WorldWideScience

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. Certified pediatric nurses' perceptions of job satisfaction.

    Science.gov (United States)

    Wyatt, Janet; Harrison, Margaret

    2010-01-01

    The Pediatric Nursing Certification Board surveyed a national sample of 1354 hospital-based certified pediatric nurses (CPNs) to determine their perceptions of certification on job satisfaction and other factors. There is a substantial body of literature that demonstrates job satisfaction among nurses positively increases retention and reduces absenteeism and burnout. CPNs seek certification for a personal sense of achievement, professional recognition, and validation of clinical competency. The certified nurse survey respondents had self-reported high levels of job satisfaction and indicated that relationships with colleagues and a supportive work environment were very important to their levels of job satisfaction. The results of this study highlight important factors for hospitals to consider as they plan strategies and cost-effective ways to positively affect patient care and retain qualified pediatric nurses at the bedside.

  3. 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...

  4. Residency program characteristics that are associated with pass rate of the American Board of Pediatrics certifying exam.

    Science.gov (United States)

    Atsawarungruangkit, Amporn

    2015-01-01

    The US is home to almost 200 pediatrics residency programs; despite this, there is little information about the relationship between program characteristics and performance in the American Board of Pediatrics (ABP) certifying exam. To evaluate the relationship between pass rate of the ABP certifying exam with the characteristics of categorical pediatrics residency programs. This retrospective, cross-sectional study used publicly available data from the ABP website and the Fellowship and Residency Electronic Interactive Database. All programs that reported pass rates were included. The analysis, comprising univariate and multivariate linear regression, involved determining how 69 factors (eg, general information, number of faculty and trainees, work schedule, educational environment) related to the pass rate. Of 199 programs, 194 reported pass rates. The univariate analysis revealed 20 program characteristics with P-values program characteristics: ratio of full-time equivalent paid faculty to positions, percentage of US medical graduates, and average hours per week of regularly scheduled lectures or conferences. Unlike in previous studies, location and program size were not significantly associated with the pass rate in this multivariate analysis. The finding regarding the ratio of full-time equivalent paid faculty to positions highlighted the benefits of a well-supervised training environment, while that regarding the percentage of US medical graduates indicated the necessity of high competition in residency programs. Finally, longer hours per week of regularly scheduled lectures or conferences were associated with better academic outcomes, both statistically and intuitively.

  5. The new era of postgraduate certified general practice training in Japan.

    Science.gov (United States)

    Takamura, Akiteru

    2016-09-01

    This paper describes the background to, and the recent evolution of general practice as a recognised medical specialism in Japan (2015), and the evolution of a system of training to support this development. We, the general practitioners (GPs) in Japan have not been recognised as one body of medical specialists and have been training in our own way. A new certified training system will commence in 2018, authorised by a new third organisation, the Japanese Medical Specialty Board. An effective educational system has been developed for medical graduates that have a career intention in general practice that is distinct from other basic medical fields, but collaborates with them. A challenge exists to provide clarity to the Japanese population about what the specialty of general practice is, and what professionals in general practice can do for them. Japan currently has approximately 500 certified GPs and it is unclear at present what numbers will eventually be required. This paper reviews some of the challenges facing the development of general practice from the perspective of the Japan Primary Care Association.

  6. Mentorship Programs for Faculty Development in Academic General Pediatric Divisions

    Directory of Open Access Journals (Sweden)

    Jennifer Takagishi

    2011-01-01

    Discussion. General pediatric division chiefs acknowledge the benefits of mentoring relationships, and some have programs in place. Many need tools to create them. Pediatric societies could facilitate this critical area of professional development.

  7. 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

    Purpose 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. Methods 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. Results 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 (P<.001); number of teeth treated (P<.001); and dentist operator type (P=.005). Conclusions Overall, 73% of dental procedures under GA finished early or on time. Significant variables included patient age, medical status, treatment type and extent, and dentist operator type. Assessing factors that impact the time needed in GA may enhance efficiency for pediatric dental procedures. PMID:23211897

  8. Postanesthetic Emergence Agitation in Pediatric Patients under General Anesthesia

    OpenAIRE

    Mohkamkar, Masoumeh; Farhoudi, Fatemeh; Alam-Sahebpour, Alireza; Mousavi, Seyed-Abdullah; Khani, Soghra; Shahmohammadi, Soheila

    2014-01-01

    Abstract Objective Postanesthetic emergence agitation is a common problem in pediatric postanesthetic care unit with an incidence ranging from 10 to 80%. This study was done to determine the prevalence of emergence agitation and associated risk factors in pediatric patients who underwent general anesthesia. Methods This cross-sectional descriptive and analytic study was performed on 747 pediatric patients aged 3- 7 years that underwent general anesthesia for various elective surgeries at Bou-...

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

    African Journals Online (AJOL)

    of mental health needs of America's youth, with 1 ... health services to children and adolescents in the primary ... Conclusion: The establishment of the Pediatric residency with a dedicated curriculum to address mental health ... However, there are few young patients being evaluated ... mental health care without stigma.

  10. The in-training examination: an analysis of its predictive value on performance on the general pediatrics certification examination.

    Science.gov (United States)

    Althouse, Linda A; McGuinness, Gail A

    2008-09-01

    This study investigates the predictive validity of the In-Training Examination (ITE). Although studies have confirmed the predictive validity of ITEs in other medical specialties, no study has been done for general pediatrics. Each year, residents in accredited pediatric training programs take the ITE as a self-assessment instrument. The ITE is similar to the American Board of Pediatrics General Pediatrics Certifying Examination. First-time takers of the certifying examination over a 5-year period who took at least 1 ITE examination were included in the sample. Regression models analyzed the predictive value of the ITE. The predictive power of the ITE in the first training year is minimal. However, the predictive power of the ITE increases each year, providing the greatest power in the third year of training. Even though ITE scores provide information regarding the likelihood of passing the certification examination, the data should be used with caution, particularly in the first training year. Other factors also must be considered when predicting performance on the certification examination. This study continues to support the ITE as an assessment tool for program directors, as well as a means of providing residents with feedback regarding their acquisition of pediatric knowledge.

  11. Estimating pediatric general anesthesia exposure: Quantifying duration and risk.

    Science.gov (United States)

    Bartels, Devan Darby; McCann, Mary Ellen; Davidson, Andrew J; Polaner, David M; Whitlock, Elizabeth L; Bateman, Brian T

    2018-05-02

    Understanding the duration of pediatric general anesthesia exposure in contemporary practice is important for identifying groups at risk for long general anesthesia exposures and designing trials examining associations between general anesthesia exposure and neurodevelopmental outcomes. We performed a retrospective cohort analysis to estimate pediatric general anesthesia exposure duration during 2010-2015 using the National Anesthesia Clinical Outcomes Registry. A total of 1 548 021 pediatric general anesthetics were included. Median general anesthesia duration was 57 minutes (IQR: 28-86) with 90th percentile 145 minutes. Children aged 3 hours. High ASA physical status and care at a university hospital were associated with longer exposure times. While the vast majority (94%) of children undergoing general anesthesia are exposed for risk for longer exposures. These findings may help guide the design of future trials aimed at understanding neurodevelopmental impact of prolonged exposure in these high-risk groups. © 2018 John Wiley & Sons Ltd.

  12. Appropriateness of pediatric hospitalization in a general hospital in Kuwait.

    Science.gov (United States)

    Shafik, Magdy H; Seoudi, Tarek M M; Raway, Tarek S; Al Harbash, Nowair Z; Ahmad, Meshal M A; Al Mutairi, Hanan F

    2012-01-01

    To determine the rate of inappropriate pediatric admissions using the Pediatric Appropriateness Evaluation Protocol (PAEP) and to examine variables associated with inappropriateness of admissions. A prospective study was conducted in the Department of Pediatrics, Farwania General Hospital, Kuwait, to examine successive admissions for appropriateness of admission as well as several sociodemographic characteristics over a 5-month period (August 2010 to December 2010). A total of 1,022 admissions were included. Of the 1,022 admissions, 416 (40.7%) were considered inappropriate. Factors associated with a higher rate of inappropriate admission included older age of patients and self-referral. The rate of inappropriate hospitalization of children was high in Farwania Hospital, Kuwait, probably due to the relatively free health care services, parental preference for hospital care, easy access to hospital services, and insufficient education about the child's condition. Copyright © 2012 S. Karger AG, Basel.

  13. Treatment of Generalized Convulsive Status Epilepticus in Pediatric Patients

    Science.gov (United States)

    Alford, Elizabeth L.; Wheless, James W.

    2015-01-01

    Generalized convulsive status epilepticus (GCSE) is one of the most common neurologic emergencies and can be associated with significant morbidity and mortality if not treated promptly and aggressively. Management of GCSE is staged and generally involves the use of life support measures, identification and management of underlying causes, and rapid initiation of anticonvulsants. The purpose of this article is to review and evaluate published reports regarding the treatment of impending, established, refractory, and super-refractory GCSE in pediatric patients. PMID:26380568

  14. 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.

  15. 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.

  16. Mentorship programs for faculty development in academic general pediatric divisions.

    Science.gov (United States)

    Takagishi, Jennifer; Dabrow, Sharon

    2011-01-01

    Introduction. Mentoring relationships have been shown to support academicians in areas of research, work/life balance, and promotion. Methods. General pediatric division chiefs accessed an electronic survey asking about mentorship relationships, their ability to create a mentorship program, and resources needed. Results. Dyadic mentorship programs were available at 53% of divisions. Peer mentorship programs were available at 27% of divisions. Overall, 84% of chiefs believed that dyadic mentorship would benefit their faculty. 91% of chiefs believed that peer mentorship would benefit their faculty. Chiefs were interested in starting peer (57%) or dyadic (55%) mentorship programs. Few divisions had a peer mentorship program available, whereas 24% already had a dyadic program. 43% of chiefs felt that they had the tools to start a program. Many tools are needed to create a program. Discussion. General pediatric division chiefs acknowledge the benefits of mentoring relationships, and some have programs in place. Many need tools to create them. Pediatric societies could facilitate this critical area of professional development.

  17. 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,...

  18. The importance of cultural competency in general pediatrics.

    Science.gov (United States)

    Brotanek, Jane M; Seeley, Christina E; Flores, Glenn

    2008-12-01

    There is a growing awareness of the importance of cultural competency in pediatrics. The authors review the most recent studies that examine the impact of cultural competency on general pediatric care, explore cultural beliefs and practices affecting clinical care, and describe culturally sensitive interventions designed to address racial/ethnic health disparities. The beneficial effects of cultural competency embrace health outcomes, quality of care, and patient satisfaction, while failure to consider language and culture can have serious adverse consequences for clinical care, including patient safety and healthcare access. A five-component model of cultural competency has been developed, and a growing literature details an array of normative cultural values, folk illnesses, parent beliefs/practices, and provider behaviors that can have a profound impact on pediatric care. Culturally sensitive interventions are being developed to lessen racial/ethnic health disparities. A goal for the pediatrician is to provide culturally competent healthcare by using trained medical interpreters with limited English-proficient families, being familiar with normative cultural values that affect the healthcare of commonly encountered racial/ethnic groups, and asking about folk illness beliefs and ethnomedical treatments.

  19. Failure Rate of Pediatric Dental Treatment under General Anesthesia

    Directory of Open Access Journals (Sweden)

    Effat Khodadadi

    2018-06-01

    Full Text Available Aim: To assess the failure rates of various pediatric dental treatments performed under general anesthesia (GA after six months to five years of follow-up. Design: This multicenter retrospective cohort study was performed on patients treated by five pedodontists in two private hospitals located in northern Iran during 2010–2013 and comprised 155 patients. The patients were recalled and clinically examined. During the clinical examination of the primary teeth, oral hygiene, dmft index, and failure of previous treatments was evaluated. The data were analyzed using the Chi square and regression analyses with a significance level of 0.05. Results: 114 patients (74 males and 40 females, mean age: 37.17 ± 10.75 months with 1155 primary teeth treated under GA participated in the follow-up. The overall failure rate was 6.59%. The failure rates of pulpectomy, pulopotomy, fissure sealant, stainless steel crown (SSC, amalgam, and composite fillings were 2.90%, 3.03%, 4.83%, 5.26%, 5.33%, and 9.63%, respectively. Among the confounding factors, only gender had a significant effect on the anterior composite failure rate (p = 0.029 and age had a significant effect on the failure rate of fissure sealant therapy (p = 0.015 and SSC (p = 0.018. Conclusion: The overall rate of treatment failure in pediatric patients, treated under GA, was 6.59%.

  20. Could Bad Certifiers Certify Best?

    DEFF Research Database (Denmark)

    Bizotto, Jacopo; Rudiger, Jesper; Vigier, Adrien

    2017-01-01

    We study product certification in settings where the certifier maximizes social welfare and bases his decisions on a mixture of information, some of which is voluntarily disclosed by the sellers, and some of which he acquires first hand by testing products. We show that unless the certifier is able...... to pre-commit to a testing strategy, then having better access to information may lead to worse certification quality, by crowding out information disclosed by the sellers. Policy implications are discussed....

  1. 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.

  2. Buccal Dosage Forms: General Considerations for Pediatric Patients.

    Science.gov (United States)

    Montero-Padilla, Soledad; Velaga, Sitaram; Morales, Javier O

    2017-02-01

    The development of an appropriate dosage form for pediatric patients needs to take into account several aspects, since adult drug biodistribution differs from that of pediatrics. In recent years, buccal administration has become an attractive route, having different dosage forms under development including tablets, lozenges, films, and solutions among others. Furthermore, the buccal epithelium can allow quick access to systemic circulation, which could be used for a rapid onset of action. For pediatric patients, dosage forms to be placed in the oral cavity have higher requirements for palatability to increase acceptance and therapy compliance. Therefore, an understanding of the excipients required and their functions and properties needs to be particularly addressed. This review is focused on the differences and requirements relevant to buccal administration for pediatric patients (compared to adults) and how novel dosage forms can be less invasive and more acceptable alternatives.

  3. Levels of evidence: a comparison between top medical journals and general pediatric journals.

    Science.gov (United States)

    Jacobson, Dustin A; Bhanot, Kunal; Yarascavitch, Blake; Chuback, Jennifer; Rosenbloom, Ehud; Bhandari, Mohit

    2015-02-12

    Given the large number of publications in all fields of practice, it is essential that clinicians focus on the resources that provide the highest level of evidence (LOE). We sought to determine the LOE that exists in the field of pediatrics, present in the general pediatric as well as high impact clinical literature. Clinical pediatric literature, published between April 2011 and March 2012 inclusive in high-impact clinical journals (HICJ) (New England Journal of Medicine, Journal of the American Medical Association, & The Lancet) and the highest-impact general pediatric journals (GPJ) (Pediatrics, Journal of Pediatrics, & Archives of Pediatrics & Adolescent Medicine), was assessed. In addition to the LOE, articles were evaluated on criteria including subspecialty within pediatrics, number of authors, number of centers, and other parameters. Eligible level I randomized control trials were appraised using the Consolidated Standards of Reporting Trials (CONSORT) guidelines. Of 6511 articles screened, 804 met inclusion criteria (68 in HICJ and 736 in GPJ). On average, LOE in pediatrics-focused articles within The Lancet were significantly higher than all GPJ (p journals and articles of greater clinical impact.

  4. 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.

  5. Pediatric dentists' perspective of general dentists' role in treating children aged 0-3 years.

    Science.gov (United States)

    Coe, Julie M; Razdan, Shinjni; Best, Al M; Brickhouse, Tegwyn H

    2017-01-01

    This study examined pediatric dentists' perspectives on the types of dental services general dentists provide to children who are 0-3 years old. A web-based survey was sent to 5185 pediatric dentists and 769 (14.8%) responded. Among the respondents, 58% agreed with general dentists' providing an age 1 dental visit. Only 24% agreed with general dentists' performing complex behavior management techniques, such as sedation, to patients aged 0-3 years. Those respondents who taught pediatric dentistry full time were more likely to agree with general dentists' providing an age 1 dental visit (P = 0.0088). Those who reported that their own dental school had adequately prepared them for this type of age 1 visit were also more in agreement (P pediatric dentists' perceptions of the level of collaboration between general dentists and pediatric dentists; the types of oral health services general dentists can provide for children aged 0-3 years; and the anticipated level of competency of entry-level general dentists.

  6. A national general pediatric clerkship curriculum: the process of development and implementation.

    Science.gov (United States)

    Olson, A L; Woodhead, J; Berkow, R; Kaufman, N M; Marshall, S G

    2000-07-01

    To describe a new national general pediatrics clerkship curriculum, the development process that built national support for its use, and current progress in implementing the curriculum in pediatric clerkships at US allopathic medical schools. CURRICULUM DEVELOPMENT: A curriculum project team of pediatric clerkship directors and an advisory committee representing professional organizations invested in pediatric student education developed the format and content in collaboration with pediatric educators from the Council on Medical Student Education in Pediatrics (COMSEP) and the Ambulatory Pediatric Association (APA). An iterative process or review by clerkship directors, pediatric departmental chairs, and students finalized the content and built support for the final product. The national dissemination process resulted in consensus among pediatric educators that this curriculum should be used as the national curricular guideline for clerkships. MONITORING IMPLEMENTATION: Surveys were mailed to all pediatric clerkship directors before dissemination (November 1994), and in the first and third academic years after national dissemination (March 1996 and September 1997). The 3 surveys assessed schools' implementation of specific components of the curriculum. The final survey also assessed ways the curriculum was used and barriers to implementation. The final curriculum provided objectives and competencies for attitudes, skills, and 18 knowledge areas of general pediatrics. A total of 216 short clinical cases were also provided as an alternative learning method. An accompanying resource manual provided suggested strategies for implementation, teaching, and evaluation. A total of 103 schools responded to survey 1; 84 schools to survey 2; and 85 schools responded to survey 3 from the 125 medical schools surveyed. Before dissemination, 16% of schools were already using the clinical cases. In the 1995-1996 academic year, 70% of schools were using some or all of the curricular

  7. 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.; 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 1...

  8. 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.

  9. Prevalence and characteristics of general and football-specific emergency medical service activations by high school and collegiate certified athletic trainers: a national study.

    Science.gov (United States)

    Decoster, Laura C; Swartz, Erik E; Cappaert, Thomas A; Hootman, Jennifer M

    2010-11-01

    To describe frequency and characteristics of emergency medical services (EMS) activations by certified athletic trainers (ATs) and effects of pre-season planning meetings on interactions between ATs and EMS both generally and specifically during football head/neck emergencies. Retrospective cross-sectional survey. 2009 Web-based survey. Athletic trainers (n = 1884; participation rate, 28%) in high school and collegiate settings. Athletic trainer work setting, AT demographics, history of pre-season planning meetings. Proportions and 95% confidence intervals (CIs) estimated the prevalence of EMS activation, planning meetings, and characteristics of AT-EMS interactions (eg, episodes of AT-perceived inappropriate care and on-field disagreements). Chi square tests tested differences (P football injury, 59.9% vs 27.5%; P football season, high school ATs perceived more episodes of inappropriate care (10.4% vs 3.9%; P emergency care providers.

  10. Work-related gender differences in physician-certified sick leave: a prospective study of the general working population in Norway.

    Science.gov (United States)

    Sterud, Tom

    2014-07-01

    This study aimed to examine gender differences in physician-certified sick leave and the extent to which these differences can be explained by work-related psychosocial and mechanical risk factors. Randomly drawn from the general population in Norway, the cohort comprised working men and women aged 18-69 years (N=12 255, response rate at baseline = 60.9%). Eligible respondents were interviewed in 2009 and registered with an active employee relationship of ≥ 100 actual working days in 2009 and 2010 (N=3688 men and 3070 women). The study measured 11 work-related psychosocial factors and 11 mechanical exposures, and outcomes of interest were physician-certified general sick leave (GSL) >0 days and long-term sick leave (LTSL) ≥ 40 working days during 2010. Women reported a significantly higher level of exposure to 9 of the 11 psychosocial factors evaluated. For mechanical factors, the reporting was mixed. After controlling for age, educational level, sick leave during 2009, housework, working hours and family status, a 1.7-fold risk for GSL and LTSL were found among women. In comparison with the initial model, adjusting for psychosocial factors reduced the excess risk by 21% and 27% for GSL and LTSL, respectively. The total effect of mechanical factors was negligible. Differences between occupations held by women and men explained an additional one-tenth of the excess risk for LTSL among women. Work-related psychosocial factors contributed significantly to a higher level of GSL and LTSL among women. The most important factors were demands for hiding emotions, emotional demands, and effort-payment imbalance.

  11. 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.

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

    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. PMID:27493983

  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. Pediatrics

    NARCIS (Netherlands)

    Rasheed, Shabana; Teo, Harvey James Eu Leong; Littooij, Annemieke Simone

    2015-01-01

    Imaging of pediatric patients involves many diverse modalities, including radiography, ultrasound imaging, computed tomography, magnetic resonance imaging, and scintigraphic and angiographic studies. It is therefore important to be aware of potential pitfalls that may be related to these modalities

  15. Prospective review of a single center's general pediatric neurosurgical intraoperative and postoperative complication rates

    NARCIS (Netherlands)

    Lindert, E.J. van; Delye, H.H.; Leonardo, J.

    2014-01-01

    OBJECT: The authors conducted a study to compare the complication rate (CR) of pediatric neurosurgical procedures in a general neurosurgery department to the CRs that are reported in the literature and to establish a baseline of CR for further targeted improvement of quality neurosurgical care.

  16. 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. PMID:22428968

  17. 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.

  18. DGNB certified Healthcare Centres

    DEFF Research Database (Denmark)

    Brunsgaard, Camilla; Larsen, Tine Steen

    2015-01-01

    for sustainability and wants a certification. This research investigates the decision‐making and design process (DMaDP) behind four DGNB certified Healthcare Centres (HCC) in Northern Jutland in Denmark. In general, knowledge about the DMaDP is important. However it is important to know what part DGNB plays...... a dialog about DGNB and energy concept is important even before anyone start sketching. Experiences with the different approaches will be further outlined in the paper.Future research has the intention to collect further knowledge about DGNB and DMaDP in practise. This project was limited to Healthcare...

  19. Synthesizing Certified Code

    Science.gov (United States)

    Whalen, Michael; Schumann, Johann; Fischer, Bernd

    2002-01-01

    Code certification is a lightweight approach to demonstrate software quality on a formal level. Its basic idea is to require producers to provide formal proofs that their code satisfies certain quality properties. These proofs serve as certificates which can be checked independently. Since code certification uses the same underlying technology as program verification, it also requires many detailed annotations (e.g., loop invariants) to make the proofs possible. However, manually adding theses annotations to the code is time-consuming and error-prone. We address this problem by combining code certification with automatic program synthesis. We propose an approach to generate simultaneously, from a high-level specification, code and all annotations required to certify generated code. Here, we describe a certification extension of AUTOBAYES, a synthesis tool which automatically generates complex data analysis programs from compact specifications. AUTOBAYES contains sufficient high-level domain knowledge to generate detailed annotations. This allows us to use a general-purpose verification condition generator to produce a set of proof obligations in first-order logic. The obligations are then discharged using the automated theorem E-SETHEO. We demonstrate our approach by certifying operator safety for a generated iterative data classification program without manual annotation of the code.

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

    OpenAIRE

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

    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 necessary. ...

  1. Incidence and risk factors of emergence agitation in pediatric patients after general anesthesia.

    Science.gov (United States)

    Saringcarinkul, Ananchanok; Manchupong, Sithapan; Punjasawadwong, Yodying

    2008-08-01

    To study the incidence and evaluate factors associated with emergence agitation (EA) in pediatrics after general anesthesia. A prospective observational study was conducted in 250 pediatric patients aged 2-9 years, who received general anesthesia for various operative procedures in Maharaj Nakorn Chiang Mai Hospital between October 2006 and September 2007. The incidence of EA was assessed Difficult parental-separation behavior, pharmacologic and non-pharmacologic interventions, and adverse events were also recorded Univariate and multivariate analysis were used to determine the factors associated with EA. A p-value of less than 0.05 was considered significant. One hundred and eight children (43.2%) had EA, with an average duration of 9.6 +/- 6.8 minutes. EA associated with adverse events occurred in 32 agitated children (29.6%). From univariate analysis, factors associated with EA were difficult parental-separation behavior, preschool age (2-5 years), and general anesthesia with sevoflurane. However; difficult parental-separation behavior; and preschool age were the only factors significantly associated with EA in the multiple logistic regression analysis with OR = 3.021 (95% CI = 1.680, 5.431, p anesthesia personnel responsible for pediatric anesthesia should have essential skills and knowledge to effectively care for children before, during, and after an operation, including implementing the methods that minimize incidence of EA.

  2. Alternatives to Sedation and General Anesthesia in Pediatric Magnetic Resonance Imaging: A Literature Review.

    Science.gov (United States)

    McGuirt, Delaney

    2016-09-01

    To assess alternatives to sedation and general anesthesia to prepare children for magnetic resonance (MR) imaging examinations. Online databases were searched for articles discussing methods of preparing children for MR imaging procedures. Because of the large number of articles returned, criteria were limited to only studies that prepared patients without the use of sedation or general anesthesia. Twenty-four studies were deemed appropriate for inclusion in the review. The following methods emerged as alternatives to pediatric sedation: mock scanners, MR-compatible audiovisual systems, feed-sleep manipulation, play therapy, infant incubators/immobilizers, photo diaries, sucrose solutions, and guided imagery. The approaches with the most extensive research were mock MR scanners and feed-sleep manipulation. Evidence supports the use of these alternative techniques as valid substitutes for pediatric sedation and general anesthesia. To reduce the risks associated with sedation of pediatric patients, institutions could implement the alternatives discussed in this review. Cost analyses should be conducted first because some methods are more expensive than others. Finally, further research is needed to better assess the effectiveness of lesser-practiced methods, including photo diaries, sucrose solutions, and guided imagery. ©2016 American Society of Radiologic Technologists.

  3. Virtual Pediatric Hospital

    Science.gov (United States)

    ... Thoracopaedia - An Imaging Encyclopedia of Pediatric Thoracic Disease Virtual Pediatric Hospital is the Apprentice's Assistant™ Last revised ... pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com Virtual Pediatric Hospital is curated by Donna M. D' ...

  4. [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.

  5. Pediatric reference intervals for general clinical chemistry components - merging of studies from Denmark and Sweden.

    Science.gov (United States)

    Ridefelt, Peter; Hilsted, Linda; Juul, Anders; Hellberg, Dan; Rustad, Pål

    2018-05-28

    Reference intervals are crucial tools aiding clinicians when making medical decisions. However, for children such values often are lacking or incomplete. The present study combines data from separate pediatric reference interval studies of Denmark and Sweden in order to increase sample size and to include also pre-school children who were lacking in the Danish study. Results from two separate studies including 1988 healthy children and adolescents aged 6 months to 18 years of age were merged and recalculated. Eighteen general clinical chemistry components were measured on Abbott and Roche platforms. To facilitate commutability, the NFKK Reference Serum X was used. Age- and gender-specific pediatric reference intervals were defined by calculating 2.5 and 97.5 percentiles. The data generated are primarily applicable to a Nordic population, but could be used by any laboratory if validated for the local patient population.

  6. Trends in death associated with pediatric dental sedation and general anesthesia.

    Science.gov (United States)

    Lee, Helen H; Milgrom, Peter; Starks, Helene; Burke, Wylie

    2013-08-01

    Inadequate access to oral health care places children at risk of caries. Disease severity and inability to cooperate often result in treatment with general anesthesia (GA). Sedation is increasingly popular and viewed as lower risk than GA in community settings. Currently, few data are available to quantify pediatric morbidity and mortality related to dental anesthesia. Summarize dental anesthesia-related pediatric deaths described in media reports. Review of media reports in the Lexis-Nexis Academic database and a private foundation website. Dental offices, ambulatory surgery centers, and hospitals. Patients :US-based children (≤21 years old) who died subsequently receiving anesthesia for a dental procedure between 1980-2011. Most deaths occurred among 2-5 year-olds (n = 21/44), in an office setting (n = 21/44), and with a general/pediatric dentist (n = 25/44) as the anesthesia provider. In this latter group, 17 of 25 deaths were linked with a sedation anesthetic. This series of media reports likely represent only a fraction of the overall morbidity and mortality related to dental anesthesia. These data may indicate an association between mortality and pediatric dental procedures under sedation, particularly in office settings. However, these relationships are difficult to test in the absence of a database that could provide an estimate of incidence and prevalence of morbidity and mortality. With growing numbers of children receiving anesthesia for dental procedures from providers with variable training, it is imperative to be able to track anesthesia-related adverse outcomes. Creating a national database of adverse outcomes will enable future research to advance patient safety and quality. © 2013 John Wiley & Sons Ltd.

  7. 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.

  8. 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 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.

  9. A Very General Overview of the Development Pediatric Emergency Medicine as a Specialty in the United States and Advocacy for Pediatric Healthcare; the Charge to Other Countries

    Directory of Open Access Journals (Sweden)

    Ron D. Waldrop

    2017-12-01

    and publications. In addition, as trauma specialties and general emergency medicine grew under the auspices of the American College of Emergency Physicians (ACEP and the American Heart Association (AHA so did the need for sub-specialization for pediatric emergency medicine (PEM. In the early 1980s as an outgrowth of the ACEP and AAP, plans to cooperate and create the subspecialty of PEM began. The goal of the specialty was to train specialists, procure resources funding for research, and standardize training.  The first subspecialty board for PEM was administered in 1992 and has continues to this date. Another outgrowth was federally funded agency called Emergency Medicine Services for Children (EMSC whose goal was to find and fund resources, research, and training for PEM specialists, particularly prehospital providers. As late as 2001 the Institute of Medicine in their periodic report regarding United States healthcare noted that most emergency departments were still largely deficient regarding preparedness for pediatric emergencies. Since that time there has been intense emphasis on preparedness for pediatric emergencies and now the United States has innumerable academic and community hospitals with full pediatric preparedness. Similarly, with the modern explosion of medical information it is now virtually impossible for any physician to know all of one field.  Most certainly no general emergency physician can possibly know everything regarding PEM thus obviating the need for PEM specialists to provide optimum care beyond the basics.  Numerous studies in the United States have also demonstrated seriously ill or injured children care receive superior care with better outcomes when cared for in pediatric specific facilities.  This does not imply that general emergency medicine and pediatric emergency medicine cannot co-exist and have economy of resources.  It simply seems to be true that the best possible pediatric care is delivered by pediatric subspecialists

  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.

    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

  11. 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.

  12. [A prospective cohort study of the risk factors of emergence agitation in pediatric after general anesthesia].

    Science.gov (United States)

    Fan, Hao; Tao, Fan; Wan, Hai-fang; Luo, Hong

    2012-05-08

    To evaluate risk factors associated with emergence agitation (EA) in pediatrics after general anesthesia. A prospective cohort study was conducted in 268 pediatric patients aged 2-9 years, who received general anesthesia for various operative procedures in our hospital between January 2008 and October 2011. The incidence of EA was assessed. Difficult parental-separation behavior, pharmacologic and non-pharmacologic interventions, and adverse events were also recorded. Univariate and multivariate analysis were used to determine the factors associated with EA. A p-value of less than 0.05 was considered significant. One hundred and sixteen children (43.3%) had EA, with an average duration of 9.1 ± 6.6 minutes. EA associated with adverse events occurred in 35 agitated children (30.2%). From univariate analysis, factors associated with EA were difficult parental-separation behavior, preschool age (2 - 5 years), and general anesthesia with sevoflurane. However, difficult parental-separation behavior, and preschool age were the only factors significantly associated with EA in the multiple Logistic regression analysis with OR = 3.091 (95%CI: 1.688, 5.465, P < 0.01) and OR = 1.965 (95%CI: 1.112, 3.318, P = 0.024), respectively. The present study indicated that the incidence of EA was high in PACU. Preschool children and difficult parental-separation behavior were the predictive factors of emergence agitation.

