure (94.2±8.3)mmHg and heart rate (115.1±17.2)times

  2. Aspectos generales y académicos de los aspirantes y los admitidos a la Especialidad en Pediatría de la Universidad Nacional de Colombia

    Directory of Open Access Journals (Sweden)

    Jairo Echeverry-Raad

    2015-01-01

    Full Text Available Antecedentes: El presente artículo es un avance de investigación, de las pocas que existen alrededor de la admisión a especialidades médicas. En este se indagaron aspectos concernientes a la admisión a la Especialidad en Pediatría de la Universidad Nacional de Colombia, entre los cuales se encuentran: tipo de aspirantes, características del proceso de admisión y resultados de las pruebas.Existe escasa investigación del proceso de admisión a las especialidades medico-quirúrgicas. Objetivo: Caracterizar a los aspirantes y admitidos a la Especialidad en Pediatría de la Universidad Nacional de Colombia (UN. Material y Métodos: Se estudiaron aspirantes y admitidos al programa, cohortes 2009 a 2011, y se estimó la tasa de admisión y factores relacionados con ella. Resultados: Se identificaron 997 aspirantes, de predominio femenino (71%, mediana de 28 años, provenientes de Bogotá. La mitad de ellos eran egresados de universidades públicas. Se convocó a entrevista a 125 (12.5% y 42 fueron aceptados: 34% de los convocados a entrevista y 4.2% de los inscritos. La calificación promedio en la prueba cognitiva y en la prueba de inglés fue 2.72 y 2.63, respectivamente. En los preseleccionados no admitidos, la calificación final fue 3.19, y en los admitidos 3.54. Dentro de los admitidos predominaron mujeres (60%, de 28 años, egresadas de universidades públicas (88%. Significativamente, la admisión pudo ser predicha por: la calificación en la prueba cognitiva, la calificación de la hoja de vida, ser egresado de la Universidad Nacional de Colombia, la calificación en la entrevista, el sexo masculino, tener menor edad, y la calificación en la prueba de inglés (LR ji²(7=307.93, R²=94.7%, p=0.0000. Después de controlar las demás variables, la admisión es explicada casi exclusivamente por la calificación en la prueba cognitiva, (LR ji²(1=300.53, R²=92.08%, p=0.0000. Conclusión: Este trabajo muestra la consistencia y

  3. Pediatric neurosurgery: pride and prejudice.

    Science.gov (United States)

    Winston, K R

    2000-02-01

    Pediatric neurosurgery now exists as a member of the family of neurosurgery with its own training programs, process of accreditation, national and international conferences and scientific journals. The relentless expansion of science relevant to the practice of neurosurgery and the changing patterns of neurosurgical practice have driven and continue to drive the juggernaut of evolutionary process which sometimes necessitates the birth of new specialties of practice. The history and the development of neurosurgery as they relate to children are presented. There is no more reason to think that the established specialty of pediatric neurosurgery or the patients under the care of pediatric neurosurgeons would benefit from the collapsing of pediatric neurosurgery back into the general neurosurgical fold than to think that all of neurosurgery, and hence all patients cared for by neurosurgeons, would benefit from the return of organized neurosurgery to its general surgical parent. Just as mankind benefits from the steady advancement of all aspects of neurosurgery, children benefit from the existence and steady advancement of pediatric neurosurgery.

  4. Certifying Auto-Generated Flight Code

    Science.gov (United States)

    Denney, Ewen

    2008-01-01

    Model-based design and automated code generation are being used increasingly at NASA. Many NASA projects now use MathWorks Simulink and Real-Time Workshop for at least some of their modeling and code development. However, there are substantial obstacles to more widespread adoption of code generators in safety-critical domains. Since code generators are typically not qualified, there is no guarantee that their output is correct, and consequently the generated code still needs to be fully tested and certified. Moreover, the regeneration of code can require complete recertification, which offsets many of the advantages of using a generator. Indeed, manual review of autocode can be more challenging than for hand-written code. Since the direct V&V of code generators is too laborious and complicated due to their complex (and often proprietary) nature, we have developed a generator plug-in to support the certification of the auto-generated code. Specifically, the AutoCert tool supports certification by formally verifying that the generated code is free of different safety violations, by constructing an independently verifiable certificate, and by explaining its analysis in a textual form suitable for code reviews. The generated documentation also contains substantial tracing information, allowing users to trace between model, code, documentation, and V&V artifacts. This enables missions to obtain assurance about the safety and reliability of the code without excessive manual V&V effort and, as a consequence, eases the acceptance of code generators in safety-critical contexts. The generation of explicit certificates and textual reports is particularly well-suited to supporting independent V&V. The primary contribution of this approach is the combination of human-friendly documentation with formal analysis. The key technical idea is to exploit the idiomatic nature of auto-generated code in order to automatically infer logical annotations. The annotation inference algorithm

  5. 7 CFR 457.145 - Potato crop insurance-certified seed endorsement.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Potato crop insurance-certified seed endorsement. 457... insurance—certified seed endorsement. The Potato Crop Insurance Certified Seed Endorsement Provisions for...) Both FCIC and reinsured policies: Potato Crop Insurance Certified Seed Endorsement 1. In return...

  6. 7 CFR 201.67 - Seed certifying agency standards and procedures.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Seed certifying agency standards and procedures. 201...) FEDERAL SEED ACT FEDERAL SEED ACT REGULATIONS Certified Seed § 201.67 Seed certifying agency standards and procedures. In order to qualify as a seed certifying agency for purposes of section 101(a)(25) of the...

  7. Pediatric Appendicitis.

    Science.gov (United States)

    Rentea, Rebecca M; St Peter, Shawn D

    2017-02-01

    Appendicitis is one of the most common surgical pathologies in children. It can present with right lower quadrant pain. Scoring systems in combination with selective imaging and surgical examination will diagnose most children with appendicitis. Clinical pathways should be used. Most surgical interventions for appendicitis are now almost exclusively laparoscopic, with trials demonstrating better outcomes for children who undergo index hospitalization appendectomies when perforated. Nonoperative management has a role in the treatment of both uncomplicated and complicated appendicitis. This article discusses the workup and management, modes of treatment, and continued areas of controversy in pediatric appendicitis. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Pediatric urticaria.

    Science.gov (United States)

    Tsakok, Teresa; Du Toit, George; Flohr, Carsten

    2014-02-01

    Although urticaria is not a life-threatening disease, its impact on quality of life in children should not be overlooked. A systematic search of online databases, including Medline, was performed to inform a review aiming to equip clinicians with an evidence-based approach to all aspects of pediatric urticaria. This review hinges on an illustrative case and includes a summary table of studies pertaining to disease management in children. The multiple issues faced by patients, their families, and treating clinicians are highlighted, and the current literature on the presentation, natural history, investigation, and management of this poorly understood condition is assessed.

  9. National Board Certified Teachers andTheir Students' Achievement

    Directory of Open Access Journals (Sweden)

    Leslie G. Vandevoort

    2004-09-01

    Full Text Available Contemporary research on teaching indicates that teachers are powerful contributors to students’ academic achievement, though the set and interrelationships of characteristics that make for high-quality and effective teaching have yet to be satisfactorily determined. Nevertheless, on the basis of the extant research and a vision of exemplary teaching, the National Board for Professional Teaching Standards stipulated a definition of a superior teacher. The Board did this without empirical evidence to support their claim that teachers’ who meet the standards set by the Board were superior in promoting academic achievement to those who did not meet those standards. In the 17 years since the founding of the National Board, only a few empirical studies have addressed this important issue. In this study we compare the academic performance of students in the elementary classrooms of 35 National Board Certified teachers and their non-certified peers, in 14 Arizona school districts. Board Certified teachers and their principals provide additional information about these teachers and their schools. Four years of results from the Stanford Achievement Tests in reading, mathematics and language arts, in grades three through six, were analyzed. In the 48 comparisons (four grades, four years of data, three measures of academic performance, using gain scores adjusted for students’ entering ability, the students in the classes of National Board Certified Teachers surpassed students in the classrooms of non-Board certified teachers in almost threequarters of the comparisons. Almost one-third of these differences were statistically significant. In the cases where the students of non-Board certified teachers gained more in an academic year, none of the differences found were statistically significant. Effect size, translated into grade equivalents, informs us that the gains made by students of Board Certified teachers were over one month greater than the

  10. Forest Stewardship Council (FSC) pesticide policy and integrated pest management in certified tropical plantations.

    Science.gov (United States)

    Lemes, Pedro Guilherme; Zanuncio, José Cola; Serrão, José Eduardo; Lawson, Simon A

    2017-01-01

    The Forest Stewardship Council (FSC) was the first non-governmental organization composed of multi-stakeholders to ensure the social, environmental, and economic sustainability of forest resources. FSC prohibits certain chemicals and active ingredients in certified forest plantations. A company seeking certification must discontinue use of products so listed and many face problems to comply with these constraints. The aim of this study was to assess the impacts of certification on pest management from the perspective of Brazilian private forestry sector. Ninety-three percent of Brazilian FSC-certified forest companies rated leaf-cutting ants as "very important" pests. Chemical control was the most important management technique used and considered very important by 82 % of respondents. The main chemical used to control leaf-cutting ants, sulfluramid, is in the derogation process and was classified as very important by 96.5 % of the certified companies. Certified companies were generally satisfied in relation to FSC certification and the integrated management of forest pests, but 27.6 % agreed that the prohibitions of pesticides for leaf-cutting ant and termite control could be considered as a non-tariff barrier on high-productivity Brazilian forest plantations. FSC forest certification has encouraged the implementation of more sustainable techniques and decisions in pest management in forest plantations in Brazil. The prohibition on pesticides like sulfluramid and the use of alternatives without the same efficiency will result in pest mismanagement, production losses, and higher costs. This work has shown that the application of global rules for sustainable forest management needs to adapt to each local reality.

  11. The Effectiveness of "Teach for America" and Other Under-certified Teachers

    OpenAIRE

    Ildiko Laczko-Kerr; David C. Berliner

    2002-01-01

    The academic achievements of students taught by under-certified primary school teachers were compared to the academic achievements of students taught by regularly certified primary school teachers.  This sample of under-certified teachers included three types of under-qualified personnel: emergency, temporary and provisionally certified teachers.  One subset of these under-certified teachers was from the national program "Teach For America (TFA)."  Recent college graduates are placed by TF...

  12. Pediatric transplantation: preventing thrombosis.

    Science.gov (United States)

    Robertson, J D

    2015-06-01

    Due to progressive advances in surgical techniques, immunosuppressive therapies, and supportive care, outcomes from both solid organ transplantation and hematopoietic stem cell transplantation continue to improve. Thrombosis remains a challenging management issue in this context, with implications for both graft survival and long-term quality of life. Unfortunately, there remains a general paucity of pediatric-specific data regarding thrombosis incidence, risk stratification, and the safety or efficacy of preventative strategies with which to guide treatment algorithms. This review summarizes the available evidence and rationale underlying the spectrum of current practices aimed at preventing thrombosis in the transplant recipient, with a particular focus on risk factors, pathophysiology, and described antithrombotic regimens.

  13. The "In-Training Examination" of the American Board of Pediatrics: does it test for "new" or "old" information?

    Science.gov (United States)

    Hoffer, F A; Oski, F A

    1979-07-01

    The American Board of Pediatrics In-Training Examination or "Pre-Test" is not in widespread use as a means of evaluating the cognitive knowledge and problem-solving skills of hourse officers. The examination is modeled after the certifying examination of the American Board of Pediatrics. The 1977 Pre-Test was analyzed in an attempt to determine whether awareness of recent medical knowledge was required to pass this examination. The 7th through 10th editions of the Nelson Textbook of Pediatrics were used as a reference source. These editions represent information that is from 5 to at least 20 years of age. Analysis of the 190 items revealed that the correct answer was known for 148 or 78% of the questions at least 20 years ago. These results suggest that the Pre-Test, and presumably the American Board of Pediatrics certifying exam, measures the candidates' knowledge of long-standing core information.

  14. 48 CFR 52.215-20 - Requirements for Certified Cost or Pricing Data and Data Other Than Certified Cost or Pricing Data.

    Science.gov (United States)

    2010-10-01

    ... Certificate of Current Cost or Pricing Data, as prescribed by FAR 15.406-2. (End of provision) Alternate I... Cost or Pricing Data and Data Other Than Certified Cost or Pricing Data. 52.215-20 Section 52.215-20... Certified Cost or Pricing Data and Data Other Than Certified Cost or Pricing Data. As prescribed in...

  15. 48 CFR 52.215-21 - Requirements for Certified Cost or Pricing Data and Data Other Than Certified Cost or Pricing...

    Science.gov (United States)

    2010-10-01

    ... Contractor shall submit a Certificate of Current Cost or Pricing Data, as prescribed by FAR 15.406-2. (End of... Cost or Pricing Data and Data Other Than Certified Cost or Pricing Data-Modifications. 52.215-21... Requirements for Certified Cost or Pricing Data and Data Other Than Certified Cost or Pricing...

  16. Missed Nursing Care in Pediatrics.

    Science.gov (United States)

    Lake, Eileen T; de Cordova, Pamela B; Barton, Sharon; Singh, Shweta; Agosto, Paula D; Ely, Beth; Roberts, Kathryn E; Aiken, Linda H

    2017-07-01

    A growing literature suggests that missed nursing care is common in hospitals and may contribute to poor patient outcomes. There has been scant empirical evidence in pediatric populations. Our objectives were to describe the frequency and patterns of missed nursing care in inpatient pediatric settings and to determine whether missed nursing care is associated with unfavorable work environments and high nurse workloads. A cross-sectional study using registered nurse survey data from 2006 to 2008 was conducted. Data from 2187 NICU, PICU, and general pediatric nurses in 223 hospitals in 4 US states were analyzed. For 12 nursing activities, nurses reported about necessary activities that were not done on their last shift because of time constraints. Nurses reported their patient assignment and rated their work environment. More than half of pediatric nurses had missed care on their previous shift. On average, pediatric nurses missed 1.5 necessary care activities. Missed care was more common in poor versus better work environments (1.9 vs 1.2; P < .01). For 9 of 12 nursing activities, the prevalence of missed care was significantly higher in the poor environments (P < .05). In regression models that controlled for nurse, nursing unit, and hospital characteristics, the odds that a nurse missed care were 40% lower in better environments and increased by 70% for each additional patient. Nurses in inpatient pediatric care settings that care for fewer patients each and practice in a professionally supportive work environment miss care less often, increasing quality of patient care. Copyright © 2017 by the American Academy of Pediatrics.

  17. Pediatric intensive care in Argentina.

    Science.gov (United States)

    Schnitzler, E J

    1993-09-01

    8.2% of the gross domestic product is spent annually on health care in Argentina, a country of 32 million people. There is 1 medical doctor of every 147,000 beds in a total 3180 hospitals. The infant mortality rate in Argentina is 24.5/1000 live births which is high compared to developed countries. Perinatal causes and congenital anomalies are the main cause of death after the neonatal period, and accidents, cardiac disease, and respiratory tract infections are the main causes of death among children over age 1 year. Argentina has approximately 35 pediatric intensive care units (ICU), but 154 of 244 beds are within or near the capital. Only 2 hospitals have pediatric intensive care fellowship programs, so full time dedicated staff is rare. 250 registered pediatricians dedicated to intensive care are in the Argentine Pediatric Society and the nurse/bed ratio is 1:2-1:3. Moreover, the country has neither postanesthesia recuperation units, burn units, chronic ventilation units, nor approved home assistance programs, and intermediate care is not clearly standardized. These inadequacies have led to a shortage of beds and the caring for of critically ill children in general pediatric or emergency wards in hospitals which lack adequate equipment; patients are often discharged inappropriately to clear bed space. Even so, prehospital and emergency room care tends to be provided without the necessary coordination with the pediatric ICU, and structural conditions regarding electrical self-sufficiency, air conditioning, and circulation are met in only few units. Despite the existence of these adverse conditions for the care of critically ill children, a pediatric organ transplant program developed since 1987 has demonstrated 70% to 100% survival rates for 16l orthotopic liver and 9 heart transplants, respectively. Alternatives to improving intensive care in Argentina include optimizing the response of emergency and critical care delivery systems, categorizing hospitals and

  18. Certified Basic Life Support Instructors Assess Cardiopulmonary Resuscitation Skills Poorly

    DEFF Research Database (Denmark)

    Hansen, Camilla; Rasmussen, Stinne E; Kristensen, Mette Amalie

    2016-01-01

    Introduction: High-quality cardiopulmonary resuscitation (CPR) improves survival from cardiac arrest. During basic life support (BLS) training, instructors assess CPR skills to enhance learning outcome. Emergency department staff and senior residents have been shown to assess chest compression...... quality poorly. Currently no studies have evaluated CPR assessment among certified BLS instructors. The aim of this study was to investigate certified BLS instructors’ assessment of chest compressions and rescue breathing.Methods: Data were collected at BLS courses for medical students at Aarhus...... University, Denmark. In pairs, BLS instructors, certified by the European Resuscitation Council, evaluated each learner in an end-of-course cardiac arrest test. Instructors’ assessments were compared with CPR quality data collected from the resuscitation manikin. Correct chest compressions were defined as ≥2...

  19. Multidisciplinary care in pediatric oncology

    Directory of Open Access Journals (Sweden)

    Cantrell MA

    2011-05-01

    Full Text Available Mary Ann Cantrell1, Kathy Ruble21College of Nursing, Villanova University, Villanova, PA, USA; 2Department of Pediatric Oncology, Johns Hopkins University, School of Medicine, Baltimore, MD, USAAbstract: This paper describes the significant advances in the treatment of childhood cancer and supportive care that have occurred over the last several decades and details how these advances have led to improved survival and quality of life (QOL for children with cancer through a multidisciplinary approach to care. Advances in the basic sciences, general medicine, cooperative research protocols, and policy guidelines have influenced and guided the multidisciplinary approach in pediatric oncology care across the spectrum from diagnosis through long-term survival. Two case studies are provided to highlight the nature and scope of multidisciplinary care in pediatric oncology care.Keywords: childhood cancer, chemotherapy, leukemia

  20. The global pediatric antiretroviral market: analyses of product availability and utilization reveal challenges for development of pediatric formulations and HIV/AIDS treatment in children

    Directory of Open Access Journals (Sweden)

    Jambert Elodie

    2010-10-01

    Full Text Available Abstract Background Important advances in the development and production of quality-certified pediatric antiretroviral (ARV formulations have recently been made despite significant market disincentives for manufacturers. This progress resulted from lobbying and innovative interventions from HIV/AIDS activists, civil society organizations, and international organizations. Research on uptake and dispersion of these improved products across countries and international organizations has not been conducted but is needed to inform next steps towards improving child health. Methods We used information from the World Health Organization Prequalification Programme and the United States Food and Drug Administration to describe trends in quality-certification of pediatric formulations and used 7,989 donor-funded, pediatric ARV purchase transactions from 2002-2009 to measure uptake and dispersion of new pediatric ARV formulations across countries and programs. Prices for new pediatric ARV formulations were compared to alternative dosage forms. Results Fewer ARV options exist for HIV/AIDS treatment in children than adults. Before 2005, most pediatric ARVs were produced by innovator companies in single-component solid and liquid forms. Five 2-in1 and four 3-in-1 generic pediatric fixed-dose combinations (FDCs in solid and dispersible forms have been quality-certified since 2005. Most (67% of these were produced by one quality-certified manufacturer. Uptake of new pediatric FDCs outside of UNITAID is low. UNITAID accounted for 97-100% of 2008-2009 market volume. In total, 33 and 34 countries reported solid or dispersible FDC purchases in 2008 and 2009, respectively, but most purchases were made through UNITAID. Only three Global Fund country recipients reported purchase of these FDCs in 2008. Prices for pediatric FDCs were considerably lower than liquids but typically higher than half of an adult FDC. Conclusion Pediatric ARV markets are more fragile than

  1. The global pediatric antiretroviral market: analyses of product availability and utilization reveal challenges for development of pediatric formulations and HIV/AIDS treatment in children.

    Science.gov (United States)

    Waning, Brenda; Diedrichsen, Ellen; Jambert, Elodie; Bärnighausen, Till; Li, Yun; Pouw, Mieke; Moon, Suerie

    2010-10-17

    Important advances in the development and production of quality-certified pediatric antiretroviral (ARV) formulations have recently been made despite significant market disincentives for manufacturers. This progress resulted from lobbying and innovative interventions from HIV/AIDS activists, civil society organizations, and international organizations. Research on uptake and dispersion of these improved products across countries and international organizations has not been conducted but is needed to inform next steps towards improving child health. We used information from the World Health Organization Prequalification Programme and the United States Food and Drug Administration to describe trends in quality-certification of pediatric formulations and used 7,989 donor-funded, pediatric ARV purchase transactions from 2002-2009 to measure uptake and dispersion of new pediatric ARV formulations across countries and programs. Prices for new pediatric ARV formulations were compared to alternative dosage forms. Fewer ARV options exist for HIV/AIDS treatment in children than adults. Before 2005, most pediatric ARVs were produced by innovator companies in single-component solid and liquid forms. Five 2-in1 and four 3-in-1 generic pediatric fixed-dose combinations (FDCs) in solid and dispersible forms have been quality-certified since 2005. Most (67%) of these were produced by one quality-certified manufacturer. Uptake of new pediatric FDCs outside of UNITAID is low. UNITAID accounted for 97-100% of 2008-2009 market volume. In total, 33 and 34 countries reported solid or dispersible FDC purchases in 2008 and 2009, respectively, but most purchases were made through UNITAID. Only three Global Fund country recipients reported purchase of these FDCs in 2008. Prices for pediatric FDCs were considerably lower than liquids but typically higher than half of an adult FDC. Pediatric ARV markets are more fragile than adult markets. Ensuring a long-term supply of quality, well

  2. Features of Teaching Third-Year Students the Subject «Assessment of the General State of a Child. Anthropometry. Measuring and Recording Body Temperature. Work with Newborn Children» by the Module «Nursing in Pediatrics» at the Department of Propedeut

    Directory of Open Access Journals (Sweden)

    A.A. Koniushevska

    2014-12-01

    Full Text Available The paper presents the methodology of teaching at the department of propedeutics of pediatrics the subject «Assessment of the general state of a child. Anthropometry. Measuring and recording body temperature. Work with newborn children». Objectives of the lesson, the skills needed to achieve the goal are provided. Stages of lessons are presented.

