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Sample records for general studies latest

  1. The latest general chemistry

    International Nuclear Information System (INIS)

    Ryu, Geun Bae; Choi, Se Yeong; Kim, Chin Yeong; Yoon, Gil Jung; Lee, Eun Seok; Seo, Moon Gyu

    1995-02-01

    This book deals with the latest general chemistry, which is comprised of twenty-three chapters, the contents of this book are introduction, theory of atoms and molecule, chemical formula and a chemical reaction formula, structure of atoms, nature of atoms and the periodic table, structure of molecule and spectrum, gas, solution, solid, chemical combination, chemical reaction speed, chemical equilibrium, thermal chemistry, oxidation-reduction, electrochemistry, acid-base, complex, aquatic chemistry, air chemistry, nuclear chemistry, metal and nonmetal, organic chemistry and biochemistry. It has exercise in the end of each chapter.

  2. Ground water pollution: General studies. (Latest citations from the NTIS bibliographic database). Published Search

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-05-01

    The bibliography contains citations concerning sources, contaminant transport, and monitoring of pollutants in aquifers. Topics include pollution characterization from landfills and mine drainage, descriptions of study programs undertaken by specific states, and Superfund site studies of contaminated areas. The uses of mathematical models are also discussed. (Contains 50-250 citations and includes a subject term index and title list.) (Copyright NERAC, Inc. 1995)

  3. The Latest Forecast.

    Science.gov (United States)

    Laurence, David

    2002-01-01

    Discusses the "latest forecast" for the future of English departments. Addresses departmental and institutional staffing practices, employment opportunities for PhDs, the acceleration of change in the institution, and the general state of the study and teaching of English. (RS)

  4. Impact of generalized dissipative coefficient on warm inflationary dynamics in the light of latest Planck data

    Energy Technology Data Exchange (ETDEWEB)

    Jawad, Abdul; Rani, Shamaila [COMSATS Institute of Information Technology, Department of Mathematics, Lahore (Pakistan); Hussain, Shahzad [Aspire College, Department of Mathematics, Hafizabad (Pakistan); Videla, Nelson [Pontificia Universidad Catolica de Valparaiso, Instituto de Fisica, Valparaiso (Chile)

    2017-10-15

    The warm inflation scenario in view of the modified Chaplygin gas is studied. We consider the inflationary expansion to be driven by a standard scalar field whose decay ratio Γ has a generic power-law dependence with the scalar field φ and the temperature of the thermal bath T. By assuming an exponential power-law dependence in the cosmic time for the scale factor a(t), corresponding to the intermediate inflation model, we solve the background and perturbative dynamics considering our model to evolve according to (1) weak dissipative regime and (2) strong dissipative regime. Specifically, we find explicit expressions for the dissipative coefficient, scalar potential, and the relevant inflationary observables like the scalar power spectrum, scalar spectral index, and tensor-to-scalar ratio. The free parameters characterizing our model are constrained by considering the essential condition for warm inflation, the conditions for the model evolves according to weak or strong dissipative regime, and the 2015 Planck results through the n{sub s}-r plane. (orig.)

  5. The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency. Latest Status

    International Nuclear Information System (INIS)

    1979-03-01

    The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency were approved by the Board of Governors on 21 February 1979. The test is reproduced herein for the information of all Members. The provisions established by the Board of Governors on 24 September 1977 for the application of safeguards in relation to the granting of technical assistance are also reproduced in the Annex to the Revised Guiding Principles and General Operating Rules.

  6. Measuring growth index in a universe with massive neutrinos: A revisit of the general relativity test with the latest observations

    Science.gov (United States)

    Zhao, Ming-Ming; Zhang, Jing-Fei; Zhang, Xin

    2018-04-01

    We make a consistency test for the general relativity (GR) through measuring the growth index γ in a universe with massive (sterile/active) neutrinos. We employ the redshift space distortion measurements to do the analysis. To constrain other cosmological parameters, we also use other cosmological measurements, including the Planck 2015 cosmic microwave background temperature and polarization data, the baryon acoustic oscillation data, the type Ia supernova JLA data, the weak lensing galaxy shear data, and the Planck 2015 lensing data. In a universe with massive sterile neutrinos, we obtain γ =0.624-0.050+0.055, with the tension with the GR prediction γ = 0.55 at the 1.48σ level, showing that the consideration of sterile neutrinos still cannot make the true measurement of γ be well consistent with the GR prediction. In a universe with massive active neutrinos, we obtain γ = 0.663 ± 0.045 for the normal hierarchy case, γ =0.661-0.050+0.044 for the degenerate hierarchy case, and γ =0.668-0.051+0.045 for the inverted hierarchy case, with the tensions with GR all at beyond the 2σ level. We find that the consideration of massive active neutrinos (no matter what mass hierarchy is considered) almost does not influence the measurement of the growth index γ.