  13. Epidemiology Characteristics of Constipation for General Population, Pediatric Population, and Elderly Population in China

    Directory of Open Access Journals (Sweden)

    Huikuan Chu

    2014-01-01

    Full Text Available Objective. To acquire more data about the epidemiologic characteristics of constipation in different kinds of populations in China. Methods. Using “constipation” and “China” as search terms; relevant papers were searched from January 1995 to April 2014. Data on prevalence, gender, diagnostic criteria, geographical area, educational class, age, race, and physician visit results were extracted and analyzed. Results. 36 trials were included. Prevalence rates of constipation in elderly population (18.1% and pediatric population (18.8% were significantly higher than that in general population (8.2%. Prevalence of constipation defined by non-Rome criteria was higher than that by Rome criteria in general population. Prevalence rates of constipation were different for different geographical area. People with less education were predisposed to constipation. In pediatric population, prevalence of constipation was the lowest in children aged 2–6 years. Prevalence of constipation in ethnic minorities was higher than that in Han people. People with constipation were predisposed to FD, haemorrhoid, and GERD. Only 22.2% patients seek medical advice in general population. Conclusions. In China, prevalence of constipation was lower compared with most of other countries. The factors including female gender, diagnostic criteria, geographical area, age, educational class, and race seemed to have major effects on prevalence of constipation.

  14. ENERGY STAR Certified Displays

    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 Displays that are effective as of July 1, 2016....

  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 Televisions

    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 Televisions that are effective as of October 30,...

  17. ENERGY STAR Certified Dehumidifiers

    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 Dehumidifiers that are effective as of October...

  18. ENERGY STAR Certified Telephones

    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 Telephony (cordless telephones and VoIP...

  19. 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.

  20. Interfacility Transfers to General Pediatric Floors: A Qualitative Study Exploring the Role of Communication.

    Science.gov (United States)

    Rosenthal, Jennifer L; Okumura, Megumi J; Hernandez, Lenore; Li, Su-Ting T; Rehm, Roberta S

    2016-01-01

    Children with special health care needs often require health services that are only provided at subspecialty centers. Such children who present to nonspecialty hospitals might require a hospital-to-hospital transfer. When transitioning between medical settings, communication is an integral aspect that can affect the quality of patient care. The objectives of the study were to identify barriers and facilitators to effective interfacility pediatric transfer communication to general pediatric floors from the perspectives of referring and accepting physicians, and then develop a conceptual model for effective interfacility transfer communication. This was a single-center qualitative study using grounded theory methodology. Referring and accepting physicians of children with special health care needs were interviewed. Four researchers coded the data using ATLAS.ti (version 7, Scientific Software Development GMBH, Berlin, Germany), using a 2-step process of open coding, followed by focused coding until no new codes emerged. The research team reached consensus on the final major categories and subsequently developed a conceptual model. Eight referring and 9 accepting physicians were interviewed. Theoretical coding resulted in 3 major categories: streamlined transfer process, quality handoff and 2-way communication, and positive relationships between physicians across facilities. The conceptual model unites these categories and shows how these categories contribute to effective interfacility transfer communication. Proposed interventions involved standardizing the communication process and incorporating technology such as telemedicine during transfers. Communication is perceived to be an integral component of interfacility transfers. We recommend that transfer systems be re-engineered to make the process more streamlined, to improve the quality of the handoff and 2-way communication, and to facilitate positive relationships between physicians across facilities. Copyright

  1. Outcomes following implementation of a pediatric procedural sedation guide for referral to general anesthesia for magnetic resonance imaging studies.

    Science.gov (United States)

    Grunwell, Jocelyn R; Marupudi, Neelima K; Gupta, Rohan V; Travers, Curtis D; McCracken, Courtney E; Williamson, Julie L; Stockwell, Jana A; Fortenberry, James D; Couloures, Kevin; Cravero, Joseph; Kamat, Pradip P

    2016-06-01

    Guidelines for referral of children to general anesthesia (GA) to complete MRI studies are lacking. We devised a pediatric procedural sedation guide to determine whether a pediatric procedural sedation guide would decrease serious adverse events and decrease failed sedations requiring rescheduling with GA. We constructed a consensus-based sedation guide by combining a retrospective review of reasons for referral of children to GA (n = 221) with published risk factors associated with the inability to complete the MRI study with sedation. An interrupted time series analysis of 11 530 local sedation records from the Pediatric Sedation Research Consortium between July 2008 and March 2013, adjusted for case-mix differences in the pre- and postsedation guide cohorts, evaluated whether a sedation guide resulted in decreased severe adverse events (SAE) and failed sedation rates. A significant increase in referrals to GA following implementation of a sedation guide occurred (P pediatric procedural sedation services. © 2016 John Wiley & Sons Ltd.

  2. The Evaluation of a Noninvasive Respiratory Volume Monitor in Pediatric Patients Undergoing General Anesthesia.

    Science.gov (United States)

    Gomez-Morad, Andrea D; Cravero, Joseph P; Harvey, Brian C; Bernier, Rachel; Halpin, Erin; Walsh, Brian; Nasr, Viviane G

    2017-12-01

    Pediatric patients following surgery are at risk for respiratory compromise such as hypoventilation and hypoxemia depending on their age, comorbidities, and type of surgery. Quantitative measurement of ventilation in nonintubated infants/children is a difficult and inexact undertaking. Current respiratory assessment in nonintubated patients relies on oximetry data, respiratory rate (RR) monitors, and subjective clinical assessment, but there is no objective measure of respiratory parameters that could be utilized to predict early respiratory compromise. New advances in technology and digital signal processing have led to the development of an impedance-based respiratory volume monitor (RVM, ExSpiron, Respiratory Motion, Inc, Waltham, MA). The RVM has been shown to provide accurate real-time, continuous, noninvasive measurements of tidal volume (TV), minute ventilation (MV), and RR in adult patients.In this prospective observational study, our primary aim was to determine whether the RVM accurately measures TV, RR, and MV in pediatric patients. A total of 72 pediatric patients (27 females, 45 males), ASA I to III, undergoing general anesthesia with endotracheal intubation were enrolled. After endotracheal intubation, continuous data of MV, TV, and RR were recorded from the RVM and an in-line monitoring spirometer (NM3 monitor, Phillips Healthcare). RVM and NM3 measurements of MV, TV, and RR were compared during a 10-minute period prior to the incision ("Presurgery") and a 10-minute period after the end of surgery ("Postsurgery"). Relative errors were calculated over 1-minute segment within each 10-minute period. Bias, precision, and accuracy were calculated using Bland-Altman analyses and paired-difference equivalence tests were performed. Combined across the Presurgery and Postsurgery periods, the RVM's mean measurement bias (RVM - NM3 measurement) for MV was -3.8% (95% limits of agreement) (±1.96 SD): (-19.9% to 12.2%), for TV it was -4.9 (-21.0% to 11.3%), and

  3. 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.

  4. 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

    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) (p<.001). Common medical comorbidities appear evenly distributed: autism (12%), cardiac anomalies (14%), developmental delay (14%), genetic syndromes/chromosomal disorders (13%), and neurological disorders (12%). Younger age groups (1 to 2 years and 3 to 5 years) had a high percentage of hospitalizations due to the extent and severity of the dental disease (83%) and behavior (77%) (p<0.001). No single comorbidity was seen more often than others in this patient population. The range of medical conditions in this population may be a reflection of the range of pediatric specialty services at Children's Hospital of NewYork-Presbyterian.

  5. Management of mediastinal syndromes in pediatrics: a new challenge of ultrasound guidance to avoid high-risk general anesthesia.

    Science.gov (United States)

    Sola, Chrystelle; Choquet, Olivier; Prodhomme, Olivier; Capdevila, Xavier; Dadure, Christophe

    2014-05-01

    Adverse events associated with anesthetic management of anterior mediastinal masses in pediatrics are common. To avoid an extremely hazardous general anesthesia, the use of real-time ultrasonography offers an effective alternative in high-risk cases. We report the anesthetic management including a light sedation and ultrasound guidance for regional anesthesia, surgical node biopsy, and placement of a central venous line in two children with an anterior symptomatic mediastinal mass. For pediatric patients with clinical and/or radiologic signs of airway compression, ultrasound guidance provides safety technical assistance to avoid general anesthesia and should be performed for the initial diagnostic and therapeutic procedures. © 2013 John Wiley & Sons Ltd.

  6. [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

  7. [Rapid malnutrition in patient with anorexia nervosa: experience of a general pediatric department].

    Science.gov (United States)

    Cros, G; Sznajder, M; Meuric, S; Mignot, C; Chevallier, B; Stheneur, C

    2010-02-01

    Rapid undernutrition in patients with anorexia nervosa can compromise vital functions, notably due to cardiac complications. The aim of this study was to analyze the clinical parameters of anorexic patients, hospitalized for substantial weight loss, in a general pediatric inpatient unit, in order to determine which parameters should be tested by the medical doctor. We performed a retrospective study on 20 consecutive patients (18 girls), median age of 13.75 (+/-2.3) years, admitted for the first time in our pediatric inpatient unit for anorexia nervosa. Symptoms evolved for a median duration of 11.5 (+/-10.2) months before admittance and was shorter for the youngest patients (r = 0.42, p = 0.067). The mean BMI was 13.3 (+/-0.6) kg/m(2) (-3.0+/-1.2 Z-score) and was inversely correlated with serum creatinine levels (74+/-15 micromol/l) (r = 0.44, p case. Mean serum glucose was 3.5+/-1.2 mmol/l. At admittance, an electrocardiogram, performed for 16 patients, showed sinusal bradycardia without conduction impairment. Enteral nutrition was necessary for 14 patients (70%) for a mean duration of 18.1 days (range, 6-56 days). The mean weight gain was 3.1+/-2 kg and was inversely correlated to the BMI at admittance (r = 0.49, p anorexia nervosa is above all clinical, as hematological and biological parameters remain normal for a long time. The cardiac complications found in our study appeared to be more related to the rapid rate of weight loss than to the amount of weight loss itself. Copyright 2009 Elsevier Masson SAS. All rights reserved.

  8. 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.

  9. 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.

  10. Radioactive certified reference materials

    International Nuclear Information System (INIS)

    Watanabe, Kazuo

    2010-01-01

    Outline of radioactive certified reference materials (CRM) for the analysis of nuclear materials and radioactive nuclides were described. The nuclear fuel CRMs are supplied by the three institutes: NBL in the US, CETAMA in France and IRMM in Belgium. For the RI CRMs, the Japan Radioisotope Association is engaged in activities concerning supply. The natural-matrix CRMs for the analysis of trace levels of radio-nuclides are prepared and supplied by NIST in the US and the IAEA. (author)

  11. Trends and Characteristics of Pediatric Dentistry Patients Treated under General Anesthesia.

    Science.gov (United States)

    Rudie, Maxwell N; Milano, Michael M; Roberts, Michael W; Divaris, Kimon

    2018-05-11

    The aims of this study were to describe the demographic characteristics of pediatric dentistry patients undergoing dental rehabilitation under general anesthesia (DRGA) at UNC-Chapel Hill during the last 13 years and identify factors associated with multiple (1 versus 2 or more) DRGA visits during that timeframe. Administrative claims data were used to identify children and adolescents (age <18 years) who underwent DRGA between 1/1/2002 and 12/31/2014 at the UNC Hospitals system. Information on children's age, sex and all treatment-associated CDT codes were collected. Descriptive statistics and bivariate tests of association were used for data analyses. There were 4,413 DRGAs among 3,973 children (median age=4 years 8 months, males=55%) during the study period. The annual rate of DRGAs increased over time, peaking (n=447) in 2013. Overall, 9% of children had ≥2 visits with repeat rates up to 18%. There was no association between children's sex and receipt of one versus multiple DRGAs; however, craniofacial cases were more likely (p<0.0005) to have multiple DRGAs compared to non-craniofacial ones. DRGAs are on the increase-with the exception of craniofacial and special health care needs patients, multiple DRGAs may be reflective of sub-optimal adherence to preventive and continuing care recommendations.

  12. Pediatrics chest x-ray examination in general hospitals in Khartoum State

    International Nuclear Information System (INIS)

    Elawad, S. O. A.

    2011-01-01

    Study was performed to evaluate radiation dose for pediatric patients undergoing chest x-ray examination in selected general radiography hospitals in Khartoum State in seven x-ray machines. x-ray tube output measurements were made in the range of typical exposure parameters using calibrated dose rate meter. To estimate entrance surface air kerma (ESA K), the radiographer in charge of the facility was asked to provide typical exposure parameters (kV, m As and FSD) for each age category (newborn (1-30 days), 1,5.10 and years). ESA K was estimated using the x-ray tube output measurements and the recorded exposure parameters. The obtained mean ESA K range from /27/ to 57/ μGy, /25 -103/ μGy, /45-128/ μGy, /47-139/ μGy and from /68-299/ μGy for newborn, 1,5,10, and 15 years patients, respectively. The estimated ESA K were within the established international reference dose values and also the values obtained in previous studies. However, variations were observed in ESA K values among hospitals under study which could be due to the differences in exposure parameters used. Also tube output has some difference on the obtained ESA K. (Author)

  13. 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…

  14. Do work-related factors contribute to differences in doctor-certified sick leave? A prospective study comparing women in health and social occupations with women in the general working population.

    Science.gov (United States)

    Aagestad, Cecilie; Tyssen, Reidar; Sterud, Tom

    2016-03-08

    Doctor -certified sick leave is prevalent in the health and social sector. We examined whether the higher risk of doctor-certified sick leave in women in health and social occupations compared to women in other occupations was explained by particular work-related psychosocial and mechanical risk factors. A randomly drawn cohort aged 18-69 years from the general population in Norway was surveyed in 2009 (n = 12,255, response at baseline = 60.9 %), and was followed up in the national registry of social transfer payments in 2010. Eligible respondents were women registered with an active employee relationship for ≥100 actual working days in 2009 and 2010 (n = 3032). Using this sample, we compared health and social workers (n = 661) with the general working population (n = 2371). The outcome of interest was long-term sick leave (LTSL) ≥21 working days during 2010. Eight psychosocial and eight mechanical factors were evaluated. After adjusting for age, previous LTSL, education and working hours/week, women in health and social occupations had a higher risk for LTSL compared with women in the general working population (OR = 1.42, 95 % CI = 1.13-1.79; p = 0.003). After adjusting for psychosocial and mechanical factors, 70 % of the excess risk for LTSL was explained compared with the initial model. The main contributory factors to the increased risk were threats of violence and violence, emotional demands and awkward lifting. Psychosocial and mechanical factors explained much of the excess risk for LTSL in women in health and social occupations compared with working women in general. Psychosocial risk factors were the most important contributors.

  15. Do work-related factors contribute to differences in doctor-certified sick leave? A prospective study comparing women in health and social occupations with women in the general working population

    Directory of Open Access Journals (Sweden)

    Cecilie Aagestad

    2016-03-01

    Full Text Available Abstract Background Doctor –certified sick leave is prevalent in the health and social sector. We examined whether the higher risk of doctor-certified sick leave in women in health and social occupations compared to women in other occupations was explained by particular work-related psychosocial and mechanical risk factors. Methods A randomly drawn cohort aged 18–69 years from the general population in Norway was surveyed in 2009 (n = 12,255, response at baseline = 60.9 %, and was followed up in the national registry of social transfer payments in 2010. Eligible respondents were women registered with an active employee relationship for ≥100 actual working days in 2009 and 2010 (n = 3032. Using this sample, we compared health and social workers (n = 661 with the general working population (n = 2371. The outcome of interest was long-term sick leave (LTSL ≥21 working days during 2010. Eight psychosocial and eight mechanical factors were evaluated. Results After adjusting for age, previous LTSL, education and working hours/week, women in health and social occupations had a higher risk for LTSL compared with women in the general working population (OR = 1.42, 95 % CI = 1.13–1.79; p = 0.003. After adjusting for psychosocial and mechanical factors, 70 % of the excess risk for LTSL was explained compared with the initial model. The main contributory factors to the increased risk were threats of violence and violence, emotional demands and awkward lifting. Conclusions Psychosocial and mechanical factors explained much of the excess risk for LTSL in women in health and social occupations compared with working women in general. Psychosocial risk factors were the most important contributors.

  16. 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

    2017-11-01

    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.

  17. 19 CFR 115.9 - Certifying Authorities responsibilities-containers.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Certifying Authorities responsibilities-containers...; DEPARTMENT OF THE TREASURY CARGO CONTAINER AND ROAD VEHICLE CERTIFICATION PURSUANT TO INTERNATIONAL CUSTOMS CONVENTIONS Administration § 115.9 Certifying Authorities responsibilities—containers. (a) General. Containers...

  18. 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.

  19. Incidence of trampoline related pediatric fractures in a large district general hospital in the United Kingdom: lessons to be learnt.

    Science.gov (United States)

    Bhangal, K K; Neen, D; Dodds, R

    2006-04-01

    To test the observation that the incidence of trampoline related pediatric fractures is increasing-both nationally and in a large district general hospital. A retrospective analysis was undertaken of patient records establishing mechanism of injury of pediatric fractures over three consecutive summers from 2000-03. Theatre records of fractures treated operatively were used as the initial data source. A statistically significant increase in trampoline related injuries was discovered. This reflects the rising incidence of injuries from national data and furthermore corresponds to the growing popularity of domestic use trampolines in the UK. The incidence of injuries is increasing. There are lessons to be learnt from existing work from countries where trampoline prevalence has been greater for longer. The authors recommend various safety measures that may reduce children's injuries.

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

    NARCIS (Netherlands)

    Bruijn, M.

    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)

  1. Monitoreo neurointensivo en pediatría (III: Tratamiento. Medidas generales

    Directory of Open Access Journals (Sweden)

    Eduardo M. Pleguezuelo Rodríguez

    2001-06-01

    ón cardiorrespiratoria, y medidas generales encaminadas a evitar la progresión o aparición de lesiones cerebrales secundarias.Summary It is reported that with neuromonitoring and the intensive management of severe cranioencephalic trauma, a group of different physiopathological phenomena has been identified that requires diverse and specific measures for each patient, making their treatment more rational. This has also led to a radical change of conceptions about old therapeutic patterns established for many years. An example of this change is their hydric replacement. They were before on a dry flowing and today it is preconized the strict euvolemia, the substitution of routine hyperventilation by optimized ventilation, changes in the policy of use of osmotic agents, the barbiturate therapy and the decompressive craniotomy in cases of intracranial hypertension refractory to the conventional therapeutic measures. In this paper, an updated review of the main therapeutic measures used in these patients is made according to the guidelines for the treatment of severe cranial trauma of the American Association of Neurological Surgeons and of the European Consortium for Brain Injury. The therapeutic measures used in these patients are divided into 2 stages. In this third updating paper, the management of the first stage that corresponds to the urgent initial stabilization before determining the measurement of the intracranial pressure (ICP, as well as the general measures of the second phase, once the monitoring of the ICP has started, are approached. The therapeutic principles that have been used for many years at the Provincial General Hospital and at the Provincial Pediatric Teaching Hospital of Camagüey to manage severe cranial trauma and which are based on the initial measures taken on admission, according to the principles of advanced vital support in trauma for the cardiopulmonary resuscitation, and some general measures directed to avoid the progression or appearance of secondary

  2. Comparative Evaluation of Pediatric Patients with Mental Retardation undergoing Dental Treatment under General Anesthesia: A Retrospective Analysis.

    Science.gov (United States)

    Ahuja, Ravish; Jyoti, Bhuvan; Shewale, Vinod; Shetty, Shridhar; Subudhi, Santosh Kumar; Kaur, Manpreet

    2016-08-01

    Behavioral management of patients forms one of the foremost components of pediatric dental treatment. Some children readily cooperate with dental treatment, while others require general anesthesia as a part of treatment protocol for carrying out various dental procedures. Hence, we evaluated the pediatric patients with and without mental retardation, who underwent dental treatment under general anesthesia. The present study analyzed the record of 480 pediatric patients reporting in the department of pedodontics from 2008 to 2014. Analysis of the records of the patients who underwent dental treatment under general anesthesia was done and all the patients were divided into two study groups depending upon their mental level. For the purpose of evaluation, the patients were also grouped according to their age; 4 to 7 years, 8 to 12 years, and 13 to 18 years. Measurement of decayed, missing, and filled teeth and scores for both deciduous and permanent dentition was done before and after the commencement of the dental treatment. Chi-square test and independent t-test were used for evaluating the level of significance. While comparing the patients in the two groups, maximum number of patients is present in the age group of 13 to 18 years. While comparing the indices' score between the two study groups in various age intervals, no statistically significant results were obtained. Restorative treatment and dental extractions were the most common dental treatments that were seen at a higher frequency in the intellectual disability study group. In patients with mental retardation, a higher frequency of restorative treatment and extractions occurs as compared to healthy subjects of similar age group. Therefore, they require special attention regarding maintenance of their oral health. Special attention should be given for maintaining the oral health of patients with special health care needs as compared to their physically and mentally normal counterparts.

  3. 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.

  4. Pediatric MS

    Science.gov (United States)

    ... Pediatric MS Share this page Facebook Twitter Email Pediatric MS Pediatric MS Pediatric MS Support Pediatric Providers ... system through the Pediatric MS Support Group . Treating pediatric MS In 2018 the U.S. Food and Drug ...

  5. Certifying the absence of quantum nonlocality

    OpenAIRE

    Miller, Carl A.; Shi, Yaoyun

    2016-01-01

    Quantum nonlocality is an inherently non-classical feature of quantum mechanics and manifests itself through violation of Bell inequalities for nonlocal games. We show that in a fairly general setting, a simple extension of a nonlocal game can certify instead the absence of quantum nonlocality. Through contraposition, our result implies that a super-classical performance for such a game ensures that a player's output is unpredictable to the other player. Previously such output unpredictabilit...

  6. Appropriateness of hospitalization for CAP-affected pediatric patients: report from a Southern Italy General Hospital

    Directory of Open Access Journals (Sweden)

    Antonelli Fabio

    2009-09-01

    Full Text Available Abstract Background Community-acquired pneumonia (CAP is a common disease, responsible for significant healthcare expenditures, mostly because of hospitalization. Many practice guidelines on CAP have been developed, including admission criteria, but a few on appropriate hospitalization in children. The aim of this study was to evaluate appropriate hospital admission for CAP in a pediatric population. Methods We evaluated appropriate admission to a Pediatric Unit performing a retrospective analysis on CAP admitted pediatric patients from a Southern Italy area. Diagnosis was made based on clinical and radiological signs. Appropriate hospital admission was evaluated following clinical and non-clinical international criteria. Family ability to care children was assessed by evaluating social deprivation status. Results In 2 winter seasons 120 pediatric patients aged 1-129 months were admitted because of CAP. Median age was 28.7 months. Raised body temperature was scored in 68.3% of patients, cough was present in 100% of cases, and abdominal pain was rarely evidenced. Inflammatory indices (ESR and CRP were found elevated in 33.3% of cases. Anti-Mycoplasma pneumoniae antibodies were found positive in 20.4%. Trans-cutaneous (TC SaO2 was found lower than 92% in 14.6%. Dyspnoea was present in 43.3%. Dehydration requiring i.v. fluid supplementation was scored in 13.3%. Evaluation of familial ability to care their children revealed that 76% of families (derived from socially depressed areas were "at social risk", thus not able to appropriately care their children. Furthermore, analysis of CAP patients revealed that "at social risk" people accessed E.D. and were hospitalized more frequently than "not at risk" patients (odds ratio = 3.59, 95% CI: 1,15 to 11,12; p = 0.01, and that admitted "at social risk" people presented without clinical signs of severity (namely dyspnoea, and/or SaO2 ≤ 92%, and/or dehydration more frequently than "not at risk" population

  7. Causes of fatal accidents for instrument-certified and non-certified private pilots.

    Science.gov (United States)

    Shao, Bob Siyuan; Guindani, Michele; Boyd, Douglas D

    2014-11-01

    Instrument certification (IFR) enhances a pilot's skills in precisely controlling the aircraft and requires a higher level of standards in maintaining heading and altitude compared with the less stringent private pilot certificate. However, there have been no prior studies to compare fatal accident causes for airmen with, and without, this rating, The NTSB accident database was queried for general aviation fatal accidents for private pilots with, and without IFR certification. Exact Poisson tests were used to calculate whether two rate parameters were equal (ratio of 1), normalized to the number of IFR-rated pilots and flight hours in the given time period. Proportion tests were used to determine whether there were significant differences in fatal accident causes between IFR-certified and non-certified pilots. A logistic regression for log-odds success was used in determining the trend and effect of age on fatal accident rates. IFR certification was associated with a reduced risk of accidents due to failure to maintain obstacle/terrain clearance and spatial disorientation for day and night operations respectively. In contrast, the likelihood of fatal accident due to equipment malfunction during day operations was higher for IFR-certified pilots. The fatal accident rate decreased over the last decade for IFR-certified but not for non-IFR-certified private pilots. However, the overall accident rate for IFR-certified private pilots was more than double that of the cohort lacking this certification. Finally, we found a trend for an increased fatality rate with advancing age for both group of pilots. Our findings informs on where training and/or technology should be focused. Both training for aerodynamic stalls, which causes over a quarter of all fatal accidents, should be intensified for both IFR-certified and non-certified private pilots. Similarly, adherence to minimum safe altitudes for both groups of pilots should be encouraged toward reducing the fatal accidents

  8. 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 average total time (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.

  9. 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...

  10. ENERGY STAR Certified Commercial Ovens

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 2.2 ENERGY STAR Program Requirements for Commercial Ovens that are effective as of...

  11. ENERGY STAR Certified Commercial Boilers

    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 Commercial Boilers that are effective as of...

  12. ENERGY STAR Certified Commercial Griddles

    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 Commercial Griddles that are effective as of May...

  13. ENERGY STAR Certified Smart Thermostats

    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 Connected Thermostats that are effective as of...

  14. 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...

  15. ENERGY STAR Certified Roof Products

    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 Roof Products that are effective as of July 1,...

  16. ENERGY STAR Certified Pool Pumps

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 1.1 ENERGY STAR Program Requirements for Pool Pumps that are effective as of February 15,...

  17. 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...

  18. 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 3.1 ENERGY STAR Program Requirements for Refrigerated Beverage Vending Machines that are...

  19. Find a NCCAOM Certified Practitioner

    Science.gov (United States)

    ... in finding a NCCAOM Certified Diplomate. The NCCAOM Find a Practitioner Directory is a voluntary directory designed ... by the NCCAOM. If you are unable to find an individual in our registry and would like ...

  20. 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...

  1. 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...

  2. ENERGY STAR Certified Ceiling Fans

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 3.1 ENERGY STAR Program Requirements for Ceiling Fans that are effective as of April 1,...

  3. ENERGY STAR Certified Ventilating Fans

    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 Ventilating Fans that are effective as of...

  4. 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...

  5. ENERGY STAR Certified Products - Lighting

    Data.gov (United States)

    U.S. Environmental Protection Agency — This data set contains a simplified list of all currently certified ENERGY STAR Lighting models with basic model information collected across all product categories...

  6. ENERGY STAR Certified Residential Freezers

    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 Residential Refrigerators and Freezers that are...

  7. ENERGY STAR Certified Residential Refrigerators

    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 Residential Refrigerators and Freezers that are...

  8. DENTAL CONSIDERATIONS FOR LEUKEMIC PEDIATRIC PATIENTS: AN UPDATED REVIEW FOR GENERAL DENTAL PRACTITIONER.

    Science.gov (United States)

    Lowal, Kholoud A; Alaizari, Nader Ahmed; Tarakji, Bassel; Petro, Waleed; Hussain, Khaja Amjad; Altamimi, Mohamed Abdullah Alsakran

    2015-10-01

    The early signs of leukemia can usually manifest in the oral cavity due to infiltration of leukemic cells or due to associated decline in normal marrow elements, especially in the acute phase of leukemia, as common lesions at this stage of the disease can be screened and diagnosed by the dentist. Therefore, the dental community should be aware of the oral manifestations of leukemia and oral complications of anticancer treatment. This can eliminate the oral symptoms of the disease and to improve quality of life for these patients. An extensive search in PubMed line using a combination of terms like "leukemia, children, dental, Acute lymphoblastic leukemia, pediatric" for last ten years was made. Reviews and case reports concerned about acute lymphoblastic leukemia in children were all collected and analyzed and data were extracted. Accordingly, the aim of this review is to highlight on the oral presentations of leukemia in children attending dental clinics and the management of its undesirable side effects.

  9. Characterizing the adequacy, effectiveness, and barriers related to research mentorship among junior pediatric hospitalists and general pediatricians at a large academic institution.

    Science.gov (United States)

    Ragsdale, Judith R; Vaughn, Lisa M; Klein, Melissa

    2014-03-01

    The purpose of this qualitative study was to characterize the adequacy, effectiveness, and barriers related to research mentorship among junior pediatric hospitalists and general pediatricians at a large academic institution. Junior faculty and staff physicians in hospital medicine and general pediatrics at a large academic institution were invited to participate in this qualitative study. In-depth interviews were conducted. Experienced mentors were invited to be interviewed for theoretical sampling. Interviews were conducted and analyzed by using grounded theory methodology. Twenty-six (75%) of the eligible physicians, pediatric hospitalists representing 65% of this sample, agreed to be interviewed about their mentoring experiences. Satisfied and dissatisfied participants expressed similar mentoring themes: acquisition of research skills, academic productivity, and career development. Four experienced mentors were interviewed and provided rationale for mentoring clinicians in research. Both groups of participants agreed that institutional support is vital for promoting mentorship. Junior pediatric hospitalists and general pediatricians indicated considerable interest in being mentored to learn to do clinical research. Developing faculty and staff physicians to their utmost potential is critical for advancement in academic medicine. Mentoring clinical physicians seeking to add research skills and academic productivity to their practice merits study as an innovative path to develop clinical investigators. Hospital medicine, as a rapidly developing pediatric specialty, is well-positioned to implement the necessary infrastructure to mentor junior faculty in their academic pursuits, thereby optimizing the potential impact for individuals, families, learners, and institutions.

  10. 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

    2015-09-01

    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.

  11. Barriers to Medical Compassion as a Function of Experience and Specialization: Psychiatry, Pediatrics, Internal Medicine, Surgery, and General Practice.

    Science.gov (United States)

    Fernando, Antonio T; Consedine, Nathan S

    2017-06-01

    Compassion is an expectation of patients, regulatory bodies, and physicians themselves. Most research has, however, studied compassion fatigue rather than compassion itself and has concentrated on the role of the physician. The Transactional Model of Physician Compassion suggests that physician, patient, external environment, and clinical factors are all relevant. Because these factors vary both across different specialities and among physicians with differing degrees of experience, barriers to compassion are also likely to vary. We describe barriers to physician compassion as a function of specialization (psychiatry, general practice, surgery, internal medicine, and pediatrics) and physician experience. We used a cross-sectional study using demographic data, specialization, practice parameters, and the Barriers to Physician Compassion Questionnaire. Nonrandom convenience sampling was used to recruit 580 doctors, of whom 444 belonged to the targeted speciality groups. The sample was characterized before conducting a factorial Multivariate Analysis of Covariance and further post hoc analyses. A 5 (speciality grouping) × 2 (more vs. less physician experience) Multivariate Analysis of Covariance showed that the barriers varied as a function of both speciality and experience. In general, psychiatrists reported lower barriers, whereas general practitioners and internal medicine specialists generally reported greater barriers. Barriers were generally greater among less experienced doctors. Documenting and investigating barriers to compassion in different speciality groups have the potential to broaden current foci beyond the physician and inform interventions aimed at enhancing medical compassion. In addition, certain aspects of the training or practice of psychiatry that enhance compassion may mitigate barriers to compassion in other specialities. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  12. Pediatric nurse practitioners: influences on career choice.