  3. Final Report - Certifying the Performance of Small Wind Turbines

    Energy Technology Data Exchange (ETDEWEB)

    Sherwood, Larry [Small Wind Certification Council, Clifton Park, NY (United States)

    2015-08-28

    The Small Wind Certification Council (SWCC) created a successful accredited certification program for small and medium wind turbines using the funding from this grant. SWCC certifies small turbines (200 square meters of swept area or less) to the American Wind Energy Association (AWEA) Small Wind Turbine Performance and Safety Standard (AWEA Standard 9.1 – 2009). SWCC also certifies medium wind turbines to the International Electrical Commission (IEC) Power Performance Standard (IEC 61400-12-1) and Acoustic Performance Standard (IEC 61400-11).

  4. CEH certified ethical hacker : version 8 : study guide

    CERN Document Server

    Oriyano, Sean-Philip

    2014-01-01

    Prepare for the new Certified Ethical Hacker version 8 exam with this Sybex guide Security professionals remain in high demand. The Certified Ethical Hacker is a one-of-a-kind certification designed to give the candidate a look inside the mind of a hacker. This study guide provides a concise, easy-to-follow approach that covers all of the exam objectives and includes numerous examples and hands-on exercises. Coverage includes cryptography, footprinting and reconnaissance, scanning networks, enumeration of services, gaining access to a system, Trojans, viruses, worms, covert channels, and muc

  5. 喉罩联合无肌松全麻在小儿眼科手术中的应用%The application of LMA combined with general anesthesia without muscle relaxants in the pediatric department of ophthalmology operation

    Institute of Scientific and Technical Information of China (English)

    贺伟忠; 杨义; 范小丽; 李萌

    2014-01-01

    目的:研究无肌松全麻联合喉罩置入对小儿眼科手术围术期应激反应的影响。方法选择全身麻醉下小儿眼科手术患者90例,随机分为A、B两组,每组各45例。 A组使用肌松药插入气管导管,B组采用无肌松药全麻并置入喉罩。对比手术中各时间点的平均动脉压(MAP)、心率(P)、心率收缩压乘积(RPP)、血氧饱和度(SpO2)。观察两组拔管期呛咳、躁动等拔管反应,并记录拔管(喉罩)时间、麻醉药总量。结果A组麻醉诱导及拔管期血流动力学波动高于B组;A组严重呛咳、躁动例数高于B组;A组拔管时间长于B组;A组麻醉药物总量多于B组。结论喉罩联合无肌松全麻应用于小儿眼科手术安全可靠,相较气管插管围术期应激反应更低。%Objective To study without muscle relaxants combined general effect of laryngeal mask insertion on the pe-diatric department of ophthalmology operation perioperative stress responses. Methods Ninety patients with pediatric eye surgery were randomly divided into group A and group B, 45 cases in each group. Group A treated with muscle re-laxants insert the tracheal tube, group B treated with without anesthesia and muscle relaxants into the LMA. Contrast surgery mean arterial pressure at each time point (MAP), heart rate (P), rate pressure product (RPP), oxygen saturation (SpO2). Extubation were observed choking, restlessness, etc. extubation reaction, record extubation (LMA) time, total quantity of using drug. Results A induction of anesthesia and extubation hemodynamic fluctuations was higher than that of group B; Severe cough, agitation of group A were higher than that in B group; The extubation time was longer than that of group B; Drug amount was higher than that of group B. Conclusion LMA Joint no muscle relaxant used in pe-diatric anesthesia eye surgery is safe and reliable, with lower stress response.

  6. SEVOFLURANE VERSUS HALOTHANE FOR GENERAL ANESTHESIA IN PEDIATRIC PATIENTS – A COMPARATIVE STUDY OF INDUCTION TIME, INTUBATION TIME AND EMERGENCE TIME

    Directory of Open Access Journals (Sweden)

    Santosh K

    2014-03-01

    Full Text Available AIM: This study was conducted to compare the speed of induction, intubation, and speed of emergence with sevoflurane and halothane in pediatric patients. METHODOLOGY: All the patients had full preanesthetic check-up and the routine investigation (complete blood count, urine albumin was done. Patients were kept fasting for 6 hrs. for solid food, 4hours for semisolid and 2 hours for liquid. They were randomly divided into Gr S and Gr H each comprising of 30 patients each to receive sevoflurane and halothane with 60% nitrous and 40% oxygen respectively by inhalation. On arrival in the operation theatre, the standard monitors were applied including an electrocardiogram, pulse oximeter, non-invasive blood pressure and precordial stethoscope and the baseline readings of respective parameters were taken. Anesthetic induction was done with face mask application using incremental dosing of 0.5% for halothane and 1% for sevoflurane every three to five breath to deliver maximum inspired concentration of upto 5% halothane(maximum inspired concentration or 8% sevoflurane (maximum inspired concentration. Spontaneous ventilation was maintained till loss of eye lash reflex. Following the loss of the eyelash reflex, the vaporizer concentration was decreased to 4% for sevoflurane and 0.86 % for halothane (approximately 2 MAC. Intravenous catheter was inserted. Inhalational agent at the same concentration was given until the loss of corneal reflex. After the intravenous line was secured, inj pentazocine 0.3 mg/kg was given. The patients were intubated with appropriate size endotracheal tube only after the loss of corneal reflex. After successful intubation, intravenous vecuronium 0.1 mg/kg was administered for muscle paralysis and the anesthetic concentrations was adjusted at 1.3 MAC with N2O (0.56% halothane and 2.6% sevoflurane. Time intervals measured: (induction time, intubation time, emergence time were measured. Vitals recorded: Heart rate, systolic

  7. Pediatric tracheomalacia.

    Science.gov (United States)

    Fraga, Jose Carlos; Jennings, Russell W; Kim, Peter C W

    2016-06-01

    Tracheomalacia (TM) is defined as an increased collapsibility of the trachea due to structural anomalies of the tracheal cartilage and/or posterior membrane. Tracheomalacia has a wide range of etiologies but is most commonly present in children born with esophageal atresia and tracheal esophageal fistula. Clinical symptoms can range from minor expiratory stridor with typical barking cough to severe respiratory distress episodes to acute life-threatening events (ALTE). Although the majority of children have mild-to-moderate symptoms and will not need surgical intervention, some will need life-changing surgical treatment. This article examines the published pediatric literature on TM, discusses the details of clinical presentation, evaluation, diagnosis, and a variety of treatments.

  8. Fragmented international volunteerism: need for a global pediatric surgery network.

    Science.gov (United States)

    Butler, Marilyn W

    2010-02-01

    Pediatric general surgeons volunteering internationally often work independently, some without prior assessment of the needs of those they wish to assist. Consequently, care may be inefficient, duplicated, or misdirected. A study was performed to assess whether a network for pediatric surgery volunteer work exists. A search of the Internet was performed to determine whether a pediatric surgery network exists. Worldwide pediatric surgery societies were identified and grouped by country according to income. Web sites for medical volunteer organizations were examined for links to a network of pediatric surgery volunteer work. A search of the Internet revealed no pediatric surgery volunteer network. Ninety-seven pediatric surgery societies were identified. Fifty-one of the organizations were identified as residing in low- and middle-income countries. Searching 50 Web sites for these societies revealed no existing pediatric surgery network. Of 45 Web sites for volunteer medical work, 1 surgery networking Web site was identified. Only 4 pediatric general surgery international volunteer opportunities were cited on that Web site. This study demonstrated that no pediatric surgery volunteer network exists. By identifying pediatric surgery organizations in low- and middle-income countries, it is speculated that one might link the surgeons in these regions with those wishing to volunteer their services. Copyright 2010 Elsevier Inc. All rights reserved.

  9. What Is a Pediatric Rheumatologist?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Rheumatologist? Page Content Article Body If your child ... a pediatric rheumatologist. What Kind of Training Do Pediatric Rheumatologists Have? Pediatric rheumatologists are medical doctors who ...

  10. Observation of curative effect by carbamazepine in the treatment of pediatric refractory generalized convulsive status epilepticus%卡马西平治疗小儿难治性惊厥持续状态疗效观察

    Institute of Scientific and Technical Information of China (English)

    唐容华; 周江堡

    2016-01-01

    ObjectiveTo investigate effective treatment method for pediatric refractory generalized convulsive status epilepticus.MethodsA total of 14 children patients with refractory generalized convulsive status epilepticus received carbamazepine after failed conventional first and second line drug, and their curative effects were observed.ResultsAmong 14 cases, there were 6 cases with obviously reduced convulsions times after 24 h of medication and controlled convulsions after 48 h, 6 cases with obviously reduced convulsions times after 48 h of medication and controlled convulsions after 72 h, and the other 2 cases with obviously reduced convulsions times after 72 h, along with 1 quit case of them due to severe raticide poisoning. There was no case with adverse drug reaction.ConclusionCarbamazepine provides remarkable effect for pediatric refractory generalized convulsive status epilepticus, especially for refractory partial convulsive status epilepticus. Course of treatment requires further investigation.%目的:探讨小儿难治性惊厥持续状态的有效治疗方法。方法14例难治性惊厥持续状态患儿,在使用常规一线、二线止惊药物失败后,开始采用卡马西平治疗,观察疗效。结果14例患儿中,6例患儿在给药24 h后惊厥次数明显减少,48 h惊厥控制;6例患儿在给药48 h后惊厥次数明显减少,72 h惊厥控制;另2例患儿在给药72 h后惊厥次数明显减少,其中1例灭鼠药中毒后终因病情太重放弃治疗,自动出院。无一例出现药物不良反应。结论卡马西平对小儿难治性惊厥持续状态有明显疗效,尤其对难治性部分性惊厥持续状态效果好,其使用疗程有待进一步探索。

  11. Relevant or determinant: Importance in certified sustainable food consumption

    NARCIS (Netherlands)

    Dam, van Y.K.; Trijp, van J.C.M.

    2013-01-01

    Perceived relevance and determinance are two distinct constructs, underlying the overall concept of attribute importance. The present study proposes a survey based measure of attribute determinance. Based on construal level theory it is argued and empirically shown that actual choices of certified

  12. Becoming a National Board Certified Teacher: One Teacher's Perspective

    Science.gov (United States)

    Burns, John

    2007-01-01

    Reflecting on one's practice, whether it is a conversation with a single student, a lesson, or a unit plan, is the surest way for a teacher to improve. Going through the process of becoming a National Board Certified Teacher (NBCT) is a journey of reflective practice. The National Board of Professional Teaching Standards (NBPTS) is a nonprofit,…

  13. Certifying and reasoning on cost annotations of functional programs

    CERN Document Server

    Amadio, Roberto M

    2011-01-01

    We present a so-called labelling method to insert cost annotations in a higher-order functional program, to certify their correctness with respect to a standard compilation chain to assembly code, and to reason on them in a higher-order Hoare logic.

  14. 76 FR 80741 - TRICARE: Certified Mental Health Counselors

    Science.gov (United States)

    2011-12-27

    .... 13132. List of Subjects in 32 CFR Part 199 Claims, Dental health, Health care, Health insurance... referred for therapy by a physician; and (ii) A physician is providing ongoing oversight and supervision of the therapy being provided; and (iii) The mental health counselor certifies on each claim...

  15. Software testing an ISTQB-BCS certified tester foundation guide

    CERN Document Server

    Hambling, Brian; Samaroo, Angelina; Thompson, Geoff; Williams, Peter; Hambling, Brian

    2015-01-01

    This practical guide provides insight into software testing, explaining the basics of the testing process and how to perform effective tests. It provides an overview of different techniques and how to apply them. It is the best-selling official textbook of the ISTQB-BCS Certified Tester Foundation Level.

  16. The Effectiveness of National Board Certified Teachers: Policy Implications

    Science.gov (United States)

    Okpala, Comfort O.; James, Ioney; Hopson, Linda

    2009-01-01

    In this mixed-method research study, data from public school personnel were used to determine the professional preparation of teachers through the National Board Certification process. The major goals of the study were to (a) analyze the perceptions of public school principals on the effectiveness of National Board certified teachers, (b) analyze…

  17. Importance of Addressing Sexuality in Certified Rehabilitation Counselor Practice

    Science.gov (United States)

    Kazukauskas, Kelly A.; Lam, Chow S.

    2009-01-01

    This study investigated Certified Rehabilitation Counselors' (CRCs) beliefs about the importance of addressing sexuality issues during rehabilitation. A modified version of the Family Life Sex Education Goals Questionnaire (FLSEGQ) was completed by 199 CRCs to determine which issues CRCs believe are most important to address. Six sexuality-related…

  18. Relevant or determinant: Importance in certified sustainable food consumption

    NARCIS (Netherlands)

    Dam, van Y.K.; Trijp, van J.C.M.

    2013-01-01

    Perceived relevance and determinance are two distinct constructs, underlying the overall concept of attribute importance. The present study proposes a survey based measure of attribute determinance. Based on construal level theory it is argued and empirically shown that actual choices of certified

  19. Compatibility of OMRI certified surfactants with three entomopathogenic fungi

    Science.gov (United States)

    The Organic Materials Review Institute (OMRI) is a nonprofit organization providing an independent review of products intended for use in organic production systems to certify compliance with U.S. National organic standards. Since all adjuvants to be used in organic agriculture production are requir...

  20. Nurse Practitioners, Physician Assistants and Certified Nurse Midwives in California.

    Science.gov (United States)

    California Univ., San Francisco. Center for California Health Workforce Studies.

    Surveys were mailed to all nurse practitioners (NPs), physician assistants (PAs) and certified nurse midwives (CNMs) registered in California, asking questions about education, labor force participation, specialty, and location and type of practice site, as well as the demographic characteristics of these professionals and their patients. Response…

  1. Job Satisfaction of Certified Nurse Midwives: An Examination

    Science.gov (United States)

    Hampton, Gerald M.; Peterson, Robin T.

    2012-01-01

    Health care providers face pressure to reduce costs and enhance patient satisfaction. One approach is to employ primary care providers such as nurse practitioners, physician assistants, and certified nurse midwives. Since there is a positive relationship between job satisfaction and patient satisfaction, positive job satisfaction on the part of…

  2. 31 CFR 360.55 - Individuals authorized to certify.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Individuals authorized to certify. 360.55 Section 360.55 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... imprint of either the corporate seal of the institution or of the issuing or paying agent's stamp. The...

  3. 31 CFR 315.55 - Individuals authorized to certify.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Individuals authorized to certify. 315.55 Section 315.55 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... authenticated by a legible imprint either of a corporate stamp of the institution or of the issuing or paying...

  4. 31 CFR 353.55 - Individuals authorized to certify.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Individuals authorized to certify. 353.55 Section 353.55 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... imprint of either the corporate seal of the institution or of the issuing or paying agent's stamp. The...

  5. Contemporary pediatric gynecologic imaging.

    Science.gov (United States)

    Servaes, Sabah; Victoria, Teresa; Lovrenski, Jovan; Epelman, Monica

    2010-04-01

    Ultrasound is the primary screening modality for the evaluation of pediatric gynecologic maladies. Magnetic resonance imaging (MRI) is used progressively more in this field, particularly for the evaluation of complex pelvic masses and congenital anomalies. However, ultrasound remains the preferred modality due to the excellent visualization, the dynamic nature of the examination modality, lack of ionizing radiation and sedation risks, and comparatively lower cost. MRI is generally a second-line examination and is preferred over computed tomography as it does not involve the use of ionizing radiation. Additionally, visualization of the female reproductive system anatomy with MRI is superior to computed tomography, the latter being reserved generally for tumor staging. Fluoroscopic examinations and abdominal radiographs can provide additional information that may support a diagnosis. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  6. Teacher Quality: A Comparison of National Board--Certified and Non--Board--Certified Teachers of Deaf Students

    Science.gov (United States)

    Scheetz, Nanci A.; Martin, David S.

    2006-01-01

    The study was designed to identify specific components of teacher excellence, focusing initially on the characteristics of the small number of teachers of the deaf who are certified by the National Board for Professional Teaching Standards (NBPTS), then comparing those with the characteristics of other teachers identified as master teachers by…

  7. What is in a label? Rainforest-Alliance certified banana production versus non-certified conventional banana production

    NARCIS (Netherlands)

    Bellamy, Angelina Sanderson; Svensson, Ola; Brink, van den Paul J.; Tedengren, Michael

    2016-01-01

    Export banana production in Latin America is pesticide intensive, receiving much negative publicity regarding human health problems and environmental degradation. The Rainforest Alliance (RA) certification scheme was established to certify farms that met a number of social, occupation health and

  8. 7 CFR 90.101 - General.

    Science.gov (United States)

    2010-01-01

    ... of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS INTRODUCTION Quality Assurance § 90.101 General. Laboratory service programs of laboratories certified...

  9. Snapshot of Pediatric Cancers

    Science.gov (United States)

    ... Childhood Cancers Late Effects of Childhood Cancer Treatment Pediatric Supportive Care Unusual Cancers of Childhood Treatment Childhood ... Childhood Cancers Late Effects of Childhood Cancer Treatment Pediatric Supportive Care Unusual Cancers of Childhood Treatment Childhood ...

  10. Pediatric MATCH Infographic

    Science.gov (United States)

    Infographic explaining NCI-COG Pediatric MATCH, a cancer treatment clinical trial for children and adolescents, from 1 to 21 years of age, that is testing the use of precision medicine for pediatric cancers.

  11. American Pediatric Surgical Association

    Science.gov (United States)

    American Pediatric Surgical Association Search for: Login Resources + For Members For Professionals For Training Program Directors For Media For ... Surgical Outcomes Surveys & Results Publications Continuing Education + ExPERT Pediatric Surgery NaT Annual Meeting CME MOC Requirements Residents / ...

  12. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Us News Physician Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine ... physicians diagnose and evaluate medical conditions. These imaging scans use radioactive materials called radiopharmaceuticals or radiotracers . Depending ...

  13. Pediatric Celiac Disease

    Science.gov (United States)

    ... of Pediatric Gastroenterology and Nutrition Nurses Print Share Celiac Disease Many kids have sensitivities to certain foods, and ... protein found in wheat, rye, and barley. Pediatric Celiac Disease If your child has celiac disease, consuming gluten ...

  14. Assessment of the Mexican Board of Pediatric Surgery Certification System.

    Science.gov (United States)

    Porras-Hernandez, Juan D; Mora-Fol, Jose R; Lezama-Del Valle, Pablo; Yanowsky-Reyes, Guillermo; Perez-Lorenzana, Hector; Ortega-Salgado, Arturo; Aguirre-Jauregui, Oscar; Bracho-Blanchet, Eduardo; Sanchez-Mendiola, Melchor

    2015-01-01

    To evaluate the quality of the Mexican Board of Pediatric Surgery (MBPS) certifying system, using contemporary international guidelines. Retrospective assessment of evidence collected during the design and implementation processes of 2 consecutive applications of the MBPS certifying examination, using Cizek's checklist for evaluating credential-testing programs. It includes the relevant guidelines from the American Education Research Association, the American Psychological Association, the National Council on Measurement in Education, and the National Commission for Certifying Agencies. Four independent and previously trained raters used the checklist. They underwent a 2-week training using frame-of-reference and performance dimensions methodologies. Certification examinations of MBPS. The 2013 and 2014 MBPS certification examinations, with 111 evidence items of the processes, followed for the assessment of 86 examinees. The checklist internal consistency was 0.89. Absolute interrater agreement was 0.34 for the 2013 and 0.66 for the 2014 editions of the examination. The 2013 examination complied with 55 (64%) of the checklist 86 items, in 2014 with 72 (84%). In 2014, the certifying system reached a quality of 84%. For optimal fulfillment of its social responsibility, the MBPS is required to maintain its level of quality and attempt to improve its performance. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  15. Historic Sites and National Register of Historic Places - MO 2009 Certified Local Historic Districts (SHP)

    Data.gov (United States)

    NSGIC State | GIS Inventory — Certified Local Districts are historic districts established by state or local governments that have been certified by the Secretary of the Interior as substantially...

  16. Developing competencies for pediatric hospice and palliative medicine.

    Science.gov (United States)

    Klick, Jeffrey C; Friebert, Sarah; Hutton, Nancy; Osenga, Kaci; Pituch, Kenneth J; Vesel, Tamara; Weidner, Norbert; Block, Susan D; Morrison, Laura J

    2014-12-01

    In 2006, hospice and palliative medicine (HPM) became an officially recognized subspecialty. This designation helped initiate the Accreditation Council of Graduate Medical Education Outcomes Project in HPM. As part of this process, a group of expert clinician-educators in HPM defined the initial competency-based outcomes for HPM fellows (General HPM Competencies). Concurrently, these experts recognized and acknowledged that additional expertise in pediatric HPM would ensure that the competencies for pediatric HPM were optimally represented. To fill this gap, a group of pediatric HPM experts used a product development method to define specific Pediatric HPM Competencies. This article describes the development process. With the ongoing evolution of HPM, these competencies will evolve. As part of the Next Accreditation System, the Accreditation Council of Graduate Medical Education uses milestones as a framework to better define competency-based, measurable outcomes for trainees. Currently, there are no milestones specific to HPM, although the field is designing curricular milestones with multispecialty involvement, including pediatrics. These competencies are the conceptual framework for the pediatric content in the HPM milestones. They are specific to the pediatric HPM subspecialist and should be integrated into the training of pediatric HPM subspecialists. They will serve a foundational role in HPM and should inform a wide range of emerging innovations, including the next evolution of HPM Competencies, development of HPM curricular milestones, and training of adult HPM and other pediatric subspecialists. They may also inform pediatric HPM outcome measures, as well as standards of practice and performance for pediatric HPM interdisciplinary teams.

  17. Pediatric allergy and immunology in Israel.

    Science.gov (United States)

    Geller-Bernstein, Carmi; Etzioni, Amos

    2013-03-01

    After the geographic and sociodemographic settings as well as the health care in Israel are briefly described, the scope of pediatric allergy and immunology in Israel is presented. This includes specific disorders commonly encountered, the environment that induces symptoms, the specialists who treat them, and the common challenges of patients, parents, doctors, and allied health personnel who collaborate to manage the maladies and patient care. Allergies usually affect some overall 15-20% of the pediatric population. The main allergens are inhaled, ingested, or injected (insects stings). Generally, the incidence of the various allergens affecting children in Israel, is similar to other parts of the Western world. Owing to the high consanguinity rate in the Israeli population, the prevalence of the various immunodeficiency conditions (in the adaptive as well as the innate system) is higher than that reported worldwide. Pediatric allergists/immunologists also treat autoimmune disorders affecting the pediatric group. Pediatric allergy and clinical immunology are not separate specialties. The 25 specialists who treat children with allergic/immunologic diseases have undergone a basic training in Pediatrics. They also received an additional 2-yr training in allergy and clinical immunology and then have to pass the board examinations. They work mainly in pediatric allergy units, in several hospitals that are affiliated to the five medical schools in the country. Aside from clinical work, most of the centers are also heavily involved in clinical and basic research in allergy and immunology.