  7. Reconciling divergent results of the latest parenteral nutrition studies in the ICU.

    Science.gov (United States)

    Singer, Pierre; Pichard, Claude

    2013-03-01

    Recent studies on the optimal modalities to feed patients during the ICU stay show divergent results. The level and the timing of energy provision is a critical issue, associated with the clinical outcome. These results questioned the clinical relevance of the recent guidelines issued by American, Canadian and European academic societies. Four recent prospective randomized studies enrolled critically ill patients who received various nutritional regimens and tested the effect of nutritional support on outcome. The Tight Calorie balance Control Study (TICACOS) targeted on calorie administration according to measured energy expenditure and found increased ICU morbidity but improved hospital mortality. The large EpaNIC study compared 'early' with 'late' (parenteral nutrition) nutrition, mostly in patients after cardiac surgery, and found an increased morbidity associated with early parenteral nutrition. The supplemental parenteral nutrition (SPN) study randomized the patients after 3 days and targeted the calories administered by parenteral nutrition as a complement to unsuccessful enteral nutrition using indirect calorimetry. The SPN resulted in less nosocomial infections and shorter duration of mechanical ventilation. Finally, a recent Australian study enrolled patients unable to be early fed enterally to receive, or not, parenteral nutrition targeted at 1500 kcal. No complications were noted in the parenteral nutrition group. Lessons from all these studies are summarized and should help in designing better studies and guidelines. The critical analysis of recent prospective studies comparing various levels of calorie administration, enteral versus parenteral nutrition and enteral versus SPN confirms the recommendations to avoid underfeeding and overfeeding. Parenteral nutrition, required if enteral feeding is failing, and if adjusted up to a measured optimal level, may improve outcome. More studies on the optimal level of energy and protein administration to

  8. Standardized reactors for the study of medical biofilms: a review of the principles and latest modifications.

    Science.gov (United States)

    Gomes, Inês B; Meireles, Ana; Gonçalves, Ana L; Goeres, Darla M; Sjollema, Jelmer; Simões, Lúcia C; Simões, Manuel

    2018-08-01

    Biofilms can cause severe problems to human health due to the high tolerance to antimicrobials; consequently, biofilm science and technology constitutes an important research field. Growing a relevant biofilm in the laboratory provides insights into the basic understanding of the biofilm life cycle including responses to antibiotic therapies. Therefore, the selection of an appropriate biofilm reactor is a critical decision, necessary to obtain reproducible and reliable in vitro results. A reactor should be chosen based upon the study goals and a balance between the pros and cons associated with its use and operational conditions that are as similar as possible to the clinical setting. However, standardization in biofilm studies is rare. This review will focus on the four reactors (Calgary biofilm device, Center for Disease Control biofilm reactor, drip flow biofilm reactor, and rotating disk reactor) approved by a standard setting organization (ASTM International) for biofilm experiments and how researchers have modified these standardized reactors and associated protocols to improve the study and understanding of medical biofilms.

  9. Uranium mining and milling environmental studies. (Latest citations from the EI Compendex plus database). Published Search

    International Nuclear Information System (INIS)

    1993-08-01

    The bibliography contains citations concerning environmental and social aspects of uranium mining, milling and ore treatment. Environmental and social aspects include air and water pollution, public health, occupational safety, land reclamation, and waste disposal. The citations refer to monitoring and control of contaminants, and environmental surveys and impact statements for specific areas in the vicinity of mining and ore treatment facilities. There are also references to health studies performed on miners and millworkers. (Contains 250 citations and includes a subject term index and title list.)

  10. A STUDY PAPER HOW LATEST TECHNOLOGIES LIKES TABS AND DIGITAL MEDIA CAN PROVIDE EFFICIENT WAY TO LEARNING AND EDUCATION

    OpenAIRE

    Aditya Jain*, Aditya Sharma, Aditya Singh Baghel, Ambar Pathak

    2016-01-01

    The use of latest trends and technologies in academic research may now be changing with such a frequency in the universities in terms of faculties who teaches and students that learn. Each and every universities wants to not only improve the syllabus but they also want to upgrade their labs with latest use of hardware and software. They are also focusing upon the technological growth of the students and their students can also develop their applications in different zones like traffic managem...