    Science.gov (United States)

    Freed, Gary L; Dunham, Kelly M; Martyn, Kristy; Martin, Jean; Moran, Lauren M; Spera, Laura

    2014-01-01

    The demand for hiring pediatric nurse practitioners (PNPs) is strong. However, the number of newly educated PNPs has remained relatively flat during the past several years. Understanding the rationale and timing for the decision to pursue this profession is essential to having a positive impact on increasing the future workforce. A mail survey of all new PNPs certified between January 2009 and July 2011 (N = 1040) was conducted. The response rate was 79.9%. Nearly half of all respondents (45%, N = 314) reported that they work in outpatient general pediatrics, 26% (N = 184) in outpatient subspecialty pediatrics, and 22% (N = 152) in inpatient settings. More than one third (36%, N = 253) spend most of their time in a private practice. Forty percent (N = 307) reported that they decided to pursue education as an advanced practice nurse while in practice as a registered nurse (RN), and 38% (N = 289) made the decision before pursuing RN education. Efforts to increase the PNP pipeline will need to be directed both to students during their RN education and to creating opportunities for current RNs to pursue advanced practice nurse education that is focused on children. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

  13. 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

    2018-01-01

    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. To determine national pediatric information needs, seeking behaviours, and preferences of health care professionals working in general EDs. An electronic cross-sectional survey was conducted with health care professionals in 32 Canadian general EDs. Data were collected in the EDs using the iPad and in-person data collectors. Total of 1,471 surveys were completed (57.1% response rate). Health care professionals sought information on children's health care by talking to colleagues (n=1,208, 82.1%), visiting specific medical/health websites (n=994, 67.7%), and professional development opportunities (n=941, 64.4%). Preferred child health resources included protocols and accepted treatments for common conditions (n=969, 68%), clinical pathways and practice guidelines (n=951, 66%), and evidence-based information on new diagnoses and treatments (n=866, 61%). Additional pediatric clinical information is needed about multisystem trauma (n=693, 49%), severe head injury (n=615, 43%), and meningitis (n=559, 39%). Health care professionals preferred to receive child health information through professional development opportunities (n=1,131, 80%) and printed summaries (n=885, 63%). By understanding health care professionals' information seeking behaviour, information needs, and information preferences, knowledge synthesis and knowledge translation initiatives can be targeted to improve pediatric emergency care. The findings from this study will inform the following two phases of the TREKK initiative to bridge the research-practice gap in Canadian general EDs.

  14. ENERGY STAR Certified Vending Machines

    Science.gov (United States)

    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 effective as of March 1, 2013. A detailed listing of key efficiency criteria are available at

  15. ENERGY STAR Certified Ceiling Fans

    Science.gov (United States)

    Certified models meet all ENERGY STAR requirements as listed in the Version 3.0 ENERGY STAR Program Requirements for Ceiling Fans that are effective as of April 1, 2012. A detailed listing of key efficiency criteria are available at http://www.energystar.gov/index.cfm?c=ceiling_fans.pr_crit_ceiling_fans

  16. ENERGY STAR Certified Ventilating Fans

    Science.gov (United States)

    Certified models meet all ENERGY STAR requirements as listed in the Version 4.0 ENERGY STAR Program Requirements for Ventilating Fans that are effective as of October 1, 2015. A detailed listing of key efficiency criteria are available at http://www.energystar.gov/index.cfm?c=vent_fans.pr_crit_vent_fans

  17. 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.

  18. Pediatric Oncology Palliative Care: Experiences of General Practitioners and Bereaved Parents.

    OpenAIRE

    Neilson, SJ; Gibson, F; Greenfield, SM

    2015-01-01

    Objective: This qualitative study set in the West Midlands region of the United Kingdom, aimed to examine the\\ud role of the general practitioner (GP) in children's oncology palliative care from the perspective of GPs who had cared for a child with cancer receiving palliative care at home and bereaved parents.\\ud Methods: One-to-one semi-structured interviews were undertaken with 18 GPs and 11 bereaved parents\\ud following the death. A grounded theory data analysis was undertaken; identifying...

  19. 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.

  20. 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 meet...

  1. 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 pursuant...

  2. 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 pursuant...

  3. Pediatric Oncology Palliative Care: Experiences of General Practitioners and Bereaved Parents.

    Science.gov (United States)

    Neilson, Sue J; Gibson, Faith; Greenfield, Sheila M

    2015-03-01

    This qualitative study set in the West Midlands region of the United Kingdom, aimed to examine the role of the general practitioner (GP) in children's oncology palliative care from the perspective of GPs who had cared for a child with cancer receiving palliative care at home and bereaved parents. One-to-one semi-structured interviews were undertaken with 18 GPs and 11 bereaved parents following the death. A grounded theory data analysis was undertaken; identifying generated themes through chronological comparative data analysis. Similarity in GP and parent viewpoints was found, the GPs role seen as one of providing medication and support. Time pressures GPs faced influenced their level of engagement with the family during palliative and bereavement care and their ability to address their identified learning deficits. Lack of familiarity with the family, coupled with an acknowledgment that it was a rare and could be a frightening experience, also influenced their level of interaction. There was no consistency in GP practice nor evidence of practice being guided by local or national policies. Parents lack of clarity of their GPs role resulted in missed opportunities for support. Time pressures influence GP working practices. Enhanced communication and collaboration between the GP and regional childhood cancer centre may help address identified GP challenges, such as learning deficits, and promote more time-efficient working practices through role clarity. Parents need greater awareness of their GP's wide-ranging role; one that transcends palliative care incorporating bereavement support and on-going medical care for family members.

  4. 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

  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. A Grounded Theory Qualitative Analysis of Interprofessional Providers' Perceptions on Caring for Critically Ill Infants and Children in Pediatric and General Emergency Departments.

    Science.gov (United States)

    Gangadharan, Sandeep; Tiyyagura, Gunjan; Gawel, Marcie; Walsh, Barbara M; Brown, Linda L; Lavoie, Megan; Tay, Khoon-Yen; Auerbach, Marc A

    2016-10-04

    The objective of this study was to explore pediatric emergency department (PED) and general emergency department (GED) providers' perceptions on caring for critically ill infants and children. This study utilized qualitative methods to examine the perceptions of emergency department providers caring for critically ill infants and children. Teams of providers participated in 4 in situ simulation cases followed by facilitated debriefings. Debriefings were recorded and professionally transcribed. The transcripts were reviewed independently and followed by group coding discussions to identify emerging themes. Consistent with grounded theory, the team iteratively revised the debriefing script as new understanding was gained. A total of 188 simulation debriefings were recorded in 24 departments, with 15 teams participating from 8 PEDs and 32 teams from 16 GEDs. Twenty-four debriefings were audiotaped and professionally transcribed verbatim. Thematic saturation was achieved after 20 transcripts. In our iterative qualitative analysis of these transcripts, we observed 4 themes: (1) GED provider comfort with algorithm-based pediatric care and overall comfort with pediatric care in PED, (2) GED provider reliance on cognitive aids versus experience-based recall by PED providers, (3) GED provider discomfort with locating and determining size or dose of pediatric-specific equipment and medications, and (4) PED provider reliance on larger team size and challenges with multitasking during resuscitation. Our qualitative analysis produced several themes that help us to understand providers' perceptions in caring for critically ill children in GEDs and PEDs. These data could guide the development of targeted educational and improvement interventions.

  7. 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 ...

  8. Skill qualifications in pediatric minimally invasive surgery.

    Science.gov (United States)

    Iwanaka, Tadashi; Morikawa, Yasuhide; Yamataka, Atsuyuki; Nio, Masaki; Segawa, Osamu; Kawashima, Hiroshi; Sato, Masahito; Terakura, Hirotsugu; Take, Hiroshi; Hirose, Ryuichiro; Yagi, Makoto

    2011-07-01

    In 2006, The Japanese Society of Pediatric Endoscopic Surgeons devised a plan to develop a pediatric endoscopic surgical skill qualification (ESSQ) system. This system is controlled by The Japan Society for Endoscopic Surgery. The standard requirement for skills qualification is the ability of each applicant to complete common types of laparoscopic surgery. The main goal of the system is to decrease complications of laparoscopic surgery by evaluating the surgical skills of each applicant and subsequently certify surgeons with adequate skills to perform laparoscopic operations safely. A committee of pediatric ESSQ created a checklist to assess the applicant's laparoscopic surgical skills. Skills are assessed in a double-blinded fashion by evaluating an unedited video recording of a fundoplication for pediatric gastroesophageal reflux disease. The initial pediatric ESSQ system was started in 2008. In 2008 and 2009, respectively, 9 out of 17 (53%) and 6 out of 12 (50%) applicants were certified as expert pediatric laparoscopic surgeons. Our ultimate goal is to provide safe and appropriate pediatric minimally invasive procedures and to avoid severe complications. To prove the predictive validity of this system, a survey of the outcomes of operations performed by certified pediatric surgeons is required.

  9. 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...

  10. 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.

  11. Residency factors that influence pediatric in-training examination score improvement.

    Science.gov (United States)

    Chase, Lindsay H; Highbaugh-Battle, Angela P; Buchter, Susie

    2012-10-01

    The goal of this study was to determine which measurable factors of resident training experience contribute to improvement of in-training examination (ITE) and certifying examination (CE) scores. This is a descriptive retrospective study analyzing data from July 2003 through June 2006 at a large academic pediatric training program. Pediatric categorical residents beginning residency in July 2003 were included. Regression analyses were used to determine if the number of admissions performed, core lectures attended, acute care topics heard, grand rounds attended, continuity clinic patients encountered, or procedures performed correlated with improvement of ITE scores. These factors were then analyzed in relation to CE scores. Seventeen residents were included in this study. The number of general pediatric admissions was the only factor found to correlate with an increase in ITE score (P = .04). Scores for the ITE at pediatric levels 1 and 3 were predictive of CE scores. No other factors measured were found to influence CE scores. Although all experiences of pediatric residents likely contribute to professional competence, some experiences may have more effect on ITE and CE scores. In this study, only general pediatric admissions correlated significantly with an improvement in ITE scores from year 1 to year 3. Further study is needed to identify which elements of the residency experience contribute most to CE success. This would be helpful in optimizing residency program structure and curriculum within the limitations of duty hour regulations.

  12. Financing of certified centers: a willingness-to-pay analysis.

    Science.gov (United States)

    Thiel, Falk C; Scharl, Anton; Hildebrandt, Thomas; Kotziabassis, Efstratios; Schrauder, Michael G; Bani, Mayada R; Müller, Andreas; Hauzenberger, Tanja; Loehberg, Christian R; Jud, Sebastian M; Fasching, Peter A; Hartmann, Arndt; Schulz-Wendtland, Rüdiger; Strnad, Vratislav; Beckmann, Matthias W; Lux, Michael Patrick

    2013-03-01

    .67, gynecological oncology €532.47). In all, 33.9 % would accept an increase in health-insurance fees (averaging 0.3865 %), and 28.3 % were in favor of reduced remuneration for non-certified centers. The existence of certified centers is being increasingly recognized by patients. Additional charges for certified centers are generally supported. There is therefore a clear demand for them-from patients as well. This may be useful when negotiations are being conducted.

  13. Survey of the professors of child neurology: neurology versus pediatrics home for child neurology.

    Science.gov (United States)

    Pearl, Phillip L; McConnell, Emily R; Fernandez, Rosamary; Brooks-Kayal, Amy

    2014-09-01

    The optimal academic home for child neurology programs between adult neurology versus pediatric departments remains an open question. The Professors of Child Neurology, the national organization of child neurology department chairs, division chiefs, and training program directors, was surveyed to evaluate the placement of child neurology programs. Professors of Child Neurology members were surveyed regarding the placement of child neurology programs within adult neurology versus pediatric departments. Questions explored academic versus clinical lines of reporting and factors that may be advantages and disadvantages of these affiliations. Issues also addressed were the current status of board certification and number of clinics expected in academic child neurology departments. Of 120 surveys sent, 95 responses were received (79% response rate). The primary academic affiliation is in neurology in 54% of programs versus 46% in pediatrics, and the primary clinical affiliation is 45% neurology and 55% pediatrics. Advantages versus disadvantages of one's primary affiliation were similar whether the primary affiliation was in neurology or pediatrics. While 61% of respondents are presently board certified in pediatrics, only 2% of those with time-limited certification in general pediatrics plan to be recertified going forward. Typically six to eight half-day clinics per week are anticipated for child neurologists in academic departments without additional funding sources. Overall, leaders of child neurology departments and training programs would not change their affiliation if given the opportunity. Advantages and disadvantages associated with current affiliations did not change whether child neurology was located in neurology or pediatrics. Board certification by the American Board of Psychiatry and Neurology in child neurology is virtually universal, whereas pediatric board certification by the American Board of Pediatrics is being maintained by very few. Most academic

  14. Utility of the General Ability Index (GAI) and Cognitive Proficiency Index (CPI) with Survivors of Pediatric Brain Tumors: Comparison to Full Scale IQ and Premorbid IQ Estimates

    Science.gov (United States)

    Kahalley, Lisa S.; Winter-Greenberg, Amanda; Stancel, Heather; Ris, M. Douglas; Gragert, Marsha

    2016-01-01

    Introduction Pediatric brain tumor survivors are at risk for working memory and processing speed impairment. The General Ability Index (GAI) provides an estimate of intellectual functioning that is less influenced by working memory and processing speed than a Full Scale IQ (FSIQ). The Cognitive Proficiency Index (CPI) provides a measure of efficient information processing derived from working memory and processing speed tasks. We examined the utility of the GAI and CPI to quantify neurocognitive outcomes in a sample of pediatric brain tumor survivors. Methods GAI, CPI, and FSIQ scores from the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) were examined for 57 pediatric brain tumor survivors (ages 6–16) treated with cranial radiation therapy (RT). Results GAI scores were higher than FSIQ and CPI scores, both p < .001. Lower CPI scores were associated with history of craniospinal irradiation and time since RT. Lower FSIQ and GAI scores were associated with higher RT dose and time since RT. The rate of clinically significant GAI-FSIQ discrepancies in our sample was greater than observed in the WISC-IV standardization sample, p < .001. Estimated premorbid IQ scores were higher than GAI, p < .01, and FSIQ scores, p < .001. Conclusions Pediatric brain tumor survivors exhibit weaker cognitive proficiency than expected for age, while general reasoning ability remains relatively spared. The GAI may be useful to quantify the intellectual potential of a survivor when appropriate accommodations are in place for relative cognitive proficiency weaknesses. The CPI may be a particularly sensitive outcome measure of treatment-related cognitive change in this population. PMID:27295192

  15. 78 FR 48438 - Pediatric Ethics Subcommittee of the Pediatric Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2013-08-08

    ...] Pediatric Ethics Subcommittee of the Pediatric Advisory Committee; Notice of Meeting AGENCY: Food and Drug... of Subcommittee: Pediatric Ethics Subcommittee of the Pediatric Advisory Committee. General Function... pediatric ethical issues. Date and Time: The meeting will be held on September 9, 2013, from 8 a.m. to 5:30...

  16. ENERGY STAR Certified Data Center Storage

    Science.gov (United States)

    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 December 2, 2013. A detailed listing of key efficiency criteria are available at http://www.energystar.gov/certified-products/detail/data_center_storage

  17. 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.

  18. 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.

  19. 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.

  20. Pediatric Sinusitis

    Science.gov (United States)

    ... ENTCareers Marketplace Find an ENT Doctor Near You Pediatric Sinusitis Pediatric Sinusitis Patient Health Information News media interested in ... sinuses are present at birth. Unlike in adults, pediatric sinusitis is difficult to diagnose because symptoms of ...

  1. 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 ...

  2. A comparison of certified and noncertified pet foods.

    Science.gov (United States)

    Brown, R G

    1997-11-01

    The market presents the buyer with a wide array of pet food choices. Marketing pet foods has changed in the last decade and today foods may be bought at a variety of outlets. The present study compares nutrient composition, digestibility, and effect on urine pH (cat foods only) of selected certified and noncertified pet foods from different outlets. The selected foods were considered analogous in terms of declared ingredients and macronutrient profiles. The analytical methods used were those of the Association of Official Analytical Chemists as described in the Pet Food Certification Protocol of the Canadian Veterinary Medical Association. The test foods were sampled 4 times from August 1994 to July 1995. Both certified and noncertified products met the nutritional requirements on a consistent basis, although 1 of the noncertified dog foods consistently failed to meet the zinc requirements. This same product also failed to meet the Canadian Veterinary Medical Association's standards for concentrations of protein, calcium, and phosphorus. One of the noncertified cat foods failed to meet the recommended calcium level. With the exception of fat digestion in 1 noncertified food, there were no statistically significant differences in major nutrient digestibility between certified and noncertified pet foods. There were some statistically significant differences in digestibility within both the certified and noncertified groups of foods. The practical significance of any of the statistical differences in digestibility is uncertain. Urine pH observed in cats fed noncertified test diets was variable, with some values greater than 7.0 as a maximum or 6.5 as an average. The general conclusion of this study was that the commonly available certified products were the nutritional equal of those foods that position themselves as "premium."

  3. Effectiveness of preoperative intranasal dexmedetomidine, compared with oral midazolam, for the prevention of emergence delirium in the pediatric patient undergoing general anesthesia: a systematic review.

    Science.gov (United States)

    FitzSimons, James; Bonanno, Laura S; Pierce, Stephanie; Badeaux, Jennifer

    2017-07-01

    Emergence delirium is defined as a cognitive disturbance during emergence from general anesthesia resulting in hallucinations, delusions and confusion manifested by agitation, restlessness, involuntary physical movement and extreme flailing in bed. Postoperative emergence delirium develops in 12% to 18% of all children undergoing general anesthesia for surgery. This post-anesthetic phenomenon changes cognitive and psychomotor behavior, and puts pediatric patients and health care personnel at risk of injury. A newer drug, dexmedetomidine, is a selective alpha-2 agonist, which works in the brain and spinal cord that has sedative, analgesic and anxiolytic properties. Dexmedetomidine also has the ability to lower the overall anesthetic requirements by reducing sympathetic outflow in response to painful surgical stimulation. In current literature, there is not a systematic review that compares the effectiveness of preoperative intranasal dexmedetomidine administration against oral midazolam for the prevention of emergence delirium. The objective of this review was to identify the effectiveness of preoperative intranasal dexmedetomidine compared to oral midazolam for the prevention of emergence delirium in the pediatric patient undergoing general anesthesia. This review considered studies that included pediatric patients aged three to seven years, with an American Society of Anesthesiologists (ASA) classification of I or II, and undergoing general anesthesia for elective/ambulatory surgery. This review excluded studies that included patients who had special needs including: developmental delay, chronic pain issues, and/or any preexisting mental or physical health disorders which categorized them above an ASA II. This review considered studies that compared preoperative intranasal administration of dexmedetomidine with preoperative oral administration of midazolam for the prevention of emergence delirium. This review considered both experimental and non-experimental study

  4. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... The teddy bear denotes child-specific content. Related Articles and Media General Nuclear Medicine Children's (Pediatric) CT ( ... About Us | Contact Us | FAQ | Privacy | Terms of Use | Links | Site Map Copyright © 2018 Radiological Society of ...

  5. ENERGY STAR Certified Commercial Ice Machines

    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 Automatic Commercial Ice Makers that are...

  6. 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 4.0 ENERGY STAR Program Requirements for Commercial Refrigerators and Freezers that are...

  7. 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 3.1 ENERGY STAR Program Requirements for Geothermal Heat Pumps that are effective as of...

  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...

  9. ENERGY STAR Certified Residential Clothes Washers

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 8.0 ENERGY STAR Program Requirements for Clothes Washers that are effective as of...

  10. 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 1.1 ENERGY STAR Program Requirements for Clothes Dryers that are effective as of January...

  11. 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 8.0 ENERGY STAR Program Requirements for Clothes Washers that are effective as of...

  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 Light Commercial HVAC

    Data.gov (United States)

    U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 3.1 ENERGY STAR Program Requirements for Light Commercial HVAC that are effective as of...

  14. ENERGY STAR Certified Room Air Conditioners

    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 Room Air Conditioners that are effective as of...

  15. ENERGY STAR Certified Commercial Steam Cookers

    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 Commercial Steam Cookers that are effective as...

  16. ENERGY STAR Certified Small Network 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 Small Networking Equipment that are effective as...

  17. 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...

  18. Get Your Automotive Program Nationally Certified!

    Science.gov (United States)

    Lundquist, Patricia A.

    2000-01-01

    Automotive programs that nationally certified enhance student recruitment and give students better employment opportunities. Technicians who earn the Automotive Service Excellence credential have joined the ranks of professionals in the automotive service industry. (Author/JOW)

  19. 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...

  20. 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.

  1. Pediatric fibromyalgia.

    Science.gov (United States)

    Buskila, Dan

    2009-05-01

    Fibromyalgia is an idiopathic chronic pain syndrome defined by widespread nonarticular musculoskeletal pain and generalized tender points. The syndrome is associated with a constellation of symptoms, including fatigue, nonrefreshing sleep, irritable bowel, and more. Central nervous system sensitization is a major pathophysiologic aspect of fibromyalgia; in addition, various external stimuli such as trauma and stress may contribute to development of the syndrome. Fibromyalgia is most common in midlife, but may be seen at any age. This article reviews the epidemiology, clinical characteristics, etiology, management, and outcome of pediatric fibromyalgia.

  2. The importance of using certified seed

    OpenAIRE

    Bogdanović Sandra; Mladenov Velimir; Balešević-Tubić Svetlana

    2015-01-01

    Certified seed is produced from the seed of known genetic origin and genetic purity with controlled and tested production, processed and declared in accordance with the Law on Seeds. Production of certified seed is carried out under the supervision of the Ministry of Agriculture and Environmental Protection, by seed producers formally listed in the Seed Register. Seed is processed in registered seed processing centres and quality is tested in laboratories accredited for seed testing. The orga...

  3. Geographic proximity to specialized pediatric neurosurgical care in the contiguous United States.

    Science.gov (United States)

    Ahmed, Abdul-Kareem; Duhaime, Ann-Christine; Smith, Timothy R

    2018-04-01

    OBJECTIVE Absent from an analysis of supply is consideration of the geographic distribution of pediatric neurosurgeons. Several patient socioeconomic metrics are known to be associated with outcome in pediatric neurosurgical diseases, such as hydrocephalus. The purpose of this study was to determine current geographic proximity to pediatric neurosurgical care using professional society databases. This study also sought to establish how socioeconomic factors are related to distance to care, using federal government-collected data. METHODS A list of currently practicing American Board of Pediatric Neurological Surgery (ABPNS)-certified neurosurgeons was compiled (ABPNS group). A separate list of practicing members of the Joint Pediatric Section (JPS) of the American Association of Neurological Surgeons/Congress of Neurological Surgeons was prepared (JPS group). Current primary practice locations were collected from each professional society database for each ABPNS or JPS neurosurgeon and were charted using ArcGIS mapping software (ESRI, version 10.3) on a United States Census Bureau map. The straight distance from the centroid of each zip code tabulation area (ZCTA) to the nearest neurosurgeon was determined by group type of neurosurgeon (ABPNS vs ABPNS + JPS). ZCTA-level data on demographic and socioeconomic factors were acquired from the American Community Survey, including data in children and young adults (0-18 or 0-24 years old) and the general population. These data were compared by distance to care and by groups of neurosurgeons (Pearson's chi-square analysis; the threshold of significance was set at 0.05). RESULTS Three hundred fifty-five practicing neurosurgeons providing pediatric care were located, of whom 215 surgeons were certified by the ABPNS and 140 were JPS members only. The analysis showed that 1 pediatric neurosurgeon is in practice for every 289,799 persons up to the age of 24 years. The average distance between a ZCTA and the nearest pediatric

  4. 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

    Science.gov (United States)

    Galeotti, Angela; Garret Bernardin, Annelyse; D'Antò, Vincenzo; Viarani, Valeria; Cassabgi, Giorgio

    2016-01-01

    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. PMID:27747238

  5. 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.

  6. Predictors of parent post-traumatic stress symptoms after child hospitalization on general pediatric wards: a prospective cohort study.

    Science.gov (United States)

    Franck, Linda S; Wray, Jo; Gay, Caryl; Dearmun, Annette K; Lee, Kirsty; Cooper, Bruce A

    2015-01-01

    The aim of this study was to identify predictors of parental post-traumatic stress symptoms following child hospitalization. In this prospective cohort study, a sample of 107 parents completed questionnaires during their child's hospitalization on pediatric (non-intensive care) wards and again three months after discharge. Eligible parents had a child expected to be hospitalized for three or more nights. Standardized questionnaires were used to assess parent distress during the child's hospitalization, parent coping strategies and resources, and symptoms of post-traumatic stress after the hospitalization. Correlations and multiple regressions were used to determine whether parent distress during hospitalization and coping strategies and resources predicted post-traumatic stress symptoms three months after the child's discharge, while controlling for relevant covariates. Three months after the child's hospital discharge, 32.7% of parents (n=35) reported some degree of post-traumatic stress symptoms, and 21.5% (n=23) had elevated (≥34) scores consistent with a probable diagnosis of post-traumatic stress disorder. In the multivariable model, parent anxiety and uncertainty during hospitalization and use of negative coping strategies, such as denial, venting and self-blame, were associated with higher post-traumatic stress symptoms scores at three months post-discharge, even after controlling for the child's health status. Parental anxiety and depression during hospitalization moderated the relationship between negative coping strategies and post-traumatic stress symptoms. More than one quarter of parents of children hospitalized on pediatric (non-intensive care) wards experienced significant post-traumatic stress symptoms after their child's discharge. Parents' hospital-related anxiety, uncertainty and use of negative coping strategies are potentially modifiable factors that most strongly influenced post-traumatic stress symptoms. Further research is urgently needed

  7. 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 portion...

  8. 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.

  9. 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... Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE IRISH POTATOES GROWN IN CERTAIN... Certified seed potatoes. Certified seed potatoes means and includes all potatoes officially certified and...

  10. A Comparison of Retention Rates of Alternatively Certified and Traditional Certified Teachers.

    Science.gov (United States)

    Dial, Micah

    1992-01-01

    A survey of 2,500 teachers entering a large urban school district over the last 7 years showed that alternatively certified teachers were as likely as traditional, university-certified teachers to remain in the profession and pay back the school district's initial investment in teacher training. Many become committed to teaching as a meaningful…

  11. An investigation of safety climate in OHSAS 18001-certified and non-certified organizations.

    Science.gov (United States)

    Ghahramani, Abolfazl

    2016-09-01

    Many organizations worldwide have implemented Occupational Health and Safety Assessment Series (OHSAS) 18001 in their premises because of the assumed positive effects of this standard on safety. Few studies have analyzed the effect of the safety climate in OHSAS 18001-certified organizations. This case-control study used a new safety climate questionnaire to evaluate three OHSAS 18001-certified and three non-certified manufacturing companies in Iran. Hierarchical regression indicated that the safety climate was influenced by OHSAS implementation and by safety training. Employees who received safety training had better perceptions of the safety climate and its dimensions than other respondents within the certified companies. This study found that the implementation of OHSAS 18001 does not guarantee improvement of the safety climate. This study also emphasizes the need for high-quality safety training for employees of the certified companies to improve the safety climate.

  12. Pediatric Stroke

    Science.gov (United States)

    ... and Patient Resources Home » Patients & Families » About Stroke » Pediatric Stroke » Introduction Introduction What is a Stroke? Ischemic Stroke Intracerebral Hemorrhage Subarachnoid Hemorrhage Pediatric Stroke Introduction Types of Stroke Diagnosis and Treatment ...

  13. 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 ...

  14. Chronicle of pediatric radiology

    International Nuclear Information System (INIS)

    Benz-Bohm, Gabriele; Richter, Ernst

    2012-01-01

    The chronicle of pediatric radiology covers the following issues: Development of pediatric radiology in Germany (BRD, DDR, pediatric radiological accommodations); development of pediatric radiology in the Netherlands (chronology and pediatric radiological accommodations); development of pediatric radiology in Austria (chronology and pediatric radiological accommodations); development of pediatric radiology in Switzerland (chronology and pediatric radiological accommodations).

  15. 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

  16. Certified reference materials for organic analysis

    International Nuclear Information System (INIS)

    QianChuanfan

    2002-01-01

    This presentation discusses the requirements for certified reference materials (CRMs) to be used in measurements of residues of pesticides in food and environmental samples. It deals with the types of CRMs, matrix selection, sample preparation and representativeness. It also discusses CRM validity period and gives some examples of CRM preparation

  17. 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... employees of depository institutions, corporate central credit unions, and institutions that are members of...

  18. 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...

  19. 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...

  20. 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...

  1. 28 CFR 33.32 - Certified programs.

    Science.gov (United States)

    2010-07-01

    ... Statistics, and the Office of Juvenile Justice and Delinquency Prevention, certifies that the following... the National Institute of Justice, Director of the Bureau of Justice Statistics, and Administrator of the Office of Juvenile Justice and Delinquency Prevention, as having proved successful. (15)(i...

  2. Prevalence of early and late prematurity is similar among pediatric type 1 diabetes patients and the general population.

    Science.gov (United States)

    Adar, Adi; Shalitin, Shlomit; Eyal, Ori; Loewenthal, Neta; Pinhas-Hamiel, Orit; Levy, Milana; Dally-Gottfried, Orna; Landau, Zohar; Zung, Amnon; Levy-Khademi, Floris; Zangen, David; Tenenbaum-Rakover, Yardena; Rachmiel, Marianna

    2018-02-22

    The incidence of type 1 diabetes mellitus (T1DM) has increased in recent decades, as has the incidence of preterm births (prematurity and early prematurity (prematurity and birth season were compared with the general population birth registry using Pearson Chi-square test. The study population included 1452 T1DM patients, 52.7% males, and 2 138 668 subjects in the general non-T1DM population, 51.2% males. The prevalence of late and early prematurity was similar between groups (6.1% and 2.2% in the T1DM group vs 5.6% and 2.0% in the general non-T1DM group, P = 0.25 and P = 0.38, respectively). OR for prematurity among T1DM patients was 1.15 (0.95-1.39), P = 0.16. No difference in birth season was demonstrated between preterm and term, in T1DM and general non-T1DM populations. Ethiopian descent was more prevalent among T1DM patients compared with the non-T1DM population, in both term and preterm born. This is the largest population-based study, and the first in the Middle East geographical area, indicating that prematurity, including early prematurity, is not associated with T1DM during childhood. The study was registered at https://clinicaltrials.gov/: NCT02929953. Copyright © 2018 John Wiley & Sons, Ltd.

  3. Attention for pediatric interventional radiology

    International Nuclear Information System (INIS)

    Zhu Ming; Cheng Yongde

    2005-01-01

    ; devices closure of atrial septal defect, ventricular septal defect and patent ducts; and radiofrequency ablation of arrhythmias and others. Pediatric radiologists usually only take the responsibility for diagnosis of angiocardiography and do not take part in cardiac interventional procedures in most children's hospitals of China. The problem of underdevelopment of pediatric interventional radiology in China possesses a lot of reasons, even historical. Most of pediatric patients are confined in children's hospital with shortage of advanced equipment and enough pediatric interventional patients due to the old price system, the old medical insurance system and old financial support system, outcoming with the economic condition of most children's hospital be more inferior than the adult general hospital. (authors)

  4. 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. ...

  5. Leakage from medically-certified to self-certified workplace absence among norwegian employees

    OpenAIRE

    Karlsen, Geir Runar; Ytterstad, Elinor

    2017-01-01

    Source at https://dx.doi.org/10.1080/20021518.2017.1411119 There are two different kinds of sickness absence in Norway: self-certified absence (SCA), and medically-certified absence (MCA). In this study of 6437 Norwegian employees, we applied logistic regression models for a dichotomous SCA variable on initially 38 independent vari- ables including age and gender. Our findings showed that employees reporting long-term health issues but no record of MCA in the past 12 months (...

  6. Significant Factors Related to Failed Pediatric Dental General Anesthesia Appointments at a Hospital-based Residency Program.

    Science.gov (United States)

    Emhardt, John R; Yepes, Juan F; Vinson, LaQuia A; Jones, James E; Emhardt, John D; Kozlowski, Diana C; Eckert, George J; Maupome, Gerardo

    2017-05-15

    The purposes of this study were to: (1) evaluate the relationship between appointment failure and the factors of age, gender, race, insurance type, day of week, scheduled time of surgery, distance traveled, and weather; (2) investigate reasons for failure; and (3) explore the relationships between the factors and reasons for failure. Electronic medical records were accessed to obtain data for patients scheduled for dental care under general anesthesia from May 2012 to May 2015. Factors were analyzed for relation to appointment failure. Data from 3,513 appointments for 2,874 children were analyzed. Bivariate associations showed statistically significant (Pgeneral anesthesia face specific barriers to care.

  7. The features of general anesthesia by sevofluran in pediatric vitreoretinal surgery with different diseases and ophthalmosurgeral pathologies

    Directory of Open Access Journals (Sweden)

    Pronin S.N.