  18. 7 CFR 785.4 - Grants to certified State mediation programs.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Grants to certified State mediation programs. 785.4..., DEPARTMENT OF AGRICULTURE SPECIAL PROGRAMS CERTIFIED STATE MEDIATION PROGRAM § 785.4 Grants to certified State mediation programs. (a) Eligibility. To be eligible to receive a grant, a State mediation...

  19. 40 CFR 33.206 - Is there a list of certified MBEs and WBEs?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Is there a list of certified MBEs and... PROTECTION AGENCY PROGRAMS Certification § 33.206 Is there a list of certified MBEs and WBEs? EPA OSDBU will maintain a list of certified MBEs and WBEs on EPA OSDBU's Home Page on the Internet. Any interested...

  20. 42 CFR 410.77 - Certified nurse-midwives' services: Qualifications and conditions.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Certified nurse-midwives' services: Qualifications... Medical and Other Health Services § 410.77 Certified nurse-midwives' services: Qualifications and conditions. (a) Qualifications. For Medicare coverage of his or her services, a certified nurse-midwife...

  1. 42 CFR 414.54 - Payment for certified nurse-midwives' services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Payment for certified nurse-midwives' services. 414... Physicians and Other Practitioners § 414.54 Payment for certified nurse-midwives' services. For services...)(1)(K) of the Act for the payment of certified nurse-midwife services may not exceed 65 percent...

  2. 13 CFR 121.705 - Must a business concern self-certify its size status?

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Must a business concern self-certify its size status? 121.705 Section 121.705 Business Credit and Assistance SMALL BUSINESS...-certify its size status? (a) A firm must self-certify that it currently meets the eligibility...

  3. 7 CFR 201.71 - Establishing the source of all classes of certified seed.

    Science.gov (United States)

    2010-01-01

    ... seed. 201.71 Section 201.71 Agriculture Regulations of the Department of Agriculture (Continued... (CONTINUED) FEDERAL SEED ACT FEDERAL SEED ACT REGULATIONS Certified Seed § 201.71 Establishing the source of all classes of certified seed. The certifying agency shall have evidence of the class and source...

  4. 7 CFR 201.74 - Labeling of all classes of certified seed.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Labeling of all classes of certified seed. 201.74... SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) FEDERAL SEED ACT FEDERAL SEED ACT REGULATIONS Certified Seed § 201.74 Labeling of all classes of certified seed....

  5. 7 CFR 201.70 - Limitations of generations for certified seed.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Limitations of generations for certified seed. 201.70... SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) FEDERAL SEED ACT FEDERAL SEED ACT REGULATIONS Certified Seed § 201.70 Limitations of generations for certified...

  6. 7 CFR 201.72 - Production of all classes of certified seed.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Production of all classes of certified seed. 201.72... SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) FEDERAL SEED ACT FEDERAL SEED ACT REGULATIONS Certified Seed § 201.72 Production of all classes of certified...

  7. 48 CFR 52.215-10 - Price Reduction for Defective Certified Cost or Pricing Data.

    Science.gov (United States)

    2010-10-01

    ... complete, accurate, and current as certified in its Certificate of Current Cost or Pricing Data; (2) A... complete, accurate, and current as certified in the Contractor's Certificate of Current Cost or Pricing... been modified even if accurate, complete, and current certified cost or pricing data had been...

  8. 9 CFR 355.29 - Composition of certified products for dogs, cats, and other carnivora.

    Science.gov (United States)

    2010-01-01

    ... dogs, cats, and other carnivora. 355.29 Section 355.29 Animals and Animal Products FOOD SAFETY AND... PRODUCTS INSPECTION AND VOLUNTARY INSPECTION AND CERTIFICATION CERTIFIED PRODUCTS FOR DOGS, CATS, AND OTHER... Composition of Certified Products § 355.29 Composition of certified products for dogs, cats, and other...

  9. Measuring Certified Registered Nurse Anesthetist Organizational Climate: Instrument Adaptation.

    Science.gov (United States)

    Boyd, Donald; Poghosyan, Lusine

    2017-08-01

    No tool exists measuring certified registered nurse anesthetist (CRNA) organizational climate. The study's purpose is to adapt a validated tool to measure CRNA organizational climate. Content validity of the Certified Registered Nurse Anesthetist Organizational Climate Questionnaire (CRNA-OCQ) was established. Pilot testing was conducted to determine internal reliability consistency of the subscales. Experts rated the tool as content valid. The subscales had high internal consistency reliability (with respective Cronbach's alphas): CRNA-Anesthesiologist Relations (.753), CRNA-Physician Relations (.833), CRNA-Administration Relations (.895), Independent Practice (.830), Support for CRNA Practice (.683), and Professional Visibility (.772). Further refinement of the CRNA-OCQ is necessary. Measurement and assessment of CRNA organizational climate may produce evidence needed to improve provider and patient outcomes.

  10. Fault tolerant quantum random number generator certified by Majorana fermions

    Science.gov (United States)

    Deng, Dong-Ling; Duan, Lu-Ming

    2013-03-01

    Braiding of Majorana fermions gives accurate topological quantum operations that are intrinsically robust to noise and imperfection, providing a natural method to realize fault-tolerant quantum information processing. Unfortunately, it is known that braiding of Majorana fermions is not sufficient for implementation of universal quantum computation. Here we show that topological manipulation of Majorana fermions provides the full set of operations required to generate random numbers by way of quantum mechanics and to certify its genuine randomness through violation of a multipartite Bell inequality. The result opens a new perspective to apply Majorana fermions for robust generation of certified random numbers, which has important applications in cryptography and other related areas. This work was supported by the NBRPC (973 Program) 2011CBA00300 (2011CBA00302), the IARPA MUSIQC program, the ARO and the AFOSR MURI program.

  11. Integration of Pediatric Mental Health in General Pediatrics in Eritrea ...

    African Journals Online (AJOL)

    changes the way in which his/her parents or others ... treatment of many mental disorders has been deemed ... relationships, pediatricians can and should deliver mental ... anxiety disorders, and substance use. ... Methods: prospective descriptive study on policies, practices and interventions targeted at improvement of.

  12. Promoting innovation in pediatric nutrition.

    Science.gov (United States)

    Bier, Dennis M

    2010-01-01

    Truly impactful innovation can only be recognized in retrospect. Moreover, almost by definition, developing algorithmic paths on roadmaps for innovation are likely to be unsuccessful because innovators do not generally follow established routes. Nonetheless, environments can be established within Departments of Pediatrics that promote innovating thinking. The environmental factors necessary to do so include: (1) demand that academic Pediatrics Departments function in an aggressively scholarly mode; (2) capture the most fundamental science in postnatal developmental biology; (3) focus education and training on the boundaries of our knowledge, rather than the almost exclusive attention to what we think we already know; (4) devote mentoring, time and resources to only the most compelling unanswered questions in the pediatric sciences, including nutrition; (5) accept only systematic, evidence-based answers to clinical questions; (6) if systematic, evidence-based data are not available, design the proper studies to get them; (7) prize questioning the answers to further move beyond the knowledge limit; (8) support the principle that experiments in children will be required to convincingly answer clinical questions important to children, and (9) establish the multicenter resources in pediatric scientist training, clinical study design and implementation, and laboratory and instrument technologies required to answer today's questions with tomorrow's methods.

  13. The potential of MIR spectra to certify milk geographic origin

    OpenAIRE

    Dale, Laura-Monica; Laine, Aurélie; Goubau, Amaury; Bel Mabrouk, Hana; Hammami, Hedi; Gengler, Nicolas

    2013-01-01

    Protecting and supporting local production systems, regional authorities, as well as producers, give a very important role to milk quality. Therefore, this study was aimed to investigate the potential of mid-infrared spectroscopy (MIR) for certifying the geographic origin of milk. Because milk MIR spectral databases and extra phenotypes (breed, testday, livestock herd and origin appellation of traditional products) were available in the Belgium Walloon Region via European project OptiMIR (INT...

  14. [The newly certified 105 Japanese medical technologists in clinical microbiology].

    Science.gov (United States)

    Kumasaka, Kazunari

    2002-05-01

    Interest in quality assurance(QA) in clinical laboratories in Japan has increased over the past 30 years. We have however been lagging behind countries such as the USA, Canada and the UK in QA of clinical microbiology. The main problem of QA in Japan is human resources. There are only about 400 laboratory physicians certified by the Japanese Society of Laboratory Medicine(JSLM). Almost no academics in microbiology are interested in QA and they mostly lack clinical competence. There is a small number of faculty positions, and promotions are mostly based on research productivity while medical graduates are increasingly drawn to bench work for basic, short-term research. The Japanese Society for Clinical Microbiology (JSCM) was established in 1990 in order to promote the development of clinical microbiology and its relevant fields in Japan. And 2001 was a milestone in sustained efforts of the JSLM to initiate qualifying examinations of medical technologists(MT) in clinical microbiology. 105 MT in clinical microbiology were newly certified by the Joint Committee of JSCM, JSLM, Japanese Association of Medical Technologists (JAMT) and College of Clinical Pathology of Japan(CCPJ). The certified MTs have appropriate educational background and are well motivated. With good on-the-job training, they are expected to perform effectively various tasks, including laboratory management. Recent radical changes in the health care delivery system have also had serious implications on laboratory services and QA of microbiological tests. The primary goal of the clinical microbiology laboratory is to provide accurate diagnostic testing and high-quality service at a low cost for its customers. It is believed that the Joint Committee and the newly certified MTs will contribute to narrowing the gap between Japan and other countries in clinical microbiology.

  15. Climate change and WTO : boundary mediation on certified emission reductions

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ho Cheol

    2011-07-15

    This book mentions climate change and WTO with is climate change true? International effort for reduce of greenhouse gas with UNFCCC, Kyoto protocol, Copenhagen Accord and Cancun Agreement, WTO norm, discussion on introduction of boundary mediation on certified emission reductions, analysis on regulation related WTO norm, violation of regulation on border measure of prohibition, violation of principle on GATT, justification, except through Article 20 of GATT, assessment of policy and supplementation on the law.

  16. Certified Nursing Assistants’ Explanatory Models of Nursing Home Resident Depression

    OpenAIRE

    Piven, Mary Lynn; Anderson, Ruth A.; Colón-Emeric, Cathleen S.; Sandelowski, Margarete

    2008-01-01

    In this study, we explored how Certified Nursing Assistants (CNAs) understood resident depression. Interviews with 18 CNAs, working in two nursing homes were guided by Kleinman’s Explanatory Models of Illness framework. Interview data were content analyzed and CNAs’ descriptions of depression were compared to the MDS 2.0 Mood Screen and to DSM-IV-TR Depression Criteria. CNAs identified causes, signs, and symptoms of depression, but they were unsure about the duration and normalcy of depressio...

  17. Certified reduced basis methods for parametrized partial differential equations

    CERN Document Server

    Hesthaven, Jan S; Stamm, Benjamin

    2016-01-01

    This book provides a thorough introduction to the mathematical and algorithmic aspects of certified reduced basis methods for parametrized partial differential equations. Central aspects ranging from model construction, error estimation and computational efficiency to empirical interpolation methods are discussed in detail for coercive problems. More advanced aspects associated with time-dependent problems, non-compliant and non-coercive problems and applications with geometric variation are also discussed as examples.

  18. Brazilian Board of Orthodontics and Facial Orthopedics: certifying excellence

    OpenAIRE

    Lima Filho,Roberto M. A.; VogelI, Carlos Jorge; Zen,Estélio; Bolognese,Ana Maria; Mucha,José Nelson; Araújo,Telma Martins de

    2011-01-01

    p. 148-157 The Brazilian Board of Orthodontics and Facial Orthopedics (BBO) is the institution that certifies the standards of clinical excellence in the practice of this specialty. This article describes the history of BBO's creation and the examination structure and phases to obtain the BBO Certification. It also presents a detailed report of the first exam applied in Brazil. Its purpose is to expand the knowledge, among professionals in the area, about the importance of BBO Certificatio...

  19. Certified reference materials of trace elements in water

    Indian Academy of Sciences (India)

    A K Agrawal

    2005-07-01

    Measurement of trace elements is playing a vital role in industries and various sectors of science and technology including semiconductors, food, health and environmental sectors. In most of the cases a small error in measurement can vitiate all the measures taken for quality control and management. Many decisions regarding the suitability of material/products are based on the analysis. To reduce or eliminate the rejection rate of the products, accurate and reliable measurements are needed which can be achieved by the use of certified reference materials (CRMs). Their use in calibration of analytical equipments and validation of test methods ensures high quality in measurements and it provides traceability to the measurement data with national/international measurement systems (SI unit) also. In the present scenario of globalization of economy, use of certified reference materials (CRMs) in measurements is essential for global acceptance of products and test reports. Their use fulfil a mandatory requirement of international quality systems (ISO 9000, ISO/IEC standard 17025) including our national accreditation body, National Accreditation Board for Testing and Calibration Laboratories (NABL), World Trade Organization (WTO) etc. International manufacturers of CRMs are meeting most of the requirement of CRMs of the country. To meet the demand of CRMs indigenously, the National Physical Laboratory, India initiated a national programme on preparation and dissemination of certified reference materials.

  20. Creating a Pediatric Digital Library for Pediatric Health Care Providers and Families

    Science.gov (United States)

    D'Alessandro, Donna; Kingsley, Peggy

    2002-01-01

    The goal of this study was to complete a literature-based needs assessment with regard to common pediatric problems encountered by pediatric health care providers (PHCPs) and families, and to develop a problem-based pediatric digital library to meet those needs. The needs assessment yielded 65 information sources. Common problems were identified and categorized, and the Internet was manually searched for authoritative Web sites. The created pediatric digital library (www.generalpediatrics.com) used a problem-based interface and was deployed in November 1999. From November 1999 to November 2000, the number of hyperlinks and authoritative Web sites increased 51.1 and 32.2 percent, respectively. Over the same time, visitors increased by 57.3 percent and overall usage increased by 255 percent. A pediatric digital library has been created that begins to bring order to general pediatric resources on the Internet. This pediatric digital library provides current, authoritative, easily accessed pediatric information whenever and wherever the PHCPs and families want assistance. PMID:11861631

  1. Pediatric Headache: An Overview.

    Science.gov (United States)

    Langdon, Raquel; DiSabella, Marc T

    2017-03-01

    Headache represents the most common neurologic disorder in the general population including children and is increasingly being recognized as a major source of morbidity in youth related to missed school days and activities. In this article, we take a holistic approach to the child presenting with headache with a focus on the detailed headache history, physical and neurologic examinations, and diagnostic evaluation of these patients. Clinical presentations and classification schema of multiple primary and secondary headache types in children are discussed using the International Headache Criteria (IHCD-3) as a guide, and a summary provided of the various treatment modalities employed for pediatric headache including lifestyle modifications, behavioral techniques, and abortive and preventive medications. Copyright © 2017 Mosby, Inc. All rights reserved.

  2. Resources for pediatric drug information.

    Science.gov (United States)

    Zenk, K E

    1990-10-01

    Finding information on the use of drugs fro infants and children is becoming easier with the publication of excellent resources for pediatric and neonatal drug information. Useful pediatric texts and journals are listed. Texts are graded A and B. Category A books would be useful to include in a basic pharmacy library; Category B books are more comprehensive but expensive, or texts that are not as highly recommended as those in Category A. Some of the resources listed include: (1) Pediatrics--Nelson Textbook of Pediatrics, Rudolph's Pediatrics, Current Pediatric Diagnosis and Treatment, Manual of Pediatric Therapeutics; (2) Dosage Guides--The Pediatric Drug Handbook, Harriet Lane Handbook, Problems in Pediatric Drug THerapy; (3) Intensive Care--Textbook of Pediatric Intensive Care; (4) Infectious Disease--Report of the Committee on Infectious Diseases, Pocketbook of Pediatric Antimicrobial Therapy; (5) Poisoning--Handbook of Poisoning, Medical Toxicology; (6) Parenteral Nutrition--Manual of Pediatric Parenteral Nutrition; (7) Pregnancy and Lactation--Drugs in Pregnancy and Lactation; (8) Compounding--Handbook on Extemporaneous Formulation; (9) IV Administration--Guidelines for Administration of Intravenous Medications to Pediatric Patients; (1) Neonatology--Schaffers Diseases of the Newborn, Neonatology, Basic Management, On-Call Problems, Diseases, Drugs, Drug Therapy in Infants; (11) Pediatric Journals--Pediatrics, Journal of Pediatrics, American Journal of Diseases of Children, Pediatric Infectious Disease Journal, Pediatric Alert, Clinics in Perinatology, Pediatric Clinics of North America, Pediatric Clinical Oncology Journal, and Pediatric Surgery.

  3. Prognosis of pediatric epilepsy

    Directory of Open Access Journals (Sweden)

    Girish C Nair

    2008-01-01

    Full Text Available Epilepsy is a significant and commonplace neurological disability in the pediatric population. Data from increasingly larger and more representative studies have brought about noteworthy changes in our understanding of the prognosis of epilepsy in the pediatric age-group. Prevalence rates for epilepsy in both the developing and the developed world are surprisingly similar despite distinct differences in incidence and large treatment gaps in the developing world; this strongly points towards the possibility of spontaneous remission, at least in some patients. Prognosis after an isolated first seizure is generally quite favorable, but worsens with recurring seizures, remote symptomatic etiology, and the presence of abnormalities on EEG. Presently available antiepileptic drugs (AEDs are at best seizure suppressant in their action and have not been shown to be antiepileptic in the sense that they alter the long-term prognosis of the epilepsy for the better. Epilepsy syndromes can be considered to belong to distinct groups on the basis of their prognosis. Some have an excellent outcome in terms of seizure freedom and neurological development; yet others have a grim prognosis with respect to these variables. Factors that impact on the prognosis of treated epilepsy are being understood and include the specific etiology, age of onset of epilepsy, and EEG findings. Epileptics, especially those with remote symptomatic seizures and refractory epilepsy, suffer higher mortality as compared to the general population. While the outcomes in terms of seizure freedom in patients with epilepsy appear favorable, disturbing data on psychosocial morbidity are coming to light and are reflected in the lower rates of higher education, employment, marriage, and fertility among epileptics.

  4. Bispectoral index scores of pediatric patients under dental treatment and recovery conditions: Study of children assigned for general anesthesia under propofol and isofloran regimes.

    Science.gov (United States)

    Tahririan, Dana; Kaviani, Naser; Nourbakhsh, Nosrat

    2016-01-01

    This study was planned to determine the relationship between bispectoral index (BIS) during dental treatment and recovery conditions in children undergoing two regimes of anesthesia of propofol and isoflurane. In this single-blind clinical trial study, 57 4-7-year-old healthy children who had been referred for dental treatment under general anesthesia between 60 and 90 min were selected by convenience sampling and assigned to two groups, after obtaining their parents' written consent. The anesthesia was induced by inhalation. For the first group, the anesthesia was preserved by a mixture of oxygen (50%), nitrous oxide (50%), and isoflurane (1%). For the second group, the anesthesia was preserved by a mixture of oxygen (50%), nitrous oxide (50%), and propofol was administered intravenously at a dose of 100 Ng/kg/min. The patients' vital signs, BIS, and agitation scores were recorded every 10 min. The data were analyzed by repeated measure ANOVA and t-tests at a significance level of α = 0.05 using SPSS version 20. The results of independent t-test for anesthesia time showed no statistically significant difference between isoflurane and propofol (P = 0.87). Controlling age, the BIS difference between the two anesthetic agents was not significant (P > 0.05); however, it was negatively correlated with the duration of anesthesia and the discharge time (P = 0.001, r = -0.308) and (P anesthesia is produced by propofol and isoflurane, but lower recovery complications from anesthesia are observed with isoflurane.

  5. COMPARATIVE ANALYSIS OF INNOVATION PERFORMANCE IN CERTIFIED FIRMS IN MONTENEGRO AND REPUBLIC OF SRPSKA

    Directory of Open Access Journals (Sweden)

    Zdravko Krivokapic

    2014-03-01

    Full Text Available Research subjects of this study are certified companies and their commitment to innovation, as well as their own development and implementation of innovation. Certified companies are those companies that have set one or more standards: ISO 9001:2008, ISO 14001: 2004, HACCP, OHSAS 18001, ISO 17025:2006, ISO 27001. The research is based on 60 certified companies in Montenegro and 165 certified companies Republic of Srpska. The research was conducted at certified companies from all regions, for every activity and sizes. For this purpose it was used questionnaire with 91 questions and it was filled in like interview.

  6. Bispectoral index scores of pediatric patients under dental treatment and recovery conditions: Study of children assigned for general anesthesia under propofol and isofloran regimes

    Directory of Open Access Journals (Sweden)

    Dana Tahririan

    2016-01-01

    Full Text Available Background: This study was planned to determine the relationship between bispectoral index (BIS during dental treatment and recovery conditions in children undergoing two regimes of anesthesia of propofol and isoflurane. Materials and Methods: In this single-blind clinical trial study, 57 4-7-year-old healthy children who had been referred for dental treatment under general anesthesia between 60 and 90 min were selected by convenience sampling and assigned to two groups, after obtaining their parents′ written consent. The anesthesia was induced by inhalation. For the first group, the anesthesia was preserved by a mixture of oxygen (50%, nitrous oxide (50%, and isoflurane (1%. For the second group, the anesthesia was preserved by a mixture of oxygen (50%, nitrous oxide (50%, and propofol was administered intravenously at a dose of 100 Ng/kg/min. The patients′ vital signs, BIS, and agitation scores were recorded every 10 min. The data were analyzed by repeated measure ANOVA and t-tests at a significance level of α = 0.05 using SPSS version 20. Results: The results of independent t-test for anesthesia time showed no statistically significant difference between isoflurane and propofol (P = 0.87. Controlling age, the BIS difference between the two anesthetic agents was not significant (P > 0.05; however, it was negatively correlated with the duration of anesthesia and the discharge time (P = 0.001, r = -0.308 and (P < 0.001, r = -0.55. Conclusion: The same depth of anesthesia is produced by propofol and isoflurane, but lower recovery complications from anesthesia are observed with isoflurane.