    2017-06-01

    Full Text Available Objective: clinical studies of inhalation anesthesia with sevoflurane as the main anesthetic for various diseases in children with vitreoretinal operations. Material and Methods. There was considered the age groups of children from 3 to 16 years old. Among 76 children: 18 with non-prosperrous psycho-emotional statuses, 2 with ICP, 2 with bronchial asthma, 3 with atopic dermatitis, 5 with small anomalies of heart development, 46 were somatically healthy. All of children had different ophthalmosuregery pathology. Results. The performing of general anesthesia by sevoflurane at vitreoretinal surgeries of children with the different diseases and ophthalmological pathologies displayed appropriateness and safety during the surgeries. Conclusion. The appliance of sevoflurane is the reasonable and optimal scheme in modern ophtalmosurgery and anesthesiology.

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

    Medline Plus

    Full Text Available ... information about radiation dose. There always is a risk of complications from general anesthesia or sedation. Every measure will be taken to ... in X-Ray and CT Exams Contrast Materials Anesthesia Safety Children and Radiation Safety ... (Pediatric) CT (Computed Tomography) Videos related to Children's (Pediatric) ...

  9. 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

  10. 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.”

  11. 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.

  12. 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.

  13. Pediatric dental care in a tertiary public hospital. Four years of experience in the Service of Stomatology of Valencia University General Hospital (Valencia, Spain).

    Science.gov (United States)

    Poveda, Rafael; Jiménez, Yolanda; Gavaldá, Carmen; Sanchís, José María; Carbonell, Enrique; Margaix, María; Sarrión, Gracia

    2008-05-01

    A study is made of the experience gained with the Child Oral Care Program (Plan de Atención Dental Infantil, PADI) in the Service of Stomatology of Valencia University General Hospital (Valencia, Spain) after four years in operation (July 2003 - July 2007). The sample comprised 2626 children between 5-14 years of age, pertaining to department 9 of the Valencian public health system. A clinical history was compiled in each case, a radiological study was made, and a treatment plan was elaborated including fillings, extractions, and control visits. Of the 2626 designated children, 2369 visited our Service - mostly referred from the Preventive Dental Care Units. A total of 5784 fillings were carried out (93.3% with silver amalgam, 5.6% with composites and the rest as provisional fillings). The permanent first molars were the teeth with the largest number of fillings (70.2% of the total). These were followed in order of frequency by the second molars (19.1%). As regards composite resin fillings, most involved the upper central incisors, followed by the upper lateral incisors. A total of 644 extractions were performed, corresponding to 110 permanent teeth and 534 temporary teeth. In the case of the permanent dentition, the first molars were the most commonly removed teeth. In the temporary dentition, the most frequently removed teeth were the second molars. The response of the population to this program has been very good, and reinforces the preventive measures already in place, with the provision of restorative treatments to improve the oral and dental health of the pediatric population, and yielding good results in terms of the program quality indicators. The Service of Stomatology (Valencia University General Hospital) is able to address the demand and offers the public health network integrated and continuous patient care.

  14. Job satisfaction among multiple sclerosis certified nurses.

    Science.gov (United States)

    Gulick, Elsie E; Halper, June; Costello, Kathleen

    2007-08-01

    Several studies document high levels of job satisfaction among certified nurses, but no study has examined job satisfaction and factors influencing job satisfaction of certified multiple sclerosis (MS) nurses. This study tested a theoretical model proposing that two organizational factors, colleague relationships and benefits, will predict job satisfaction. Job satisfaction was represented by four factors: autonomy, professional status, professional growth, and time efficiency. Participants included MS nurses certified for 6 months or more practicing mostly in three countries (Canada, Great Britain, and the United States) who anonymously completed the Misener Nurse Practitioner Job Satisfaction Scale, an overall job satisfaction rating, and demographic information. Findings indicate that colleague relationships and benefits significantly estimated organization structure and that autonomy, professional status, professional growth, and time efficiency significantly estimated job satisfaction; furthermore, organization factors such as colleague relationships and benefits significantly predict job satisfaction. Among the countries, several statistically significant differences were observed between job satisfaction factors as well as items in both organization and job satisfaction subscales. Average factor scores among the countries were mostly rated satisfactory. The International Organization of Multiple Sclerosis Nurses Executive Board plans to use the study findings to see how it needs to focus efforts as an organization toward enhancing and standardizing MS care and develop MS nurse professionalism worldwide.

  15. Development of solid water-equivalent radioactive certified reference materials

    International Nuclear Information System (INIS)

    Finke, E.; Greupner, H.; Groche, K.; Rittwag, R.; Geske, G.

    1991-01-01

    This paper presents a brief description of the development of solid water-equivalent beta volume radioactive certified reference materials. These certified reference materials were prepared for the beta fission nuclides 90 Sr/ 90 Y, 137 Cs, 147 Pm and 204 Tl. Comparative measurements of liquid and solid water-equivalent beta volume radioactive certified reference materials are discussed. (author)

  16. 76 FR 19310 - Information Collection; Certified State Mediation Program

    Science.gov (United States)

    2011-04-07

    ... DEPARTMENT OF AGRICULTURE Farm Service Agency Information Collection; Certified State Mediation... supports the Certified State Mediation Program. The information collection is necessary to ensure the grant... submit comments by any of the following methods: Mail: Carol Wagner, Certified State Mediation Program...

  17. 30 CFR 90.203 - Certified person; maintenance and calibration.

    Science.gov (United States)

    2010-07-01

    ... COAL MINE SAFETY AND HEALTH MANDATORY HEALTH STANDARDS-COAL MINERS WHO HAVE EVIDENCE OF THE DEVELOPMENT OF PNEUMOCONIOSIS Sampling Procedures § 90.203 Certified person; maintenance and calibration. (a) Approved sampling devices shall be maintained and calibrated by a certified person. (b) To be certified, a...

  18. 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 take...

  19. 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. (b...

  20. Pediatric vascular access

    International Nuclear Information System (INIS)

    Donaldson, James S.

    2006-01-01

    Pediatric interventional radiologists are ideally suited to provide vascular access services to children because of inherent safety advantages and higher success from using image-guided techniques. The performance of vascular access procedures has become routine at many adult interventional radiology practices, but this service is not as widely developed at pediatric institutions. Although interventional radiologists at some children's hospitals offer full-service vascular access, there is little or none at others. Developing and maintaining a pediatric vascular access service is a challenge. Interventionalists skilled in performing such procedures are limited at pediatric institutions, and institutional support from clerical staff, nursing staff, and technologists might not be sufficiently available to fulfill the needs of such a service. There must also be a strong commitment by all members of the team to support such a demanding service. There is a slippery slope of expected services that becomes steeper and steeper as the vascular access service grows. This review is intended primarily as general education for pediatric radiologists learning vascular access techniques. Additionally, the pediatric or adult interventional radiologist seeking to expand services might find helpful tips. The article also provides education for the diagnostic radiologist who routinely interprets radiographs containing vascular access devices. (orig.)

  1. Assessment of Oral Status in Pediatric Patients with Special Health Care Needs receiving Dental Rehabilitation Procedures under General Anesthesia: A Retrospective Analysis.

    Science.gov (United States)

    Solanki, Neeraj; Kumar, Anuj; Awasthi, Neha; Kundu, Anjali; Mathur, Suveet; Bidhumadhav, Suresh

    2016-06-01

    Dental problems serve as additional burden on the children with special health care needs (CSHCN) because of additional hospitalization pressure, they face for the treatment of various serious medical problems. These patients have higher incidence of dental caries due to increased quantity of sugar involved in the drug therapies and lower salivary flow in the oral cavity. Such patients are difficult to treat with local anesthesia or inhaled sedatives. Single-sitting dental treatment is possible in these patients with general anesthesia. Therefore, we conducted this retrospective analysis of oral health status of CSHCN receiving various dental treatments in a given population. A total of 200 CSHCN of age 14 years or less reporting in the pediatric wing of the general hospital from 2005 to 2014 that underwent comprehensive dental treatment under general anesthesia were included in the study. Patients with history of any additional systemic illness, any malignancy, any known drug allergy, or previous history of any dental treatment were excluded from the study. Complete mouth rehabilitation was done in these patients under general anesthesia following standard protocols. Data regarding the patient's disability, type, duration, and severity of disability was collected and analyzed. All the results were analyzed by Statistical Package for the Social Sciences (SPSS) software. Chi-square test, Student's t-test, and one-way analysis of variance were used to assess the level of significance. Statistically significant results were obtained while analyzing the subject's decayed missing filled/decayed extracted filled teeth indices divided based on age. Significant difference was observed only in cases where patients underwent complete crown placement even when divided based on type of disability. While analyzing the prevalence, statistically significant results were observed in patients when divided based on their age. In CSHCN, dental pathologies and caries indices are

  2. Pediatric dermatology training during residency: a survey of the 2014 graduating residents.

    Science.gov (United States)

    Akhavan, Alaleh; Murphy-Chutorian, Blair; Friedman, Adam

    2015-01-01

    Knowledge of pediatric dermatology is considered a core competency of dermatology training and should be expected of all practicing dermatologists. While the numbers of both pediatric dermatology fellowships and board certified pediatric dermatologists in the workforce have increased over the years, recent reports suggest that there is a gap in pediatric dermatology education during dermatology residency. The goal of this study is to assess the current state of pediatric education during residency, as well as the clinical experience, satisfaction and expectations of graduating dermatology residents. A 31-question self-report survey was distributed electronically to 294 third-year dermatology residents with questions pertaining to demographics, didactic education, resident experience in pediatric dermatology training, satisfaction with pediatric training and future plans. One hundred and twenty-three residents responded (41.8% response rate) representing approximately 29.1% of the total number of graduating residents. 69 (56.1%) residents reported academic time specifically devoted to pediatric dermatology, the majority (79.7%) of which was led by pediatric dermatologists. 82% of residents reported dedicated pediatric dermatology clinics at their program. 86.8% of respondents felt that their training in pediatric dermatology will allow them to confidently see pediatric dermatology patients in practice. This survey highlights a promising state of pediatric dermatology training among current graduating dermatology residents. The majority of current graduating dermatology residents are satisfied with their pediatric dermatology education, feel confident treating pediatric patients, and plan to see pediatric patients in clinical practice. © 2015 Wiley Periodicals, Inc.

  3. Understanding the pediatric dermatology workforce shortage: mentoring matters.

    Science.gov (United States)

    Admani, Shehla; Caufield, Maura; Kim, Silvia S; Siegfried, Elaine C; Friedlander, Sheila Fallon

    2014-02-01

    To target pediatric dermatologists directly in order to evaluate their current demographics and the most important motivating factors that influenced their career choice. Pediatric dermatology is one of the pediatric subspecialties with an inadequate supply to meet current patient needs. A survey was designed to evaluate the training pathway, employment status, participation in teaching, and clinical practice characteristics of pediatric dermatologists. The survey was administered to attendants of the 2010 Society for Pediatric Dermatology annual meeting. Any remaining board certified pediatric dermatologists who had not previously responded were queried via Survey Monkey. There was a 71% response rate. The majority chose a career in pediatric dermatology early, often prior to starting a dermatology residency. The vast majority of respondents noted mentorship as the most important influence on their decision to pursue a career in pediatric dermatology. The most common obstacles cited by respondents were financial hardship and resistance of some dermatology programs to accept applicants previously trained in pediatrics. Our survey provides evidence to support the importance of early exposure to the field and, most importantly, to committed pediatric dermatologists who can serve as mentors. This information may be helpful in approaching solutions to the workforce shortage in the field of pediatric dermatology. Copyright © 2014 Mosby, Inc. All rights reserved.

  4. 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…

  5. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... radioactive energy that is emitted from the patient's body and converts it into an image. The gamma camera itself does not emit any ... bear denotes child-specific content. Related Articles and Media General Nuclear ... (Pediatric) Nuclear Medicine Videos related ...

  6. 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.

  7. 5 CFR 1330.405 - Procedures for certifying agency appraisal systems.

    Science.gov (United States)

    2010-01-01

    ... Certification for Pay Purposes § 1330.405 Procedures for certifying agency appraisal systems. (a) General. To... senior employees based on appraisals of their relative performance against performance expectations in... responsibilities— (A) The performance standards, requirements, or expectations for the employees they supervise to...

  8. 78 FR 66261 - Certified Flight Instructor Flight Reviews; Recent Pilot in Command Experience; Airmen Online...

    Science.gov (United States)

    2013-11-05

    ...-0780; Amdt. No. 61-131] RIN 2120-AK23 Certified Flight Instructor Flight Reviews; Recent Pilot in Command Experience; Airmen Online Services; Confirmation of Effective Date AGENCY: Federal Aviation...-calendar month flight review requirements. This rule also clarifies that the generally applicable recent...

  9. 78 FR 56822 - Certified Flight Instructor Flight Reviews; Recent Pilot in Command Experience; Airmen Online...

    Science.gov (United States)

    2013-09-16

    ...-0780; Amdt. No. 61-131] RIN 2120-AK23 Certified Flight Instructor Flight Reviews; Recent Pilot in Command Experience; Airmen Online Services AGENCY: Federal Aviation Administration (FAA), DOT. ACTION... review requirements. This rule also clarifies that the generally applicable recent flight experience...

  10. International directory of certified radioactive sources

    International Nuclear Information System (INIS)

    Grosse, G.; Bambynek, W.

    1983-01-01

    This directory lists the products of 16 suppliers of certified reference materials (CRM) of radioactivity as given in their catalogues. Included are only products for which certificates are delivered and whose uncertainties are given according to the rules defined in ICRU Report No. 12, ''Certification of Standardized Radioactive Sources'' (International Commission on Radiation and Measurements, Washington, 1968). Only those products are included of which the standard uncertainties according to the above rules are less than 10%. Prices of the products are not mentioned since they frequently change. The products are divided into four groups: Radioactive Solutions, Radioactive Gases, Solid Sources and Sources for Liquid Scintillation Counting). (orig./WL)

  11. International directory of certified radioactive sources

    Energy Technology Data Exchange (ETDEWEB)

    Grosse, G; Bambynek, W

    1983-01-01

    This directory lists the products of 16 suppliers of certified reference materials (CRM) of radioactivity as given in their catalogues. Included are only products for which certificates are delivered and whose uncertainties are given according to the rules defined in ICRU Report No. 12, ''Certification of Standardized Radioactive Sources'' (International Commission on Radiation and Measurements, Washington, 1968). Only those products are included of which the standard uncertainties according to the above rules are less than 10%. Prices of the products are not mentioned since they frequently change. The products are divided into four groups: Radioactive Solutions, Radioactive Gases, Solid Sources and Sources for Liquid Scintillation Counting).

  12. 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.

  13. 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

  14. 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

  15. The Stress and Coping Responses of Certified Graduate Athletic Training Students

    Science.gov (United States)

    Reed, Sarah

    2004-01-01

    Objective: To assess the sources of stress and coping responses of certified graduate athletic training students. Design and Setting: We interviewed certified graduate athletic training students 3 times over a 9-month period. We transcribed the interviews verbatim and used grounded theory analytic procedures to inductively analyze the participants' sources of stress and coping responses. Subjects: Three male and 3 female certified graduate athletic training students from a postcertification graduate athletic training program volunteered to participate in this investigation. The participants were full-time graduate students, with a mean age of 23 years, who had worked an average of 1.5 years as certified athletic trainers at the time of the first interview. Measurements: We used grounded theory analytic procedures to inductively analyze the participants' sources of stress and coping responses. Results: A total of 6 general sources of stress and 11 coping dimensions were revealed. The stress dimensions were labeled athletic training duties, comparing job duties, responsibilities as student, time management, social evaluation, and future concerns. The coping responses were planning, instrumental social support, adjusting to job responsibilities, positive evaluations, emotional social support, humor, wishful thinking, religion, mental or behavioral disengagement, activities outside the profession, and other outcomes. Conclusions: Certified graduate athletic training students should be encouraged to use problem-focused (eg, seeking advice, planning) and emotion-focused (eg, positive evaluations, humor) forms of coping with stress. PMID:15173872

  16. 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

  17. Reflections on International Certified Nursing Assistants.

    Science.gov (United States)

    Shaw, Penelope Ann

    2017-01-01

    The author, a former university faculty member who taught English to speakers of other languages and now a nursing home resident, shares her observations about how English language proficiency, culture, and religious differences affect her care. She provides examples of communication challenges that can be annoying or cause harm, her coping strategies, and reasons many certified nursing assistants might never be fully fluent in English. She explains how international certified nursing assistants can benefit residents because of skills developed by family-centered care in their countries of origin. She also discusses related issues-the importance of being culturally competent about U.S. culture. She points out how religiousness not only affects residents but is a buffer for staff against the stress of physically and emotionally demanding low-wage work. Overall, the author likes receiving care from individuals from other countries, finding reward in comparing how her personal struggle with illness and paralysis resonates with the trauma of migration and how learning firsthand about varying beliefs and attitudes clarifies her identity and place in world history.

  18. 77 FR 5415 - National Organic Program: Notice of Draft Guidance for Accredited Certifying Agents, Certified...

    Science.gov (United States)

    2012-02-03

    ... in order to be excluded from the organic certification requirements of Part 205. The NOSB recommended... handling operations that are or are not excluded from organic certification. The draft guidance proposes... excluded from certification and, therefore, must be certified organic operations. \\1\\ NOSB Recommendation...

  19. 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.

  20. 76 FR 61713 - Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2011-10-05

    ...] Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting AGENCY: Food... of Committee: Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee. General... adult oncology indication, or in late stage development in pediatric patients with cancer. The...

  1. Pediatric Terminology

    Science.gov (United States)

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

  2. 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...

  3. Development of solid water-equivalent radioactive certified reference materials

    Energy Technology Data Exchange (ETDEWEB)

    Finke, E.; Greupner, H.; Groche, K.; Rittwag, R. (Office for Standardization, Metrology and Quality Control (ASMW), Berlin (Germany, F.R.)); Geske, G. (Jena Univ. (Germany, F.R.))

    1991-01-01

    This paper presents a brief description of the development of solid water-equivalent beta volume radioactive certified reference materials. These certified reference materials were prepared for the beta fission nuclides {sup 90}Sr/{sup 90}Y, {sup 137}Cs, {sup 147}Pm and {sup 204}Tl. Comparative measurements of liquid and solid water-equivalent beta volume radioactive certified reference materials are discussed. (author).

  4. Pediatric sleep apnea

    Science.gov (United States)

    Sleep apnea - pediatric; Apnea - pediatric sleep apnea syndrome; Sleep-disordered breathing - pediatric ... Untreated pediatric sleep apnea may lead to: High blood pressure Heart or lung problems Slow growth and development

  5. Fertilizers applied to certified organic tomato culture

    International Nuclear Information System (INIS)

    Martins, T.C.G.; De Nadai Fernandes, E.A.; Ferrari, A.A.; Bacchi, M.A.; Tagliaferro, F.S.

    2010-01-01

    The tomato culture demands large quantities of mineral nutrients, which are supplied by synthetic fertilizers in the conventional cultivation system. In the organic cultivation system only alternative fertilizers are allowed by the certifiers and accepted as safe for humans and environment. The chemical composition of rice bran, oyster flour, cattle manure and ground charcoal, as well as soils and tomato fruits were evaluated by instrumental neutron activation analysis (INAA). The potential contribution of organic fertilizers to the enrichment of chemical elements in soil and their transfer to fruits was investigated using concentration ratios for fertilizer and soil samples, and also for soil and tomato. Results evidenced that these alternative fertilizers could be taken as important sources of Br, Ca, Ce, K, Na and Zn for the organic tomato culture. (author)

  6. 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.

  7. [The state of pediatric anesthesia in Japan: an analysis of the Japanese society of anesthesiologists survey of critical incidents in the operating room].

    Science.gov (United States)

    Irita, Kazuo; Tsuzaki, Koichi; Sawa, Tomohiro; Sanuki, Michiyoshi; Nakatsuka, Hideki; Makita, Koshi; Morita, Kiyoshi

    2007-01-01

    .3%) and the other hospitals (84.0%). The recovery rate from cardiac arrest was 51.1% (2.49 times higher than the university hospitals; CI 1.23-5.06, and 3.05 times higher than the other hospitals ; CI 1.45-6.43), 29.6%, and 25.5%, respectively. The mortality rate was 9.54 (1.77 times higher than the other hospitals; CI 1.25-2.52), 8.87, and 5.38/10,000 anesthetic procedures in children's hospitals, university hospitals and other hospitals, respectively. Almost all JSA Certified Training Hospitals conducted pediatric anesthesia, although only 15.6% of them had an annual pediatric anesthetic volume of more than 200. It was suggested that general pediatric anesthesia was conduced safely in JSA Certified Training Hospitals, even if they had a low annual pediatric anesthetic volume. The exception was newborn anesthetic procedures : the mortality was high in hospitals with an annual newborn anesthetic volume of less than 12. Analysis of critical incidents in the operating room failed to show the superiority of children's hospitals in comparison with the university hospitals and other hospitals. Collecting and analyzing data including the patients without critical incidents are required for further analysis.

  8. The Current Landscape of US Pediatric Anesthesiologists: Demographic Characteristics and Geographic Distribution.

    Science.gov (United States)

    Muffly, Matthew K; Muffly, Tyler M; Weterings, Robbie; Singleton, Mark; Honkanen, Anita

    2016-07-01

    There is no comprehensive database of pediatric anesthesiologists, their demographic characteristics, or geographic location in the United States. We endeavored to create a comprehensive database of pediatric anesthesiologists by merging individuals identified as US pediatric anesthesiologists by the American Board of Anesthesiology, National Provider Identifier registry, Healthgrades.com database, and the Society for Pediatric Anesthesia membership list as of November 5, 2015. Professorial rank was accessed via the Association of American Medical Colleges and other online sources. Descriptive statistics characterized pediatric anesthesiologists' demographics. Pediatric anesthesiologists' locations at the city and state level were geocoded and mapped with the use of ArcGIS Desktop 10.1 mapping software (Redlands, CA). We identified 4048 pediatric anesthesiologists in the United States, which is approximately 8.8% of the physician anesthesiology workforce (n = 46,000). The median age of pediatric anesthesiologists was 49 years (interquartile range, 40-57 years), and the majority (56.4%) were men. Approximately two-thirds of identified pediatric anesthesiologists were subspecialty board certified in pediatric anesthesiology, and 33% of pediatric anesthesiologists had an identified academic affiliation. There is substantial heterogeneity in the geographic distribution of pediatric anesthesiologists by state and US Census Division with urban clustering. This description of pediatric anesthesiologists' demographic characteristics and geographic distribution fills an important gap in our understanding of pediatric anesthesia systems of care.

  9. Experimentally generated randomness certified by the impossibility of superluminal signals.

    Science.gov (United States)

    Bierhorst, Peter; Knill, Emanuel; Glancy, Scott; Zhang, Yanbao; Mink, Alan; Jordan, Stephen; Rommal, Andrea; Liu, Yi-Kai; Christensen, Bradley; Nam, Sae Woo; Stevens, Martin J; Shalm, Lynden K

    2018-04-01

    From dice to modern electronic circuits, there have been many attempts to build better devices to generate random numbers. Randomness is fundamental to security and cryptographic systems and to safeguarding privacy. A key challenge with random-number generators is that it is hard to ensure that their outputs are unpredictable 1-3 . For a random-number generator based on a physical process, such as a noisy classical system or an elementary quantum measurement, a detailed model that describes the underlying physics is necessary to assert unpredictability. Imperfections in the model compromise the integrity of the device. However, it is possible to exploit the phenomenon of quantum non-locality with a loophole-free Bell test to build a random-number generator that can produce output that is unpredictable to any adversary that is limited only by general physical principles, such as special relativity 1-11 . With recent technological developments, it is now possible to carry out such a loophole-free Bell test 12-14,22 . Here we present certified randomness obtained from a photonic Bell experiment and extract 1,024 random bits that are uniformly distributed to within 10 -12 . These random bits could not have been predicted according to any physical theory that prohibits faster-than-light (superluminal) signalling and that allows independent measurement choices. To certify and quantify the randomness, we describe a protocol that is optimized for devices that are characterized by a low per-trial violation of Bell inequalities. Future random-number generators based on loophole-free Bell tests may have a role in increasing the security and trust of our cryptographic systems and infrastructure.

  10. The Impact of Mentoring on Alternatively Certified Teachers

    Science.gov (United States)

    Kesler, Becky

    2013-01-01

    The purpose of this study was to explore the perceived effectiveness of mentoring for teachers certified through non-traditional avenues. This quantitative study investigated the type and amount of support teachers certified through the Arkansas Non-traditional Licensure Program (NTLP) and the Master of Arts in Teaching Program (MATP) received…

  11. 19 CFR 159.36 - Multiple certified rates.

    Science.gov (United States)

    2010-04-01

    ... multiple rates have been certified for a foreign currency, the rate to be used for Customs purposes shall... 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...

  12. 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 and certified to the Secretary of the Treasury in accordance with 31 U.S.C. 5151(e) shall be used for...

  13. 76 FR 80741 - TRICARE: Certified Mental Health Counselors

    Science.gov (United States)

    2011-12-27

    ...] TRICARE: Certified Mental Health Counselors AGENCY: Office of the Secretary, Department of Defense. ACTION... would allow licensed or certified mental health counselors to be able to independently provide care to... mental health counselors (CMHCs), who will be authorized to practice independently under TRICARE. During...

  14. 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... HEALTH MANDATORY HEALTH STANDARDS-COAL MINERS WHO HAVE EVIDENCE OF THE DEVELOPMENT OF PNEUMOCONIOSIS Sampling Procedures § 90.202 Certified person; sampling. (a) The respirable dust sampling required by this...

  15. Pediatric AIDS

    International Nuclear Information System (INIS)

    Price, D.B.; Haller, J.O.; Kramer, J.; Hotson, G.C.; Loh, J.P.; Schlusselberg, D.; Inglese, C.M.; Jacobs, J.; Rose, A.L.; Menez-Bautista, R.; Fikrig, S.

    1988-01-01

    A group of 23 pediatric patients seropositive for HIV antibody were studied by computed tomography and evaluated neurodevelopmentally. Significant neurodevelopmental delays were found in over 95% of the patients studied. CT findings in six patients were normal and thirteen of 23 (57%) had prominence of the CSF spaces. Less frequent findings included calcifications in the basal ganglia and white matter. Cerebral mass lesions included one case of lymphoma and one case of hemorrhage. The CT findings in the pediatric age group differs from the adult population in that that contrast enhancing inflammatory mass lesions are uncommon. (orig.)

  16. Internet use of parents before attending a general pediatric outpatient clinic: does it change their information level and assessment of acute diseases?

    Science.gov (United States)

    Sebelefsky, Christian; Voitl, Jasmin; Karner, Denise; Klein, Frederic; Voitl, Peter; Böck, Andreas

    2016-08-18

    Before seeing a pediatrician, parents often look online to obtain child health information. We aimed to determine the influence of IUC (internet use regarding the reason for consultation) on their subjective information level, their assessment of acute diseases and the change in this assessment. Secondary objectives were to identify the most commonly used online resources and factors with an influence on IUC. This cross-sectional observational study was conducted at a general pediatric outpatient clinic located in Vienna, Austria. An anonymous, voluntary and 14-items-containing questionnaire served to gather all data. A total number of 500 questionnaires were collected. Of the parents attending the outpatient clinic, 21 % use the internet before the appointment (= IUC). Most common online resources utilized for this purpose are websites run by doctors (61.3 %), the outpatient clinic's homepage (56.3 %), Google (40 %), Wikipedia (32.5 %), health advisory services provided by doctors (28.7 %), health portals (21.3 %) and health forums and communities (18.8 %). The information level in terms of the reason for consultation is rated as good by 50.6 %, as average by 46.7 % and as insufficient by 2.7 % (internet users: 42.7 %, 55.3 %, 1.9 %). Acute diseases of the children are estimated to be mild by 58.4 %, to be moderate by 41.1 % and to be severe by 0.5 % (internet users: 54.9 %, 45.1 %, 0 %). After having used any source of information, this assessment is unchanged in 82.8 %, acute diseases are rated as more severe in 13.8 % and as less severe in 3.4 % (internet users: 79.2 %, 16.7 %, 4.2 %). Internet users and non-users do not differ with respect to their information level (p = 0.178), the assessment of acute diseases (p = 0.691) and the change in this assessment (p = 0.999). A higher education level of parents (mothers: p = 0.025, fathers: p = 0.037), a young age of their children (p = 0.012) and acute diseases of

  17. Characterizations of a quality certified athletic trainer.

    Science.gov (United States)

    Raab, Scot; Wolfe, Brent D; Gould, Trenton E; Piland, Scott G

    2011-01-01

    Didactic proficiency does not ensure clinical aptitude. Quality athletic health care requires clinical knowledge and affective traits. To develop a grounded theory explaining the constructs of a quality certified athletic trainer (AT). Delphi study. Interviews in conference rooms or business offices and by telephone. Thirteen ATs (men = 8, women = 5) stratified across the largest employment settings (high school, college, clinical) in the 4 largest districts of the National Athletic Trainers? Association (2, 3, 4, 9). Open-ended interview questions were audio recorded, transcribed, and reviewed before condensing. Two member checks ensured trustworthiness. Open coding reduced text to descriptive adjectives. We grouped adjectives into 5 constructs (care, communication, commitment, integrity, knowledge) and grouped these constructs into 2 higher-order constructs (affective traits, effective traits). According to participants, ATs who demonstrate the ability to care, show commitment and integrity, value professional knowledge, and communicate effectively with others can be identified as quality ATs. These abilities facilitate the creation of positive relationships. These relationships allow the quality AT to interact with patients and other health care professionals on a knowledgeable basis that ultimately improves health care delivery. Our resulting theory supported the examination of characteristics not traditionally assessed in an athletic training education program. If researchers can show that these characteristics develop ATs into quality ATs (eg, those who work better with others, relate meaningfully with patients, and improve the standard of health care), they must be cultivated in the educational setting.

  18. 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.

  19. 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.

  20. Burnout Risk and Protection Factors in Certified Nursing Aides.

    Science.gov (United States)

    Molero Jurado, María Del Mar; Pérez-Fuentes, María Del Carmen; Gázquez Linares, José Jesús Gázquez; Simón Márquez, María Del Mar; Martos Martínez, África

    2018-05-30

    Studies have found a higher risk of burnout among employees in the healthcare sector. As such, this study focused on Certified Nursing Aides (CNAs) who have shown a high prevalence of burnout and are therefore considered an especially vulnerable group. The objective of this study was to identify the relationships between some organizational, personal, and sociodemographic factors and burnout. The final study sample included 278 working CNAs with a mean age of 40.88 (SD = 9.41). To compile the data, an ad hoc questionnaire was used to collect sociodemographic information. To collect professional and employment information, we used the Brief Emotional Intelligence Inventory for Adults, the Brief Questionnaire on Perceived Social Support, and the General Self-Efficacy Scale. The results showed that Burnout Syndrome is significantly and negatively related to all the emotional intelligence factors, self-efficacy, and perceived social support. The risk of burnout is higher in younger persons and in permanently employed professionals. General self-efficacy and stress management act as protective factors against the likelihood of burnout. This study suggests that organizations should urge coaching and transformational leadership training programs to promote the wellbeing and organizational commitment of workers.

  1. Burnout Risk and Protection Factors in Certified Nursing Aides

    Directory of Open Access Journals (Sweden)

    María del Mar Molero Jurado

    2018-05-01

    Full Text Available Studies have found a higher risk of burnout among employees in the healthcare sector. As such, this study focused on Certified Nursing Aides (CNAs who have shown a high prevalence of burnout and are therefore considered an especially vulnerable group. The objective of this study was to identify the relationships between some organizational, personal, and sociodemographic factors and burnout. The final study sample included 278 working CNAs with a mean age of 40.88 (SD = 9.41. To compile the data, an ad hoc questionnaire was used to collect sociodemographic information. To collect professional and employment information, we used the Brief Emotional Intelligence Inventory for Adults, the Brief Questionnaire on Perceived Social Support, and the General Self-Efficacy Scale. The results showed that Burnout Syndrome is significantly and negatively related to all the emotional intelligence factors, self-efficacy, and perceived social support. The risk of burnout is higher in younger persons and in permanently employed professionals. General self-efficacy and stress management act as protective factors against the likelihood of burnout. This study suggests that organizations should urge coaching and transformational leadership training programs to promote the wellbeing and organizational commitment of workers.

  2. Mediated definite delegation - Certified Grid jobs in ALICE and beyond

    Science.gov (United States)

    Schreiner, Steffen; Grigoras, Costin; Litmaath, Maarten; Betev, Latchezar; Buchmann, Johannes

    2012-12-01

    Grid computing infrastructures need to provide traceability and accounting of their users’ activity and protection against misuse and privilege escalation, where the delegation of privileges in the course of a job submission is a key concern. This work describes an improved handling of Multi-user Grid Jobs in the ALICE Grid Services. A security analysis of the ALICE Grid job model is presented with derived security objectives, followed by a discussion of existing approaches of unrestricted delegation based on X.509 proxy certificates and the Grid middleware gLExec. Unrestricted delegation has severe security consequences and limitations, most importantly allowing for identity theft and forgery of jobs and data. These limitations are discussed and formulated, both in general and with respect to an adoption in line with Multi-user Grid Jobs. A new general model of mediated definite delegation is developed, allowing a broker to dynamically process and assign Grid jobs to agents while providing strong accountability and long-term traceability. A prototype implementation allowing for fully certified Grid jobs is presented as well as a potential interaction with gLExec. The achieved improvements regarding system security, malicious job exploitation, identity protection, and accountability are emphasized, including a discussion of non-repudiation in the face of malicious Grid jobs.

  3. Mediated definite delegation - Certified Grid jobs in ALICE and beyond

    International Nuclear Information System (INIS)

    Schreiner, Steffen; Buchmann, Johannes; Grigoras, Costin; Litmaath, Maarten; Betev, Latchezar

    2012-01-01

    Grid computing infrastructures need to provide traceability and accounting of their users’ activity and protection against misuse and privilege escalation, where the delegation of privileges in the course of a job submission is a key concern. This work describes an improved handling of Multi-user Grid Jobs in the ALICE Grid Services. A security analysis of the ALICE Grid job model is presented with derived security objectives, followed by a discussion of existing approaches of unrestricted delegation based on X.509 proxy certificates and the Grid middleware gLExec. Unrestricted delegation has severe security consequences and limitations, most importantly allowing for identity theft and forgery of jobs and data. These limitations are discussed and formulated, both in general and with respect to an adoption in line with Multi-user Grid Jobs. A new general model of mediated definite delegation is developed, allowing a broker to dynamically process and assign Grid jobs to agents while providing strong accountability and long-term traceability. A prototype implementation allowing for fully certified Grid jobs is presented as well as a potential interaction with gLExec. The achieved improvements regarding system security, malicious job exploitation, identity protection, and accountability are emphasized, including a discussion of non-repudiation in the face of malicious Grid jobs.

  4. 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

    ... 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 15.408(l), insert the following provision: Requirements for Certified Cost or Pricing Data and Data Other Than...

  5. 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

    ... 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 Data... Pricing Data and Data Other Than Certified Cost or Pricing Data—Modifications (OCT 2010) (a) Exceptions...

  6. Formulating evidence-based guidelines for certified nurse-midwives and certified midwives attending home births.

    Science.gov (United States)

    Cook, Elizabeth; Avery, Melissa; Frisvold, Melissa

    2014-01-01

    Implementing national home birth guidelines for certified nurse-midwives (CNMs) and certified midwives (CMs) in the United States may facilitate a common approach to safe home birth practices. Guidelines are evidence-based care recommendations for specified clinical situations that can be modified by individual providers to meet specific client needs. Following a review of home birth guidelines from multiple countries, a set of home birth practices guidelines for US CNMs/CMs was drafted. Fifteen American Midwifery Certification Board, Inc. (AMCB)-certified home birth midwives who participate in the American College of Nurse-Midwives (ACNM) home birth electronic mailing list considered the use of such a document in their practices and reviewed and commented on the guidelines. The proposed guidelines addressed client screening, informed consent, antepartum care, routine intrapartum care, obstetric complications and hospital transports, postpartum care, neonatal care, gynecologic care, primary care, peer reviews, recordkeeping, and physician collaboration. The reviewers had varying assessments as to whether the guidelines reflected international standards and current best evidence. The primary concern expressed was that an adoption of national guidelines could compromise provider autonomy. Incorporation of evidence-based guidelines is an ACNM standard and was recommended by the Home Birth Consensus Summit. Clinical practice guidelines are informed by current evidence and supported by experts in a given discipline. Implementation of guidelines ensures optimal patient care and is becoming increasingly central to reimbursement and to medicolegal support. A set of practice guidelines based on current best evidence and internationally accepted standards was developed and reviewed by an interested group of US CNMs/CMs. Further discussion with home birth midwives and other stakeholders about the development and implementation of home birth guidelines is needed, especially in

  7. 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

    2013-01-01

    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.

  8. “Booster” training: Evaluation of instructor-led bedside cardiopulmonary resuscitation skill training and automated corrective feedback to improve cardiopulmonary resuscitation compliance of Pediatric Basic Life Support providers during simulated cardiac arrest

    Science.gov (United States)

    Sutton, Robert M.; Niles, Dana; Meaney, Peter A.; Aplenc, Richard; French, Benjamin; Abella, Benjamin S.; Lengetti, Evelyn L.; Berg, Robert A.; Helfaer, Mark A.; Nadkarni, Vinay

    2013-01-01

    Objective To investigate the effectiveness of brief bedside “booster” cardiopulmonary resuscitation (CPR) training to improve CPR guideline compliance of hospital-based pediatric providers. Design Prospective, randomized trial. Setting General pediatric wards at Children’s Hospital of Philadelphia. Subjects Sixty-nine Basic Life Support–certified hospital-based providers. Intervention CPR recording/feedback defibrillators were used to evaluate CPR quality during simulated pediatric arrest. After a 60-sec pretraining CPR evaluation, subjects were randomly assigned to one of three instructional/feedback methods to be used during CPR booster training sessions. All sessions (training/CPR manikin practice) were of equal duration (2 mins) and differed only in the method of corrective feedback given to participants during the session. The study arms were as follows: 1) instructor-only training; 2) automated defibrillator feedback only; and 3) instructor training combined with automated feedback. Measurements and Main Results Before instruction, 57% of the care providers performed compressions within guideline rate recommendations (rate >90 min−1 and 38 mm); and 36% met overall CPR compliance (rate and depth within targets). After instruction, guideline compliance improved (instructor-only training: rate 52% to 87% [p .01], and overall CPR compliance, 43% to 78% [p CPR compliance, 35% to 96% [p training combined with automated feedback: rate 48% to 100% [p CPR compliance, 30% to 100% [p CPR instruction, most certified Pediatric Basic Life Support providers did not perform guideline-compliant CPR. After a brief bedside training, CPR quality improved irrespective of training content (instructor vs. automated feedback). Future studies should investigate bedside training to improve CPR quality during actual pediatric cardiac arrests. PMID:20625336

  9. "Booster" training: evaluation of instructor-led bedside cardiopulmonary resuscitation skill training and automated corrective feedback to improve cardiopulmonary resuscitation compliance of Pediatric Basic Life Support providers during simulated cardiac arrest.

    Science.gov (United States)

    Sutton, Robert M; Niles, Dana; Meaney, Peter A; Aplenc, Richard; French, Benjamin; Abella, Benjamin S; Lengetti, Evelyn L; Berg, Robert A; Helfaer, Mark A; Nadkarni, Vinay

    2011-05-01

    To investigate the effectiveness of brief bedside "booster" cardiopulmonary resuscitation (CPR) training to improve CPR guideline compliance of hospital-based pediatric providers. Prospective, randomized trial. General pediatric wards at Children's Hospital of Philadelphia. Sixty-nine Basic Life Support-certified hospital-based providers. CPR recording/feedback defibrillators were used to evaluate CPR quality during simulated pediatric arrest. After a 60-sec pretraining CPR evaluation, subjects were randomly assigned to one of three instructional/feedback methods to be used during CPR booster training sessions. All sessions (training/CPR manikin practice) were of equal duration (2 mins) and differed only in the method of corrective feedback given to participants during the session. The study arms were as follows: 1) instructor-only training; 2) automated defibrillator feedback only; and 3) instructor training combined with automated feedback. Before instruction, 57% of the care providers performed compressions within guideline rate recommendations (rate >90 min(-1) and 38 mm); and 36% met overall CPR compliance (rate and depth within targets). After instruction, guideline compliance improved (instructor-only training: rate 52% to 87% [p .01], and overall CPR compliance, 43% to 78% [p CPR compliance, 35% to 96% [p training combined with automated feedback: rate 48% to 100% [p CPR compliance, 30% to 100% [p CPR instruction, most certified Pediatric Basic Life Support providers did not perform guideline-compliant CPR. After a brief bedside training, CPR quality improved irrespective of training content (instructor vs. automated feedback). Future studies should investigate bedside training to improve CPR quality during actual pediatric cardiac arrests.

  10. 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

  11. Pulmonary parenchymal changes in the pediatric patient

    International Nuclear Information System (INIS)

    Atkinson, G.O. Jr.

    1987-01-01

    Analysis of the pediatric chest radiograph for parenchymal pathology is similar to that of the adult. This chapter focuses primarily on the radiographic changes of certain entities presenting to the pediatric intensive care unit (ICU), including airway diseases, pneumonia, pulmonary hemorrhage, and lung trauma, as well as problems related to general anesthesia and surgery

  12. 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

  13. Pediatric biobanking

    DEFF Research Database (Denmark)

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

    2012-01-01

    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 such as ......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...... such as decision making, privacy protection, minor recontact, and research withdrawal by focusing on theoretical or empirical perspectives. Our research attempted to analyze such issues in a comprehensive manner by exploring practices, rules, and researcher opinions regarding proxy consent, minor assent, specimens...

  14. Pediatric stroke

    International Nuclear Information System (INIS)

    Hoermann, M.

    2008-01-01

    Stroke in childhood has gained increasingly more attention and is accepted as an important disease in childhood. The reasons for this severe event and the consequences for the rest of the life are totally different than for adults. This is also true for the diagnosis and therapy. This paper gives a comprehensive overview on the characteristics of pediatric stroke to assist radiologists in making a rapid and safe diagnosis in order to identify the underlying disease. (orig.) [de

  15. 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.

  16. Imaging in the diagnosis of pediatric urolithiasis

    International Nuclear Information System (INIS)

    Colleran, Gabrielle C.; Callahan, Michael J.; Paltiel, Harriet J.; Chow, Jeanne S.; Nelson, Caleb P.; Cilento, Bartley G.; Baum, Michelle A.

    2017-01-01

    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.)

  17. 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.)

  18. 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 ...

  19. 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. ...

  20. 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 ...

  1. 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 ...

  2. 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 ...

  3. 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 ...

  4. Pediatric radiology

    International Nuclear Information System (INIS)

    Benz-Bohm, G.

    1997-01-01

    Pediatric radiology is an important subsection of diagnostic radiology involving specific difficulties, but unfortunately is quite too often neglected as a subject of further education and training. The book therefore is not intended for specialists in the field, but for radiologists wishing to plunge deeper into the matter of pediatric radiology and to acquire a sound, basic knowledge and information about well-proven modalities, the resulting diagnostic images, and interpretation of results. The book is a compact guide and a helpful source of reference and information required for every-day work, or in special cases. With patients who are babies or children, the challenges are different. The book offers all the information needed, including important experience from pediatric hospital units that may be helpful in diagnostic evaluation, information about specific dissimilarities in anatomy and physiology which affect the imaging results, hints for radiology planning and performance, as well as information about the various techniques and their indication and achievements. The book presents a wide spectrum of informative and annotated images. (orig./CB) [de

  5. 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.

  6. 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...

  7. Certified reference materials of trace elements in water

    Indian Academy of Sciences (India)

    Many decisions regarding the suitability of material/products are based on the ... In the present scenario of globalization of economy, use of certified reference ... our national accreditation body, National Accreditation Board for Testing and ...

  8. 7 CFR 205.665 - Noncompliance procedure for certifying agents.

    Science.gov (United States)

    2010-01-01

    ... applicable State organic program's governing State official all records concerning its certification...) ORGANIC FOODS PRODUCTION ACT PROVISIONS NATIONAL ORGANIC PROGRAM Administrative Compliance § 205.665... agent. (f) Cessation of certification activities. A certifying agent whose accreditation is suspended or...

  9. 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.

  10. Find a Pediatric Dentist

    Science.gov (United States)

    ... AAPD AAPD Publications Advertising Brochures Journals & Publications Full Journal Archives Access Pediatric Dentistry Today Practice Management and Marketing Newsletter Pediatric Dentistry Journal Open Access Articles Oral ...

  11. [Analysis of qualifications of medical and health institutions and certified doctors for providing occupational disease diagnosis in China].

    Science.gov (United States)

    Wang, Huan-qiang; Li, Tao; Qi, Fang; Wu, Rui; Nie, Wu; Yu, Chen

    2013-10-01

    To investigate the qualifications and current situations of the medical and health institutions and certified doctors for providing occupational disease diagnosis in China and to provide a reference for developing relevant policies. Work reports and questionnaires survey were used to investigate the qualifications of all medical and health institutions and certified doctors for providing occupational disease diagnosis in China and their acceptance and diagnosis of occupational disease cases from 2006 to 2010. The rate for the work reports was 100%, and the response rate for the questionnaires was 71.0%. By the end of 2010, in the 31 provincial-level regions (excluding Hong Kong, Macao, and Taiwan) in China, there had been 503 medical and health institutions which were qualified for providing occupational disease diagnosis, including 207 centers for disease control and prevention, accounting for 41.2%, 145 general hospitals, accounting for 28.8%, 69 enterprise-owned hospitals, accounting for 13.7%, and 64 institutes or centers for occupational disease prevention and control, accounting for 12.7%; 4986 certified doctors got the qualification for providing occupational disease diagnosis, with 9.4 certified doctors on average in each institution, and there was 0.65 certified doctor per 100 000 employees. In addition, 16.5% of the institutions got all the qualifications for diagnosing 9 occupational diseases, and 17.1% of the institutions got the qualification for diagnosing one occupational disease. Each certified doctor accepted diagnosis of 16.8 cases of occupational diseases on average every year. A national occupational disease diagnosis network has been established in China, but the imbalance in regional distribution and specialty programs still exists among the qualified medical and health institutions and certified doctors. It is essential to further strengthen the development of regional qualified medical and health institutions and training of qualified

  12. Perceived value of national certification for pediatric nurses.

    Science.gov (United States)

    Messmer, Patricia R; Hill-Rodriguez, Deborah; Williams, Arthur R; Ernst, Mary E; Tahmooressi, Jill

    2011-09-01

    This study evaluated whether pediatric nurses who were certified valued national certifications to a greater degree than those who were not certified. The Gaberson, Schroeter, Killen, and Valentine (2003) Perceived Value of Certification Tool (PVCT) was used to measure nurses' perceptions of certification. The PVCT includes 18 certification-related value statements, using a five-point Likert scale response ranging from strongly agree to strongly disagree. A principal factor analysis was performed to identify clusters of related variables. Certified pediatric nurses valued national certifications to a greater degree than those who were not certified. More favorable views of certification were moderately associated with favorable views of the effects of certification on salary. The PVCT was found to have one factor, not two, as previously reported in the literature. Lower perceived relationships were reported between certification and salary, clinical competence, and consumer confidence compared with feelings of professionalism and personal satisfaction. Efforts to improve the relationship between certification and its perceived value at one institution were addressed. More attention may be needed to strengthen relationships, perceived or otherwise, between certification and competency skills, public awareness, and compensation of nurses for holding national certification. Copyright 2011, SLACK Incorporated.

  13. Pediatric radiology

    International Nuclear Information System (INIS)

    Silverman, F.N.

    1982-01-01

    A literature review with 186 references of diagnostic pediatric radiology, a speciality restricted to an age group rather than to an organ system or technique of examination, is presented. In the present chapter topics follow the basic organ system divisions with discussions of special techniques within these divisions. The diagnosis of congenital malformations, infectious diseases and neoplasms are a few of the topics discussed for the head and neck region, the vertebrae, the cardiovascular system, the respiratory system, the gastrointestinal tract, the urinary tract, and the skeleton

  14. Pediatric neuroimaging

    International Nuclear Information System (INIS)

    Tidwell, A.S.; Solano, M.; Schelling, S.H.

    1994-01-01

    In this article, some of the common and not-so-common neuropediatric disorders were discussed. As in the full-grown animal, abnormalities of the CNS in the pediatric animal patient may be classified according to the type of insult present (eg, malformation, injury, neoplasia, inflammation, or degeneration). To recognize the imaging manifestations of such disorders, an appreciation of normal anatomy, the pathological response of nervous system tissue to insult, and the principles of image interpretation is required. These fundamentals may then be applied to any CNS disease, regardless of frequency and to any animal patient, regardless of age

  15. Streptococcus pneumoniae carriage among healthy and sick pediatric patients before the generalized implementation of the 13-valent pneumococcal vaccine in Morocco from 2010 to 2011.

    Science.gov (United States)

    Jroundi, Imane; Mahraoui, Chafik; Benmessaoud, Rachid; Moraleda, Cinta; Munoz Almagro, Carmen; Seffar, Meryem; Tligui, Houssain; Kettani, Selma C; Benjelloun, Badr S; Alonso, Pedro L; Bassat, Quique

    Nasopharyngeal carriage studies provide insights into the local prevalence of circulating pneumococcal serotypes. These data are critical to vaccination monitoring, as they allow for the prediction and assessment of impact. Very little data are available on the carriage of pneumococcal serotypes in Morocco. Here, we describe the prevalence of Streptococcus pneumoniae carriage and serotype distribution among 697 pediatric patients with ages ranging from 2 to 59 months who were admitted to a Moroccan hospital with severe pneumonia, as well as 195 healthy infants and young children who were recruited at a vaccination clinic. Carriage rates were 40.5% (79/195) for healthy children and 22.8% (159/697) for sick children. The most commonly observed circulating serotypes included 6A, 6B and 19F, all of which are included in the current 13-valent anti-pneumococcal conjugate vaccine that was recently introduced in Morocco. Monitoring of circulating serotypes remains necessary after vaccine introduction to assess whether serotype replacement is occurring. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  16. Pediatric radiology

    International Nuclear Information System (INIS)

    Kirkpatrick, J.A. Jr.

    1985-01-01

    Computed tomography has made possible the excellent and basic work having to do with the characteristics of the trachea, its caliber, shape, and length in children. Another group of articles has to do with interventional pediatric radiology. This year there were a number of articles of which only a sample is included, dealing with therapeutic procedures involving drainage of abscesses, angioplasty, nephrostomy, therapeutic embolization, and the removal of esophageal foreign bodies. Obviously, there is no reason to think that techniques developed for the adult may not be applicable to the infant or child; also, there is no reason to believe that processes peculiar to the child should not be amenable to intervention, for instance, use of embolization of hepatic hemangioma and transluminal balloon valvuloplasty for pulmonary valvular stenosis. Among the reports and reviews, the author would add that sonography remains a basic imaging technique in pediatric radiology and each year its application broadens. For example, there is an excellent article having to do with sonography of the neonatal and infant hip and evaluation of the inferior vena cava and the gallbladder. Nuclear medicine continues to play a significant role in diagnosis, which is featured in two articles concerned with problems of the hip

  17. 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

  18. 21 CFR 82.5 - General specifications for straight colors.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false General specifications for straight colors. 82.5... LISTING OF CERTIFIED PROVISIONALLY LISTED COLORS AND SPECIFICATIONS General Provisions § 82.5 General specifications for straight colors. No batch of a straight color listed in subpart B, C, or D shall be certified...

  19. Education in Quality Improvement for Pediatric Practice: an online program to teach clinicians QI.

    Science.gov (United States)

    Bundy, David G; Morawski, Lori F; Lazorick, Suzanne; Bradbury, Scott; Kamachi, Karen; Suresh, Gautham K

    2014-01-01

    Education in Quality Improvement for Pediatric Practice (EQIPP) is an online program designed to improve evidence-based care delivery by teaching front-line clinicians quality improvement (QI) skills. Our objective was to evaluate EQIPP data to characterize 1) participant enrollment, use patterns, and demographics; 2) changes in performance in clinical QI measures from baseline to follow-up measurement; and 3) participant experience. We conducted an observational study of EQIPP participants utilizing 1 of 3 modules (asthma, immunizations, gastroesophageal reflux disease) from 2009 to 2013. Enrollment and use, demographic, and quality measure data were extracted directly from the EQIPP system; participant experience was assessed via an optional online survey. Study participants (n = 3501) were diverse in their gender, age, and race; most were board certified. Significant quality gaps were observed across many of the quality measures at baseline; sizable improvements were observed across most quality measures at follow-up. Participants were generally satisfied with their experience. The most influential module elements were collecting and analyzing data, creating and implementing aim statements and improvement plans, and completing "QI Basics." Online educational programs, such as EQIPP, hold promise for front-line clinicians to learn QI. The sustainability of the observed improvements in care processes and their linkage to improvements in health outcomes are unknown and are an essential topic for future study. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  20. Moral Hazard in Pediatrics.

    Science.gov (United States)

    Brunnquell, Donald; Michaelson, Christopher M

    2016-07-01

    "Moral hazard" is a term familiar in economics and business ethics that illuminates why rational parties sometimes choose decisions with bad moral outcomes without necessarily intending to behave selfishly or immorally. The term is not generally used in medical ethics. Decision makers such as parents and physicians generally do not use the concept or the word in evaluating ethical dilemmas. They may not even be aware of the precise nature of the moral hazard problem they are experiencing, beyond a general concern for the patient's seemingly excessive burden. This article brings the language and logic of moral hazard to pediatrics. The concept reminds us that decision makers in this context are often not the primary party affected by their decisions. It appraises the full scope of risk at issue when decision makers decide on behalf of others and leads us to separate, respect, and prioritize the interests of affected parties.

  1. [Quality management in acute pain therapy: results from a survey of certified hospitals].

    Science.gov (United States)

    Böhmer, A B; Poels, M; Simanski, C; Trojan, S; Messer, K; Wirtz, M D; Neugebauer, E A M; Wappler, F; Joppich, R

    2012-08-01

    Systems for and methods of quality management are increasingly being implemented in public health services. The aim of our study was to analyze the current state of the integrated quality management concept "quality management acute pain therapy" of the TÜV Rheinland® (TÜV) after a 5-year project period. General characteristics of the participating hospitals, number of departments certified by the TÜV and implementation of structures and processes according to the TÜV guidelines were evaluated by a mail questionnaire. Furthermore, positive and negative aspects concerning the effects of certification were evaluated by the hospitals' representatives of certification. A total of 36 questionnaires were returned. Since 2006 the number of certified hospitals (2011: n = 48) and surgical departments (2011: n = 202) has increased continuously. The number of certified medical departments is low (2011: n = 39); however, in the last 3 years, it has increased by about 200-300% annually. Standard operative procedures for pain therapy and measurement of pain intensity at regular intervals were implemented in all certified clinics (100%). Although 41% take part in the benchmarking project QUIPS (Quality Improvement in Postoperative Pain Therapy), 24% do not systematically check the quality of the outcome of pain management. Acceptance of the new pain therapy concepts among nursing staff was rated positively (ratio positive:negative 16:1); however, acceptance among physicians was rated negatively (1:15). Certification by the TÜV leads to sustainable implementation of quality management principles. Future efforts should focus on better integration of physicians in acute pain therapy and the development of an integrated tool to measure patients' outcome.

  2. Pediatric Academic Productivity: Pediatric Benchmarks for the h- and g-Indices.

    Science.gov (United States)

    Tschudy, Megan M; Rowe, Tashi L; Dover, George J; Cheng, Tina L

    2016-02-01

    To describe h- and g-indices benchmarks in pediatric subspecialties and general academic pediatrics. Academic productivity is measured increasingly through bibliometrics that derive a statistical enumeration of academic output and impact. The h- and g-indices incorporate the number of publications and citations. Benchmarks for pediatrics have not been reported. Thirty programs were selected randomly from pediatric residency programs accredited by the Accreditation Council for Graduate Medical Education. The h- and g-indices of department chairs were calculated. For general academic pediatrics, pediatric gastroenterology, and pediatric nephrology, a random sample of 30 programs with fellowships were selected. Within each program, an MD faculty member from each academic rank was selected randomly. Google Scholar via Harzing's Publish or Perish was used to calculate the h-index, g-index, and total manuscripts. Only peer-reviewed and English language publications were included. For Chairs, calculations from Google Scholar were compared with Scopus. For all specialties, the mean h- and g-indices significantly increased with academic rank (all P calculation using different bibliographic databases only differed by ±1. Mean h-indices increased with academic rank and were not significantly different across the pediatric specialties. Benchmarks for h- and g-indices in pediatrics are provided and may be one measure of academic productivity and impact. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. 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

    2014-11-01

    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.

  4. 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...

  5. Pediatric Uveitis.

    Science.gov (United States)

    Chan, Nicole Shu-Wen; Choi, Jessy; Cheung, Chui Ming Gemmy

    2018-01-01

    Pediatric uveitis differs from adult-onset uveitis and is a topic of special interest because of its diagnostic and therapeutic challenges. Children with uveitis are often asymptomatic and the uveitis is often chronic, persistent, recurrent, and resistant to conventional treatment. Anterior uveitis is the most common type of uveitis in children; the prevalence of intermediate, posterior, and panuveitis varies geographically and among ethnic groups. Regarding etiology, most cases of pediatric uveitis are idiopathic but can be due to systemic inflammatory disorders, infections, or a manifestation of masquerade syndrome. Ocular complications include cataracts, hypotony or glaucoma, band keratopathy, synechiae formation, macular edema, optic disc edema, choroidal neovascular membranes, and retinal detachment. These complications are often severe, leading to irreversible structural damage and significant visual disability due to delayed presentation and diagnosis, persistent chronic inflammation from suboptimal treatment, topical and systemic corticosteroid dependence, and delayed initiation of systemic disease‒modifying agents. Treatment for noninfectious uveitis is a stepwise approach starting with corticosteroids. Immunomodulatory therapy should be initiated in cases where quiescence cannot be achieved without steroid dependence. Patients should be monitored regularly for complications of uveitis along with systemic and ocular adverse effects from treatments. The goals are to achieve steroid-free durable remission, to reduce the risk of sight-threatening complications from the uncontrolled ocular inflammation, and to avoid the impact of lifelong burden of visual loss on the child and their family. Multidisciplinary management will ensure holistic care of affected children and improve the support for their families. Copyright 2018 Asia-Pacific Academy of Ophthalmology.

  6. NEW CZECH & CERTIFIED METHODOLOGY „TOOLS OF RESILIENCE“

    Directory of Open Access Journals (Sweden)

    Pavel DOBEŠ

    2017-12-01

    Full Text Available The article deals with possibilities of better governance regarding natural and anthropogenic risks and building of resilience of medium towns and cities against disasters. Such systematic approach could be applied for example using new Czech certified methodology “Tools Of Resilience”, which has been developed recently within the short project number no. VF20152016047 under the grant of Czech Ministry of the Interior in period 2015 - 2016 and afterwards certified in 2017 by Czech Ministry of the Environment. Basic starting points, used methods, steps of new methodology and its annexes, will be breafly described in the topic.

  7. 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).

  8. 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

  9. General Ultrasound Imaging

    Medline Plus

    Full Text Available ... Send us your feedback Did you find the information you were looking for? Yes No Please type your comment or suggestion ... General ultrasound procedure View full size with caption Pediatric ...

  10. 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

  11. 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

  12. 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 ...

  13. Sedation in Pediatric Esophagogastroduodenoscopy

    Directory of Open Access Journals (Sweden)

    Seak Hee Oh

    2018-03-01

    Full Text Available Pediatric esophagogastroduodenoscopy (EGD has become an established diagnostic and therapeutic modality in pediatric gastroenterology. Effective sedation strategies have been adopted to improve patient tolerance during pediatric EGD. For children, safety is a fundamental consideration during this procedure as they are at a higher risk of severe adverse events from procedural sedation compared to adults. Therefore, a detailed risk evaluation is required prior to the procedure, and practitioners should be aware of the benefits and risks associated with sedation regimens during pediatric EGD. In addition, pediatric advanced life support by endoscopists or immediate intervention by anesthesiologists should be available in the event that severe adverse events occur during pediatric EGD.

  14. 40 CFR 85.1505 - Final admission of certified vehicles.

    Science.gov (United States)

    2010-07-01

    ... PROGRAMS (CONTINUED) CONTROL OF AIR POLLUTION FROM MOBILE SOURCES Importation of Motor Vehicles and Motor... vehicle or engine from the previous test (e.g., adjusting the RPM, timing, air-to-fuel ratio, etc.) other... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Final admission of certified vehicles...

  15. 77 FR 43535 - Grantee Codes for Certified Radiofrequency Equipment

    Science.gov (United States)

    2012-07-25

    ... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 2 [FCC 12-60] Grantee Codes for Certified Radiofrequency Equipment AGENCY: Federal Communications Commission. ACTION: Final rule. SUMMARY: This document... authorization program for radiofrequency (RF) devices under part 2 of its rules. This program is one of the...

  16. 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. [T.D. 73-175, 38 FR 17482, July 2, 1973, as amended by T.D. 81-117, 46 FR...

  17. A Comparison of Alienation among Alternatively and Traditionally Certified Teachers.

    Science.gov (United States)

    Shoho, Alan R.; Martin, Nancy K.

    The purpose of this study was to investigate the perceptions of alienation among alternatively and traditionally certified teachers. A total of 228 teachers in grades K-12 from a public university offering both traditional certification (TC) and cooperative alternative certification (AC) graduate programs were assessed using the School Alienation…

  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. 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.

  20. 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...

  1. 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...

  2. 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...

  3. 78 FR 79010 - Criteria to Certify Coal Mine Rescue Teams

    Science.gov (United States)

    2013-12-27

    ... coal requires more heat to combust; (3) anthracite dust does not propagate an explosion; and (4) there... to Certify Coal Mine Rescue Teams AGENCY: Mine Safety and Health Administration, Labor. ACTION... updated the coal mine rescue team certification criteria. The Mine Improvement and New Emergency Response...

  4. The Meaning of Reflective Teaching to National Board Certified Teachers

    Science.gov (United States)

    Carey, Sharlotte F.

    2017-01-01

    This qualitative study examined how National Board certified teachers (NBCTs) perceive the meaning of reflective teaching and how their perceptions compare to the literature on reflective thinking and teaching. The study included five participants who had completed the National Board certification process. Data collection included three…

  5. 19 CFR 115.7 - Designation of additional Certifying Authorities.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Designation of additional Certifying Authorities. 115.7 Section 115.7 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY CARGO CONTAINER AND ROAD VEHICLE CERTIFICATION PURSUANT TO INTERNATIONAL CUSTOMS...

  6. 19 CFR 115.12 - Records maintained by Certifying Authority.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Records maintained by Certifying Authority. 115.12 Section 115.12 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY CARGO CONTAINER AND ROAD VEHICLE CERTIFICATION PURSUANT TO INTERNATIONAL CUSTOMS...

  7. 44 CFR 204.53 - Certifying costs and payments.

    Science.gov (United States)

    2010-10-01

    ....21 and U. S. Treasury 31 CFR part 205, Cash Management Improvement Act. ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Certifying costs and payments. 204.53 Section 204.53 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY...

  8. 40 CFR 85.1407 - Notification of intent to certify.

    Science.gov (United States)

    2010-07-01

    ... handling costs and taxes; (ii) A detailed breakout of the total number of hours necessary to install the... documentation that demonstrate compliance with the life cycle cost requirements specified in § 85.1403(b)(1)(ii... by the equipment certifier as evidence of compliance with the emission requirements specified in § 85...