  7. 42 CFR 482.76 - Condition of participation: Pediatric Transplants.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Pediatric Transplants... Requirements for Specialty Hospitals General Requirements for Transplant Centers § 482.76 Condition of participation: Pediatric Transplants. A transplant center that seeks Medicare approval to...

  8. 76 FR 21382 - Pediatric Ethics Subcommittee; Notice of Meeting

    Science.gov (United States)

    2011-04-15

    ... Subcommittee of the Pediatric Advisory Committee will meet to discuss the general topic of the ethics of... HUMAN SERVICES Food and Drug Administration Pediatric Ethics Subcommittee; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice announces a forthcoming meeting of...

  9. Defining and Assessing Knowledge and Skill Outcomes in Undergraduate Pediatric Dentistry Education.

    Science.gov (United States)

    Hanes, Carole M.

    1990-01-01

    Methods of assessing the general goals for the Pediatric Dentistry Department at the Medical College of Georgia School of Dentistry are discussed. Goals are: (1) to prepare dentists to provide comprehensive dental care for the pediatric patient; (2) to create positive attitudes toward pediatric dentistry; (3) to encourage students to seek to…

  10. Pediatric obesity. An introduction ☆

    Science.gov (United States)

    Yanovski, Jack A.

    2015-01-01

    The prevalence of child and adolescent obesity in the United States increased dramatically between 1970 and 2000, and there are few indications that the rates of childhood obesity are decreasing. Obesity is associated with myriad medical, psychological, and neurocognitive abnormalities that impact children’s health and quality of life. Genotypic variation is important in determining the susceptibility of individual children to undue gains in adiposity; however, the rapid increase in pediatric obesity prevalence suggests that changes to children’s environments and/or to their learned behaviors may dramatically affect body weight regulation. This paper presents an overview of the epidemiology, consequences, and etiopathogenesis of pediatric obesity, serving as a general introduction to the subsequent papers in this Special Issue that address aspects of childhood obesity and cognition in detail. PMID:25836737

  11. Age Limit of Pediatrics.

    Science.gov (United States)

    Hardin, Amy Peykoff; Hackell, Jesse M

    2017-09-01

    Pediatrics is a multifaceted specialty that encompasses children's physical, psychosocial, developmental, and mental health. Pediatric care may begin periconceptionally and continues through gestation, infancy, childhood, adolescence, and young adulthood. Although adolescence and young adulthood are recognizable phases of life, an upper age limit is not easily demarcated and varies depending on the individual patient. The establishment of arbitrary age limits on pediatric care by health care providers should be discouraged. The decision to continue care with a pediatrician or pediatric medical or surgical subspecialist should be made solely by the patient (and family, when appropriate) and the physician and must take into account the physical and psychosocial needs of the patient and the abilities of the pediatric provider to meet these needs. Copyright © 2017 by the American Academy of Pediatrics.

  12. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) is ... a CT scan. View full size with caption Pediatric Content Some imaging tests and treatments have special ...

  13. Children's (Pediatric) CT (Computed Tomography)

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) is ... a CT scan. View full size with caption Pediatric Content Some imaging tests and treatments have special ...

  14. What Is a Pediatric Urologist?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Urologist? Page Content Article Body If your child ... treat your child. What Kind of Training Do Pediatric Urologists Have? Pediatric urologists are medical doctors who ...

  15. What Is a Pediatric Geneticist?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Geneticist? Page Content Article Body Fortunately, most children ... with similar problems. What Kind of Training Do Pediatric Geneticists Have? Pediatric geneticists are medical doctors who ...

  16. What Is a Pediatric Gastroenterologist?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Gastroenterologist? Page Content Article Body If your child ... children, and teens. What Kind of Training Do Pediatric Gastroenterologists Have? Pediatric gastroenterologists are medical doctors who ...

  17. What Is a Pediatric Endocrinologist?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Endocrinologist? Page Content Article Body If your child ... the teen years. What Kind of Training Do Pediatric Endocrinologists Have? Pediatric endocrinologists are medical doctors who ...

  18. What Is a Pediatric Neurosurgeon?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Neurosurgeon? Page Content Article Body If your child ... childhood and adolescence. What Kind of Training Do Pediatric Neurosurgeons Have? Pediatric neurosurgeons are medical doctors who ...

  19. What Is a Pediatric Anesthesiologist?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Anesthesiologist? Page Content Article Body If your child ... children undergoing anesthesia. What kind of training do pediatric anesthesiologists have? Pediatric anesthesiologists are physicians who have ...

  20. Laser gingivectomy for pediatrics.

    Science.gov (United States)

    Kelman, Michelle M; Poiman, David J; Jacobson, Barry L

    2010-01-01

    Traditional gingivectomy procedures have been a challenge for pediatric dentists who confront issues of patient cooperation and discomfort. Treatment of pediatric patients must involve minimal operative and postoperative discomfort. Laser soft-tissue surgery has been shown to be well accepted by children. For the pediatric patient, the greatest advantage of the laser is the lack of local anesthesia injection and the associated pre- and postoperative discomfort. The following case report describes a gingivectomy procedure performed on a 14-year-old female.

  1. Pediatric facial nerve rehabilitation.

    Science.gov (United States)

    Banks, Caroline A; Hadlock, Tessa A

    2014-11-01

    Facial paralysis is a rare but severe condition in the pediatric population. Impaired facial movement has multiple causes and varied presentations, therefore individualized treatment plans are essential for optimal results. Advances in facial reanimation over the past 4 decades have given rise to new treatments designed to restore balance and function in pediatric patients with facial paralysis. This article provides a comprehensive review of pediatric facial rehabilitation and describes a zone-based approach to assessment and treatment of impaired facial movement.

  2. Pediatric hospital medicine: historical perspectives, inspired future.

    Science.gov (United States)

    Fisher, Erin Stucky

    2012-05-01

    Pediatric hospital medicine (PHM) is in an accelerated growth phase. Multiple elements have combined to affect the current state of the field. PHM is similar to other geographic specialties such as pediatric emergency medicine and pediatric critical care that deliver general, comprehensive care to patients based on hospital site. Pediatric hospitalists have been molded by changes in medicine, consumer expectations, and training program modifications. The history of PHM dates back for more than 3 decades, when unwitting pediatricians began to focus on delivering care for the hospitalized child. The ensuing years allowed for natural responses to external pressures that resulted in much of the field's initial development. In more recent years, however, pediatric hospitalists have been catalysts for change and driving forces for health care systems' improvements. Simultaneous with this has been the nearly exponential surge of energy focused on targeted initiatives, which have further defined the field and brought attention on a national level. PHM is at a critical but brilliant juncture in development. Further decisions regarding scope and demonstration of competencies are important to make with clarity of purpose. Pediatric hospitalists are advancing child health in the inpatient setting through evidence-based care, research, education, clinical excellence, advocacy, and health care business acumen. With a strong community sense and leadership evident, PHM has a bright future. Copyright © 2012 Mosby, Inc. All rights reserved.

  3. Find a Pediatric Dentist

    Science.gov (United States)

    ... New Dentist Resources Volunteering in AAPD AAPD Publications Advertising Brochures Journals & Publications Full Journal Archives Access Pediatric ... Us Site Map Privacy Policy Terms of Use facebook twitter instagram

  4. Sedation for pediatric endoscopy.

    Science.gov (United States)

    Lee, Myung Chul

    2014-03-01

    It is more difficult to achieve cooperation when conducting endoscopy in pediatric patients than adults. As a result, the sedation for a comfortable procedure is more important in pediatric patients. The sedation, however, often involves risks and side effects, and their prediction and prevention should be sought in advance. Physicians should familiarize themselves to the relevant guidelines in order to make appropriate decisions and actions regarding the preparation of the sedation, patient monitoring during endoscopy, patient recovery, and hospital discharge. Furthermore, they have to understand the characteristics of the pediatric patients and different types of endoscopy. The purpose of this article is to discuss the details of sedation in pediatric endoscopy.

  5. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... Appendicitis Images related to Children's (Pediatric) Ultrasound - Abdomen Videos related to Children's (Pediatric) Ultrasound - Abdomen Sponsored by Please note RadiologyInfo. ...

  6. Pediatric dental chair vs. traditional dental chair: A pediatric dentist′s poll

    Directory of Open Access Journals (Sweden)

    Khushboo Barjatya

    2015-01-01

    Full Text Available Objective: Proper positioning of the child patient, can not only have positive ramifications for the operator′s posture, comfort, and career longevity - it can also lead to better treatment and increased productivity. The aim of the survey questionnaire was to assess the utilization, need, and attitude concerning dental chairs among pediatric dentist while working on and managing the child patient. Study Design: The questions were structured using adobe forms central online software, regarding the user-friendliness of pediatric dental chair vs. traditional adult dental chair available in the market. Results: Our result shows that out of 337 respondents, 79% worked on pediatric dental chair, whereas 21% had no experience of it. Of these 79% pediatric dentist, 48% preferred pediatric dental chair. But pediatric dental problem still has certain disadvantages like higher cost, leg space problem, lower availability, etc. Conclusion: During the research it was found that ergonomics and usability issues were the main problems. Thus, pediatric dental chair is not so popular in the current scenario. This study allowed for general ideas for the improvement of dental chairs and thus improved dental chair would fill the gap in the current scenario.

  7. Office pediatrics. Physical growth and general nutrition.

    Science.gov (United States)

    Oski, F A

    1995-06-01

    Obesity is now one of the most prevalent diseases in the US population. Many observations suggest that two and possibly three critical periods exist for the development of obesity and its complications. An expert committee has developed guidelines for obesity in adolescence and recommendations for preventive services, whereas others have examined adolescent obesity and its cardiovascular risks and have suggested a rational approach to management and the effects of persistent physical activity and inactivity on coronary risk factors in children and young adults.

  8. Certifiable higher order sliding mode control: Practical stability margins approach

    Science.gov (United States)

    Panathula, Chandrasekhara Bharath

    The Higher Order Sliding Mode (HOSM) controllers are well known for their robustness/insensitivity to bounded perturbations and for handling any given arbitrary relative degree system. The HOSM controller is to be certified for robustness to unmodeled dynamics, before deploying the controller for practical applications. Phase Margin (PM) and Gain Margin ( GM) are the classical characteristics used in linear systems to quantify the linear controller robustness to unmodeled dynamics, and certain values of these margins are required to certify the controller. These conventional margins (PM and GM) are extended to Practical Stability Phase Margin (PSPM) and Practical Stability Gain Margin (PSGM) in this dissertation, and are used to quantify the HOSM control robustness to unmodeled dynamics, presiding the tool to close the gap for HOSM control certification. The proposed robustness metrics ( PSPM and PSGM) are identified by developing tools/algorithms based on Describing Function-Harmonic Balance method. In order for the HOSM controller to achieve the prescribed values on robustness metrics ( PSPM and PSGM), the HOSM controller is cascaded with a linear compensator. A case study of the application of the proposed metrics (PSPM and PSGM) for the certification of F-16 aircraft HOSM attitude control robustness to cascade unmodeled dynamics is presented. In addition, several simulation examples are presented to verify and to validate the proposed methodology.

  9. The Effectiveness of "Teach for America" and Other Under-certified Teachers

    Directory of Open Access Journals (Sweden)

    Ildiko Laczko-Kerr

    2002-09-01

    Full Text Available The academic achievements of students taught by under-certified primary school teachers were compared to the academic achievements of students taught by regularly certified primary school teachers.  This sample of under-certified teachers included three types of under-qualified personnel: emergency, temporary and provisionally certified teachers.  One subset of these under-certified teachers was from the national program "Teach For America (TFA."  Recent college graduates are placed by TFA where other under-qualified under-certified teachers are often called upon to work, namely, low-income urban and rural school districts. Certified teachers in this study were from accredited universities and all met state requirements for receiving the regular initial certificate to teach.  Recently hired under-certified and certified teachers (N=293 from five low-income school districts were matched on a number of variables, resulting in 109 pairs of teachers whose students all took the mandated state achievement test. Results indicate 1 that students of TFA teachers did not perform significantly different from students of other under-certified teachers, and 2 that students of certified teachers out-performed students of teachers who were under-certified.  This was true on all three subtests of the SAT 9—reading, mathematics and language arts.  Effect sizes favoring the students of certified teachers were substantial.  In reading, mathematics, and language, the students of certified teachers outperformed students of under-certified teachers, including the students of the TFA teachers, by about 2 months on a grade equivalent scale.  Students of under-certified teachers make about 20% less academic growth per year than do students of teachers with regular certification.  Traditional programs of teacher preparation apparently result in positive effects on the academic achievement of low-income primary school children.  Present

  10. Myasthenia gravis in pediatric and elderly patients

    Institute of Scientific and Technical Information of China (English)

    刘伟; 刘国津; 范志民; 盖学良

    2003-01-01

    Objective To determine whether the clinical and pathologic characteristics and prognoses of myasthenia gravis (MG) patients below 15 years differ from those patients over 50 years after thymectomy. Methods We reviewed the registry material of 30 pediatric and 32 elderly MG patients after thymectomy, including their age, sex, clinical classification, pathological types, and prognoses. The Chi-square test or Wilcoxon ' s rank-sum test was used to determine the statistical differences between the children and elderly groups.Results No significant difference was seen in sex distribution between the two groups (Chi-square test, P=0.625), but there were differences in clinical classification: more type Ⅰ was observed in the pediatric group than in the elderly group, but more type Ⅱor Ⅲ was seen in the elderly group (Wilcoxon ' s rank-sum test, P<0.001). As to pathological types, the pediatric group was also significantly different from the elderly group (Chi-square test, P<0.01). All of the patients (100%) in the pediatric group had thymus hyperplasia, but in the elderly group more than half (56.26%) were found to have thymoma (benign or malignant). The prognoses after thymectomy were better in the pediatric group than in the elderly group (Wilcoxon ' s rank-sum test, P<0.001). Conclusions Because the prognoses are generally better than those of the elderly patients, we should be careful when operating on pediatric patients of ocular type. The elderly patients tend to receive more aggressive treatment because of more severe generalized types often associated with thymoma and poor prognoses. Both pediatric and elderly patients are seldom associated with other autoimmune disease.

  11. Economics of pediatric burns.

    Science.gov (United States)

    Bass, Michael J; Phillips, Linda G

    2008-07-01

    Sustaining a burn injury sets in motion a cycle of pain, disfigurement, and a search for survival. In pediatric burns, the injury extends to the parents where fear, ignorance, and helplessness forever change their lives. Pediatric burn injuries are caused by fire, hot liquids, clothing irons, hair curlers, caustic substances like drain cleaner, the grounding of an electrical source, and exposure to radiation. Efficiency in the delivery of pediatric burn care is critical. Maximizing resource utilization means continual self-evaluation and economic analysis of therapeutic modalities. Griffiths et al found that most childhood burns are due to scalds, which can be treated for $1061 per percent burn. Paddock et al reduced the cost of treating superficial pediatric burns and reduced the length of stay in hospital using silver-impregnated gauze over traditional methods. Barrett et al found improved cosmesis of skin grafts using cultured epithelial autografts but at a substantially increased cost. Corpron et al showed that pediatric burn units that treat burns >10% total body surface area and operative treatment of pediatric burns regardless of size generate positive revenue. There is a paucity of evidentiary pediatric burn economic data. More research is needed to address areas of pediatric burn care inefficiency. Improving knowledge of cost in all health care endeavors will create competition and drive down expenditures.

  12. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... scan being performed, you will receive specific preparation instructions for what your child may eat and drink before the exam, especially ... Epilepsy Images related to Children's (Pediatric) Nuclear Medicine ... Videos related to Children's (Pediatric) Nuclear Medicine Sponsored by Please note RadiologyInfo. ...

  13. Pediatric intensive care.

    Science.gov (United States)

    Macintire, D K

    1999-07-01

    To provide optimal care, a veterinarian in a pediatric intensive care situation for a puppy or kitten should be familiar with normal and abnormal vital signs, nursing care and monitoring considerations, and probable diseases. This article is a brief discussion of the pediatric intensive care commonly required to treat puppies or kittens in emergency situations and for canine parvovirus type 2 enteritis.

  14. Pediatric Endocrinology Nurses Society

    Science.gov (United States)

    ... Springs 2018! Wednesday, May 16, 2018 ​​​​​​​​​​​​​​​​​​​​​​​​​​​ Journal of Pediatric Nursing The Journal of Pediatric Nursing provides original, ...

  15. [Research in pediatrics].

    Science.gov (United States)

    Herrera-Márquez, Julia Rocío; González-Cabello, Héctor Jaime

    2015-01-01

    In the interest of encouraging the promotion of research done by physicians of the Instituto Mexicano del Seguro Social, in this supplement we publish articles written by residents of different specialties related to critical themes on pediatrics. These residents are guided by affiliated physicians from the Hospital de Pediatría del Centro Médico Nacional Siglo XXI.

  16. REIMEP-22 inter-laboratory comparison. ''U Age Dating - determination of the production date of a uranium certified test sample''

    Energy Technology Data Exchange (ETDEWEB)

    Venchiarutti, Celia; Richter, Stephan; Jakopic, Rozle; Aregbe, Yetunde [European Commission, Joint Research Centre (JRC), Geel (Belgium). Institute for Reference Materials and Measurements (IRMM); Varga, Zsolt; Mayer, Klaus [European Commission, Joint Research Centre (JRC), Karlsruhe (Germany). Institute for Transuranium Elements (ITU)

    2015-07-01

    The REIMEP-22 inter-laboratory comparison aimed at determining the production date of a uranium certified test sample (i.e. the last chemical separation date of the material). Participants in REIMEP-22 on ''U Age Dating - Determination of the production date of a uranium certified test sample'' received one low-enriched 20 mg uranium sample for mass spectrometry measurements and/or one 50 mg uranium sample for a-spectrometry measurements, with an undisclosed value for the production date. They were asked to report the isotope amount ratios n({sup 230}Th)/n({sup 234}U) for the 20 mg uranium sample and/or the activity ratios A({sup 230}Th)/A({sup 234}U) for the 50 mg uranium sample in addition to the calculated production date of the certified test samples with its uncertainty. Reporting of the {sup 231}Pa/{sup 235}U ratio and the respective calculated production date was optional. Eleven laboratories reported results in REIMEP-22. Two of them reported results for both the 20 mg and 50 mg uranium certified test samples. The measurement capability of the participants was assessed against the independent REIMEP-22 reference value by means of z- and zeta-scores in compliance with ISO 13528:2005. Furthermore a performance assessment criterion for acceptable uncertainty was applied to evaluate the participants' results. In general, the REIMEP-22 participants' results were satisfactory. This confirms the analytical capabilities of laboratories to determine accurately the age of uranium materials with low amount of ingrown thorium (young certified test sample). The Joint Research Centre of the European Commission (EC-JRC) organised REIMEP-22 in parallel to the preparation and certification of a uranium reference material certified for the production date (IRMM-1000a and IRMM-1000b).

  17. Pediatric allergy and immunology in Japan.

    Science.gov (United States)

    Ebisawa, Motohiro; Nishima, Sankei; Ohnishi, Hidenori; Kondo, Naomi

    2013-11-01

    The Japanese Society of Pediatric Allergy and Clinical Immunology (JSPACI) was started in 1966 and currently has 3613 members as of August 1, 2012. The number of pediatricians specializing in allergies who have been certified by the Japanese Society of Allergology is 817. Among these, there are 125 training directors and training facilities for allergy and clinical immunology. The JSPACI first published an asthma guideline specific for children in 2000, and this has been revised every 3 yrs, contributing to better control of pediatric asthma. Food allergy management guidelines were first developed in 2005, which have helped to improve the care of food allergy patients. Among 514 pediatric training programs by the Japanese Society of Pediatrics, there are 312 facilities routinely performing oral food challenges. Among these, there were already 53 facilities performing oral immunotherapy at the end of 2011, treating 1400 cases of food allergy. The prevalence of pediatric allergic diseases has increased in Japan over the past 50 yrs. A number of International Study of Asthma and Allergies in Childhood surveys have been conducted in the past at specific times. The prevalence of wheezing among children aged 13-14 yrs in 2002 was 13.0%. Multi-year surveys found a 1.5- to 2-fold increase every 10 yrs until 2002. However, according to the latest data in 2012, asthma prevalence seems to have slightly decreased in Japan. Food allergy mainly associated with infantile atopic eczema among infants younger than 1 yr of age is the most common form as with other developed countries. The estimated food allergy prevalence based on data from several surveys is 5-10% among infants (0-6 yrs) and 1-2% among schoolchildren (6-15 yrs). A variety of patients suffering from primary deficiency syndrome have been actively analyzed. Previously, antibody defects and well-defined syndromes with immunodeficiency were analyzed, but recent research is focusing on not only acquired immune

  18. A Comparative Analysis of Health-Related Quality of Life and Family Impact between Children with ADHD Treated in a General Pediatric Clinic and a Psychiatric Clinic Utilizing the PedsQL

    Science.gov (United States)

    Limbers, Christine A.; Ripperger-Suhler, Jane; Boutton, Kelly; Ransom, Daniel; Varni, James W.

    2011-01-01

    Objective: To evaluate health-related quality of life (HRQOL) from the perspective of children with ADHD and their parents being seen in a Pediatric Clinic in comparison to healthy children and children with ADHD being seen in a Psychiatric Clinic. Method: Participants were children with a physician diagnosis of ADHD ages 5-18 years and their…

  19. Creating a pediatric digital library for pediatric health care providers and families: using literature and data to define common pediatric problems.

    Science.gov (United States)

    D'Alessandro, Donna; Kingsley, Peggy

    2002-01-01

    The goal of this study was to complete a literature-based needs assessment with regard to common pediatric problems encountered by pediatric health care providers (PHCPs) and families, and to develop a problem-based pediatric digital library to meet those needs. The needs assessment yielded 65 information sources. Common problems were identified and categorized, and the Internet was manually searched for authoritative Web sites. The created pediatric digital library (www.generalpediatrics.com) used a problem-based interface and was deployed in November 1999. From November 1999 to November 2000, the number of hyperlinks and authoritative Web sites increased 51.1 and 32.2 percent, respectively. Over the same time, visitors increased by 57.3 percent and overall usage increased by 255 percent. A pediatric digital library has been created that begins to bring order to general pediatric resources on the Internet. This pediatric digital library provides current, authoritative, easily accessed pediatric information whenever and wherever the PHCPs and families want assistance.