  9. Variation in Part-Time Work among Pediatric Subspecialties.

    Science.gov (United States)

    Freed, Gary L; Boyer, Debra M; Van, Kenton D; Macy, Michelle L; McCormick, Julie; Leslie, Laurel K

    2018-04-01

    To assess the part-time workforce and average hours worked per week among pediatric subspecialists in the 15 medical subspecialties certified by the American Board of Pediatrics. We examined data from pediatric subspecialists who enrolled in Maintenance of Certification with the American Board of Pediatrics from 2009 to 2015. Data were collected via an online survey. Providers indicated whether they worked full time or part time and estimated the average number of hours worked per week in clinical, research, education, and administrative tasks, excluding time on call. We calculated and compared the range of hours worked by those in full- and part-time positions overall, by demographic characteristics, and by subspecialty. Overall, 9.6% of subspecialists worked part time. There was significant variation in part-time employment rates between subspecialties, ranging from 3.8% among critical care pediatricians to 22.9% among developmental-behavioral pediatricians. Women, American medical graduates, and physicians older than 70 years of age reported higher rates of part-time employment than men, international medical graduates, and younger physicians. There was marked variation in the number of hours worked across subspecialties. Most, but not all, full-time subspecialists reported working at least 40 hours per week. More than one-half of physicians working part time in hematology and oncology, pulmonology, and transplant hepatology reported working at least 40 hours per week. There are unique patterns of part-time employment and hours worked per week among pediatric medical subspecialists that make simple head counts inadequate to determine the effective workforce. Our findings are limited to the 15 American Board of Pediatrics-certified medical subspecialties. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Pediatric Celiac Disease

    Science.gov (United States)

    ... a protein found in wheat, rye, and barley. Pediatric Celiac Disease If your child has celiac disease, ... physician. Established by the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) Celiac Disease Eosinophilic ...

  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. Pediatric Voiding Cystourethrogram

    Science.gov (United States)

    Scan for mobile link. Children's (Pediatric) Voiding Cystourethrogram A children’s (pediatric) voiding cystourethrogram uses fluoroscopy – a form of real-time x-ray – to examine a child’s bladder ...

  13. 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.

  14. Pediatric Brain Tumor Foundation

    Science.gov (United States)

    ... navigate their brain tumor diagnosis. WATCH AND SHARE Brain tumors and their treatment can be deadly so ... Pediatric Central Nervous System Cancers Read more >> Pediatric Brain Tumor Foundation 302 Ridgefield Court, Asheville, NC 28806 ...

  15. Pediatric Thyroid Cancer

    Science.gov (United States)

    ... Marketplace Find an ENT Doctor Near You Pediatric Thyroid Cancer Pediatric Thyroid Cancer Patient Health Information News media ... and neck issues, should be consulted. Types of thyroid cancer in children: Papillary : This form of thyroid cancer ...

  16. Pediatric Endocrinology Nurses Society

    Science.gov (United States)

    ... Join Now International Welcome to PENS The Pediatric Endocrinology Nursing Society (PENS) is committed to the development ... nurses in the art and science of pediatric endocrinology nursing. Learn More Text1 2018 PENS Call for ...

  17. National Pediatric Program Update

    International Nuclear Information System (INIS)

    2008-01-01

    The book of the National Pediatric Program Update, issued by the Argentina Society of Pediatrics, describes important issues, including: effective treatment of addictions (drugs); defects of the neural tube; and the use of radiation imaging in diagnosis. [es

  18. Evaluation of Wheat (Triticum aestivum, L. Seed Quality of Certified Seed and Farm-Saved Seed in Three Provinces of Iran

    Directory of Open Access Journals (Sweden)

    Khazaei Fardin

    2016-06-01

    Full Text Available The objective of this study was to study the seed quality aspects of wheat (Triticum aestivum L. and the extent of weed seed contamination present in wheat seeds produced in different regions of Iran. Four districts (cities, each including 12 fields (six certified seed fields and six farm-saved seed fields, were selected in each regions (provinces. One kilogram of the wheat seed sample was collected from each field for analysis in the laboratory. Wheat seeding was commonly done by farm-saved seed sourced from within the farm due to the high costs of certified seeds purchased from outside sources, followed by the low seed quality. The use of a farm-saved seed resulted in a higher germination rate and a lower mean time to germination compared with another system. The more positive temperatures experienced by mother plants could decrease the number of normal seedling and seedling length vigor index. Generally there was virtually no difference about physiological quality between certified seed and farm-saved seed sector that is related to lower quality of certified seed. The certified produced seeds had the lower number of weed seed, species and genus before and after cleaning. The highest seed purity and 1000 seed weight was obtained from the certified seed production system. The need for cleaning the farm-saved seed samples before sowing is one of the important findings of this survey.

  19. Pediatric portal hypertension

    Science.gov (United States)

    Vogel, Clarissa Barbon

    2017-01-01

    Abstract: Pediatric portal hypertension management is a team approach between the patient, the patient's family, the primary caregiver, and specialty providers. Evidence-based practice guidelines have not been established in pediatrics. This article serves as a review for the primary care NP in the management of pediatric portal hypertension, discussing the etiology, pathophysiology, and clinical presentation of pediatric portal hypertension, diagnostic tests, and treatment and management options. PMID:28406835

  20. Nuclear imaging in pediatrics

    International Nuclear Information System (INIS)

    Siddiqui, A.R.

    1985-01-01

    The author's intent is to familiarize practicing radiologists with the technical aspects and interpretation of nuclear medicine procedures in children and to illustrate the indications for nuclear medicine procedures in pediatric problems. Pediatric doses, dosimetry, sedation, and injection techniques, organ systems, oncology and infection, testicular scanning and nuclear crystography, pediatric endocrine and skeletal systems, ventilation and perfusion imaging of both congenital and acquired pediatric disorders, cardiovascular problems, gastrointestinal, hepatobiliary, reticuloendothelial studies, and central nervous system are all topics which are included and discussed

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

    African Journals Online (AJOL)

    Background: Recognition of mental health problems among children continues to be a diagnostic challenge especially in resource poor countries where integration of such services within the primary health care framework has not been fully successfully. Objective: To document the prevailing mental services among ...

  2. Pharmacology of pediatric resuscitation.

    Science.gov (United States)

    Ushay, H M; Notterman, D A

    1997-02-01

    The resuscitation of children from cardiac arrest and shock remains a challenging goal. The pharmacologic principles underlying current recommendations for intervention in pediatric cardiac arrest have been reviewed. Current research efforts, points of controversy, and accepted practices that may not be most efficacious have been described. Epinephrine remains the most effective resuscitation adjunct. High-dose epinephrine is tolerated better in children than in adults, but its efficacy has not received full analysis. The preponderance of data continues to point toward the ineffectiveness and possible deleterious effects of overzealous sodium bicarbonate use. Calcium chloride is useful in the treatment of ionized hypocalcemia but may harm cells that have experienced asphyxial damage. Atropine is an effective agent for alleviating bradycardia induced by increased vagal tone, but because most bradycardia in children is caused by hypoxia, improved oxygenation is the intervention of choice. Adenosine is an effective and generally well-tolerated agent for the treatment of supraventricular tachycardia. Lidocaine is the drug of choice for ventricular dysrhythmias, and bretylium, still relatively unexplored, is in reserve. Many pediatricians use dopamine for shock in the postresuscitative period, but epinephrine is superior. Most animal research on cardiac arrest is based on models with ventricular fibrillation that probably are not reflective of cardiac arrest situations most often seen in pediatrics.

  3. Annals of Pediatric Surgery

    African Journals Online (AJOL)

    The Annals of Pediatric Surgery is striving to fill an important niche that provides focus to clinical care, technical innovation and clinical research. The Annals of Pediatric Surgery has the responsibility to serve not only pediatric surgeons in the Middle East and North Africa but also should be an important conduit for scientific ...

  4. Pediatric neurocritical care.

    Science.gov (United States)

    Murphy, Sarah

    2012-01-01

    Pediatric neurocritical care is an emerging multidisciplinary field of medicine and a new frontier in pediatric critical care and pediatric neurology. Central to pediatric neurocritical care is the goal of improving outcomes in critically ill pediatric patients with neurological illness or injury and limiting secondary brain injury through optimal critical care delivery and the support of brain function. There is a pressing need for evidence based guidelines in pediatric neurocritical care, notably in pediatric traumatic brain injury and pediatric stroke. These diseases have distinct clinical and pathophysiological features that distinguish them from their adult counterparts and prevent the direct translation of the adult experience to pediatric patients. Increased attention is also being paid to the broader application of neuromonitoring and neuroprotective strategies in the pediatric intensive care unit, in both primary neurological and primary non-neurological disease states. Although much can be learned from the adult experience, there are important differences in the critically ill pediatric population and in the circumstances that surround the emergence of neurocritical care in pediatrics.

  5. Radiodiagnosis in pediatrics today

    International Nuclear Information System (INIS)

    Baklanova, V.F.

    1982-01-01

    The fields of radiodiagnosis application in pediatrics are considered. The improvement of roentgenologic methods and application of various contrast proparations enable to study and precisely differentiate congenital and acquired diseases. The scope of roentgenology application in pediatrics extends due to differentiation of pediatric specialities. New methods of investigation with decreasing radiation exposure to minimal are realized [ru

  6. Pediatric advanced life support and sedation of pediatric dental patients.

    Science.gov (United States)

    Kim, Jongbin

    2016-03-01

    Programs provided by the Korea Association of Cardiopulmonary Resuscitation include Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Korean Advanced Life Support (KALS). However, programs pertinent to dental care are lacking. Since 2015, related organizations have been attempting to develop a Dental Advanced Life Support (DALS) program, which can meet the needs of the dental environment. Generally, for initial management of emergency situations, basic life support is most important. However, emergencies in young children mostly involve breathing. Therefore, physicians who treat pediatric dental patients should learn PALS. It is necessary for the physician to regularly renew training every two years to be able to immediately implement professional skills in emergency situations. In order to manage emergency situations in the pediatric dental clinic, respiratory support is most important. Therefore, mastering professional PALS, which includes respiratory care and core cases, particularly upper airway obstruction and respiratory depression caused by a respiratory control problem, would be highly desirable for a physician who treats pediatric dental patients. Regular training and renewal training every two years is absolutely necessary to be able to immediately implement professional skills in emergency situations.

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

    DEFF Research Database (Denmark)

    Alfonso, Jose H; 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....... Occupational skin exposure (in 2009) was measured based on 5 items. The outcome of interest was physician-certified long-term sick leave ≥ 16 days during 2010. Statistical adjustment for psychosocial and mechanical occupational exposures was performed. Long-term sick leave was predicted by occupational skin...... exposure to cleaning products (odds ratio (OR) 1.7; 95% confidence interval (95% CI) 1.1-2.5) and waste (OR 2.1; 95% CI 1.1-3.7) among men, and occupational skin exposure to water (OR 1.3; 95% CI 1.0-1.6) among women. The estimated population attributable risk for occupational skin exposure was 14...

  8. Pediatric advanced life support and sedation of pediatric dental patients

    OpenAIRE

    Kim, Jongbin

    2016-01-01

    Programs provided by the Korea Association of Cardiopulmonary Resuscitation include Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Korean Advanced Life Support (KALS). However, programs pertinent to dental care are lacking. Since 2015, related organizations have been attempting to develop a Dental Advanced Life Support (DALS) program, which can meet the needs of the dental environment. Generally, for initial management of emergency ...

  9. Risk Factors for Postoperative Nausea and Vomiting in Pediatric ...

    African Journals Online (AJOL)

    2018-05-22

    May 22, 2018 ... nausea and vomiting (PONV) in children receiving dental treatment under general anesthesia .... For pediatric patients undergoing dental treatment under general anesthesia ..... Consensus guidelines for the management.

  10. Perception of pediatric neurology among non-neurologists.

    Science.gov (United States)

    Jan, Mohammed M S

    2004-01-01

    Pediatric neurology is considered a relatively new and evolving subspecialty. In Saudi Arabia, neurologic disorders in children are common, and the demand for trained pediatric neurologists is strong. The aim was to study the perception of the pediatric neurology specialty among practicing generalists and their referral practices. Attendees of a symposium on pediatric epilepsy comprehensive review for the generalist were included. A structured 25-item questionnaire was designed to examine their demographics, training, practice, and referral patterns. One hundred nineteen participants attended the symposium, and 90 (76%) questionnaires were returned. Attendees' ages were 22 to 70 years (mean 32 years), with 65.5% female physicians. There were 32% consultants, 51% trainees, and 17% students. Most physicians (67%) were practicing general pediatrics. Only 36% received a structured pediatric neurology rotation during training. Children with neurologic complaints constituted 28.5% of those seen in their practice, and they referred 32.5% of them to pediatric neurology. Only 32% were moderately or highly confident in making the diagnosis or providing the appropriate treatment. Those who received a structured pediatric neurology rotation felt more comfortable in their management (P = .03). Many physicians (38.5%) had no direct access to a pediatric neurologist for referrals. To conclude, pediatric neurologic disorders are common in daily practice. Most generalists did not receive a structured neurology rotation during their training and were not highly confident in diagnosing and treating these children. Given the limited number of pediatric neurologists, I highly recommend that generalists receive appropriate neurologic training.

  11. Elemental Quantification and Residues Characterization of Wet Digested Certified and Commercial Carbon Materials

    KAUST Repository

    Simoes, Filipa R. F.; Batra, Nitin M.; Warsama, Bashir H.; Canlas, Christian; Patole, Shashikant; Yapici, Tahir F.; Costa, Pedro M. F. J.

    2016-01-01

    .g., graphene and nanotubes) has suffered from the lack of efficient digestion steps and certified reference materials (CRM). Here, various commercial and certified graphitic carbon materials were subjected to a

  12. Exponential gain of randomness certified by quantum contextuality

    Science.gov (United States)

    Um, Mark; Zhang, Junhua; Wang, Ye; Wang, Pengfei; Kim, Kihwan

    2017-04-01

    We demonstrate the protocol of exponential gain of randomness certified by quantum contextuality in a trapped ion system. The genuine randomness can be produced by quantum principle and certified by quantum inequalities. Recently, randomness expansion protocols based on inequality of Bell-text and Kochen-Specker (KS) theorem, have been demonstrated. These schemes have been theoretically innovated to exponentially expand the randomness and amplify the randomness from weak initial random seed. Here, we report the experimental evidence of such exponential expansion of randomness. In the experiment, we use three states of a 138Ba + ion between a ground state and two quadrupole states. In the 138Ba + ion system, we do not have detection loophole and we apply a methods to rule out certain hidden variable models that obey a kind of extended noncontextuality.

  13. 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...... of CPR skills may be beneficial to ensure high-quality learning outcome.Author Disclosures: C. Hansen: None. S.E. Rasmussen: None. M.A. Nebsbjerg: None. M. Stærk: None. B. Løfgren: None....

  14. 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.

  15. A new certified reference material for size analysis of nanoparticles

    International Nuclear Information System (INIS)

    Braun, Adelina; Kestens, Vikram; Franks, Katrin; Roebben, Gert; Lamberty, Andrée; Linsinger, Thomas P. J.

    2012-01-01

    A certified reference material, ERM-FD100, for quality assurance and validation of various nanoparticle sizing methods, was developed by the Institute for Reference Materials and Measurements. The material was prepared from an industrially sourced colloidal silica containing nanoparticles with a nominal equivalent spherical diameter of 20 nm. The homogeneity and stability of the candidate reference material was assessed by means of dynamic light scattering and centrifugal liquid sedimentation. Certification of the candidate reference material was based on a global interlaboratory comparison in which 34 laboratories participated with various analytical methods (DLS, CLS, EM, SAXS, ELS). After scrutinising the interlaboratory comparison data, 4 different certified particle size values, specific for the corresponding analytical method, could be assigned. The good comparability of results allowed the certification of the colloidal silica material for nanoparticle size analysis.

  16. Production of quality/certified seed of fodder-crops

    International Nuclear Information System (INIS)

    Bhutta, A.R.; Hussain, A.

    2006-01-01

    Although, Pakistan has well developed Seed-production and certification Programme for major crops, but seed programme for fodder-crops is still not well organized. Availability of local certified seed, remained 250-350 mt for Berseem, Sorghum, maize, barley and oat. About 5000 to 9000 mt of seed has being imported during 2003-04 to 2005-06. Fodder Research Institute and jullundhur Seed Corporation have demonstrated a model of public/private partnership for initiation of certified seed of a few fodder crops. To produce quality seeds of fodder crops, various steps, procedures and prescribed standards have been given, which will help in production of quality seed of fodder crops in Pakistan. (author)

  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. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

  18. 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.

  19. 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.

  20. Vehicle Authentication via Monolithically Certified Public Key and Attributes

    OpenAIRE

    Dolev, Shlomi; Krzywiecki, Łukasz; Panwar, Nisha; Segal, Michael

    2015-01-01

    Vehicular networks are used to coordinate actions among vehicles in traffic by the use of wireless transceivers (pairs of transmitters and receivers). Unfortunately, the wireless communication among vehicles is vulnerable to security threats that may lead to very serious safety hazards. In this work, we propose a viable solution for coping with Man-in-the-Middle attacks. Conventionally, Public Key Infrastructure (PKI) is utilized for a secure communication with the pre-certified public key. H...

  1. A proposed evolution for the Italian certified electronic mail system

    OpenAIRE

    Buzzi, Marina; Ferrucci, Luca; Francesco, Gennai; Petrucci, Claudio

    2016-01-01

    One the main objective of the European Commission is to innovate and bring ICT to its full potential in any sector, including eGovernment, eCommerce, and eHealth services. Certified Electronic Mail (CEM) systems of Member States are currently not interoperable, thus impacting on economic growth and competitiveness. The paper investigates the use of the DNSSec technology as a technological evolution of the Italian CEM System and the first step towards interoperability and adherence to internat...

  2. 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...

  3. Cost analysis of LEED certified United States navy buildings

    OpenAIRE

    Kirar, Carl V.

    2011-01-01

    CIVINS (Civilian Institutions) Thesis document A study was completed at UW-Madison in 2010 that reviewed the energy consumption of US Navy buildings which earned Leadership in Energy and Environmental Design (LEED) certification by the United States Green Building Council (USGBC). The research compared LEED certified buildings to a commercial counterpart within the US Navy inventory against Executive Order (EO) 13423. The EO mandated that all federal agencies meet a 30 percent reduction of...

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

    International Nuclear Information System (INIS)

    Kim, Ho Cheol

    2011-07-01

    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.

  5. A comparison of certified and noncertified pet foods.

    OpenAIRE

    Brown, R G

    1997-01-01

    The market presents the buyer with a wide array of pet food choices. Marketing pet foods has changed in the last decade and today foods may be bought at a variety of outlets. The present study compares nutrient composition, digestibility, and effect on urine pH (cat foods only) of selected certified and noncertified pet foods from different outlets. The selected foods were considered analogous in terms of declared ingredients and macronutrient profiles. The analytical methods used were those ...

  6. Implementation plans for the Korean certified tumor registrar qualification system.

    Science.gov (United States)

    Boo, Yoo-Kyung; Lim, Hyun-Sook; Won, Young-Joo

    2014-01-01

    Cancer registration data is used to understand the nation's cancer burden, and to provide significant baseline data for cancer control efforts, as well as, research on cancer incidence, mortality, survival, and prevalence. A system that approves, assesses, and manages the qualification of specialists, responsible for performing cancer registration, has not been developed in Korea. This study presents ways to implement a certification system designed for the qualification of tumor registrars in Korea. Requirements for implementing a certified tumor registrar qualification system were determined by reviewing the system for establishing qualifications in Korea and the American qualification system via the National Cancer Registrars Association (NCRA). Moreover, a survey was conducted on Korean medical records administrators, who had taken the U.S. Certified Tumor Registrar (CTR) examination, in order to review their opinions regarding these requirements. This study verified the feasibility of a qualification examination based on the opinions of CTR specialists by determining the following: items, and the associated ratings, of the qualifications necessary to register individuals as certified tumor registrars in a private qualification system; status of human resources required for the examination or training processes; plans regarding the organization needed for management, and operation of qualifications, examination standards, subject areas, examination methods, examination qualifications, or education and training programs. The implementation of a certified tumor registrar qualification system will lead to enhanced job competency for specialists and a qualitative improvement of cancer registration data. It will also reliably foster human resources that will lay the groundwork needed to establish scientific and reasonable national cancer management policies.

  7. 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.

  8. Pediatric radiology for medical-technical radiology assistants/radiologists

    International Nuclear Information System (INIS)

    Oppelt, Birgit

    2010-01-01

    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.

  9. Imbalances in the German public health system - numbers of state-certified occupational physicians and relation to socioeconomic data.

    Science.gov (United States)

    Gyo, Christoph; Boll, Michael; Brüggmann, Dörthe; Klingelhöfer, Doris; Quarcoo, David; Groneberg, David A

    2016-01-01

    State-certified occupational physicians who work as civil servants in the Federal Republic of Germany are key players in the German Public Health system. They control i.e. the legal compliance in occupational health and participate in the occupational disease procedures. Despite the role model function of the German Public health system for many developing countries, this area of Public health is debated to have been hampered in the past years by a disregard concerning structural developments. Different databases were screened for occupational health benchmarks. Obtained data were compared to socioeconomic data and indices were calculated. The overall numbers of State-certified occupational physicians decreased in Germany between 1992 and 2012 from 136 to 86 (63 %). On the single state level, the ratios of State-certified occupational physicians per 1 Mio. working population ranged from 8 for the state of Saarland to 0.8 for the state of North Rhine Westphalia. A general difference was found for old versus new German states. Also, large differences were present for the ratios of State-certified occupational physicians per 10 6 employees towards public debt per capita (€) and the ratios of State-certified occupational physicians per Gross Domestic Product (GDP) in the 16 German states in 2012. In striking contrast to the WHO document on the Occupational safety and health (OSH) system that states in its executive summary that the human and institutional capacities of the German occupational health system are very strong in both quantity and quality, we here show extreme imbalances present at the single state levels that developed over the past 20 years. With a regard to the increasing complexity of the economic system a reversal of this trend should be demanded.

  10. 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 program...

  11. 43 CFR 44.23 - How does the Department certify payment computations?

    Science.gov (United States)

    2010-10-01

    ... Certified Public Accountant, or an independent public accountant, that the statement has been audited in... guidelines that State auditors, independent Certified Public Accountants, or independent public accountants... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false How does the Department certify payment...

  12. 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 CORPORATION, DEPARTMENT OF AGRICULTURE COMMON CROP INSURANCE REGULATIONS § 457.145 Potato crop insurance—certified seed endorsement. The Potato Crop Insurance Certified Seed Endorsement Provisions for...

  13. 7 CFR 201.73 - Processors and processing of all classes of certified seed.

    Science.gov (United States)

    2010-01-01

    ... (CONTINUED) FEDERAL SEED ACT FEDERAL SEED ACT REGULATIONS Certified Seed § 201.73 Processors and processing... of certified seed: (a) Facilities shall be available to perform processing without introducing... 7 Agriculture 3 2010-01-01 2010-01-01 false Processors and processing of all classes of certified...

  14. 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.

  15. Diagnosis of poor safety culture as a major shortcoming in OHSAS 18001-certified companies.

    Science.gov (United States)

    Ghahramani, Abolfazl

    2017-04-07

    The evaluation of safety performance in occupational health and safety assessment series (OHSAS) 18001-certified companies provides useful information about the quality of the management system. A certified organization should employ an adequate level of safety management and a positive safety culture to achieve a satisfactory safety performance. The present study conducted in six manufacturing companies: three OHSAS 18001-certified, and three non-certified to assess occupational health and safety (OHS) as well as OHSAS 18001 practices. The certified companies had a better OHS practices compared with the non-certified companies. The certified companies slightly differed in OHS and OHSAS 18001 practices and one of the certified companies had the highest activity rates for both practices. The results indicated that the implemented management systems have not developed and been maintained appropriately in the certified companies. The in-depth analysis of the collected evidence revealed shortcomings in safety culture improvement in the certified companies. This study highlights the importance of safety culture to continuously improve the quality of OHSAS 18001 and to properly perform OHS/OHSAS 18001 practices in the certified companies.

  16. 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.

  17. 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

  18. 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 ...

  19. 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 ...

  20. 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 ...

  1. 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 ...

  2. What is Pediatric Palliative Care?

    Science.gov (United States)

    ... FAQ Handout for Patients and Families What Is Pediatric Palliative Care? Pediatric Palliative care (pronounced pal-lee-uh-tiv) is ... life for both the child and the family. Pediatric palliative care is provided by a team of ...

  3. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Children's (Pediatric) Ultrasound - Abdomen Children’s (pediatric) ultrasound imaging of the ... abdomen using ultrasound. View full size with caption Pediatric Content Some imaging tests and treatments have special ...

  4. 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 ...

  5. Children's (Pediatric) Abdominal Ultrasound Imaging

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Children's (Pediatric) Ultrasound - Abdomen Children’s (pediatric) ultrasound imaging of the ... abdomen using ultrasound. View full size with caption Pediatric Content Some imaging tests and treatments have special ...

  6. Norwegian farmers ceasing certified organic production: characteristics and reasons.

    Science.gov (United States)

    Flaten, Ola; Lien, Gudbrand; Koesling, Matthias; Løes, Anne-Kristin

    2010-12-01

    This article examines the characteristics of and reasons for Norwegian farmers' ceasing or planning to cease certified organic production. We gathered cross-sectional survey data in late 2007 from organic farmers deregistering between January 2004 and September 2007 (n=220), and similar data from a random sample of farmers with certified organic management in 2006 (n=407). Of the respondents deregistering by November 2007, 17% had quit farming altogether, 61% now farmed conventionally, and 21% were still farming by organic principles, but without certification. Nearly one in four organic farmers in 2007 indicated that they planned to cease certification within the next 5-10 years. From the two survey samples, we categorised farmers who expect to be deregistered in 5-10 years into three groups: conventional practices (n=139), continuing to farm using organic principles (uncertified organic deregistrants, n=105), and stopped farming (n=33). Of the numerous differences among these groups, two were most striking: the superior sales of uncertified organic deregistrants through consumer-direct marketing and the lowest shares of organic land among conventional deregistrants. We summarised a large number of reasons for deregistering into five factors through factor analysis: economics, regulations, knowledge-exchange, production, and market access. Items relating to economics and regulations were the primary reasons offered for opting out. The regression analysis showed that the various factors were associated with several explanatory variables. Regulations, for example, figured more highly among livestock farmers than crop farmers. The economic factor strongly reflected just a few years of organic management. Policy recommendations for reducing the number of dropouts are to focus on economics, environmental attitudes, and the regulatory issues surrounding certified organic production. Copyright © 2010 Elsevier Ltd. All rights reserved.

  7. 40 CFR 86.447-2006 - What provisions apply to motorcycle engines below 50 cc that are certified under the Small SI...

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 18 2010-07-01 2010-07-01 false What provisions apply to motorcycle... Regulations for 1978 and Later New Motorcycles, General Provisions § 86.447-2006 What provisions apply to motorcycle engines below 50 cc that are certified under the Small SI program or the Recreational-vehicle...

  8. Applications of nuclear magnetic resonance spectroscopy to certifiable food colors

    International Nuclear Information System (INIS)

    Marmion, D.M.

    Nuclear magnetic resonance spectroscopy was found suitable for the identification of individual colours, for distinguishing individual colours from colour mixtures, for the identification and semi-quantitative determination of the individual colours in mixtures and for proofs of the adulteration of certified colours adding noncertified colours. The method is well suited for observing the purity of colours and may also be used as the control method in the manufacture of colours and in assessing their stability and their resistance to increased temperature and light. (M.K.)

  9. Pediatric radiology

    International Nuclear Information System (INIS)

    Kirkpatrick, J.A. Jr.

    1987-01-01

    Magnetic resonance imaging is proving to be a powerful diagnostic modality. Included in this year's abstracts and discussions are papers having to do with it application to neoplasia in general and a variety of specific disorders of the brain and spinal column. Magnetic resonance spectroscopy is reported; whether or not this becomes practical, it is an exciting prospect. Perhaps because interventional techniques are so readily applicable at this time, both in the infant and child as well as in the adult, little has been included. On the other hand, some disorders that were in the province of adult medicine are now becoming distressingly common in infants and children, i.e., the adult respiratory distress syndrome; the acquired immune deficiency syndrome and AIDS-related complex; and aluminum bone disease in children. Of those developments that are promising and related to the infant or child, one can count the articles having to do with extracorporeal membrane oxygenation and the treatment of the respiratory distress syndrome, hyaline membrane disease, with human surfactant. The latter raises expectations for the end of multiple examinations of the sick neonate necessary for the definition and follow-up of pulmonary interstitial emphysema and the other complications of air block phenomenon. The two contributions on the role of diagnostic imaging before and after transplantation of the liver serve as a reference

  10. Pediatric angiography

    International Nuclear Information System (INIS)

    Fitz, A.R.

    1987-01-01

    Angiography of the cerebral and visceral arterial systems is performed much less frequently than it was before the advent of computed tomographic scanning (CT). Most institutions have experienced at least a 50% reduction in the number of angiograms performed since installing a CT scanner. However, angiography still plays an important role in the confirmation of diagnoses made using a scanner, and in providing valuable information to the surgeon prior to excision of tumors or the repair of traumatized organs. Recently a number of sophisticated therapeutic procedures requiring vascular catheterization and the injection of contrast agents have been developed. In these procedures catheters are selectively placed in blood vessels perfusing a pathological process, such as an arteriovenous malformation, or at the site of an arterial stenosis; embolization of the arteriovenous malformation or tumor, or dilatation of the stenotic segment, is then performed. Whether the vessel catheterization is for diagnostic or therapeutic purposes, the basic approach is the same, and the technologist's duties are similar. The principal difference between a diagnostic and a therapeutic procedure is the length of time required to carry out the study; therapeutic procedures often require significantly longer periods of general anesthesia or sedation than do diagnostic studies

  11. 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.

  12. Evaluating Hospice and Palliative Medicine Education in Pediatric Training Programs.

    Science.gov (United States)

    Singh, Arun L; Klick, Jeffrey C; McCracken, Courtney E; Hebbar, Kiran B

    2017-08-01

    Hospice and Palliative Medicine (HPM) competencies are of growing importance in training general pediatricians and pediatric sub-specialists. The Accreditation Council for Graduate Medical Education (ACGME) emphasized pediatric trainees should understand the "impact of chronic disease, terminal conditions and death on patients and their families." Currently, very little is known regarding pediatric trainee education in HPM. We surveyed all 486 ACGME-accredited pediatric training program directors (PDs) - 200 in general pediatrics (GP), 57 in cardiology (CARD), 64 in critical care medicine (CCM), 69 in hematology-oncology (ONC) and 96 in neonatology (NICU). We collected training program's demographics, PD's attitudes and educational practices regarding HPM. The complete response rate was 30% (148/486). Overall, 45% offer formal HPM curriculum and 39% offer a rotation in HPM for trainees. HPM teaching modalities commonly reported included conferences, consultations and bedside teaching. Eighty-one percent of all respondents felt that HPM curriculum would improve trainees' ability to care for patients. While most groups felt that a HPM rotation would enhance trainees' education [GP (96%), CARD (77%), CCM (82%) and ONC (95%)], NICU PDs were more divided (55%; p training, there remains a paucity of opportunities for pediatric trainees. Passive teaching methods are frequently utilized in HPM curricula with minimal diversity in methods utilized to teach HPM. Opportunities to further emphasize HPM in general pediatric and pediatric sub-specialty training remains.

  13. On being a certifying abortion consultant: an ethical dilemma.

    Science.gov (United States)

    Clarkson, S E

    1980-05-14

    The medical profession was relieved when the Contraceptive, Sterilization and Abortion Act was passed in New Zealand in 1977, but it now appears that there are continuing problems with the implementation of the law. Most of the law's clauses are concerned with the practical aspects of the performance of abortions in New Zealand. Outlined in the law are requirements for licenses of hospitals, certifying consultants and operating surgeons, and the tasks of the supervising committee are specified. Thus, the medical profession accepted the impossible job of becoming the arbiter of morals of New Zealand society. There have been problems, since passage of the law, with inadequate numbers of certifying consultants being recruited, the resignation of the chair of the Abortion Supervisory Committee, a lack of resources to provide the required counseling services, and local variation in interpretations resulting in inconsistent treatment of abortion requests in different parts of the country. The basis of the problem is the fact that this law requires a moral rather than a medical decision to be made. Although at 1st glance the phrase serious risk to mental health would appear to be easily interpreted, this is not so. The morality of an act of abortion depends on the right afforded the fetus, and no society has as yet achieved a consensus on this. Thus, this must remain the conviction of each separate individual. Some guidance may come from medidal and legal advisers in this moral decision, but it is impossible to delegate personal moral decisions.