  20. Social pediatrics: weaving horizontal and vertical threads through pediatric residency.

    Science.gov (United States)

    van den Heuvel, Meta; Martimianakis, Maria Athina Tina; Levy, Rebecca; Atkinson, Adelle; Ford-Jones, Elizabeth; Shouldice, Michelle

    2017-01-13

    Social pediatrics teaches pediatric residents how to understand disease within their patients' social, environmental and political contexts. It's an essential component of pediatric residency training; however there is very little literature that addresses how such a broad-ranging topic can be taught effectively. The aim of this study was to determine and characterize social pediatric education in our pediatric residency training in order to identify strengths and gaps. A social pediatrics curriculum map was developed, attending to 3 different dimensions: (1) the intended curriculum as prescribed by the Objectives of Training for Pediatrics of the Royal College of Physicians and Surgeons of Canada (RCPSC), (2) the formal curriculum defined by rotation-specific learning objectives, and (3) the informal/hidden curriculum as reflected in resident and teacher experiences and perceptions. Forty-one social pediatric learning objectives were extracted from the RCPSC Objectives of Training for Pediatrics, most were listed in the Medical Expert (51%) and Health Advocate competencies (24%). Almost all RCPSC social pediatric learning objectives were identified in more than one rotation and/or seminar. Adolescent Medicine (29.2%), Pediatric Ambulatory Medicine (26.2%) and Developmental Pediatrics (25%) listed the highest proportion of social pediatric learning objectives. Four (10%) RCPSC social pediatric objectives were not explicitly named within learning objectives of the formal curriculum. The informal curriculum revealed that both teachers and residents viewed social pediatrics as integral to all clinical encounters. Perceived barriers to teaching and learning of social pediatrics included time constraints, particularly in a tertiary care environment, and the value of social pediatrics relative to medical expert knowledge. Despite the lack of an explicit thematic presentation of social pediatric learning objectives by the Royal College and residency training program

  1. Do personality traits predict work outcomes of certified nursing assistants?

    Science.gov (United States)

    Kovach, Christine R; Simpson, Michelle R; Reitmaier, Amy B; Johnson, Addie; Kelber, Sheryl T

    2010-10-01

    The purposes of this study were to describe personality traits of certified nursing assistants (CNAs) employed at nursing homes and explore relationships between personality traits, job satisfaction, and job performance. The sample included 177 CNAs providing direct care to residents in three nursing homes. CNAs with high and low job performance skills were distinguished by the cluster of traits associated with teamwork skills. Overall, 21.3% of the variance in job satisfaction was explained by the personality traits of Adjustment, Prudence, Likeability, Excitable, and Dutiful, F(8, 145) = 4.899, p personality, job satisfaction, and job performance provide important information about the personality traits of nursing staff who are most likely to enjoy and perform well in the nursing home setting. Knowledge of these links may be useful for hiring the appropriate person for direct care nursing home positions. Copyright 2010, SLACK Incorporated.

  2. Using certified timber extraction to benefit jaguar and ecosystem conservation.

    Science.gov (United States)

    Polisar, John; de Thoisy, Benoit; Rumiz, Damián I; Santos, Fabricio Díaz; McNab, Roan Balas; Garcia-Anleu, Rony; Ponce-Santizo, Gabriela; Arispe, Rosario; Venegas, Claudia

    2017-09-01

    The jaguar Panthera onca requires large areas of relatively intact habitats containing adequate amounts of prey to survive. Since a substantial portion of jaguar range occurs outside of strict protected areas, there is a need for economic incentives for habitat conservation, which carefully managed selective logging can provide. Forest Stewardship Council and Pan European Forest Council certifications intended to regulate wood extraction to maintain the ecological functions of forests require evidence of biodiversity and ecosystem conservation. We draw on twelve surveys across four countries and a range of biomes to present evidence that adequate logging management can maintain jaguar populations, but that they are at risk without efficient control of secondary impacts of access and hunting. Where resident, the presence of jaguars can serve as an indication that the ecological requirements of certified timber extraction are being met. We present a gradient of rigor for monitoring, recommending cost-effective options.

  3. Certifiable Quantum Dice - Or, testable exponential randomness expansion

    CERN Document Server

    Vazirani, Umesh V

    2011-01-01

    We introduce a protocol through which a pair of quantum mechanical devices may be used to generate n bits of true randomness from a seed of O(log n) uniform bits. The bits generated are certifiably random based only on a simple statistical test that can be performed by the user, and on the assumption that the devices obey the no-signaling principle. No other assumptions are placed on the devices' inner workings. A modified protocol uses a seed of O(log^3 n) uniformly random bits to generate $n$ bits of true randomness even conditioned on the state of a quantum adversary who may have had prior access to the devices, and may be entangled with them.

  4. AWS certified solutions architect official study guide associate exam

    CERN Document Server

    Baron, Joe; Bixler, Tim; Gaut, Biff; Kelly, Kevin E; Senior, Sean; Stamper, John

    2017-01-01

    This is your opportunity to take the next step in your career by expanding and validating your skills on the AWS cloud. AWS has been the frontrunner in cloud computing products and services, and the AWS Certified Solutions Architect Official Study Guide for the Associate exam will get you fully prepared through expert content, and real-world knowledge, key exam essentials, chapter review questions, access to Sybex's interactive online learning environment, and much more. This official study guide, written by AWS experts, covers exam concepts, and provides key review on exam topics, including: * Mapping Multi-Tier Architectures to AWS Services, such as web/app servers, firewalls, caches and load balancers * Understanding managed RDBMS through AWS RDS (MySQL, Oracle, SQL Server, Postgres, Aurora) * Understanding Loose Coupling and Stateless Systems * Comparing Different Consistency Models in AWS Services * Understanding how AWS CloudFront can make your application more cost efficient, faster and secure * Implem...

  5. The Certified Clinical Nurse Leader in Critical Care.

    Science.gov (United States)

    L'Ecuyer, Kristine M; Shatto, Bobbi J; Hoffmann, Rosemary L; Crecelius, Matthew L

    2016-01-01

    Challenges of the current health system in the United States call for collaboration of health care professionals, careful utilization of resources, and greater efficiency of system processes. Innovations to the delivery of care include the introduction of the clinical nurse leader role to provide leadership at the point of care, where it is needed most. Clinical nurse leaders have demonstrated their ability to address needed changes and implement improvements in processes that impact the efficiency and quality of patient care across the continuum and in a variety of settings, including critical care. This article describes the role of the certified clinical nurse leader, their education and skill set, and outlines outcomes that have been realized by their efforts. Specific examples of how clinical nurse leaders impact critical care nursing are discussed.

  6. Bias detection and certified reference materials for random measurands

    Science.gov (United States)

    Rukhin, Andrew L.

    2015-12-01

    A problem that frequently occurs in metrology is the bias checking of data obtained by a laboratory against the specified value and uncertainty estimate given in the certificate of analysis. The measurand—a property of a certified reference material (CRM)—is supposed to be random with a normal distribution whose parameters are given by the certificate specifications. The laboratory’s data from subsequent measurements of the CRM (a CRM experiment) are summarized by the sample mean value and its uncertainty which is commonly based on a repeatability standard deviation. New confidence intervals for the lab’s bias are derived. Although they may lack intuitive appeal, those obtained by using higher order asymptotic methods, compared and contrasted in this paper, are recommended.

  7. Certified counting of roots of random univariate polynomials

    CERN Document Server

    Cleveland, Joseph; Hauenstein, Jonathan D; Haywood, Ian; Mehta, Dhagash; Morse, Anthony; Robol, Leonardo; Schlenk, Taylor

    2014-01-01

    A challenging problem in computational mathematics is to compute roots of a high-degree univariate random polynomial. We combine an efficient multiprecision implementation for solving high-degree random polynomials with two certification methods, namely Smale's $\\alpha$-theory and one based on Gerschgorin's theorem, for showing that a given numerical approximation is in the quadratic convergence region of Newton's method of some exact solution. With this combination, we can certifiably count the number of real roots of random polynomials. We quantify the difference between the two certification procedures and list the salient features of both of them. After benchmarking on random polynomials where the coefficients are drawn from the Gaussian distribution, we obtain novel experimental results for the Cauchy distribution case.

  8. A Quantum Random Number Generator Certified by Value Indefiniteness

    CERN Document Server

    Abbott, Alastair A; Svozil, Karl

    2010-01-01

    In this paper we propose a quantum random number generator (QRNG) which utilizes an entangled photon pair in a Bell singlet state, and is certified explicitly by value indefiniteness. While "true randomness" is a mathematical impossibility, the certification by value indefiniteness ensures the quantum random bits are incomputable in the strongest sense. This is the first QRNG setup in which a physical principle (Kochen-Specker value indefiniteness) guarantees that no single quantum bit produced can be classically computed (reproduced and validated), the mathematical form of bitwise physical unpredictability. The effects of various experimental imperfections are discussed in detail, particularly those related to detector efficiencies, context alignment and temporal correlations between bits. The analysis is to a large extent relevant for the construction of any QRNG based on beam-splitters. By measuring the two entangled photons in maximally misaligned contexts and utilizing the fact that two rather than one b...

  9. Certified reference material to water content determination in bioethanol fuel

    Directory of Open Access Journals (Sweden)

    Janaína M. Rodrigues

    2012-01-01

    Full Text Available Bioethanol is a strategic biofuel in Brazil. Thus, a strong metrological basis for its measurements is required to ensure the quality and promote its exportation. Recently, Inmetro certified a reference material for water content in bioethanol. This paper presents the results of these studies. The characterization, homogeneity, short-term stability and long-term stability uncertainty contributions values were 0.00500, 0.0166, 0.0355 and 0.0391 mg g-1, respectively. The certificated value for water content of bioethanol fuel was (3.65 ± 0.11 mg g-1. This CRM is the first and up to now the unique in the world.

  10. Pediatric cataract: challenges and future directions

    Directory of Open Access Journals (Sweden)

    Medsinge A

    2015-01-01

    Full Text Available Anagha Medsinge,1,2 Ken K Nischal1,2 1Pediatric Ophthalmology, Strabismus, and Adult Motility, Children’s Hospital of Pittsburgh of University of Pittsburgh Medical Center, (UPMC 2University of Pittsburgh School of Medicine, Pittsburgh, PA, USA Abstract: Cataract is a significant cause of visual disability in the pediatric population worldwide and can significantly impact the neurobiological development of a child. Early diagnosis and prompt surgical intervention is critical to prevent irreversible amblyopia. Thorough ocular evaluation, including the onset, duration, and morphology of a cataract, is essential to determine the timing for surgical intervention. Detailed assessment of the general health of the child, preferably in conjunction with a pediatrician, is helpful to rule out any associated systemic condition. Although pediatric cataracts have a diverse etiology, with the majority being idiopathic, genetic counseling and molecular testing should be undertaken with the help of a genetic counselor and/or geneticist in cases of hereditary cataracts. Advancement in surgical techniques and methods of optical rehabilitation has substantially improved the functional and anatomic outcomes of pediatric cataract surgeries in recent years. However, the phenomenon of refractive growth and the process of emmetropization have continued to puzzle pediatric ophthalmologists and highlight the need for future prospective studies. Posterior capsule opacification and secondary glaucoma are still the major postoperative complications necessitating long-term surveillance in children undergoing cataract surgery early in life. Successful management of pediatric cataracts depends on individualized care and experienced teamwork. We reviewed the etiology, preoperative evaluation including biometry, choice of intraocular lens, surgical techniques, and recent developments in the field of childhood cataract. Keywords: children, pediatric cataract, infantile

  11. Laser applications in pediatric airway surgery

    Science.gov (United States)

    Karamzadeh, Amir M.; Ahuja, Gurpreet S.; Nguyen, John D.; Crumley, Roger

    2003-06-01

    The smaller anatomy and limited access to instrumentation pose a challenge to the pediatric airway surgeon. The enhanced precision and ability to photocoagulate tissue while operating with the laser enhances the surgeon"s ability to successfully treat unique pediatric conditions such subglottic hemangiomas, congenital cysts, respiratory papillomatosis, and laryngeal or tracheal stenosis. Due to its shallow tissue penetration and thermal effect, the carbon dioxide (CO2) laser is generally considered the laser of choice for pediatric airway applications. The potential for increased scarring and damage to underlying tissue caused by the greater penetration depth and thermal effect of the Nd:YAG and KTP lasers preclude their use in this population. In this review, we will describe the specific advantages of using lasers in airway surgery, the current technology and where the current technology is deficient.

  12. Complex Pediatric Elbow Injury: An Uncommon Case

    Directory of Open Access Journals (Sweden)

    Taylor GR

    2005-03-01

    Full Text Available Abstract Background There is paucity of literature describing complex elbow trauma in the pediatric population. We described a case of an uncommon pediatric elbow injury comprised of lateral condyle fracture associated with posterolateral dislocation of elbow. Case presentation A 12-year-old boy sustained a direct elbow trauma and presented with Milch type II lateral condyle fracture associated with posterolateral dislocation of elbow. Elbow dislocation was managed by closed reduction. The elbow stability was assessed under general anaesthesia, followed by open K-wiring for the lateral condylar fracture fixation. The patient had an uneventful recovery with an excellent outcome at 39 months follow-up. Conclusion Complex pediatric elbow injuries are quite unusual to encounter, the management of such fractures can be technically demanding. Concomitant elbow dislocation should be managed by closed reduction followed by open reduction and internal fixation (K-wires or cannulated screws of the lateral condyle fracture.

  13. Intraoperative mechanical ventilation for the pediatric patient.

    Science.gov (United States)

    Kneyber, Martin C J

    2015-09-01

    Invasive mechanical ventilation is required when children undergo general anesthesia for any procedure. It is remarkable that one of the most practiced interventions such as pediatric mechanical ventilation is hardly supported by any scientific evidence but rather based on personal experience and data from adults, especially as ventilation itself is increasingly recognized as a harmful intervention that causes ventilator-induced lung injury. The use of low tidal volume and higher levels of positive end-expiratory pressure became an integral part of lung-protective ventilation following the outcomes of clinical trials in critically ill adults. This approach has been readily adopted in pediatric ventilation. However, a clear association between tidal volume and mortality has not been ascertained in pediatrics. In fact, experimental studies have suggested that young children might be less susceptible to ventilator-induced lung injury. As such, no recommendations on optimal lung-protective ventilation strategy in children with or without lung injury can be made.

  14. Pediatric training in emergency medicine residency programs.

    Science.gov (United States)

    Ludwig, S; Fleisher, G; Henretig, F; Ruddy, R

    1982-04-01

    Endorsed emergency medicine (EM) residency programs were surveyed as to the nature and extent of training they provided in pediatric emergency care (PEC). In the surveys returned (82%) there were several important findings. The amount of time in PEC training was generally two months per year of training. This accounted for 16% of training time. However, the volume of pediatric patients was 25% of the overall patient population. There was wide variation in the sites of PEC training. Didactic sessions often did not cover even core topics. The training program directors were equally divided in their satisfaction with this aspect of their programs. Changes were recommended by 80% of the directors. Changes most often suggested were increasing pediatric patient exposure and obtaining PEC specialists as trainers.

  15. [Robotics in pediatric surgery].

    Science.gov (United States)

    Camps, J I

    2011-10-01

    Despite the extensive use of robotics in the adult population, the use of robotics in pediatrics has not been well accepted. There is still a lack of awareness from pediatric surgeons on how to use the robotic equipment, its advantages and indications. Benefit is still controversial. Dexterity and better visualization of the surgical field are one of the strong values. Conversely, cost and a lack of small instruments prevent the use of robotics in the smaller patients. The aim of this manuscript is to present the controversies about the use of robotics in pediatric surgery.

  16. Pediatric neurosurgery--a golden decade.

    Science.gov (United States)

    Ciurea, A V; Vasilescu, G; Nuteanu, L

    1999-11-01

    Pediatric neurosurgery, once an annex of general neurosurgery, has evolved into a well-defined and complex medical specialty. The last 10 years have witnessed major advances in documentation of the minute details of CNS diseases of childhood, refinement of the specific means of action and better adaptation of therapeutic efforts to the requirements of a developing organism. Pediatric neurosurgeons are now increasingly involved in beneficial cooperation within complex medical teams. This fact has by no means diminished the importance of pediatric neurosurgery; rather, in such settings it has proved to have better effects in the struggle for stable long-lasting good results of multi-modal treatments covering all pathological entities. Progress in neurological surgery for patients in the pediatric age group has emerged from the development of supranational scientific structures and from that of specific concepts exchanging channels, so that today pediatric neurosurgeons belong to an extremely specialized medical corps, working in harmony across geographical and socio-economic national features in the interests of humankind's young generation's health.

  17. Pediatric Selective IgM Immunodeficiency

    Directory of Open Access Journals (Sweden)

    Marc F. Goldstein

    2008-01-01

    Full Text Available Objective. Limited information exists on features of pediatric Selective IgM immunodeficiency (SIgMID. Previously published pediatric cases and 2 new cases are reviewed. Methods. English literature from PubMed and references from relevant articles were reviewed. Previously reported cases and 2 new cases from an allergy/immunology practice were analyzed. Results. Forty-nine reported cases of SIgMID presented with respiratory infections (77.6%, gastrointestinal disease (16.3%, skin disease (12.2%, and meningitis (8.2%. Mean serum IgM level was 16.5±13.8 mg/dL. Two patients were identified with SIgMID among 6300 active pediatric patients (0.03% presenting with asthma, vasomotor rhinitis, and recurrent respiratory infections. In the 51 cases reported, none developed lymphoproliferative disease nor evolved into panhypogammaglobulinemia; four fatalities were reported. Conclusions. The prevalence of SIgMID in our pediatric population was 0.03%. In general, respiratory infections are the common comorbid conditions. Death and autoimmune disease are uncommon complications of pediatric SIgMID.

  18. The role of a child life specialist in a pediatric radiology department

    Energy Technology Data Exchange (ETDEWEB)

    McGee, Kristen [Children' s Hospital, Department of Radiology, 300 Longwood Avenue, Boston, MA 02115 (United States)

    2003-07-01

    Child life programming is predominantly developed in inpatient areas throughout major pediatric hospitals. However, the trend toward outpatient services has increased the need for facilities to develop child life positions to assist in the teaching demands of patients and families coming in for routine hospital visits. Since radiology is often the first experience for families, but not the last, it is essential to involve them in a positive experience. Imaging facilities serving pediatric patients are currently developing or considering child life programs. A certified child life specialist (CCLS) is committed to developing programming that enhances the child's understanding and involvement in their medical experience. This paper provides an outline of the responsibilities and areas of expertise of the CCLS in a pediatric radiology department. The reviewed program is based on, but not limited, to fluoroscopy. (orig.)

  19. 7 CFR 982.455 - Exchange of certified merchantable hazelnuts withheld.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Exchange of certified merchantable hazelnuts withheld... AGRICULTURE HAZELNUTS GROWN IN OREGON AND WASHINGTON Administrative Rules and Regulations § 982.455 Exchange of certified merchantable hazelnuts withheld. Each handler desiring to exchange hazelnuts pursuant...

  20. 7 CFR 982.55 - Exchange of certified merchantable hazelnuts withheld.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Exchange of certified merchantable hazelnuts withheld... AGRICULTURE HAZELNUTS GROWN IN OREGON AND WASHINGTON Order Regulating Handling Control of Distribution § 982.55 Exchange of certified merchantable hazelnuts withheld. Any handler who has withheld from...

  1. The Value-Added Achievement Gains of NBPTS-Certified Teachers in Tennessee: A Brief Report.

    Science.gov (United States)

    Stone, J. E.

    This study investigated whether National Board for Professional Teaching Standards (NBPTS)-certified teachers in Tennessee were exceptionally effective in bringing about objectively measured student achievement gains. Tennessee has over 40 NBPTS-certified teachers, 16 of whom teach in grades 3-8 and have value-added teacher reports in the state…

  2. 17 CFR 274.128 - Form N-CSR, certified shareholder report.

    Science.gov (United States)

    2010-04-01

    ... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Form N-CSR, certified... Form N-CSR, certified shareholder report. This form shall be used by registered management investment... of this chapter. Editorial Note: For Federal Register citations affecting Form N-CSR, see the List...

  3. 7 CFR 301.75-17 - Funds for the replacement of certified citrus nursery stock.

    Science.gov (United States)

    2010-01-01

    ...) ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE DOMESTIC QUARANTINE NOTICES Citrus Canker Notice of Quarantine and Regulations § 301.75-17 Funds for the replacement of certified citrus... 7 Agriculture 5 2010-01-01 2010-01-01 false Funds for the replacement of certified citrus...

  4. 40 CFR 91.1013 - Exemption for certified Small SI engines.

    Science.gov (United States)

    2010-07-01

    ... Marine SI Engines § 91.1013 Exemption for certified Small SI engines. The provisions of 40 CFR 1045.605... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Exemption for certified Small SI engines. 91.1013 Section 91.1013 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED)...

  5. Certified Reference Material IAEA-446 for radionuclides in Baltic Sea seaweed

    DEFF Research Database (Denmark)

    Pham, M.K.; Benmansour, M.; Carvalho, F.P.

    2014-01-01

    A Certified Reference Material (CRM) for radionuclides in seaweed (Fucus vesiculosus) from the Baltic Sea (IAEA-446) is described and the results of the certification process are presented. The 40K, 137Cs, 234U and 239þ240Pu radionuclides were certified for this material, and information values...

  6. 78 FR 8821 - Abandoned Mine Land Reclamation Program; Limited Liability for Noncoal Reclamation by Certified...

    Science.gov (United States)

    2013-02-06

    ... SMCRA, states (and, after amendment of the Act in 1987, the Navajo, Hopi, and Crow Indian tribes) that... Reclamation by Certified States and Indian Tribes; Proposed Rule #0;#0;Federal Register / Vol. 78 , No. 25... Reclamation Program; Limited Liability for Noncoal Reclamation by Certified States and Indian Tribes AGENCY...

  7. 19 CFR 115.16 - Notification of Certifying Authority by manufacturer.

    Science.gov (United States)

    2010-04-01

    ... manufacturer. 115.16 Section 115.16 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND... INTERNATIONAL CUSTOMS CONVENTIONS Administration § 115.16 Notification of Certifying Authority by manufacturer. In order that the Certifying Authority can schedule an appropriate inspection, a manufacturer...

  8. Understanding Georgia's National Board Certified Teachers: A Phenomenological Approach to a Teacher's Perspective

    Science.gov (United States)

    Brantley, Kimberly K.