  14. Sustaining without Changing: The Metabolic Rift of Certified Organic Farming

    Directory of Open Access Journals (Sweden)

    Julius Alexander McGee

    2016-01-01

    Full Text Available Many proponents of organic farming claim that it is a sustainable alternative to conventional agriculture due to its reliance on natural agro-inputs, such as manure based fertilizers and organic pesticides. However, in this analysis we argue that although particular organic farming practices clearly benefit ecosystems and human consumers, the social context in which some organic farms develop, limit the potential environmental benefits of organic agriculture. Specifically, we argue that certified organic farming’s increased reliance on agro-inputs, such as organic fertilizers and pesticides, reduces its ability to decrease global water pollution. We review recent research that demonstrates the environmental consequences of specific organic practices, as well as literature showing that global organic farming is increasing its reliance on agro-inputs, and contend that organic farming has its own metabolic rift with natural water systems similar to conventional agriculture. We use a fixed-effects panel regression model to explore how recent rises in certified organic farmland correlate to water pollution (measured as biochemical oxygen demand. Our findings indicate that increases in the proportion of organic farmland over time increases water pollution. We conclude that this may be a result of organic farms increasing their reliance on non-farm agro-inputs, such as fertilizers.

  15. Does fellowship pay: what is the long-term financial impact of subspecialty training in pediatrics?

    Science.gov (United States)

    Rochlin, Jonathan M; Simon, Harold K

    2011-02-01

    To (1) analyze the financial returns of fellowship training in pediatrics and to compare them with those generated from a career in general pediatrics and (2) evaluate the effects of including the newly enacted federal loan-repayment program and of changing the length of fellowship training. Although the choice to enter fellowship is based on many factors, economic considerations are important. We are not aware of any study that has focused on the financial impact of fellowship training in pediatrics. Using standard financial techniques, we estimated the financial returns that a graduating pediatric resident might anticipate from additional fellowship training followed by a career as a pediatric subspecialist and compared them with the returns that might be expected from starting a career as a general pediatrician immediately after residency. The financial returns of pediatric fellowship training varied greatly depending on which subspecialty fellowship was chosen. Pursuing a fellowship in most pediatric subspecialties was a negative financial decision when compared with pursuing no fellowship at all and practicing as a general pediatrician. Incorporating the federal loan-repayment program targeted toward pediatric subspecialists and decreasing the length of fellowship training from 3 to 2 years would substantially increase the financial returns of the pediatric subspecialties. Pediatric subspecialization yielded variable financial returns. The results from this study can be helpful to current pediatric residents as they contemplate their career options. In addition, our study may be valuable to policy makers evaluating health care reform and pediatric workforce-allocation issues.

  16. Comparative audit of clinical research in pediatric neurology.

    Science.gov (United States)

    Al-Futaisi, Amna; Shevell, Michael

    2004-11-01

    Clinical research involves direct observation or data collection on human subjects. This study was conducted to evaluate the profile of pediatric neurology clinical research over a decade. Trends in pediatric neurology clinical research were documented through a systematic comparative review of articles published in selected journals. Eleven journals (five pediatric neurology, three general neurology, three general pediatrics) were systematically reviewed for articles involving a majority of human subjects less than 18 years of age for the years 1990 and 2000. Three hundred thirty-five clinical research articles in pediatric neurology were identified in the 11 journals for 1990 and 398 for 2000, a 19% increase. A statistically significant increase in analytic design (21.8% vs 39.5%; P = .01), statistical support (6% vs 16.6%; P neurology over a decade. Trends apparently suggest a more rigorous approach to study design and investigation in this field.

  17. Advances in pediatric dentistry.

    Science.gov (United States)

    Yoon, Richard K; Best, Jed M

    2011-07-01

    This article addresses advances in 4 key areas related to pediatric dentistry: (1) caries detection tools, (2) early interventions to arrest disease progression, (3) caries-risk assessment tools, and (4) trends in pediatric procedures and dental materials. Copyright © 2011 Elsevier Inc. All rights reserved.

  18. Pediatric magnetic resonance imaging

    International Nuclear Information System (INIS)

    Cohen, M.D.

    1986-01-01

    This book defines the current clinical potential of magnetic resonance imaging and focuses on direct clinical work with pediatric patients. A section dealing with the physics of magnetic resonance imaging provides an introduction to enable clinicians to utilize the machine and interpret the images. Magnetic resonance imaging is presented as an appropriate imaging modality for pediatric patients utilizing no radiation

  19. Pediatric anesthesia in developing countries.

    Science.gov (United States)

    Bösenberg, Adrian T

    2007-06-01

    To highlight the problems faced in developing countries where healthcare resources are limited, with particular emphasis on pediatric anesthesia. The fact that very few publications address pediatric anesthesia in the developing world is not surprising given that most anesthetics are provided by nonphysicians, nurses or unqualified personnel. In compiling this article information is drawn from pediatric surgical, anesthetic and related texts. In a recent survey more than 80% of anesthesia providers in a poor country acknowledged that with the limited resources available they could not provide basic anesthesia for children less than 5 years. Although many publications could be regarded as anecdotal, the similarities to this survey suggest that the lack of facilities is more generalized than we would like to believe. The real risk of anesthesia in comparison to other major health risks such as human immunodeficiency virus, malaria, tuberculosis and trauma remains undetermined. The critical shortage of manpower remains a barrier to progress. Despite erratic electrical supplies, inconsistent oxygen delivery, paucity of drugs or equipment and on occasion even lack of running water, many provide life-saving anesthesia. Perioperative morbidity and mortality is, however, understandably high by developed world standards.

  20. Pediatric Pulmonary Abscess

    Directory of Open Access Journals (Sweden)

    Kyle Barbour

    2018-04-01

    Full Text Available History of present illness: A 6-year-old previously healthy male presented to the emergency department with three days of left upper quadrant abdominal pain. Family endorsed one week of fevers, cough productive of yellow sputum, and non-bilious, non-bloody emesis. He denied shortness of breath and chest pain. On exam, the patient was febrile with otherwise normal vital signs. He had diffuse tenderness to his abdomen but clear lungs. Laboratory studies revealed leukocytosis to 25,000/mm3 with a left shift. Significant findings: Upright posterior-anterior plain chest films show a left lower lobe consolidation with an air-fluid level and a single septation consistent with a pulmonary abscess (white arrows. A small left pleural effusion was also present, seen as blunting of the left costophrenic angle and obscuration of the left hemidiaphragm (black arrows. Discussion: Pediatric pulmonary abscesses are rare, most commonly caused by aspiration, and the majority consequently arise in dependent portions of the lung.1 The most common pathogens in children are Streptococcus pneumoniaeand Staphylococcus aureus.1 Immunocompromised patients and those with existing pulmonary disease more commonly contract Pseudomonas aeruginosaor Bacteroides, and fungal pathogens are possible.1 Common symptoms include tachypnea, fever, and cough. Imaging is necessary to distinguish pulmonary abscesses from pneumonia, empyema, pneumatocele, and other etiologies. Plain film radiography may miss up to 18% of pulmonary abscesses yet is often the first modality to visualize an intrathoracic abnormality.2 If seen, pulmonary abscesses most often appear as consolidations with air-fluid levels. Generally, pulmonary abscesses are round with irregular, thick walls, whereas empyemas are elliptical with smooth, thin walls.3 However, these characteristics cannot definitively distinguish these processes.2 Advantages of plain films include being low cost and easily obtained. Computed

  1. 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…

  2. 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

  3. Pediatric oncologic endosurgery.

    Science.gov (United States)

    Boo, Yoon Jung; Goedecke, Jan; Muensterer, Oliver J

    2017-08-01

    Despite increasing popularity of minimal-invasive techniques in the pediatric population, their use in diagnosis and management of pediatric malignancy is still debated. Moreover, there is limited evidence to clarify this controversy due to low incidence of each individual type of pediatric tumor, huge diversity of the disease entity, heterogeneity of surgical technique, and lack of well-designed studies on pediatric oncologic minimal-invasive surgery. However, a rapid development of medical instruments and technologies accelerated the current trend toward less invasive surgery, including oncologic endosurgery. The aim of this article is to review current literatures about the application of the minimal-invasive approach for pediatric tumors and to give an overview of the current status, indications, individual techniques, and future perspectives.

  4. Pediatric Mania: The Controversy between Euphoria and Irritability.

    Science.gov (United States)

    Serra, Giulia; Uchida, Mai; Battaglia, Claudia; Casini, Maria Pia; De Chiara, Lavinia; Biederman, Joseph; Vicari, Stefano; Wozniak, Janet

    2017-04-01

    Pediatric Bipolar Disorder (BD) is a highly morbid pediatric psychiatric disease, consistently associated with family psychiatric history of mood disorders and associated with high levels of morbidity and disability and with a great risk of suicide. While there is a general consensus on the symptomatology of depression in childhood, the phenomenology of pediatric mania is still highly debated and the course and long-term outcome of pediatric BD still need to be clarified. We reviewed the available studies on the phenomenology of pediatric mania with the aim of summarizing the prevalence, demographics, clinical correlates and course of these two types of pediatric mania. Eighteen studies reported the number of subjects presenting with either irritable or elated mood during mania. Irritability has been reported to be the most frequent clinical feature of pediatric mania reaching a sensitivity of 95-100% in several samples. Only half the studies reviewed reported on number of episodes or cycling patterns and the described course was mostly chronic and ultra-rapid whereas the classical episodic presentation was less common. Few long-term outcome studies have reported a diagnostic stability of mania from childhood to young adult age. Future research should focus on the heterogeneity of irritability aiming at differentiating distinct subtypes of pediatric psychiatric disorders with distinct phenomenology, course, outcome and biomarkers. Longitudinal studies of samples attending to mood presentation, irritable versus elated, and course, chronic versus episodic, may help clarify whether these are meaningful distinctions in the course, treatment and outcome of pediatric onset bipolar disorder.

  5. 30-Day Mortality and Readmission after Hemorrhagic Stroke among Medicare Beneficiaries in Joint Commission Primary Stroke Center Certified and Non-Certified Hospitals

    Science.gov (United States)

    Lichtman, Judith H.; Jones, Sara B.; Leifheit-Limson, Erica C.; Wang, Yun; Goldstein, Larry B.

    2012-01-01

    Background and Purpose Ischemic stroke patients treated at Joint Commission Primary Stroke Center (JC-PSC) certified hospitals have better outcomes. Data reflecting the impact of JC-PSC status on outcomes after hemorrhagic stroke are limited. We determined whether 30-day mortality and readmission rates after hemorrhagic stroke differed for patients treated at JC-PSC certified versus non-certified hospitals. Methods The study included all fee-for-service Medicare beneficiaries ≥65 years old with a primary discharge diagnosis of subarachnoid hemorrhage (SAH) or intracerebral hemorrhage (ICH) in 2006. Covariate-adjusted logistic and Cox proportional hazards regression assessed the effect of care at a JC-PSC certified hospital on 30-day mortality and readmission. Results There were 2,305 SAH and 8,708 ICH discharges from JC-PSC certified hospitals and 3,892 SAH and 22,564 ICH discharges from non-certified hospitals. Unadjusted in-hospital mortality (SAH: 27.5% vs. 33.2%, pmortality (SAH: 35.1% vs. 44.0%, pmortality was 34% lower (OR 0.66, 95% CI 0.58–0.76) after SAH and 14% lower (OR 0.86, 95% CI 0.80–0.92) after ICH for patients discharged from JC-PSC certified hospitals. There was no difference in 30-day risk-adjusted readmission rates for SAH or ICH based on JC-PSC status. Conclusions Patients treated at JC-PSC certified hospitals had lower risk-adjusted mortality rates for both SAH and ICH but similar 30-day readmission rates as compared with non-certified hospitals. PMID:22033986

  6. 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. Copyright © 2014 by the American Academy of Pediatrics.

  7. 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

  8. 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

  9. 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...

  10. 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.

  11. 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.

  12. DH-1a: a certified uranium-thorium reference ore

    International Nuclear Information System (INIS)

    Steger, H.F.; Bowman, W.S.; Zechanowitsch, G.

    1981-09-01

    A 122-kg sample of uranium-thorium ore, DH-1a, from Elliot Lake, Ontario, was prepared as a compositional reference material to replace the similar certified ore, DH-1. DH-1a was ground to minus 74μm, blended in one lot, and bottled in 200 g units. The homogeneity of DH-1a with respect to uranium was confirmed using the volumetric umpire method. The recommended value for uranium is based on the data from the confirmation of homogeneity. For thorium, twelve laboratories provided results in a free choice analytical program. A statistical analysis of the data gave a recommended value of 0.263 percent for uranium and 0.091 percent for thorium

  13. Certifying the decommissioned Shippingport reactor vessel for transport

    International Nuclear Information System (INIS)

    Towell, R.H.

    1990-01-01

    The decommissioned Shippingport reactor pressure vessel with its concentric neutron shield tank was shipped to Hanford, WA as part of the effort to restore the Shippingport Station to its original condition. The metal walls of the reactor vessel had become radioactive from neutron bombardment while the reactor was operating so it had to be shipped under the regulations for transporting radioactive material. Because of the large amount of radioactivity in the walls, 16,467 Curies, and because the potentially dispersible corrosion layer on the inner walls of both tanks was also radioactive, the Shippingport reactor vessel was transported under the most stringent of the regulations, those for a type B package. Compliance with the packaging regulations was confirmed via independent analysis by the staff of the Department of Energy certifying official and the Shippingport reactor vessel was shipped under DOE Certificate of Compliance USA/9515/B(U)

  14. Compliance with Environmental and Social Legislation in Certified Forestry Companies

    Directory of Open Access Journals (Sweden)

    Marcos Vinicius Santana Leite

    2017-12-01

    Full Text Available ABSTRACT The objective of this study was to evaluate the contribution of the FSC forestry certification system to improve the forestry sector, in terms of compliance to environmental and social laws and improvements in working conditions resulting from the certification process. Thirty-seven auditing reports from five Brazilian forestry companies were evaluated, throughout the 2006-2013 period. Non-compliance and observations were analyzed and organized into categories, which identified the main performance issues found in certified forestry organizations. 301 instances of non-compliance and 138 observations of audit reports were verified, where 48 and 57% respectively, were linked to the two principles studied. For obtaining and/or maintaining the certificate it is necessary for all violations to be resolved. Therefore, it was concluded that forest certification contributes to the advancement of the forestry sector in Brazil, in relation to compliance with legal, social and labor issues.

  15. 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.

  16. Results of the 2015 National Certified Pharmacy Technician Workforce Survey.

    Science.gov (United States)

    Desselle, Shane P; Holmes, Erin R

    2017-07-01

    The results of the 2015 National Certified Pharmacy Technician Workforce Survey are described. A survey was e-mailed to a randomized sample of 5,000 certified pharmacy technicians (CPhTs) throughout the United States, with response reminders employed. Survey items eliciting demographic and work characteristics and work life attitudes were generated from the literature and qualitative interviews. This study aimed to describe job satisfaction, sources of stress, profession and employer commitment, education and training, and reasons for entry into the profession among CPhTs and determine relationships between those variables and CPhTs' level of involvement in various work activities, with particular attention paid to differences in practice setting. Frequency statistics, correlation analysis, and means testing were used to meet study objectives and identify significant differences. A total of 516 CPhTs currently working as a pharmacy technician responded to the survey. The CPhTs reported high levels of involvement in more traditional activities but less involvement in those that involve greater cognitive load. Respondents reported moderate levels of job satisfaction and commitment and somewhat high levels of stress overall. Most CPhTs chose to be a pharmacy technician because they desired to enter a healthcare field and help people and were recruited. CPhTs derived benefit from all aspects of education and training evaluated and most from on-the-job training. Perceived value of education and training was associated with higher satisfaction and commitment and with lower stress. There were a number of differences in these work life attitudes across practice settings and by involvement in various job functions. The results of the survey indicated that job satisfaction and commitment were moderate and that stress levels were somewhat high among CPhTs. There were a number of differences in work life attitudes across practice settings and by involvement in various job

  17. 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).

  18. Pediatric maxillary fractures.

    Science.gov (United States)

    Yu, Jack; Dinsmore, Robert; Mar, Philip; Bhatt, Kirit

    2011-07-01

    Pediatric craniofacial structures differ from those of adults in many ways. Because of these differences, management of pediatric craniofacial fractures is not the same as those in adults. The most important differences that have clinical relevance are the mechanical properties, craniofacial anatomy, healing capacity, and dental morphology. This article will review these key differences and the management of pediatric maxillary fractures. From the mechanical properties' perspective, pediatric bones are much more resilient than adult bones; as such, they undergo plastic deformation and ductile failure. From the gross anatomic perspective, the relative proportion of the cranial to facial structures is much larger for the pediatric patients and the sinuses are not yet developed. The differences related to dentition and dental development are more conical crowns, larger interdental spaces, and presence of permanent tooth buds in the pediatric population. The fracture pattern, as a result of all the above, does not follow the classic Le Fort types. The maxillomandibular fixation may require circum-mandibular wires, drop wires, or Ivy loops. Interfragmentary ligatures using absorbable sutures play a much greater role in these patients. The use of plates and screws should take into consideration the future development with respect to growth centers and the location of the permanent tooth buds. Pediatric maxillary fractures are not common, require different treatments, and enjoy better long-term outcomes.

  19. [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.

  20. Pediatric emergence delirium: Canadian Pediatric Anesthesiologists' experience.

    Science.gov (United States)

    Rosen, H David; Mervitz, Deborah; Cravero, Joseph P

    2016-02-01

    Pediatric emergence agitation/delirium (ED) is a cluster of behaviors seen in the early postanesthetic period with negative emotional consequences for families and increased utilization of healthcare resources. Many studies have looked at identifying risk factors for ED and at pharmacologic regimens to prevent ED. There are few published reports on treatment options and efficacy for established ED episodes, and essentially no data concerning current practice in the treatment of ED. We sought to elicit the experience and opinions of Canadian Pediatric Anesthesiologists on the incidence of ED in their practice, definitions and diagnostic criteria, preventative strategies, treatments, and their perceived efficacy. A web-based survey was sent to pediatric anesthesiologists working at academic health science centers across Canada. The participants were selected based on being members of the Canadian Pediatric Anesthesia Society (CPAS), which represents the subspecialty in Canada. All members of CPAS who had e-mail contact information available in the membership database were invited to participate. A total of 209 members out of the total of 211 fulfilled these criteria and were included in the study population. The response rate was 51% (106/209). Of respondents, 42% felt that ED was a significant problem at their institutions, with 45% giving medication before or during anesthesia to prevent the development of ED. Propofol was the most common medication given to prevent ED (68%) and to treat ED (42%). Total intravenous anesthesia (TIVA) was considered by 38% of respondents as a technique used to prevent ED. Medications used for treatment included propofol (42%), midazolam (31%), fentanyl (10%), morphine (7%), and dexmedetomidine (5%), with 87% of respondents rating effectiveness of treatment as 'usually works quickly with one dose'. We present information on current practice patterns with respect to prophylaxis and treatment of ED among a specialized group of pediatric

  1. Challenges of pediatric residency training in Taiwan.

    Science.gov (United States)

    Tsai, Tsuen-Chiuan; Harasym, Peter H

    2006-01-01

    A crisis in pediatric residency training today has raised serious concerns about the healthcare quality for children in Taiwan. The purpose of this study was to document the problems and to propose possible solutions for improvement. The problems include: 1) manpower shortage due to the difficulty of recruiting pediatric residents; 2) heavy workload that hinders learning; 3) lack of assessment and poor program planning; and 4) inadequate institutional and financial support. As a result, physicians' competencies are not guaranteed at the end of residency training, even with the pediatric board certification. Possible solutions may include: 1) conducting research on physician manpower statistics, work hours and environment; 2) establishing a Residency Program Review Committee and provision of standards for accreditation; 3) defining the competencies mandated as a general pediatrician and developing a set of measurable qualitative standards; 4) encouraging new programs with flexibility (e.g., primary care); and 5) pursuing adequate institutional and financial supports.

  2. Cognitive dysfunction in pediatric multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Suppiej A

    2014-07-01

    Full Text Available Agnese Suppiej,1 Elisa Cainelli1,2 1Child Neurology and Clinical Neurophysiology, Pediatric University Hospital, Padua, Italy; 2Lifespan Cognitive Neuroscience Laboratory (LCNL, Department of General Psychology, University of Padua, Italy Abstract: Cognitive and neuropsychological impairments are well documented in adult ­multiple sclerosis (MS. Research has only recently focused on cognitive disabilities in pediatric cases, highlighting some differences between pediatric and adult cases. Impairments in several functions have been reported in children, particularly in relation to attention, processing speed, visual–motor skills, and language. Language seems to be particularly vulnerable in pediatric MS, unlike in adults in whom it is usually preserved. Deficits in executive functions, which are considered MS-specific in adults, have been inconsistently reported in children. In children, as compared to adults, the relationship between cognitive dysfunctions and the two other main symptoms of MS, fatigue and psychiatric disorders, was poorly explored. Furthermore, data on the correlations of cognitive impairments with clinical and neuroimaging features are scarce in children, and the results are often incongruent; interestingly, involvement of corpus callosum and reduced thalamic volume differentiated patients identified as having a cognitive impairment from those without a cognitive impairment. Further studies about pediatric MS are needed in order to better understand the impact of the disease on brain development and the resulting effect on cognitive functions, particularly with respect to different therapeutic strategies. Keywords: central nervous system, child, deficit, IQ, inflammatory demyelination, neuropsychological

  3. Certified policy synthesis for general Markov decision processes : an application in building automation systems

    NARCIS (Netherlands)

    Haesaert, S.; Cauchi, N.; Abate, A.

    2017-01-01

    In this paper, we present an industrial application of new approximate similarity relations for Markov models, and show that they are key for the synthesis of control strategies. Typically, modern engineering systems are modelled using complex and high-order models which make the correct-by-design

  4. The Anesthesiologist-Informatician: A Survey of Physicians Board-Certified in Both Anesthesiology and Clinical Informatics.

    Science.gov (United States)

    Poterack, Karl A; Epstein, Richard H; Dexter, Franklin

    2018-03-12

    All 36 physicians board-certified in both anesthesiology and clinical informatics as of January 1, 2016, were surveyed via e-mail, with 26 responding. Although most (25/26) generally expressed satisfaction with the clinical informatics boards, and view informatics expertise as important to anesthesiology, most (24/26) thought it unlikely or highly unlikely that substantial numbers of anesthesiology residents would pursue clinical informatics fellowships. Anesthesiologists wishing to qualify for the clinical informatics board examination under the practice pathway need to devote a substantive amount of worktime to informatics. There currently are options outside of formal fellowship training to acquire the knowledge to pass.

  5. Magnetic resonance spectroscopy in pediatric neuroradiology: clinical and research applications

    International Nuclear Information System (INIS)

    Panigrahy, Ashok; Nelson, Marvin D.; Blueml, Stefan

    2010-01-01

    Magnetic resonance spectroscopy (MRS) offers a unique, noninvasive approach to assess pediatric neurological abnormalities at microscopic levels by quantifying cellular metabolites. The most widely available MRS method, proton ( 1 H; hydrogen) spectroscopy, is FDA approved for general use and can be ordered by clinicians for pediatric neuroimaging studies if indicated. There are a multitude of both acquisition and post-processing methods that can be used in the implementation of MR spectroscopy. MRS in pediatric neuroimaging is challenging to interpret because of dramatic normal developmental changes that occur in metabolites, particularly in the first year of life. Still, MRS has been proven to provide additional clinically relevant information for several pediatric neurological disease processes such as brain tumors, infectious processes, white matter disorders, and neonatal injury. MRS can also be used as a powerful quantitative research tool. In this article, specific research applications using MRS will be demonstrated in relation to neonatal brain injury and pediatric brain tumor imaging. (orig.)

  6. Assessment of pediatric residents burnout in a tertiary academic centre

    Directory of Open Access Journals (Sweden)

    Roaa S. Jamjoom

    2018-03-01

    Full Text Available Objectives: To study burnout among pediatric residents at King Abdulazaiz University Hospital in Jeddah, Saudi Arabia. Methods: This is a cross-sectional survey that was administered to all pediatric residents enrolled in the Saudi Paediatric Board program (PGY1-PGY4 in a large tertiary academic hospital in the Western region of Saudi Arabia (King Abdulaziz University Hospital. The survey were sent via E-mail to 50 registered general pediatric residents. Results: Seventy percent of the pediatric residents completed the survey. More than 70% of residents experiencing severe burnout. Forty-three percent suffering emotional exhaustion, 71.8% experiencing depersonalization and 40.6% suffering from low accomplishment. Conclusion: Burnout syndrome appear to be a serious threat to resident well-being in our program. Moreover, pediatric residents in our institute experienced higher levels of depersonalization than their peers nationally and internationally.

  7. Psychiatric aspects of pediatric epilepsy: Focus on anxiety disorder

    Directory of Open Access Journals (Sweden)

    Sujita Kumar Kar

    2015-01-01

    Full Text Available Psychiatric co-morbidities are commonly seen with pediatric epilepsy, which can be in the form of cognitive deficits like - inattention and intellectual disability, motor disturbances like - hyperactivity, emotional disturbances like - depression and anxiety disorders and behavioral problems like - impulsivity, aggression and even psychotic behavior. Anxiety disorders like - Obsessive compulsive disorder, posttraumatic stress disorder, social phobia, separation anxiety disorder, agoraphobia and panic attacks are commonly seen with pediatric epilepsy. Presence of co-morbid anxiety disorder in pediatric epilepsy is responsible for scholastic decline, peer maladjustment and poor quality of life. Management of anxiety disorders in children with epilepsy is always a challenge. Until, there is no general consensus regarding management of anxiety disorders in pediatric epilepsy. Despite its enormous impact on an individual′s life, this area has not been addressed adequately through clinical research. This review focuses on psychiatric aspects of pediatric epilepsy with specific emphasis on anxiety disorders.

  8. [Complications in pediatric anesthesia].

    Science.gov (United States)

    Becke, K

    2014-07-01

    As in adult anesthesia, morbidity and mortality could be significantly reduced in pediatric anesthesia in recent decades. This fact cannot conceal the fact that the incidence of anesthetic complications in children is still much more common than in adults and sometimes with a severe outcome. Newborns and infants in particular but also children with emergency interventions and severe comorbidities are at increased risk of potential complications. Typical complications in pediatric anesthesia are respiratory problems, medication errors, difficulties with the intravenous puncture and pulmonal aspiration. In the postoperative setting, nausea and vomiting, pain, and emergence delirium can be mentioned as typical complications. In addition to the systematic prevention of complications in pediatric anesthesia, it is important to quickly recognize disturbances of homeostasis and treat them promptly and appropriately. In addition to the expertise of the performing anesthesia team, the institutional structure in particular can improve quality and safety in pediatric anesthesia.

  9. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... What are some common uses of the procedure? Children's (pediatric) nuclear medicine imaging is performed to help diagnose childhood disorders that are congenital (present at birth) or that develop during childhood. Physicians use nuclear medicine imaging to ...

  10. Pediatric Urinary Tract Infection

    Science.gov (United States)

    SBA National Resource Center: 800-621-3141 Pediatric Urinary Tract Infections and Catheterization in Children with Neurogenic Bladder and Bowel Why is it important to begin urologic care in infancy and ...

  11. Pediatric Nephrolithiasis: A Review.

    Science.gov (United States)

    Miah, Tayaba; Kamat, Deepak

    2017-06-01

    The incidence of pediatric nephrolithiasis is on the rise. The composition of kidney stones in children is different than in adults, as most stones in children have a composition of calcium oxalate and calcium phosphate mixed with a small amount of uric acid. The symptoms of pediatric nephrolithiasis are nonspecific. Computed tomography (CT) is the gold standard for diagnosis; however, because of radiation exposure associated with a CT scan, ultrasonography is also an accepted modality for the diagnosis. Extensive metabolic evaluation is important to rule out an underlying metabolic disorder. Urinary decompression, medical expulsion therapy, and surgical interventions such as ureteroscopy and extracorporeal shockwave lithotripsy are some of the options available for treating pediatric nephrolithiasis. [Pediatr Ann. 2017;46(6):e242-e244.]. Copyright 2017, SLACK Incorporated.

  12. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts of radioactive materials called radiotracers, a special ... is a branch of medical imaging that uses small amounts of radioactive material to diagnose and determine ...

  13. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... imaging techniques. top of page Additional Information and Resources The Alliance for Radiation Safety in Pediatric Imaging's " ... To locate a medical imaging or radiation oncology provider in your community, you can search the ACR- ...

  14. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... interventions. Children's (pediatric) nuclear medicine refers to imaging examinations done in babies, young children and teenagers. Nuclear ... nuclear medicine procedure work? With ordinary x-ray examinations, an image is made by passing x-rays ...

  15. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... MRI. top of page What are some common uses of the procedure? Children's (pediatric) nuclear medicine imaging ... at birth) or that develop during childhood. Physicians use nuclear medicine imaging to evaluate organ systems, including ...

  16. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... type your comment or suggestion into the following text box: Comment: E-mail: Area code: Phone no: Thank ... View full size with caption Pediatric Content Some imaging tests ...

  17. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... child is taking as well as vitamins and herbal supplements and if he or she has any ... What are the limitations of Children's (Pediatric) Nuclear Medicine? Nuclear medicine procedures can be time consuming. It ...

  18. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Children's (Pediatric) Nuclear Medicine? What are some common uses of the procedure? How does the nuclear medicine procedure work? What does the equipment look like? How is ...

  19. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... to Children's (Pediatric) Nuclear Medicine Sponsored by Please note RadiologyInfo.org is not a medical facility. Please ... is further reviewed by committees from the American College of Radiology (ACR) and the Radiological Society of ...

  20. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... MRI. top of page What are some common uses of the procedure? Children's (pediatric) nuclear medicine imaging ... community, you can search the ACR-accredited facilities database . This website does not provide cost information. The ...

  1. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... exams at the same time. An emerging imaging technology, but not readily available at this time is PET/MRI. top of page What are some common uses of the procedure? Children's (pediatric) nuclear medicine imaging ...

  2. Causes of Pediatric Cardiomyopathy

    Science.gov (United States)

    ... inherited metabolic or congenital muscle disorder such as Noonan syndrome, Pompe disease, fatty acid oxidation defect or Barth ... where a specific chromosome is deleted or duplicated. Noonan syndrome is the most common form associated with pediatric ...

  3. 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

  4. The pediatric knee.

    Science.gov (United States)

    Orth, Robert C

    2013-03-01

    Knee pain is a common problem in children and adolescents, and MRI of the knee is the most commonly performed pediatric cross-sectional musculoskeletal imaging exam. The purpose of this pictorial review is to highlight differences between adult and pediatric knee imaging with an emphasis on normal developmental variants, injury and disease patterns unique to children and adolescents, and differences in response and presentation to conditions affecting both adults and children.

  5. 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 1005.10...

  6. 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…

  7. A Study of How Certified and Noncertified Automotive Curriculum Impact Student Achievement

    Science.gov (United States)

    VanDalsem, B.

    2010-01-01

    The purpose of this case study was to examine whether written curriculum for Automotive Service Excellence (ASE) certified and non-certified training programs better prepares students for entry-level positions. The theoretical framework based on research by Frase described methodologies for comparing curricula at the system, school, and classroom…

  8. 13 CFR 124.1003 - How does a firm become certified as an SDB?

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false How does a firm become certified... Protests Relating to Federal Small Disadvantaged Business Programs § 124.1003 How does a firm become certified as an SDB? (a) All firms that are current Participants in SBA's 8(a) BD program are automatically...

  9. 9 CFR 355.26 - Samples of certified products, ingredients, etc., to be taken for examination.

    Science.gov (United States)

    2010-01-01

    ... AND POULTRY PRODUCTS INSPECTION AND VOLUNTARY INSPECTION AND CERTIFICATION CERTIFIED PRODUCTS FOR DOGS... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Samples of certified products, ingredients, etc., to be taken for examination. 355.26 Section 355.26 Animals and Animal Products FOOD SAFETY...

  10. 17 CFR 274.128 - Form N-CSR, certified shareholder report.