    2014-01-01

    The purpose of this phenomenological study was to understand what it means to be a National Board Certified teacher (NBCT) in Georgia. Georgia teachers, distinguished with the NBCT title, participated in surveys and interviews which were analyzed qualitatively in order to understand the essence of being a National Board Certified teacher. Three…

  9. 48 CFR 15.407-1 - Defective certified cost or pricing data.

    Science.gov (United States)

    2010-10-01

    ....407-1 Defective cost or pricing data. (d) For each advisory audit received based on a postaward review... Defective certified cost or pricing data. (a) If, before agreement on price, the contracting officer learns that any certified cost or pricing data submitted are inaccurate, incomplete, or noncurrent, the...

  10. A certified reference material for radionuclides in the water sample from Irish Sea (IAEA-443)

    DEFF Research Database (Denmark)

    Pham, M.K.; Betti, M.; Povinec, P.P.

    2011-01-01

    A new certified reference material (CRM) for radionuclides in sea water from the Irish sea (IAEA-443) is described and the results of the certification process are presented. Ten radionuclides (3H, 40K, 90Sr, 137Cs, 234U, 235U, 238U, 238Pu, 239+240Pu and 241Am) have been certified, and information...

  11. 48 CFR 428.204-2 - Certified or cashier's checks, bank drafts, money orders, or currency.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Certified or cashier's checks, bank drafts, money orders, or currency. 428.204-2 Section 428.204-2 Federal Acquisition... Other Security for Bonds 428.204-2 Certified or cashier's checks, bank drafts, money orders, or...

  12. 12 CFR 564.3 - Appraisals required; transactions requiring a State certified or licensed appraiser.

    Science.gov (United States)

    2010-01-01

    ... SUPERVISION, DEPARTMENT OF THE TREASURY APPRAISALS § 564.3 Appraisals required; transactions requiring a State certified or licensed appraiser. (a) Appraisals required. An appraisal performed by a State certified or..., pooled loan, or real property interest met OTS regulatory requirements for appraisals at the time...

  13. 12 CFR 34.43 - Appraisals required; transactions requiring a State certified or licensed appraiser.

    Science.gov (United States)

    2010-01-01

    ..., DEPARTMENT OF THE TREASURY REAL ESTATE LENDING AND APPRAISALS Appraisals § 34.43 Appraisals required; transactions requiring a State certified or licensed appraiser. (a) Appraisals required. An appraisal performed by a State certified or licensed appraiser is required for all real estate-related...

  14. 13 CFR 121.805 - May a business concern self-certify its size status?

    Science.gov (United States)

    2010-01-01

    ...-certify its size status? 121.805 Section 121.805 Business Credit and Assistance SMALL BUSINESS... Requirements for Paying Reduced Patent Fees § 121.805 May a business concern self-certify its size status? (a) A concern verifies its size status with its submission of its patent application. (b) Any attempt...

  15. 19 CFR 10.57 - Certified seed potatoes, and seed corn or maize.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Certified seed potatoes, and seed corn or maize... Provisions Potatoes, Corn, Or Maize § 10.57 Certified seed potatoes, and seed corn or maize. Claim for classification as seed potatoes under subheading 0701.10.00, as seed corn (maize) under subheading...

  16. 7 CFR 201.73 - Processors and processing of all classes of certified seed.

    Science.gov (United States)

    2010-01-01

    ... seed. 201.73 Section 201.73 Agriculture Regulations of the Department of Agriculture (Continued... (CONTINUED) FEDERAL SEED ACT FEDERAL SEED ACT REGULATIONS Certified Seed § 201.73 Processors and processing of all classes of certified seed. The following requirements must be met by processors of all...

  17. 20 CFR 416.804 - Certified copy in lieu of original.

    Science.gov (United States)

    2010-04-01

    ... AGED, BLIND, AND DISABLED Determination of Age § 416.804 Certified copy in lieu of original. In lieu of the original of any record, except a Bible or other family record, there may be submitted as evidence... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Certified copy in lieu of original....

  18. 30 CFR 285.705 - When must I use a Certified Verification Agent (CVA)?

    Science.gov (United States)

    2010-07-01

    ... (CVA)? 285.705 Section 285.705 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE... Certified Verification Agent (CVA)? You must use a CVA to review and certify the Facility Design Report, the Fabrication and Installation Report, and the Project Modifications and Repairs Report. (a) You must use a CVA...

  19. 30 CFR Appendix to Subpart B - Optional Form for Certifying Mine Rescue Teams

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Optional Form for Certifying Mine Rescue Teams... EDUCATION AND TRAINING MINE RESCUE TEAMS Mine Rescue Teams for Underground Coal Mines Pt. 49, Subpt. B, App. Appendix to Subpart B—Optional Form for Certifying Mine Rescue Teams ER08FE08.000 ER08FE08.001...

  20. Recognising and Certifying Lifelong Skills: Impact on Labour Market Integration of the Unemployed

    Science.gov (United States)

    Fernandes, Pedro Afonso

    2009-01-01

    The process for recognising, validating and certifying (RVC) non-formally or informally acquired lifelong learning, launched in 2000, is now part of mainstream education and training policies in Portugal. This article aims to determine how much the labour-market behaviour of the RVC-certified unemployed differs from that of other unemployed…

  1. 48 CFR 52.215-12 - Subcontractor Certified Cost or Pricing Data.

    Science.gov (United States)

    2010-10-01

    ... Cost or Pricing Data. 52.215-12 Section 52.215-12 Federal Acquisition Regulations System FEDERAL... Provisions and Clauses 52.215-12 Subcontractor Certified Cost or Pricing Data. As prescribed in 15.408(d), insert the following clause: Subcontractor Certified Cost or Pricing Data (OCT 2010) (a) Before...

  2. 48 CFR 15.403-3 - Requiring data other than certified cost or pricing data.

    Science.gov (United States)

    2010-10-01

    ... certified cost or pricing data. 15.403-3 Section 15.403-3 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.403-3 Requiring data other than certified cost or pricing data. (a)(1) In those acquisitions that...

  3. Understanding Georgia's National Board Certified Teachers: A Phenomenological Approach to a Teacher's Perspective

    Science.gov (United States)

    Brantley, Kimberly K.

    2014-01-01

    The purpose of this phenomenological study was to understand what it means to be a National Board Certified teacher (NBCT) in Georgia. Georgia teachers, distinguished with the NBCT title, participated in surveys and interviews which were analyzed qualitatively in order to understand the essence of being a National Board Certified teacher. Three…

  4. 30 CFR 18.80 - Approval of machines assembled with certified or explosion-proof components.

    Science.gov (United States)

    2010-07-01

    ... or explosion-proof components. 18.80 Section 18.80 Mineral Resources MINE SAFETY AND HEALTH... MINE EQUIPMENT AND ACCESSORIES Machines Assembled With Certified or Explosion-Proof Components, Field... assembled with certified or explosion-proof components. (a) A machine may be a new assembly, or a...

  5. Why Do National Board Certified Teachers from Generation X Leave the Classroom?

    Science.gov (United States)

    Crain, Julie Christi

    2013-01-01

    This qualitative multiple case study focused on National Board Certified teachers from Generation X who have left the classroom. The study explored aspects of the teaching profession, the National Board Certification process, and Generation X as potential influences for National Board Certified teachers from Generation X to leave the classroom.…

  6. Pediatric dental sedation: challenges and opportunities

    Directory of Open Access Journals (Sweden)

    Nelson TM

    2015-08-01

    Full Text Available Travis M Nelson, Zheng Xu Department of Pediatric Dentistry, University of Washington, Seattle, WA, USA Abstract: High levels of dental caries, challenging child behavior, and parent expectations support a need for sedation in pediatric dentistry. This paper reviews modern developments in pediatric sedation with a focus on implementing techniques to enhance success and patient safety. In recent years, sedation for dental procedures has been implicated in a disproportionate number of cases that resulted in death or permanent neurologic damage. The youngest children and those with more complicated medical backgrounds appear to be at greatest risk. To reduce complications, practitioners and regulatory bodies have supported a renewed focus on health care quality and safety. Implementation of high fidelity simulation training and improvements in patient monitoring, including end-tidal carbon dioxide, are becoming recognized as a new standard for sedated patients in dental offices and health care facilities. Safe and appropriate case selection and appropriate dosing for overweight children is also paramount. Oral sedation has been the mainstay of pediatric dental sedation; however, today practitioners are administering modern drugs in new ways with high levels of success. Employing contemporary transmucosal administration devices increases patient acceptance and sedation predictability. While recently there have been many positive developments in sedation technology, it is now thought that medications used in sedation and anesthesia may have adverse effects on the developing brain. The evidence for this is not definitive, but we suggest that practitioners recognize this developing area and counsel patients accordingly. Finally, there is a clear trend of increased use of ambulatory anesthesia services for pediatric dentistry. Today, parents and practitioners have become accustomed to children receiving general anesthesia in the outpatient setting. As a

  7. Pediatric training and job market trends: results from the American Academy of Pediatrics third-year resident survey, 1997-2002.

    Science.gov (United States)

    Cull, William L; Yudkowsky, Beth K; Shipman, Scott A; Pan, Richard J

    2003-10-01

    To examine trends in pediatric residents' training and job search experiences from 1997-2002. Annual national random samples of 500 graduating pediatric residents were surveyed, and responses were compared across survey years to identify trends. The overall response rate was 71%. From 1997-2002, there were more female residents and US underrepresented minorities and fewer international medical graduates. Each successive group of residents rated higher their preparation for fellowship training, for child advocacy, and for assessing community needs. These increases paralleled an increase in resident exposure to community sites as part of their residency education. Educational debt (in 2002 dollars) for residents increased substantially across survey years from an average of 64 070 dollars in 1997 to 87 539 dollars in 2002. Meanwhile, starting salaries (in 2002 dollars) for residents entering general pediatrics actually decreased. Interest in general pediatrics among residents decreased, whereas interest in subspecialty practice increased during this time period. Fewer residents with general pediatrics as a career goal had a job when surveyed, and fewer obtained their first-choice positions across years. Experiences of graduating residents over the past 6 years provide insights into changes in pediatric residency education and the pediatric workforce. Efforts by pediatric educators and academic leaders to increase community experiences and child advocacy and to encourage greater interest in pediatric subspecialty careers seem to be succeeding. Unfortunately, demand for general pediatricians is weakening, and residents are experiencing increasing debt burdens.

  8. Organisational learning and continuous improvement of health and safety in certified manufacturers

    DEFF Research Database (Denmark)

    Granerud, Lise; Rocha, Robson Sø

    2011-01-01

    Certified management systems have increasingly been applied by firms in recent decades and now cover the management of health and safety, principally through the OHSAS 18001 standard. In order to become certified, firms must not only observe the relevant legislation, but also improve performance...... processes. The model is applied to five cases from a qualitative study of Danish manufacturers with certified health and safety management systems. The cases illustrate the wide variation in health and safety management among certified firms. Certification is found to support lower levels of continuous...... that certified health and safety management does not obstruct learning, and can support advanced learning. Improvement practices with regard to health and safety are mainly dependent upon the firm’s overall organisational processes and do not automatically arise from the standard alone....

  9. Pediatric Thyroid Cancer

    Science.gov (United States)

    ... thyroid malignancies. Medullary thyroid carcinoma (MTC) in the pediatric population is usually associated with specific inherited genetic conditions, such as multiple endocrine neoplasia type 2 (MEN2) Anaplastic : This is the fastest ...

  10. Pediatric heart surgery

    Science.gov (United States)

    Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... the type of defect, and the type of surgery that was done. Many children recover completely and lead normal, active lives.

  11. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... of page What are some common uses of the procedure? Children's (pediatric) nuclear medicine imaging is performed ... the thyroid gland. top of page How does the procedure work? With ordinary x-ray examinations, an ...

  12. Causes of Pediatric Cardiomyopathy

    Science.gov (United States)

    Search ABOUT THE DISEASE CAUSES Although pediatric cardiomyopathy is one of the leading causes of cardiac death in children, an explanation for why it occurs remains unknown. Most cases are familial ...

  13. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... are the limitations of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a ... of your child's body. top of page How is the procedure performed? Nuclear medicine imaging is usually ...

  14. Pediatric Brain Tumor Foundation

    Science.gov (United States)

    ... you insights into your child's treatment. LEARN MORE Brain tumors and their treatment can be deadly so ... Cancer Foundation joins the PBTF Read more >> Pediatric Brain Tumor Foundation 302 Ridgefield Court, Asheville, NC 28806 ...

  15. Pediatric inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Karen A Diefenbach; Christopher K Breuer

    2006-01-01

    Inflammatory bowel disease is an important cause of gastrointestinal pathology in children and adolescents.The incidence of pediatric inflammatory bowel disease is increasing; therefore, it is important for the clinician to be aware of the presentation of this disease in the pediatric population. Laboratory tests, radiology studies,and endoscopic procedures are helpful in diagnosing inflammatory bowel disease and differentiating between Crohn's disease and ulcerative colitis. Once diagnosed,the goal of medical management is to induce remission of disease while minimizing the side effects of the medication. Specific attention needs to be paid to achieving normal growth in this susceptible population.Surgical management is usually indicated for failure of medical management, complication, or malignancy.Algorithms for diagnostic evaluation and treatment of pediatric inflammatory bowel disease are presented.The specific psychosocial issues facing these patients are also discussed in this review as are the future goals of research in the complex problem of pediatric inflammatory bowel disease.

  16. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... its earliest stages as well as a patient’s immediate response to therapeutic interventions. Children's (pediatric) nuclear medicine ... leaving the nuclear medicine facility. Through the natural process of radioactive decay, the small amount of radiotracer ...

  17. Pediatric Celiac Disease

    Science.gov (United States)

    ... Free Diet Guide Eosinophilic Esophagitis Inflammatory Bowel Disease Nutrition & Obesity Reflux & GERD Search Keyword Connect with Facebook Additional ... Nutrition (NASPGHAN) Celiac Disease Eosinophilic Esophagitis Pediatric IBD Nutrition & Obesity Reflux & GERD Research & Grants Our Supporters Site Map © ...

  18. Pediatric liver transplantation

    Institute of Scientific and Technical Information of China (English)

    Marco Spada; Silvia Riva; Giuseppe Maggiore; Davide Cintorino; Bruno Gridelli

    2009-01-01

    In previous decades, pediatric liver transplantation has become a state-of-the-art operation with excellent success and limited mortality. Graft and patient survival have continued to improve as a result of improvements in medical, surgical and anesthetic management, organ availability, immunosuppression, and identification and treatment of postoperative complications. The utilization of split-liver grafts and living-related donors has provided more organs for pediatric patients. Newer immunosuppression regimens, including induction therapy, have had a significant impact on graft and patient survival. Future developments of pediatric liver transplantation will deal with long-term followup, with prevention of immunosuppression-related complications and promotion of as normal growth as possible. This review describes the state-of-the-art in pediatric liver transplantation.

  19. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... diagnostic nuclear medicine procedures result in low radiation exposure, acceptable for diagnostic exams. Thus, the radiation risk ... long-term adverse effects from such low-dose exposure. For more information about safety in pediatric radiology ...

  20. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... of page What are some common uses of the procedure? Children's (pediatric) nuclear medicine imaging is performed ... the thyroid gland. top of page How does the nuclear medicine procedure work? With ordinary x-ray ...

  1. Advances in pediatric anesthesia.

    Science.gov (United States)

    Burns, L S

    1997-03-01

    Advances in many aspects of pediatric anesthesia have resulted in a significant reduction in morbidity and mortality in children. Research and development have created vast improvements in pharmacology. Sophisticated monitoring and improvements in equipment evolved from advances made in scientific technology. Recognition of the psychological needs of children of all ages likely has reduced the incidence of lasting psychological effects after hospitalization. Finally, these important advances have made pediatric anesthesia a safer and more compassionate specialty.

  2. Diagnostic errors in interpretation of pediatric musculoskeletal radiographs at common injury sites

    Energy Technology Data Exchange (ETDEWEB)

    Bisset, George S.; Crowe, James [Texas Children' s Hospital, Pediatric Radiology, Houston, TX (United States)

    2014-05-15

    Extremity pain represents one of the most common reasons for obtaining conventional radiographs in childhood. Despite the frequency of these examinations little is known about the incidence of diagnostic errors by interpreting pediatric radiologists. The purpose of this study was to develop a standard error rate of pediatric radiologists by double-reading of extremity radiographs (elbow, wrists, knees and ankles) in children presenting with a history of trauma or pain. During a 6-month period all major extremity radiographs (excluding digits) obtained at a large pediatric referral hospital for evaluation of pain or trauma were reviewed by two senior pediatric radiologists and compared to the official interpretation. All radiographs were interpreted initially by a board-certified pediatric radiologist with a Certificate of Added Qualification (CAQ). We reviewed 3,865 radiographic series in children and young adults 2-20 years of age. We tabulated misses and overcalls. We did not assess the clinical significance of the errors. There were 61 miss errors and 44 overcalls in 1,235 abnormal cases and 2,630 normal cases, for a 1.6% miss rate and a 1.1% overcall rate. Misses and overcalls were most common in the ankle. Interpretive errors by pediatric radiologists reviewing certain musculoskeletal radiographs are relatively infrequent. Diagnostic errors in the form of a miss or overcall occurred in 2.7% of the radiographs. (orig.)

  3. Pediatric enteral nutrition.

    Science.gov (United States)

    Axelrod, David; Kazmerski, Kimberly; Iyer, Kishore

    2006-01-01

    Common to all pediatric patients receiving enteral nutrition is the inability to consume calories orally. This is often secondary to issues of inadequate weight gain, inadequate growth, prolonged feeding times, weight loss, a decrease in weight/age or weight/height ratios, or a persistent triceps skinfold thickness <5% for age. Enteral nutrition requires enteral access. In the neonatal period the nasoenteric route is usually used. In pediatric patients requiring long-term enteral access, surgically, endoscopically, or radiologically placed percutaneous feeding tubes are common. Jejunal feeding tubes are used in pediatric patients with gastric feeding intolerance or persistent gastroesophageal reflux. Low-profile enteral access devices are preferred by most pediatric patients because of their cosmetic appearance. For most children, a standard pediatric polypeptide enteral formula is well tolerated. There are specialized pediatric enteral formulas available for patients with decreased intestinal length, altered intestinal absorptive capacity, or altered pancreatic function. Weaning patients from tube feeding to oral nutrition is the ultimate nutrition goal. A multidisciplinary approach to patients with short bowel syndrome will maximize the use of enteral nutrition while preserving parenteral nutrition for patients with true enteral nutrition therapy failure.

  4. Cerebral imaging in pediatrics

    Energy Technology Data Exchange (ETDEWEB)

    Gordon, I. [London, Great Ormond Street Hospital for Children (United Kingdom)

    1998-06-01

    Radioisotope brain imaging has focused mainly on regional cerebral blood flow (rCBF). However the use of ligand which go to specific receptor sites is being introduced in pediatrics, mainly psychiatry. rCBF is potentially available in many institutions, especially with the availability of multi-headed gamma cameras. The use of this technique in pediatrics requires special attention to detail in the manner of data acquisition and handling the child. The interpretation of the rCBF study in a child requires knowledge of normal brain maturation. The major clinical use in pediatrics is epilepsy because of the advances in surgery and the frequency of complex partial seizures. Other indications in pediatric neurology include brain death, acute neurological loss including stroke, language disorders, cerebral palsy, hypertension due to renovascular disease, traumatic brain injury and migraine. There are pediatric physiological conditions in which rCBF has been undertaken, these include anorexia nervosa, autism, Gilles de la Tourette syndrome (GTS) and attention deficit disorder-hyperactivity (ADHD). Research using different ligands to specific receptor sites will also be reviewed in pediatrics.

  5. 7 CFR 1260.500 - General.

    Science.gov (United States)

    2010-01-01

    ... Promotion and Research: Certification and Nomination Procedures for the Cattlemen's Beef Promotion and Research Board § 1260.500 General. State organizations or associations shall be certified by the Secretary... 7 Agriculture 10 2010-01-01 2010-01-01 false General. 1260.500 Section 1260.500 Agriculture...

  6. [Performance on the Board of Pediatrics certification examination by the Sociedad Argentina de Pediatría, 2001-2010].

    Science.gov (United States)

    Ferrero, Fernando; Yulitta, Horacio; Molina, María Paz; Valli, Raúl

    2011-08-01

    Professional certification guarantees professional's performance, but the examination tool must be periodically evaluated. To describe the result of the pediatric certifying examination (PCE) of the Sociedad Argentina de Pediatría (SAP), between 2001-2010 analyzing the impact of the age and the elapsed time since the graduation and to describe the performance of training institutions in this period. Cross-section study. Data were obtained from the records of Board of Pediatrics of the SAP. The results of the PCE, were analyzed assessing examination pass rate and training institutions (2001-2010), and age and elapsed time since graduation of the examined professionals (2001-2005). Of 2527 professionals from 138 institutions, 69.6% passed. Those that passed were younger (31.7 ± 4.1 vs. 35.6 ± 6.2 years; p <0.0001) and had less years since graduation (6.3 ± 4.0 vs. 9.0 ± 5.9; p <0.0001) than those who did not pass. The examination pass rate was higher in institutions accredited by SAP (78.4% vs. 48.8%; OR= 3,8 IC95%= 3,1-4,7; p <0.001). The pass rate was significantly higher in institutions with accredited programs for 5 years than those not accredited (78.4% vs. 48.8%, OR= 3.8 95% CI= 3.1 to 4.7, p <0.001). The pass rate at accredited institutions for 3 years (53.7%) and 1 year (48.7%) showed no statistically significant differences with non-accredited institutions. The certifying examination pass rate was 68.5%. Younger professionals with fewer years since graduation, and trained in SAP 5 years accredited programs were significantly more likely to pass the examination.