    Science.gov (United States)

    2010-04-01

    ... Form N-CSR, certified shareholder report. This form shall be used by registered management investment... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Form N-CSR, certified... Form N-CSR, see the List of CFR Sections Affected, which appears in the Finding Aids section of the...

  11. 17 CFR 249.331 - 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... Required Under Sections 13 and 15(d) of the Securities Exchange Act of 1934 § 249.331 Form N-CSR, certified shareholder report. This form shall be used by registered management investment companies to file reports...

  12. Assessment of Readiness to Participate in Distance Learning of the Certified Florida Behavioral Workforce

    Science.gov (United States)

    Baston, George R.

    2011-01-01

    This research study explored perceptions of readiness to participate in distance learning among the certified behavioral workforce in Florida. The study sought to determine if there were significant differences in perception of readiness to participate in distance learning between certified behavioral health professionals at the administrator…

  13. 48 CFR 15.407-1 - Defective certified cost or pricing data.

    Science.gov (United States)

    2010-10-01

    ...—Modifications. The clauses give the Government the right to a price adjustment for defects in certified cost or... recognize that the Government's right to a price adjustment is not affected by any of the following... certified, cost or pricing data, the Government has the right, under the clauses at 52.215-10, Price...

  14. 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 awarding...

  15. 48 CFR 52.215-10 - Price Reduction for Defective Certified Cost or Pricing Data.

    Science.gov (United States)

    2010-10-01

    ... Defective Certified Cost or Pricing Data. 52.215-10 Section 52.215-10 Federal Acquisition Regulations System... Text of Provisions and Clauses 52.215-10 Price Reduction for Defective Certified Cost or Pricing Data... or Pricing Data (OCT 2010) (a) If any price, including profit or fee, negotiated in connection with...

  16. 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 do...

  17. 30 CFR 18.80 - Approval of machines assembled with certified or explosion-proof components.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Approval of machines assembled with certified... ADMINISTRATION, DEPARTMENT OF LABOR TESTING, EVALUATION, AND APPROVAL OF MINING PRODUCTS ELECTRIC MOTOR-DRIVEN MINE EQUIPMENT AND ACCESSORIES Machines Assembled With Certified or Explosion-Proof Components, Field...

  18. 19 CFR 115.16 - Notification of Certifying Authority by manufacturer.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Notification of Certifying Authority by 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...

  19. 7 CFR 301.75-17 - Funds for the replacement of certified citrus nursery stock.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 5 2010-01-01 2010-01-01 false Funds for the replacement of certified citrus nursery... nursery stock. Subject to the availability of appropriated funds, a commercial citrus nursery may be eligible to receive funds to replace certified citrus nursery stock in accordance with the provisions of...

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

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Certified copy in lieu of original. 416.804... 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...

  1. Cerebral imaging in pediatrics

    International Nuclear Information System (INIS)

    Gordon, I.

    1998-01-01

    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

  2. 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.

  3. Practical considerations in radionuclide imaging of pediatric patients

    International Nuclear Information System (INIS)

    Conway, J.J.

    1984-01-01

    A certain proportion of the patients encountered in the practice of nuclear medicine will fall within the pediatric age group. The pediatric age range is usually defined as extending from birth to 18 years. Therefore, the specialist in nuclear medicine may have to deal with pediatric patients weighing as little as 800 g or as much as 300 lb. This encounter may be pleasant or unpleasant, depending upon the physician's knowledge of the techniques required for handling children and obtaining an adequate study and a basic understanding of specific pediatric disorders. Among the issues that must be considered are the equipment, which must be suitable for handling and obtaining optimal images of small children; the development of a basic understanding of the peculiarities of radiopharmaceutical distribution in children, which differs from that in adults; and, importantly, a knowledge of radiation dosimetry as it relates to the pediatric patient. It is beyond the scope of this chapter to present a comprehensive dissertation on the topic of pediatric nuclear medicine. The theme therefore is limited to the general principles and techniques required for nuclear medicine studies on pediatric patients. In addition, studies that exhibit unique characteristics when performed on children are highlighted in an effort to define that essence of pediatric nuclear medicine that differentiates it from the practice of nuclear medicine in adults

  4. Farmers’ decision analysis to select certified palm oil seedlings in Lampung, Indonesia

    Science.gov (United States)

    Utoyo, Bambang; Yolandika, Clara

    2018-03-01

    This research aimed to analyse (1) decission making process of certified and uncertified palm oil seedlings and (2) factors that influence farmer decision to select certified and uncertified palm oil seedlings. This research was conducted in some districts in Lampung, such as Mesuji, Central Lampung, Tulang Bawang, North Lampung, Way Kanan and South Lampung. The respondents consisted of 30 farmers using certified seeds and 30 farmers using uncertified seeds. The study was conducted from January to May 2017. In addition, factors that influence farmer decision was analysed by logistic regression model. The results showed that decision making on the use of certified or uncertified palm seeds by farmers through the stages: introduction of problems or needs, searching of information, alternative evaluation, purchasing decisions, and post-purchase behaviour. Factors that significantly influence farmer's decision to use certified seeds were land area, seeds price, external influenced, and farmers’ perception.

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

    DEFF Research Database (Denmark)

    Granerud, Lise; Rocha, Robson Sø

    2011-01-01

    and raise goals within health and safety on a continuous basis. The article examines how certified occupational and health management systems influence this process to evaluate how far they hinder or support learning. It presents a model with which it is possible to identify and analyse improvement......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...

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

    International Nuclear Information System (INIS)

    McGee, Kristen

    2003-01-01

    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.)

  7. Do pediatric gastroenterology doctors address pediatric obesity?

    OpenAIRE

    Batra, Suruchi; Yee, Caitlin; Diez, Bernadette; Nguyen, Nicholas; Sheridan, Michael J; Tufano, Mark; Sikka, Natalie; Townsend, Stacie; Hourigan, Suchitra

    2017-01-01

    Objectives: To assess how often obesity is acknowledged at pediatric gastroenterology outpatient visits. Methods: A retrospective chart review was performed to identify obese children seen at a gastroenterology subspecialty clinic over a 1-year period of time; 132 children were identified. Demographics, obesity comorbidities, reasons for referral, diagnosis of obesity, and a plan to address obesity were abstracted. Chi-square or Fisher?s exact tests were used to examine statistical associatio...

  8. Infant outcomes of certified nurse midwife attended home births: United States 2000 to 2004.

    Science.gov (United States)

    Malloy, M H

    2010-09-01

    Home births attended by certified nurse midwives (CNMs) make up an extremely small proportion of births in the United States (home deliveries compared with certified nurse midwife in-hospital deliveries in the United States as measured by the risk of adverse infant outcomes among women with term, singleton, vaginal deliveries. United States linked birth and infant death files for the years 2000 to 2004 were used for the analysis. Adverse neonatal outcomes including death were determined by place of birth and attendant type for in-hospital certified nurse midwife, in-hospital 'other' midwife, home certified nurse midwife, home 'other' midwife, and free-standing birth center certified nurse midwife deliveries. For the 5-year period there were 1 237 129 in-hospital certified nurse midwife attended births; 17 389 in-hospital 'other' midwife attended births; 13 529 home certified nurse midwife attended births; 42 375 home 'other' midwife attended births; and 25 319 birthing center certified nurse midwife attended births. The neonatal mortality rate per 1000 live births for each of these categories was, respectively, 0.5 (deaths=614), 0.4 (deaths=7), 1.0 (deaths=14), 1.8 (deaths=75), and 0.6 (deaths=16). The adjusted odds ratio (95% confidence interval) for neonatal mortality for home certified nurse midwife attended deliveries vs in-hospital certified nurse midwife attended deliveries was 2.02 (1.18, 3.45). Deliveries at home attended by CNMs and 'other midwives' were associated with higher risks for mortality than deliveries in-hospital by CNMs.

  9. 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.

  10. Towards a sustainably certifiable futures contract for biofuels

    International Nuclear Information System (INIS)

    Mathews, John A.

    2008-01-01

    How are biofuels to be certified as produced in a sustainable and responsible fashion? In the global debate over this issue, one party to the proceedings seems rarely to be mentioned-namely the commodities exchanges through which a global biofuels market is being created. In this contribution, I propose a solution to the problem of sustainability certification through a biofuels futures contract equipped with 'proof of origin' documentation. The proposal does not call for any radical break with current practice, extending existing certification procedures with a requirement for the vendor to provide documentation, probably in barcoded form, of the history of the biofuel offered for sale, including plantation and biorefinery where the biofuel was produced and subsequent blendings it may have undergone. The proposal is thus compatible with the blending practices of large global traders, whose activities are the source of the difficulties of other approaches to certification. It is argued that if such a sustainable futures contract for bioethanol (in the first instance) were to be introduced, then it would likely trade at a premium and become the primary vehicle for North-South trade in biofuels

  11. 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.

  12. Neutron activation analysis of certified samples by the absolute method

    Science.gov (United States)

    Kadem, F.; Belouadah, N.; Idiri, Z.

    2015-07-01

    The nuclear reactions analysis technique is mainly based on the relative method or the use of activation cross sections. In order to validate nuclear data for the calculated cross section evaluated from systematic studies, we used the neutron activation analysis technique (NAA) to determine the various constituent concentrations of certified samples for animal blood, milk and hay. In this analysis, the absolute method is used. The neutron activation technique involves irradiating the sample and subsequently performing a measurement of the activity of the sample. The fundamental equation of the activation connects several physical parameters including the cross section that is essential for the quantitative determination of the different elements composing the sample without resorting to the use of standard sample. Called the absolute method, it allows a measurement as accurate as the relative method. The results obtained by the absolute method showed that the values are as precise as the relative method requiring the use of standard sample for each element to be quantified.

  13. Proposal for Certifying Expandable Planetary Surface Habitation Structures

    Science.gov (United States)

    Dorsey, John T.

    2011-01-01

    A factor-of-safety (FS) of 4.0 is currently used to design habitation structures made from structural soft goods. This approach is inconsistent with using a FS of 2.0 for metallic and polymeric composite pressure vessels as well as soft good structures such as space suits and parachutes. This inconsistency arises by using the FS to improperly account for the unknown effects of a variety of environmental and loading uncertainties. Using a 4.0 FS not only results in additional structural mass, it also makes it difficult to gain insight into the limitations of the material and/or product form and thus, it becomes difficult to make improvements. In order to bring consistency to the design and certification of expandable habitat structures, the approach used by the Federal Aviation Administration (FAA) to certify polymeric composite aircraft structures is used as a model and point of departure. A draft certification plan for Expandable Habitat Structures is developed in this paper and offered as an option for placing habitats made from soft goods on an equal footing with other structural implementations.

  14. Certification systems for sustainable neighbourhoods: What do they really certify?

    International Nuclear Information System (INIS)

    Wangel, Josefin; Wallhagen, Marita; Malmqvist, Tove; Finnveden, Göran

    2016-01-01

    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.

  15. Professional profile of pediatric intensivists in Rio de Janeiro, southeastern Brazil.

    Science.gov (United States)

    Lacerda, Jandra Corrêa de; Barbosa, Arnaldo Prata; Cunha, Antonio José Ledo Alves da

    2011-12-01

    This study described the sociodemographic profile and professional qualifications of pediatric intensive care physicians in the State of Rio de Janeiro (RJ), southeastern Brazil. This investigation was an observational, cross-sectional and descriptive study that was conducted in neonatal, pediatric and mixed intensive care units in the State of Rio de Janeiro. Physicians working in the participating intensive care units voluntarily completed a semistructured and anonymous questionnaire. Questionnaires that were not returned within 30 days were considered lost, and questionnaires with less than 75% questions completed were excluded. The differences in neonatal and pediatric intensive care physicians' medical training were compared using the Chi-squared test with a 5% significance level. A total of 410 physicians were included in this study: 84% female, 48% between 30 and 39 years old and 45% with monthly incomes between US $1,700 to 2,700. Forty percent of these physicians worked exclusively in this specialty, and 72% worked in more than one intensive care unit. Only 50% of the participants had received specific training (either medical residency or specialization) in neonatology, and only 33% were board-certified specialists in this area. Only 27% of the physicians had received specific training in pediatric intensive care medicine, and only 17% were board-certified specialists (p professional activity; 49% were dissatisfied due to working conditions, 23% due to low incomes and 18% due to training-related issues. These results suggested that the medical qualifications of neonatal and pediatric intensive care physicians in the State of Rio de Janeiro, Brazil are inadequate, especially in pediatric intensive care medicine. A high level of dissatisfaction was reported, which may jeopardize the quality of medical assistance that is provided by these professionals.

  16. Diagnostic errors in interpretation of pediatric musculoskeletal radiographs at common injury sites

    International Nuclear Information System (INIS)

    Bisset, George S.; Crowe, James

    2014-01-01

    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.)

  17. Simulation in pediatric anesthesiology.

    Science.gov (United States)

    Fehr, James J; Honkanen, Anita; Murray, David J

    2012-10-01

    Simulation-based training, research and quality initiatives are expanding in pediatric anesthesiology just as in other medical specialties. Various modalities are available, from task trainers to standardized patients, and from computer-based simulations to mannequins. Computer-controlled mannequins can simulate pediatric vital signs with reasonable reliability; however the fidelity of skin temperature and color change, airway reflexes and breath and heart sounds remains rudimentary. Current pediatric mannequins are utilized in simulation centers, throughout hospitals in-situ, at national meetings for continuing medical education and in research into individual and team performance. Ongoing efforts by pediatric anesthesiologists dedicated to using simulation to improve patient care and educational delivery will result in further dissemination of this technology. Health care professionals who provide complex, subspecialty care to children require a curriculum supported by an active learning environment where skills directly relevant to pediatric care can be developed. The approach is not only the most effective method to educate adult learners, but meets calls for education reform and offers the potential to guide efforts toward evaluating competence. Simulation addresses patient safety imperatives by providing a method for trainees to develop skills and experience in various management strategies, without risk to the health and life of a child. A curriculum that provides pediatric anesthesiologists with the range of skills required in clinical practice settings must include a relatively broad range of task-training devises and electromechanical mannequins. Challenges remain in defining the best integration of this modality into training and clinical practice to meet the needs of pediatric patients. © 2012 Blackwell Publishing Ltd.

  18. [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.

  19. Attributes of Candidates Passing the ABS Certifying Examination on the First Attempt-Program Directors׳ Perspective.

    Science.gov (United States)

    Sheikh, Mohd Raashid; Hulme, Michael

    2016-01-01

    The American Board of Surgery Certifying Examination (CE) is a pivotal event in a surgeon's career development, as it is the last challenge before achieving Board certification. First-time pass rate on the CE is one of the key metrics of surgery residency programs. The overall pass rate on the CE has declined significantly in recent years. The goal of this study was the identification of attributes of general surgery residents that are associated with passing the CE at the first attempt. The modified Delphi process was used to survey general surgery program directors. The study was conducted in 2 rounds in the interest of time available for surgical education research fellowship project. All 259 program directors were contacted in each round of surveys. In all, 49 (19%) responded to the first round and 54 (21%) responded to the second round of survey. The characteristics of a successful resident on CE include confidence, self-motivation, sound knowledge base, strong performance on the Board's training examination (American Board of Surgery In-Training Examination), and mock orals, and good communication skills. Postgraduate years 4 and 5 are the most likely resident levels at which failure could be predicted. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  20. 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. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Problems and preferences in pediatric imaging

    International Nuclear Information System (INIS)

    Thukral, Brij Bhushan

    2015-01-01

    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

  2. Biologics in pediatric psoriasis - efficacy and safety.

    Science.gov (United States)

    Dogra, Sunil; Mahajan, Rahul

    2018-01-01

    Childhood psoriasis is a special situation that is a management challenge for the treating dermatologist. As is the situation with traditional systemic agents, which are commonly used in managing severe psoriasis in children, the biologics are being increasingly used in the recalcitrant disease despite limited data on long term safety. Areas covered: We performed an extensive literature search to collect evidence-based data on the use of biologics in pediatric psoriasis. The relevant literature published from 2000 to September 2017 was obtained from PubMed, using the MeSH words 'biologics', 'biologic response modifiers' and 'treatment of pediatric/childhood psoriasis'. All clinical trials, randomized double-blind or single-blind controlled trials, open-label studies, retrospective studies, reviews, case reports and letters concerning the use of biologics in pediatric psoriasis were screened. Articles covering the use of biologics in pediatric psoriasis were screened and reference lists in the selected articles were scrutinized to identify other relevant articles that had not been found in the initial search. Articles without relevant information about biologics in general (e.g. its mechanism of action, pharmacokinetics and adverse effects) and its use in psoriasis in particular were excluded. We screened 427 articles and finally selected 41 relevant articles. Expert opinion: The available literature on the use of biologics such as anti-tumor necrosis factor (TNF)-α agents, and anti-IL-12/23 agents like ustekinumab suggests that these are effective and safe in managing severe pediatric psoriasis although there is an urgent need to generate more safety data. Dermatologists must be careful about the potential adverse effects of the biologics before administering them to children with psoriasis. It is likely that with rapidly evolving scenario of biologics in psoriasis, these will prove to be very useful molecules particularly in managing severe and recalcitrant

  3. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... the exam. MRI scanners are air-conditioned and well-lit. Music may be played through the headphones ... full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy ...

  4. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... a risk, depending on their nature and the strength of the MRI magnet. Many implanted devices will ... full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy ...

  5. NCI Pediatric Preclinical Testing Consortium

    Science.gov (United States)

    NCI has awarded grants to five research teams to participate in its Pediatric Preclinical Testing Consortium, which is intended to help to prioritize which agents to pursue in pediatric clinical trials.

  6. Children's (Pediatric) Abdominal Ultrasound Imaging

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    Full Text Available ... need to be returned to the transducer for analysis. top of page This page was reviewed on ... using ultrasound. View full size with caption Pediatric Content Some imaging tests and treatments have special pediatric ...

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

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    Full Text Available ... in CT scans should have no immediate side effects. Risks The risk of serious allergic reaction to ... Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes child-specific ...

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

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    Full Text Available ... your child. top of page Additional Information and Resources The Alliance for Radiation Safety in Pediatric Imaging's " ... A child being prepared for a CT scan. View full size with caption Pediatric Content Some imaging ...

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

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    Full Text Available ... Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) is a fast, painless exam that uses special ... the limitations of Children's CT? What is Children's CT? Computed tomography, more commonly known as a CT or CAT ...

  10. Children's (Pediatric) Abdominal Ultrasound Imaging

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    Full Text Available ... Imaging? Ultrasound waves are disrupted by air or gas; therefore ultrasound is not an ideal imaging technique ... with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes ...

  11. 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 ...

  12. Children's (Pediatric) Abdominal Ultrasound Imaging

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    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 ...

  13. Children's (Pediatric) Magnetic Resonance Imaging

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    Full Text Available ... MRI) exam. View full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes child-specific content. Related Articles and Media Catheter Angiography Magnetic Resonance, ...

  14. Children's (Pediatric) Abdominal Ultrasound Imaging

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    Full Text Available ... scans, your doctor may ask you to withhold food and drink for several hours before your child's ... full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy ...

  15. 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

  16. 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

  17. PET imaging in pediatric oncology

    International Nuclear Information System (INIS)

    Shulkin, B.L.

    2004-01-01

    High-quality PET imaging of pediatric patients is challenging and requires attention to issues commonly encountered in the practice of pediatric nuclear medicine, but uncommon to the imaging of adult patients. These include intravenous access, fasting, sedation, consent, and clearance of activity from the urinary tract. This paper discusses some technical differences involved in pediatric PET to enhance the quality of scans and assure the safety and comfort of pediatric patients. (orig.)

  18. Pediatric Electrocardiographic Imaging (ECGI) Applications

    Science.gov (United States)

    Silva, Jennifer N. A.

    2014-01-01

    Summary Noninvasive electrocardiographic imaging (ECGI) has been used in pediatric and congenital heart patients to better understand their electrophysiologic substrates. In this article we focus on the 4 subjects related to pediatric ECGI: 1) ECGI in patients with congenital heart disease and Wolff-Parkinson-White syndrome, 2) ECGI in patients with hypertrophic cardiomyopathy and pre-excitation, 3) ECGI in pediatric patients with Wolff-Parkinson-White syndrome, and 4) ECGI for pediatric cardiac resynchronization therapy. PMID:25722754

  19. A developmental history of the Society of Pediatric Psychology.

    Science.gov (United States)

    White, S

    1991-08-01

    Presented history of the field of pediatric psychology in general and, more specifically, the development of the Society of Pediatric Psychology. Review began with 1896 concepts of Lightner Witmer and followed with 1960 activities by Logan Wright which led to the formation of the Society. The developmental phases of the Society are described with respect to goals, publications, financial status, training issues, and awards established. Present activities of liaisons with numerous outside organizations and agencies and regional conferences are detailed.

  20. Child maltreatment and pediatric asthma: a review of the literature

    OpenAIRE

    Schreier, Hannah M. C.; Chen, Edith; Miller, Gregory E.

    2016-01-01

    Background Child maltreatment is a common problem with known adverse consequences, yet its contributions to the development and course of pediatric asthma are only poorly understood. Main This review first describes possible pathways connecting child maltreatment to pediatric asthma, including aspects of the physical home environment, health behaviors and disease management, and psychological consequences of child maltreatment. We subsequently review existing studies, which generally report a...

  1. 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

  2. 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.

  3. Medically certified sickness absence among health care workers.

    Science.gov (United States)

    Khawaja, Rajab Ali; Sikander, Raheel; Khawaja, Asad Ali; Jareno, Rechel Joy Macadaan; Halepota, Aurangzeb Taj

    2012-09-01

    To compare the days and spells of sickness absence among males versus females and Saudi nationals versus expatriate employees of King Khalid University Hospital, Riyadh, and to identify the cause of sickness absence. The cross-sectional, descriptive study comprised 3117 King Khalid University Hospital employees. Records of physician-certified sickness absence from January 1 to June 30, 2009, were obtained from the employee health clinic's register. Absence rate, frequency, duration and severity were assessed and compared between genders and nationalities, and causes were noted. SPSS version 16 and student's t test were used for statistical analyses and comparison. A total of 377 (12.1 %) employees had 416 spells of sickness absence with 639 sick-off days (mean: 1.54 +/- 0.85). The probability of sickness absence was higher among Saudi (OR=1.33) and female (OR=1.39) employees. The association of sickness absence was not found among the absentees with either gender (p= 0.335) or nationality (p = 0.086). Almost all spells of sick-off days were of short duration. Longer spells were mainly due to chicken pox which was found to be more among the expatriates. Heavy absenteeism was found only among the Saudis. The most common causes of sickness absence were acute upper respiratory infection, diseases of musculoskeletal system and the digestive system. The rate, frequency and duration of absence due to sickness in the study were higher among Saudi and female employees. The rate of absence, with passage of time, has increased significantly among Saudi nationals.

  4. Children's (Pediatric) Magnetic Resonance Imaging

    Science.gov (United States)

    ... 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 ...

  5. 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 ...

  6. 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 ...

  7. 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.

  8. 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.

  9. Pediatric nuclear cardiology

    International Nuclear Information System (INIS)

    Gelfand, M.J.; Hannon, D.W.

    1987-01-01

    Nuclear cardiology methods have had less impact upon pediatric cardiology than upon adult cardiology. Most pediatric heart disease results from congenital malformations of the heart and great vessels, which is usually discovered in infancy, and is most often treated definitively in infancy or early childhood. Unfortunately, nuclear medicine techniques are limited in their spatial resolution - structures that overlie each other are separated with difficulty. As a result, nuclear cardiology is usually of limited value in the anatomic characterization of the congenital heart abnormalities. Nevertheless, it has been useful in the detection and quantification of the pathophysiologic consequences of many congenital cardiac malformations. The authors review application of nuclear medicine in pediatric cardiology, and attempt to assess each in terms of its clinical utility

  10. Pediatric nuclear medicine

    International Nuclear Information System (INIS)

    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

  11. 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.

  12. How Accountable Care Organizations Responded to Pediatric Incentives in the Alternative Quality Contract.

    Science.gov (United States)

    Chien, Alyna T; Schiavoni, Katherine H; Sprecher, Eli; Landon, Bruce E; McNeil, Barbara J; Chernew, Michael E; Schuster, Mark A

    2016-03-01

    From 2009 to 2010, 12 accountable care organizations (ACOs) entered into the alternative quality contract (AQC), BlueCross BlueShield of Massachusetts's global payment arrangement. The AQC included 6 outpatient pediatric quality measures among 64 total measures tied to pay-for-performance bonuses and incorporated pediatric populations in their global budgets. We characterized the pediatric infrastructure of these adult-oriented ACOs and obtained leaders' perspectives on their ACOs' response to pediatric incentives. We used Massachusetts Health Quality Partners and American Hospital Association Survey data to characterize ACOs' pediatric infrastructure as extremely limited, basic, and substantial on the basis of the extent of pediatric primary care, outpatient specialist, and inpatient services. After ACOs had 16 to 43 months of experience with the AQC, we interviewed 22 leaders to gain insight into how organizations made changes to improve pediatric care quality, tried to reduce pediatric spending, and addressed care for children with special health care needs. ACOs' pediatric infrastructure ranged from extremely limited (eg, no general pediatricians in their primary care workforce) to substantial (eg, 42% of workforce was general pediatricians). Most leaders reported intensifying their pediatric quality improvement efforts and witnessing changes in quality metrics; most also investigated pediatric spending patterns but struggled to change patients' utilization patterns. All reported that the AQC did little to incentivize care for children with special health care needs and that future incentive programs should include this population. Although ACOs involved in the AQC were adult-oriented, most augmented their pediatric quality improvement and spending reduction efforts when faced with pediatric incentives. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  13. Development of a certified reference materials for composition of citric acid

    Directory of Open Access Journals (Sweden)

    D. H. Kulev

    2014-01-01

    Full Text Available The paper presents a summary of analyzing Technical Regulations of the Customs Union TR TC 029/2012 "Safety Requirements for Food Additives, Flavorings and Technological Processing Aids". Information on certified reference materials (RMs for composition of citric acid is provided. Certified characteristics of the RM are, on the one hand, mass fraction of the base substance and, on the other hand, mass fraction of impurities - toxic elements (lead, arsenic, cadmium, mercury. The first batches of the given RMs are produced, which are registered in the State Register of the approved types of certified reference materials GS010300-2013 and GS010143-2012.

  14. 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. (Pchildren undergoing dental treatments. Further research and risk/benefit assessment is needed to create a unified approach.

  15. Prophylactic antibiotics in pediatric shunt surgery.

    Science.gov (United States)

    Biyani, N; Grisaru-Soen, G; Steinbok, P; Sgouros, S; Constantini, S

    2006-11-01

    The optimal antibiotic prophylaxis for pediatric shunt-related procedures is not clear. There is much inconsistency among different medical centers. This paper summarizes and analyzes the various prophylactic antibiotic regiments used for shunt-related surgeries at different pediatric neurosurgery centers in the world. A survey questionnaire was distributed through the Pediatric Neurosurgery list-server (an e-mail-based special interest group in pediatric neurosurgery). Forty-five completed questionnaires were received, one per medical center, primarily from pediatric neurosurgeons with the following geographic breakdown: 25 from North America, 13 from Europe, and 7 from Asia and other countries. All centers routinely administered prophylactic antibiotics for shunt-related procedures. The drugs of choice were first-generation cephalosporins (23), second-generation cephalosporins (10), naficillin/oxacillin (4), vancomycin (3), clindamycin (1), amoxicillin (1), and mixed protocols in three centers. The initial drug administration ("first dose") was: in the department before transfer to operating room (5), upon arrival to operating room (11), at induction of anesthesia (13), and at initial skin incision (16). The duration of antibiotic dosage also varied: single dose (13), 24-h administration (26), 48-h administration (2), and longer than 48 h in four centers. Two general tendencies were noted, common to the majority of participating centers. There was a general trend to modify antibiotic treatment protocol in "high-risk" populations. The second common theme noted in more than half of responding centers was the use of long-term antibiotic treatment for externalized devices (such as externalized shunts, external ventricular drains or lumbar drains), usually till the device was in place.

  16. Risk in pediatric anesthesia.

    Science.gov (United States)

    Paterson, Neil; Waterhouse, Peter

    2011-08-01

    Risk in pediatric anesthesia can be conveniently classified as minor or major. Major morbidity includes cardiac arrest, brain damage and death. Minor morbidity can be assessed by clinical audits with small patient samples. Major morbidity is rare. It is best assessed by very large clinical studies and by review of closed malpractice claims. Both minor and major morbidity occur most commonly in infants and children under three, especially those with severe co-morbidities. Knowledge of risk profiles in pediatric anesthesia is a starting point for the reduction of risk. © 2010 Blackwell Publishing Ltd.

  17. 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.]. Copyright 2016, SLACK Incorporated.

  18. Geographic distribution of childhood diabetes and obesity relative to the supply of pediatric endocrinologists in the United States.

    Science.gov (United States)

    Lee, Joyce M; Davis, Matthew M; Menon, Ram K; Freed, Gary L

    2008-03-01

    To determine the geographic distribution of childhood diabetes and obesity relative to the supply of US pediatric endocrinologists. Estimation of observed and "index" ratios of children with diabetes (by region and division) and obesity (body mass index >/=95th % for age and sex) (by region and state) to board-certified pediatric endocrinologists. At the national level, the ratio of children with diabetes to pediatric endocrinologists is 290:1, and the ratio of obese children to pediatric endocrinologists is 17,741:1. Ratios of children with diabetes to pediatric endocrinologists in the Midwest (370:1), South (335:1), and West (367:1) are twice as high as in the Northeast (144:1). Across states, there is up to a 19-fold difference in the observed ratios of obese children to pediatric endocrinologists. Under conditions of equitably distributed endocrinologist supply, variation across states would be mitigated considerably. The distribution of children with diabetes and obesity does not parallel the distribution of pediatric endocrinologists in the United States, due largely to geographic disparities in endocrinologist supply. Given the large burden of obese children to endocrinologists, multidisciplinary models of care delivery are essential for the US health care system to address the needs of children with diabetes and obesity.

  19. Psychological issues in pediatric obesity

    Directory of Open Access Journals (Sweden)

    Gurvinder Kalra

    2012-01-01

    Full Text Available Pediatric obesity is a major health problem and has reached epidemiological proportions today. The present paper reviews major psychological issues in pediatric obesity from a developmental perspective. Research and literature has shown that a number of developmental, family, maternal and child factors are responsible in the genesis of pediatric obesity. Family food habits, early developmental lifestyle of the child, parenting, early family relationships and harmony all contribute towards the growth and development of a child. The present review focuses on the role of developmental psychological factors in the pathogenesis of pediatric obesity and highlights the developmental factors that must be kept in mind when evaluating a case of pediatric obesity.

  20. Hearing Status in Pediatric Renal Transplant Recipients.

    Science.gov (United States)

    Gulleroglu, Kaan; Baskin, Esra; Aydin, Erdinc; Ozluoglu, Levent; Moray, Gokhan; Haberal, Mehmet

    2015-08-01

    Renal transplant provides a long-term survival. Hearing impairment is a major factor in subjective health status. Status of hearing and the cause of hearing impairment in the pediatric renal transplant group have not been evaluated. Here, we studied to evaluate hearing status in pediatric renal transplant patients and to determine the factors that cause hearing impairment. Twenty-seven pediatric renal transplant recipients were investigated. All patients underwent audiologic assessment by means of pure-tone audiometry. The factors on hearing impairment were performed. Sensorineural hearing impairment was found in 17 patients. There was marked hearing impairment for the higher frequencies between 4000 and 8000 Hz. Sudden hearing loss developed in 2 patients, 1 of them had tinnitus. Decrease of speech understanding was found in 8 patients. The cyclosporine level was significantly high in patients with hearing impairment compared with group without hearing impairment. Cyclosporine levels also were found to be statistically significantly high when compared with the group with decrease of speech understanding and the group without decrease of speech understanding. Similar relations cannot be found between tacrolimus levels and hearing impairment and speech understanding. Sensorineural hearing impairment prevalence was high in pediatric renal transplant recipients when compared with the general population of children. Cyclosporine may be responsible for causing hearing impairment after renal transplant. We suggest that this effect is a dose-dependent toxicity.