  7. Pediatric integrative medicine: pediatrics' newest subspecialty?

    Directory of Open Access Journals (Sweden)

    Vohra Sunita

    2012-08-01

    Full Text Available Abstract Background Integrative medicine is defined as relationship-centered care that focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals and disciplines to achieve optimal health and healing, including evidence-based complementary and alternative medicine. Pediatric integrative medicine (PIM develops and promotes this approach within the field of pediatrics. We conducted a survey to identify and describe PIM programs within academic children’s hospitals across North America. Key barriers and opportunities were identified for the growth and development of academic PIM initiatives in the US and Canada. Methods Academic PIM programs were identified by email and eligible for inclusion if they had each of educational, clinical, and research activities. Program directors were interviewed by telephone regarding their clinical, research, educational, and operational aspects. Results Sixteen programs were included. Most (75% programs provided both inpatient and outpatient services. Seven programs operated with less than 1 FTE clinical personnel. Credentialing of complementary and alternative medicine (CAM providers varied substantially across the programs and between inpatient and outpatient services. Almost all (94% programs offered educational opportunities for residents in pediatrics and/or family medicine. One fifth (20% of the educational programs were mandatory for medical students. Research was conducted in a range of topics, but half of the programs reported lack of research funding and/or time. Thirty-one percent of the programs relied on fee-for-service income. Conclusions Pediatric integrative medicine is emerging as a new subspecialty to better help address 21st century patient concerns.

  8. Certification systems for sustainable neighbourhoods: What do they really certify?

    Energy Technology Data Exchange (ETDEWEB)

    Wangel, Josefin, E-mail: josefin.wangel@abe.kth.se [Division of Environmental Strategies Analysis (fms), KTH Royal Institute of Technology, SE-100 44 Stockholm (Sweden); Wallhagen, Marita, E-mail: marita.wallhagen@hig.se [Division of Environmental Strategies Analysis (fms), KTH Royal Institute of Technology, SE-100 44 Stockholm (Sweden); Department of Building, Energy and Environmental Engineering, University of Gävle, SE-801 76 Gävle (Sweden); Malmqvist, Tove, E-mail: tove.malmqvist@abe.kth.se [Division of Environmental Strategies Analysis (fms), KTH Royal Institute of Technology, SE-100 44 Stockholm (Sweden); Finnveden, Göran, E-mail: goran.finnveden@abe.kth.se [Division of Environmental Strategies Analysis (fms), KTH Royal Institute of Technology, SE-100 44 Stockholm (Sweden)

    2016-01-15

    Certification systems for sustainable neighbourhoods started to emerge around a decade ago. This study analysed the content, structure, weighting and indicators of two established certification systems for sustainable urban development – BREEAM Communities and LEED for Neighborhood Development. Several limitations of these systems were identified: both have a bias for procedure and feature indicators over indicators that assess actual performance; performance demands are set according to a relative understanding of sustainable development; the focus is on internal sustainability, while upstream and downstream impacts of construction are disregarded; the number and distribution of mandatory issues do not cover essential sustainability aspects; and the disproportionately large number of non-mandatory issues makes benchmarking difficult and signals that sustainability aspects are exchangeable. Altogether, this means that an area can be certified without being sustainable. Moreover, the lack of continuous development of certification requirements in the systems means that they risk exerting a conservative effect on urban development, rather than pushing it forward. - Highlights: • BREEAM-C and LEED-ND were analysed in terms of content and structure. • Specific attention was given to the type of indicators used for showing compliance. • In both systems procedure and feature indicators dominate over performance indicators. • Several other limitations of these certification systems were also identified. • Altogether the limitations imply that a certificate does not warrant sustainability.

  9. Towards a Certified Lightweight Array Bound Checker for Java Bytecode

    Science.gov (United States)

    Pichardie, David

    2009-01-01

    Dynamic array bound checks are crucial elements for the security of a Java Virtual Machines. These dynamic checks are however expensive and several static analysis techniques have been proposed to eliminate explicit bounds checks. Such analyses require advanced numerical and symbolic manipulations that 1) penalize bytecode loading or dynamic compilation, 2) complexify the trusted computing base. Following the Foundational Proof Carrying Code methodology, our goal is to provide a lightweight bytecode verifier for eliminating array bound checks that is both efficient and trustable. In this work, we define a generic relational program analysis for an imperative, stackoriented byte code language with procedures, arrays and global variables and instantiate it with a relational abstract domain as polyhedra. The analysis has automatic inference of loop invariants and method pre-/post-conditions, and efficient checking of analysis results by a simple checker. Invariants, which can be large, can be specialized for proving a safety policy using an automatic pruning technique which reduces their size. The result of the analysis can be checked efficiently by annotating the program with parts of the invariant together with certificates of polyhedral inclusions. The resulting checker is sufficiently simple to be entirely certified within the Coq proof assistant for a simple fragment of the Java bytecode language. During the talk, we will also report on our ongoing effort to scale this approach for the full sequential JVM.

  10. Do LEED-certified buildings save energy? Not really...

    Energy Technology Data Exchange (ETDEWEB)

    Scofield, John H. [Department of Physics and Astronomy, Oberlin College, Oberlin, OH (United States)

    2009-12-15

    Newsham et al. have recently published a re-analysis of energy-consumption data for LEED-certified commercial buildings supplied by the New Buildings Institute (NBI) and US Green Building Council. They find that, on average, LEED buildings use 18-39% less energy per floor area than their conventional counterparts, consistent with and adding clarity to conclusions originally reached by NBI. These conclusions, however, hang on a particular definition of the mean energy intensity of a collection of buildings that is not related to the total energy used by those buildings. Furthermore, site energy considered by Newsham et al. and NBI, unlike source energy used for the EPA's building Energy Star rating, does not account for the energy consumed off-site in generating and delivering electric energy to the building, whose inclusion is crucial for understanding greenhouse gas emission associated with building operation. Here I demonstrate that both the site energy and source energy used by the set of 35 LEED office buildings and Newsham et al.'s matching CBECS office buildings are statistically equivalent. Hence Newsham et al. offer no evidence that LEED-certification has collectively lowered either site or source energy for office buildings. (author)

  11. Science inquiry learning environments created by National Board Certified Teachers

    Science.gov (United States)

    Saderholm, Jon

    The purpose of this study was to discern what differences exist between the science inquiry learning environments created by National Board Certified Teachers (NBCTs) and non-NBCTs. Four research questions organized the data collection and analysis: (a) How do National Board Certified science teachers' knowledge of the nature of science differ from that of their non-NBCT counterparts? (b) How do the frequencies of student science inquiry behaviors supported by in middle/secondary learning environments created by NBCTs differ from those created by their non-NBCT counterparts? (c) What is the relationship between the frequency of students' science inquiry behaviors and their science reasoning and understanding of the nature of science? (d) What is the impact of teacher perceptions factors impacting curriculum and limiting inquiry on the existence of inquiry learning environments? The setting in which this study was conducted was middle and high schools in Kentucky during the period between October 2006 and January 2007. The population sampled for the study was middle and secondary science teachers certified to teach in Kentucky. Of importance among those were the approximately 70 National Board Certified middle and high school science teachers. The teacher sample consisted of 50 teachers, of whom 19 were NBCTs and 31 were non-NBCTs. This study compared the science inquiry teaching environments created by NBCTs and non-NBCTs along with their consequent effect on the science reasoning and nature of science (NOS) understanding of their students. In addition, it examined the relationship with these science inquiry environments of other teacher characteristics along with teacher perception of factors influencing curriculum and factors limiting inquiry. This study used a multi-level mixed methodology study incorporating both quantitative and qualitative measures of both teachers and their students. It was a quasi-experimental design using non-random assignment of

  12. Sedation and Monitoring in the Pediatric Patient during Gastrointestinal Endoscopy.

    Science.gov (United States)

    Chung, Hyun Kee; Lightdale, Jenifer R

    2016-07-01

    Sedation is a fundamental component of pediatric gastrointestinal procedures. The 2 main types of sedation for pediatric endoscopy remain general anesthesia and procedural sedation. Although anesthesiologist-administered sedation protocols are more common, there is no ideal regimen for endoscopy in children. This article discusses specific levels of sedation for endoscopy as well as various regimens that can be used to achieve each. Risks and considerations that may be specific to performing gastrointestinal procedures in children are reviewed. Finally, potential future directions for sedation and monitoring that may change the practice of pediatric gastroenterology and ultimately patient outcomes are examined.

  13. [Pediatric emergencies: Knowledge of basic measures for the emergency physician].

    Science.gov (United States)

    Meyer, S; Grundmann, U; Reinert, J; Gortner, L

    2015-11-01

    Life-threatening pediatric emergencies are relatively rare in the prehospital setting. Thus, the treating emergency physician may not always be familiar with and well trained in these situations. However, pediatric emergencies require early recognition and initiation of specific diagnostic and therapeutic interventions to prevent further damage. The treatment of pediatric emergencies follows current recommendations as detailed in published international guidelines. The aim of this review is to familiarize the emergency physician with general aspects pertinent to this topic-most importantly anatomical and physiological characteristics in this cohort. Also, specific information with regard to analgesia and sedation, which may be warranted in the prehospital setting, will be provided.

  14. Cancer Risk After Pediatric Solid Organ Transplantation.

    Science.gov (United States)

    Yanik, Elizabeth L; Smith, Jodi M; Shiels, Meredith S; Clarke, Christina A; Lynch, Charles F; Kahn, Amy R; Koch, Lori; Pawlish, Karen S; Engels, Eric A

    2017-05-01

    The effects of pediatric solid organ transplantation on cancer risk may differ from those observed in adult recipients. We described cancers in pediatric recipients and compared incidence to the general population. The US transplant registry was linked to 16 cancer registries to identify cancer diagnoses among recipients <18 years old at transplant. Standardized incidence ratios (SIRs) were estimated by dividing observed cancer counts among recipients by expected counts based on the general population rates. Cox regression was used to estimate the associations between recipient characteristics and non-Hodgkin's lymphoma (NHL) risk. Among 17 958 pediatric recipients, 392 cancers were diagnosed, of which 279 (71%) were NHL. Compared with the general population, incidence was significantly increased for NHL (SIR = 212, 95% confidence interval [CI] = 188-238), Hodgkin's lymphoma (SIR = 19, 95% CI = 13-26), leukemia (SIR = 4, 95% CI = 2-7), myeloma (SIR = 229, 95% CI = 47-671), and cancers of the liver, soft tissue, ovary, vulva, testis, bladder, kidney, and thyroid. NHL risk was highest during the first year after transplantation among recipients <5 years old at transplant (SIR = 313), among recipients seronegative for Epstein-Barr virus (EBV) at transplant (SIR = 446), and among intestine transplant recipients (SIR = 1280). In multivariable analyses, seronegative EBV status, the first year after transplantation, intestine transplantation, and induction immunosuppression were independently associated with higher NHL incidence. Pediatric recipients have a markedly increased risk for many cancers. NHL constitutes the majority of diagnosed cancers, with the highest risk occurring in the first year after transplantation. NHL risk was high in recipients susceptible to primary EBV infection after transplant and in intestine transplant recipients, perhaps due to EBV transmission in the donor organ. Copyright © 2017 by the American Academy of Pediatrics.

  15. Electronic resources preferred by pediatric hospitalists for clinical care.

    Science.gov (United States)

    Beck, Jimmy B; Tieder, Joel S

    2015-10-01

    There is little research on pediatric hospitalists' use of evidence-based resources. The aim of this study was to determine the electronic resources that pediatric hospitalists prefer. Using a web-based survey, the authors determined hospitalists' preferred electronic resources, as well as their attitudes toward lifelong learning, practice, and experience characteristics. One hundred sixteen hospitalists completed the survey. The most preferred resource for general information, patient handouts, and treatment was UpToDate. Online search engines were ranked second for general information and patient handouts. Pediatric hospitalists tend to utilize less rigorous electronic resources such as UpToDate and Google. These results can set a platform for discussing the quality of resources that pediatric hospitalists use.

  16. Problems and preferences in pediatric imaging

    Directory of Open Access Journals (Sweden)

    Brij Bhushan Thukral

    2015-01-01

    Full Text Available Radiological imaging is extremely valuable as a diagnostic tool in the pediatric population, but it comes with a number of distinct challenges as compared to the imaging of adults. This is because of the following: It requires dedicated imaging protocols to acquire the images, there is need for sedation or general anesthesia for longer procedures such as MRI, specific training is required for the healthcare personnel involved, thorough knowledge and expertise should be applied for evaluating the images, and most importantly, it requires consideration for radiation exposure if ionizing radiation is being used. One of the challenges for clinical care personnel is to gain the child's trust and co-operation before and throughout the duration of an examination, which can prove to be difficult in children who may be ill and have pain. This is important to acquire quality images and prevent repeat examinations. Even with a quality examination, the accurate interpretation of images requires a thorough knowledge of the intricate and dynamic face of anatomy and specific pathological presentations in children. The increased radiation sensitivity of growing organs and children's longer expected life spans make them more susceptible to the harmful effects of radiation. Imaging pediatric patients in a dedicated pediatric imaging department with dedicated pediatric CT technologists may result in greater compliance with pediatric protocols and significantly reduced patient dose. In order to prevent the harmful effects of ionizing radiation, As Low As Reasonably Achievable (ALARA principle should be strictly followed. This article seeks to draw attention to various challenges of pediatric imaging and the ways to overcome them.

  17. Job dissatisfaction among certified adapted physical education specialists in the USA

    Directory of Open Access Journals (Sweden)

    Lucie Ješinová

    2014-09-01

    Full Text Available Background: Professionals working in the area of special education are exposed to the unique situation of occupational stress. Adapted physical education teachers are experiencing several symptoms of the burnout phenomenon. Objective: The purpose of this study was to identify factors causing job dissatisfaction among certified adapted physical education specialists in the USA. Methods: The survey was developed based (a on Herzberg's (1959 theory of job satisfaction, and (b a pilot study, which examined specific factors of job dissatisfaction among adapted physical education (APE teachers in the USA. The survey consisted of three parts: (a demographic information, (b paired comparison of nine general factors which could cause job dissatisfaction, and (c paired comparison of ten APE specific factors which could cause job dissatisfaction. The participants were 113 certified adapted physical education specialists (CAPES (88 females, 25 males, a 38% return rate of all mailed surveys. Results: The results indicated that 39% of CAPES have seriously considered another job outside of APE and 26% of CAPES have actively searched for job outside of APE in the last two years. 113 CAPES indicated the general factors that they found the most dissatisfying in their job (listed accordingly to rank, frequency and percent of times chosen, N for each factor = 1017 were working conditions (644, 71%; policies and administration (619, 68%; interpersonal relationship with supervisors (552, 61%; supervision (484, 54%; salary (404, 45%; interpersonal relationship with subordinates (404, 45%; benefits on job (301, 33%; interpersonal relationship with peers (293, 32%; and job security (245, 27%. 110 CAPES indicated the APE specific factors they found the most dissatisfying on their job (listed accordingly to rank, frequency and percent of times chosen, N for each factor = 990 were paperwork (687, 69%; scheduling (659, 67%; facilities (617, 62%; individualized education

  18. Management of pediatric asthma at home and in school.

    Science.gov (United States)

    Van Roeyen, Linda Sue

    2013-03-01

    The incidence of pediatric asthma in the United States creates a huge financial burden to the economy as well as a negative impact on child health. Identification and elimination of asthma triggers are helpful in reducing asthma exacerbations. The incidence of asthma is higher in African American and underserved populations. Improved management of pediatric asthma leads to improved school performance, improved mental health, and general well-being.

  19. 40 CFR 1045.610 - What provisions apply to using engines already certified to Small SI emission standards?

    Science.gov (United States)

    2010-07-01

    ... already certified to Small SI emission standards? 1045.610 Section 1045.610 Protection of Environment... engines already certified to Small SI emission standards? This section applies to marine engines that are identical to land-based engines certified under 40 CFR part 90 or 1054. See § 1045.605 for provisions...

  20. 48 CFR 52.215-11 - Price Reduction for Defective Certified Cost or Pricing Data-Modifications.

    Science.gov (United States)

    2010-10-01

    ... subcontractor furnished certified cost or pricing data that were not complete, accurate, and current as certified in its Certificate of Current Cost or Pricing Data, (2) a subcontractor or prospective... current as certified in the Contractor's Certificate of Current Cost or Pricing Data, or (3) any of...

  1. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... for a recovery period and will be given instructions on any limitations in activity for the day. ... Images related to Children's (Pediatric) CT (Computed Tomography) Videos related to Children's (Pediatric) CT (Computed Tomography) Sponsored ...

  2. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) ... are the limitations of Children's CT? What is Children's CT? Computed tomography, more commonly known as a ...

  3. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Children's (Pediatric) Ultrasound - Abdomen Children’s (pediatric) ultrasound imaging of ... 30 minutes. top of page What will my child experience during and after the procedure? Ultrasound examinations ...

  4. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... Us News Physician Resources Professions Site Index A-Z Children's (Pediatric) Ultrasound - Abdomen Children’s (pediatric) ultrasound imaging ... depends on the type of examination. For some scans, your doctor may ask you to withhold food ...

  5. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... Us News Physician Resources Professions Site Index A-Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography ( ... more commonly known as a CT or CAT scan, is a diagnostic medical test that, like traditional ...

  6. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... Professions Site Index A-Z Children's (Pediatric) Ultrasound - Abdomen Children’s (pediatric) ultrasound imaging of the abdomen is a safe, noninvasive test that uses sound ...

  7. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... Professions Site Index A-Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) is a fast, painless ... table. Other imaging methods such as ultrasound or magnetic resonance (MR) imaging can provide pictures of certain areas ...

  8. The online potential for the development of eco-certified accommodation units in Romania

    Directory of Open Access Journals (Sweden)

    Codruţa Adina BĂLTESCU

    2015-12-01

    Full Text Available The Internet and electronic communication have generated significant changes in the marketing strategies of accommodation units. On the other hand, sustainable development is a goal which requires concrete actions and changed mentalities. In Romania operates a number of eco-certified accommodation units. The online tools allow them to communicate the advantages and benefits of the sustainable services, and also to obtain a quick feedback from the consumers. This paper highlights the extent to which eco-certified accommodation units in our country offer relevant information to potential consumers and analyzes the online reviews regarding the eco-certified accommodation services

  9. Pediatric psoriasis: an update

    Directory of Open Access Journals (Sweden)

    Nanette B Silverberg

    2009-10-01

    Full Text Available Nanette B SilverbergPediatric and Adolescent Dermatology, St. Luke’s-Roosevelt Hospital Center, New York, NY, USAAbstract: Pediatric psoriasis consists broadly of 3 age groups of psoriatic patients: infantile psoriasis, a self-limited disease of infancy, psoriasis with early onset, and pediatric psoriasis with psoriatic arthritis. About one-quarter of psoriasis cases begin before the age of 18 years. A variety of clinical psoriasis types are seen in childhood, including plaque-type, guttate, erythrodermic, napkin, and nail-based disease. Like all forms of auto-immunity, susceptibility is likely genetic, but environmental triggers are required to initiate disease activity. The most common trigger of childhood is an upper respiratory tract infection. Once disease has occurred, treatment is determined based on severity and presence of joint involvement. Topical therapies, including corticosteroids and calcipotriene, are the therapies of choice in the initial care of pediatric patients. Ultraviolet light, acitretin and cyclosporine can clear skin symptoms, while methotrexate and etanercept can clear both cutaneous and joint disease. Concern for psychological development is required when choosing psoriatic therapies. This article reviews current concepts in pediatric psoriasis and a rational approach to therapeutics. Keywords: psoriasis, autoimmunity, Streptococcus, etanercept, calcipotriene, topical corticosteroids

  10. Antibiotic prophylaxis for children with sickle cell disease: a survey of pediatric dentistry residency program directors and pediatric hematologists.

    Science.gov (United States)

    Tate, Anupama Rao; Norris, Chelita Kaye; Minniti, Caterina P

    2006-01-01

    The purposes of this study were to: (1) investigate the current clinical practice regarding the use of antibiotic prophylaxis by pediatric dentistry residency program directors and pediatric hematologists for children with sickle cell disease (SCD) requiring dental treatment; and (2) evaluate the perceived relative risk of bacteremia following specific dental procedures, as defined by pediatric dentistry residency program directors and pediatric hematologists. A written survey depicting various clinical scenarios of SCD children requiring common dental procedures was mailed to directors of pediatric dental advanced education programs and distributed to pediatric hematologists attending the 2003 Annual Sickle Cell Disease Association of America conference in Washington, DC. Surveys were returned by 60% (N=34/57) of the pediatric dentistry residency program directors. The surveys were obtained from 51% of pediatric hematologists at the meeting (N=72/140). At least 50% of all respondents recommended prophylaxis for the following clinical situations: dental extractions, treatment under general anesthesia, and status post splenectomy. The perceived risk of infectious complication was highest for extractions, followed by restorative treatment and tooth polishing. Dental residency program directors were more likely (71%, N=24/34) to recommend additional antibiotic therapy for patients taking penicillin prophylaxis if they required an invasive oral surgical procedure. Conversely, only 38% (N=25/66) of pediatric hematologists recommended additional antibiotic therapy (P=.001). Eighty-six percent of dental residency program directors (N=25/29) chose amoxicillin for prophylaxis whereas only 62% of pediatric hematologists (N=36/58) recommended amoxicillin. (P<.05). There is a lack of consensus on the appropriate use of antibiotic prophylaxis in SCD children undergoing dental treatments. Further research and risk/benefit assessment is needed to create a unified approach.

  11. North American Board of Certified Energy Practitioners Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Lawrence, Richard [North American Board of Certified Energy Practitioners, Inc., Clifton Park, NY (United States)

    2014-01-31

    passing score, NABCEP certificants receive an accreditation that upholds NABCEP’s standards of quality, compliance to applicable codes and safety in PV installation. The objectives of DOE’s National Solar Energy Technology Program (SETP) are intrinsic to NABCEP. As detailed in the PV Roadmap, the lifespan of a PV system is a function of reliability and value. PV system reliability is directly dependent upon the quality of components and, design, installation and maintenance of a system. The latter three are all core components of the NABCEP Task Analysis - accordingly NABCEP certified installers will be instrumental in improving reliability of systems through safe, code and manufacturer-compliant installation and necessary post-installation maintenance of PV systems. This will have the effect of ensuring and increasing the performance of installed systems and, as consumers realize the benefits of well-installed and maintained systems, increased demand will follow and manufacturers will respond - supporting further growth in the PV industry. Furthermore, as more NABCEP certified installers perform these installations and maintenance competently, additional installations (whole system re-installations) and unnecessary repairs can be avoided. This will drive down system costs. This combined with creation/enhancement of the DE-FG36-04GO14348/005 NABCEP Central Data Base of Installers – providing consumers with installation/maintenance service options will further reduce system costs and help meet the overall goal of reducing life cycle costs. As consumers receive more value from PV systems which are providing longer, trouble free, renewable energy, they will join the ranks of professionals and enthusiasts calling for reduced technological barriers to installation (particularly for grid-tied systems). States and utilities will react to pressure and begin easing onerous net-metering and other technological restrictions. The benefits of NABCEP’s Program will be evident

  12. Spectrum of pediatric skin biopsies

    Directory of Open Access Journals (Sweden)

    Grace D′costa

    2007-01-01

    Full Text Available Background: Skin diseases are common in childhood and they are common reasons for pediatric visits to the hospital. In spite of this high occurrence, there are very few prospective studies addressing this issue. Aims: The present study was directed at determining the spectrum of dermato-pathological lesions encountered in a large general tertiary care hospital, over a two-year period. Materials and Methods: 107 cases formed the total sample studied, in a part prospective and part retrospective study. A detailed clinical history was recorded on a proforma prepared for the purpose and gross photographs were taken wherever possible. Results: Skin biopsies accounted for 7.29% of the total surgical pathology load, 55.44% of the total pediatric biopsies and 10.82% of the total number of skin biopsies. The age and sex distribution pattern revealed that the maximum number of biopsies (62.61% were of older children, with a male preponderance (57.94%. The anatomic distribution pattern indicated predominant involvement of the limbs (59.82%. The maximum numbers of cases were of infectious nature (24.29%; the most frequently encountered being borderline tuberculoid Hansen′s disease (8.4%. A positive correlation with the clinical diagnosis was obtained in 56.07% cases. Conclusions: Histopathology contributed to the diagnosis in a significant number of (82.23% cases, indicating its importance and utility.

  13. The pediatric vaccine stockpiling problem.

    Science.gov (United States)

    Truong, Van-Anh

    2012-09-21

    The U.S. has experienced many major interruptions of its pediatric vaccine production in the past decade. The Centers for Disease Control and Prevention (CDC) copes with these shortages by building a national stockpile of pediatric vaccines, which it makes accessible to the public in the event of a shortage. The management of this stockpile is difficult due to limited production capacity and long and unpredictable production interruptions. In this paper, we address policies for managing the stockpile. We provide sufficient conditions for the optimal policy to be a modified state-dependent base-stock policy, with the base-stock level decreasing in the pipeline inventory. Since the optimal policy is in general difficult to evaluate, we derive bounds on the optimal decision in each period. We develop an efficient policy that performs on average within 1% of optimality in simulations. We show that stocking the same supply of vaccine of every type can be over-conservative in some cases, and inadequate in others by large factors. We also quantify the substantial reduction in inventory level that can be achieved when there are multiple suppliers in the market. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Nontraditional roles for certified pharmacy technicians in a pharmaceutical company.

    Science.gov (United States)

    Fung, Stacey M; Gilmour, Christine; McCracken, David; Shane, Korban; Matsuura, Gary

    2006-01-01

    To describe nontraditional roles for Certified Pharmacy Technicians (CPhTs) within pharmaceutical industry. Drug information department within a large biotechnology/pharmaceutical organization. The Medical Communications department within Genentech uses a skills-mix staffing model in which employees with varying educational and training backgrounds work as a team on meeting the informational needs of consumers and health professionals who contact the company. One position within the department is that of Medical Communications Associate, responsible primarily for managing product inquiries. Medical Communications Associates have degrees in life sciences or an equivalent combination of education and experience, including a minimum of 2 years of related experience in the health care industry. Currently, four of the seven Medical Communications Associates in the department are CPhTs. Not applicable. Ability to recruit CPhTs for Medical Communications Associate positions, and job satisfaction of those hired into these positions. Critical basic skills needed for the Medical Communications Associate position include strong computer literacy, ability to multitask, and ability to work in an environment with frequent interruptions. Strong oral and written communications skills, customer service skills, ability to deal with stressful situations, product-specific knowledge, ability to work on a daily basis with Medical Communications Pharmacists, and knowledge of medical terminology are also important. The skills set of CPhTs matches these requirements, as evidenced by the experiences of the four staff members who have worked in the department for a total of 17 person-years. This nontraditional role for CPhTs can be rewarding and beneficial to all, affording an unique opportunity within the pharmaceutical industry. The skill set and experience of CPhTs can be used in the nontraditional pharmacy practice setting of drug information.

  15. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... Resources Professions Site Index A-Z Children’s (Pediatric) Magnetic Resonance Imaging Children’s magnetic resonance imaging (MRI) uses a powerful ... of Children’s (Pediatric) MRI? What is Children’s (Pediatric) MRI? Magnetic resonance imaging (MRI) is a noninvasive medical ...

  16. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Children’s (Pediatric) Magnetic Resonance Imaging Children’s magnetic resonance imaging ( ... the limitations of Children’s (Pediatric) MRI? What is Children’s (Pediatric) MRI? Magnetic resonance imaging (MRI) is a ...

  17. What's new in pediatric orthopaedics.

    Science.gov (United States)

    Sanders, James O; Otsuka, Norman Y; Martus, Jeffrey E

    2015-02-18

    This past year has seen an increase in the quality of studies in pediatric orthopaedics, and the completion of BrAIST demonstrated that high-level studies of important questions can be addressed in pediatric orthopaedics. The current commitment of improving quality of care for children promises a healthy future for pediatric orthopaedics.

  18. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Children’s (Pediatric) Magnetic Resonance Imaging Children’s magnetic resonance imaging (MRI) ... limitations of Children’s (Pediatric) MRI? What is Children’s (Pediatric) MRI? Magnetic resonance imaging (MRI) is a noninvasive ...

  19. Pediatric glaucoma: current perspectives

    Directory of Open Access Journals (Sweden)

    Marchini G

    2014-05-01

    Full Text Available Giorgio Marchini, Marco Toscani, Francesca Chemello Eye Clinic, Department of Neurological and Movement Sciences, University of Verona, Verona, Italy Abstract: “Childhood glaucoma” is a heterogeneous group of severe pediatric conditions often associated with significant visual loss and characterized by elevated intraocular pressure (IOP and optic-disk cupping. Successful IOP control is crucial but challenging and most often achieved surgically, with medical therapy playing a supportive role. There are many classifications of childhood glaucoma, but they can simply be divided into primary, in which a developmental abnormality of the anterior chamber angle only exists, and secondary, in which aqueous outflow is reduced due to independent mechanisms that secondarily impair the function of the filtration angle. The worldwide prevalence of childhood blindness ranges from 0.03% in high-income countries to 0.12% in undeveloped countries. The majority of cases do not have an identified genetic mutation and, where the mutation is known, the genes often account for only a small proportion of cases. Several pathogenetic mechanisms are known to contribute to the development of childhood glaucoma. Whatever the cause, it results in a reduced aqueous outflow at the level of the trabecular meshwork. Age of onset and magnitude of the elevated IOP largely determine the clinical manifestation the high variability of clinical manifestations. Glaucoma from any cause in a neonate and infant is characterized by the classic triad of epiphora, photophobia, and blepharospasm, and could be associated with eye enlargement (buphthalmos and Haab striae. The eye examination, usually performed under general anesthesia, includes: tonometry, anterior-segment examination, gonioscopy, corneal diameter and axial length measurement, dilated fundoscopy with optic-nerve-head evaluation. Medical therapy, considering the high frequency of side effects, is generally used as

  20. Pediatric Integrative Medicine.

    Science.gov (United States)

    McClafferty, Hilary; Vohra, Sunita; Bailey, Michelle; Brown, Melanie; Esparham, Anna; Gerstbacher, Dana; Golianu, Brenda; Niemi, Anna-Kaisa; Sibinga, Erica; Weydert, Joy; Yeh, Ann Ming

    2017-09-01

    The American Academy of Pediatrics is dedicated to optimizing the well-being of children and advancing family-centered health care. Related to this mission, the American Academy of Pediatrics recognizes the increasing use of complementary and integrative therapies for children and the subsequent need to provide reliable information and high-quality clinical resources to support pediatricians. This Clinical Report serves as an update to the original 2008 statement on complementary medicine. The range of complementary therapies is both extensive and diverse. Therefore, in-depth discussion of each therapy or product is beyond the scope of this report. Instead, our intentions are to define terms; describe epidemiology of use; outline common types of complementary therapies; review medicolegal, ethical, and research implications; review education and training for select providers of complementary therapies; provide educational resources; and suggest communication strategies for discussing complementary therapies with patients and families. Copyright © 2017 by the American Academy of Pediatrics.

  1. Pediatric perspective on pharmacogenomics.

    Science.gov (United States)

    Stevens, Adam; De Leonibus, Chiara; Hanson, Daniel; Whatmore, Andrew; Murray, Philip; Donn, Rachelle; Meyer, Stefan; Chatelain, Pierre; Clayton, Peter

    2013-11-01

    The advances in high-throughput genomic technologies have improved the understanding of disease pathophysiology and have allowed a better characterization of drug response and toxicity based on individual genetic make up. Pharmacogenomics is being recognized as a valid approach used to identify patients who are more likely to respond to medication, or those in whom there is a high probability of developing severe adverse drug reactions. An increasing number of pharmacogenomic studies are being published, most include only adults. A few studies have shown the impact of pharmacogenomics in pediatrics, highlighting a key difference between children and adults, which is the contribution of developmental changes to therapeutic responses across different age groups. This review focuses on pharmacogenomic research in pediatrics, providing examples from common pediatric conditions and emphasizing their developmental context.

  2. Pediatric nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    1986-01-01

    This symposium presented the latest techniques and approaches to the proper medical application of radionuclides in pediatrics. An expert faculty, comprised of specialists in the field of pediatric nuclear medicine, discussed the major indications as well as the advantages and potential hazards of nuclear medicine procedures compared to other diagnostic modalities. In recent years, newer radiopharmaceuticals labeled with technetium-99m and other short-lived radionuclides with relatively favorable radiation characteristics have permitted a variety of diagnostic studies that are very useful clinically and carry a substantially lower radiation burden then many comparable X-ray studies. This new battery of nuclear medicine procedures is now widely available for diagnosis and management of pediatric patients. Many recent research studies in children have yielded data concerning the effacacy of these procedures, and current recommendations will be presented by those involved in conducting such studies. Individual papers are processed separately for the Energy Data Base.

  3. Nelson Textbook of Pediatrics.

    Science.gov (United States)

    Pomerance, Herbert H

    1997-03-01

    The dedication of this volume states:To the physicians and nurses who care for children in many different circumstances throughout the world and who, by their efforts and commitment, make the world a better place for children.I have used the Nelson Textbook of Pediatrics since its third edition. It remains a source of amazement to me, as I witness the evolution of the book and of the knowledge that dictates its scope. From the days when a textbook was written by 1 or 2 authors, we have progressed to the point where this would be impossible. Three editors preside over this volume; they are also counted among the 212 contributors that lend special expertise to the work, continuing the volume as one of the traditions of pediatrics.The tremendous and rapid explosion in the amount of knowledge in pediatrics made a revision of the total material and even of.

  4. Radiology illustrated. Pediatric radiology

    Energy Technology Data Exchange (ETDEWEB)

    Kim, In-One (ed.) [Seoul National Univ. College of Medicine (Korea, Republic of). Dept. of Radiology

    2014-11-01

    Depicts characteristic imaging findings of common and uncommon diseases in the pediatric age group. Will serve as an ideal diagnostic reference in daily practice. Offers an excellent teaching aid, with numerous high-quality illustrations. This case-based atlas presents images depicting the findings typically observed when imaging a variety of common and uncommon diseases in the pediatric age group. The cases are organized according to anatomic region, covering disorders of the brain, spinal cord, head and neck, chest, cardiovascular system, gastrointestinal system, genitourinary system, and musculoskeletal system. Cases are presented in a form resembling teaching files, and the images are accompanied by concise informative text. The goal is to provide a diagnostic reference suitable for use in daily routine by both practicing radiologists and radiology residents or fellows. The atlas will also serve as a teaching aide and a study resource, and will offer pediatricians and surgeons guidance on the clinical applications of pediatric imaging.

  5. Integrative Pediatrics: Looking Forward

    Directory of Open Access Journals (Sweden)

    Hilary McClafferty

    2015-01-01

    Full Text Available Increase in the prevalence of disease and illness has dramatically altered the landscape of pediatrics. As a result, there is a demand for pediatricians with new skills and a sharper focus on preventative health. Patient demand and shifting pediatric illness patterns have accelerated research in the field of pediatric integrative medicine. This emerging field can be defined as healing-oriented medicine that considers the whole child, including all elements of lifestyle and family health. It is informed by evidence and carefully weighs all appropriate treatment options. This Special Issue of Children, containing a collection of articles written by expert clinicians, represents an important educational contribution to the field. The goal of the edition is to raise awareness about integrative topics with robust supporting evidence, and to identify areas where more research is needed.

  6. Sleeping beauties in pediatrics.

    Science.gov (United States)

    Završnik, Jernej; Kokol, Peter

    2016-10-01

    Sleeping beauties (SBs) in science have been known for few decades; however, it seems that only recently have they become popular. An SB is a publication that "sleeps" for a long time and then almost suddenly awakes and becomes highly cited. SBs present interesting findings in science. Pediatrics research literature has not yet been analyzed for their presence, and 5 pediatrics SBs were discovered in this research. Their prevalence was approximately 0.011%. Some environments or periods are more "SB fertile" than others: 3 of 5 SBs were published in the journal Pediatrics, 4 originated from the United States, and 4 were published in the period from 1992 to 1993. No institutions or authors published more than 1 SB.

  7. Sleeping beauties in pediatrics

    Directory of Open Access Journals (Sweden)

    Jernej Završnik, PhD

    2017-01-01

    Full Text Available Sleeping beauties (SBs in science have been known for few decades; however, it seems that only recently have they become popular. An SB is a publication that ‘‘sleeps’’ for a long time and then almost suddenly awakes and becomes highly cited. SBs present interesting findings in science. Pediatrics research literature has not yet been analyzed for their presence, and 5 pediatrics SBs were discovered in this research. Their prevalence was approximately 0.011%. Some environments or periods are more ‘‘SB fertile’’ than others: 3 of 5 SBs were published in the journal Pediatrics, 4 originated from the United States, and 4 were published in the period from 1992 to 1993. No institutions or authors published more than 1 SB.

  8. The American Academy of Pediatric Dentistry and the specialty of pediatric dentistry.

    Science.gov (United States)

    Largent, Beverly A

    2009-01-01

    Founded in 1947, the American Academy of Pediatric Dentistry (AAPD) is a not-for-profit membership association representing the specialty of pediatric dentistry. The AAPD's 7,500 members are primary oral health care providers who offer comprehensive specialty treatment for millions of infants, children, adolescents, and individuals with special healthcare needs. The AAPD also represents general dentists who treat a significant number of children in their practices. As advocates for children's oral health, the AAPD develops and promotes evidence-based policies and guidelines, fosters research, contributes to scholarly work concerning pediatric oral health, and educates healthcare providers, policymakers, and the public on ways to improve children's oral health. The academy's philanthropic arm, Healthy Smiles, Healthy Children: The Foundation of the AAPD, advances the AAPD mission through the support and promotion of education, research, service, and policy development.

  9. Mapping US pediatric hospitals and subspecialty critical care for public health preparedness and disaster response, 2008.

    Science.gov (United States)

    Brantley, Mary D; Lu, Hua; Barfield, Wanda D; Holt, James B; Williams, Alcia

    2012-06-01

    The objective is to describe by geographic proximity the extent to which the US pediatric population (aged 0-17 years) has access to pediatric and other specialized critical care facilities, and to highlight regional differences in population and critical resource distribution for preparedness planning and utilization during a mass public health disaster. The analysis focused on pediatric hospitals and pediatric and general medical/surgical hospitals with specialized pediatric critical care capabilities, including pediatric intensive care units (PICU), pediatric cardiac ICUs (PCICU), level I and II trauma and pediatric trauma centers, and general and pediatric burn centers. The proximity analysis uses a geographic information system overlay function: spatial buffers or zones of a defined radius are superimposed on a dasymetric map of the pediatric population. By comparing the population living within the zones to the total population, the proportion of children with access to each type of specialized unit can be estimated. The project was conducted in three steps: preparation of the geospatial layer of the pediatric population using dasymetric mapping methods; preparation of the geospatial layer for each resource zone including the identification, verification, and location of hospital facilities with the target resources; and proximity analysis of the pediatric population within these zones. Nationally, 63.7% of the pediatric population lives within 50 miles of a pediatric hospital; 81.5% lives within 50 miles of a hospital with a PICU; 76.1% lives within 50 miles of a hospital with a PCICU; 80.2% lives within 50 miles of a level I or II trauma center; and 70.8% lives within 50 miles of a burn center. However, state-specific proportions vary from less than 10% to virtually 100%. Restricting the burn and trauma centers to pediatric units only decreases the national proportion to 26.3% for pediatric burn centers and 53.1% for pediatric trauma centers. This

  10. Orthobiologics in Pediatric Orthopedics.

    Science.gov (United States)

    Murphy, Robert F; Mooney, James F

    2017-07-01

    Orthobiologics are biologic devices or products used in orthopedic surgery to augment or enhance bone formation. The use of orthobiologics in pediatric orthopedics is less frequent than in other orthopedic subspecialties, mainly due to the naturally abundant healing potential and bone formation in children compared with adults. However, orthobiologics are used in certain situations in pediatric orthopedics, particularly in spine and foot surgery. Other uses have been reported in conjunction with specific procedures involving the tibia and pelvis. The use of bioabsorable implants to stabilize children's fractures is an emerging concept but has limited supporting data. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Contact Dermatitis in Pediatrics.

    Science.gov (United States)

    Pelletier, Janice L; Perez, Caroline; Jacob, Sharon E

    2016-08-01

    Contact dermatitis is an umbrella term that describes the skin's reaction to contacted noxious or allergenic substances. The two main categories of contact dermatitis are irritant type and allergic type. This review discusses the signs, symptoms, causes, and complications of contact dermatitis. It addresses the testing, treatment, and prevention of contact dermatitis. Proper management of contact dermatitis includes avoidance measures for susceptible children. Implementation of a nickel directive (regulating the use of nickel in jewelry and other products that come into contact with the skin) could further reduce exposure to the most common allergens in the pediatric population. [Pediatr Ann. 2016;45(8):e287-e292.].

  12. Children's rights in pediatrics.

    Science.gov (United States)

    Streuli, Jürg C; Michel, Margot; Vayena, Effy

    2011-01-01

    The United Nations Convention of Children's Rights (UNCRC) introduced in 1989 has generated a global movement for the protection of children's rights and has brought about a paradigm change in how children are perceived. Pediatric healthcare professionals are interacting with children and therefore with children's rights on a daily basis. However, although at least 18 of the 54 articles are relevant for pediatric practice, there is limited systematic training on how pediatricians can support children's rights in the clinical setting. This article discusses the principles and aims of the UNCRC and proposes a comprehensive checklist of rights vis-à-vis issues that arise in clinical practice.

  13. Pediatric radiology for medical-technical radiology assistants/radiologists; Paediatrische Radiologie fuer MTRA/RT

    Energy Technology Data Exchange (ETDEWEB)

    Oppelt, Birgit

    2010-07-01

    The book on pediatric radiology includes the following chapter: differences between adults and children; psycho-social aspects concerning the patient child in radiology; relevant radiation doses in radiology; help for self-help: simple phantoms for image quality estimation in pediatric radiology; general information; immobilization of the patient; pediatric features for radiological settings; traumatology; contrast agents; biomedical radiography; computerized tomography; NMR imaging; diagnostic ultrasonography; handling of stress practical recommendations; medical displays.

  14. The objective and the prospects of creating certified reference materials of fire protection substances and materials

    Directory of Open Access Journals (Sweden)

    M. P. Dubinin

    2014-01-01

    Full Text Available The article describes the state of things in the field of production and use of fire protection materials. The need to develop certified reference materials of fire protection materials is justified.

  15. Certified reference materials for organic contaminants for use in monitoring of the aquatic environment

    NARCIS (Netherlands)

    Boer, de J.; McGovern, E.

    2001-01-01

    Over the last three decades organic contaminants have been of increasing importance in environmental monitoring. Dioxins, furans, polychlorinated biphenyls and organochlorine pesticides have determined the environmental research agenda. This has led to an increasing demand for certified reference

  16. ENERGY STAR Certified Non-AHRI Central Air Conditioner Equipment and Air Source Heat Pump

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 5.0 ENERGY STAR Program Requirements for Air Source Heat Pump and Central Air Conditioner...

  17. 48 CFR 15.403 - Obtaining certified cost or pricing data.

    Science.gov (United States)

    2010-10-01

    ... or pricing data. 15.403 Section 15.403 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 15.403 Obtaining certified cost or pricing data....

  18. Classical probabilistic realization of “Random Numbers Certified by Bell's Theorem”

    Science.gov (United States)

    Khrennikov, Andrei

    2015-07-01

    We question the commonly accepted statement that random numbers certified by Bell's theorem carry some special sort of randomness, so to say, quantum randomness or intrinsic randomness. We show that such numbers can be easily generated by classical random generators.

  19. REUSABILITY OF BOND ELUT CERTIFY COLUMNS FOR THE EXTRACTION OF DRUGS FROM PLASMA

    NARCIS (Netherlands)

    CHEN, XH; FRANKE, JP; WIJSBEEK, J; DEZEEUW, RA

    1993-01-01

    The reusability of Bond Elut Certify columns for the extraction of toxicologically relevant drugs from plasma has been evaluated. Pentobarbital, hexobarbital, mepivacaine, trimipramine and clonazepam were selected as test drugs to represent various classes of drugs. The columns were regenerated

  20. Pediatric urinary tract infections: current controversies.

    Science.gov (United States)

    MacNeily, A E

    2001-06-01

    Few topics in pediatric urology engender such vigorous debate as the who, when, how, and why related to the investigation of pediatric urinary tract infections (UTIs). Further controversy stems from management of the underlying pathology. This article first discusses the patient characteristics that are important in the evaluation of pediatric patients with UTIs, and the indications for screening tests (such as voiding cystourethrograms, ultrasound, dimercaptosuccinic acid renal scintigraphy, and intravenous pyelography). Following this, the author reviews what is known about three controversial aspects about the management of these patients. First, although the role of the prepuce in pediatric UTI is well established, the role of routine circumcision is not. Second, the natural history and etiology of antenatally detected vesicoureteral reflux (VUR) has provoked us to view the concept of "primary reflux" in a new light. Third, although the way to diagnose vesicoureteral reflux is generally agreed upon, the utility of our surgical management in view of long-term follow-up is less clear.