  11. Figures of merit and constraints from testing general relativity using the latest cosmological data sets including refined COSMOS 3D weak lensing

    International Nuclear Information System (INIS)

    Dossett, Jason N.; Moldenhauer, Jacob; Ishak, Mustapha

    2011-01-01

    We use cosmological constraints from current data sets and a figure of merit approach in order to probe any deviations from general relativity at cosmological scales. The figure of merit approach is used to study and compare the constraining power of various combinations of data sets on the modified gravity (MG) parameters. We use the recently refined HST-COSMOS weak-lensing tomography data, the ISW-galaxy cross correlations from 2MASS and SDSS luminous red galaxy surveys, the matter power spectrum from SDSS-DR7 (MPK), the WMAP7 temperature and polarization spectra, the baryon acoustic oscillations from Two-Degree Field and SDSS-DR7, and the Union2 compilation of type Ia supernovae, in addition to other bounds from Hubble parameter measurements and big bang nucleosynthesis. We use three parametrizations of MG parameters that enter the perturbed field equations. In order to allow for variations of the parameters with the redshift and scale, the first two parametrizations use recently suggested functional forms while the third is based on binning methods. Using the first parametrization, we find that the CMB+ISW+WL combination provides the strongest constraints on the MG parameters followed by CMB+WL or CMB+MPK+ISW. Using the second parametrization or the binning methods, we find that the combination CMB+MPK+ISW consistently provides some of the strongest constraints. This shows that the constraints are parametrization dependent. We find that adding up current data sets does not improve consistently the uncertainties on MG parameters due to tensions between the best-fit MG parameters preferred by different data sets. Furthermore, some functional forms imposed by the parametrizations can lead to an exacerbation of these tensions. Next, unlike some studies that used the CFHTLS lensing data, we do not find any deviation from general relativity using the refined HST-COSMOS data, confirming previous claims in those studies that their result may have been due to some

  12. The latest radiation instrument

    International Nuclear Information System (INIS)

    Kang, Se Sik; Gwon, Dal Gwan; Kim, Gyeong Geum

    2008-08-01

    This book deals with the latest radiation instrument, which is comprised of eight chapters. It explains X rays instrument for medial treatment, X-ray tube instrument and permissible burden with its history, structure and characteristic high voltage apparatus with high voltage rectifier circuit, X-ray control apparatus for medical treatment, X-ray image equipment X-ray television apparatus and CCD 205, X-ray apparatus of install and types, Digital X-ray apparatus with CR 261 and DR 269, performance management on X-ray for medical treatment with its history, necessity and management in the radiation field.

  13. The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency. Latest Status (Chinese Edition)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1979-03-15

    The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency were approved by the Board of Governors on 21 February 1979. The test is reproduced herein for the information of all Members. The provisions established by the Board of Governors on 24 September 1977 for the application of safeguards in relation to the granting of technical assistance are also reproduced in the Annex to the Revised Guiding Principles and General Operating Rules.

  14. The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency. Latest Status (Spanish Edition)

    International Nuclear Information System (INIS)

    1979-03-01

    The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency were approved by the Board of Governors on 21 February 1979. The test is reproduced herein for the information of all Members. The provisions established by the Board of Governors on 24 September 1977 for the application of safeguards in relation to the granting of technical assistance are also reproduced in the Annex to the Revised Guiding Principles and General Operating Rules. [es

  15. The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency. Latest Status (Chinese Edition)

    International Nuclear Information System (INIS)

    1979-03-01

    The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency were approved by the Board of Governors on 21 February 1979. The test is reproduced herein for the information of all Members. The provisions established by the Board of Governors on 24 September 1977 for the application of safeguards in relation to the granting of technical assistance are also reproduced in the Annex to the Revised Guiding Principles and General Operating Rules.

  16. The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency. Latest Status (Arabic Edition)

    International Nuclear Information System (INIS)

    1979-03-01

    The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency were approved by the Board of Governors on 21 February 1979. The test is reproduced herein for the information of all Members. The provisions established by the Board of Governors on 24 September 1977 for the application of safeguards in relation to the granting of technical assistance are also reproduced in the Annex to the Revised Guiding Principles and General Operating Rules.

  17. The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency. Latest Status (French Edition)

    International Nuclear Information System (INIS)

    1979-03-01

    The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency were approved by the Board of Governors on 21 February 1979. The test is reproduced herein for the information of all Members. The provisions established by the Board of Governors on 24 September 1977 for the application of safeguards in relation to the granting of technical assistance are also reproduced in the Annex to the Revised Guiding Principles and General Operating Rules. [fr

  18. The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency. Latest Status (Russian Edition)

    International Nuclear Information System (INIS)

    1979-03-01

    The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency were approved by the Board of Governors on 21 February 1979. The test is reproduced herein for the information of all Members. The provisions established by the Board of Governors on 24 September 1977 for the application of safeguards in relation to the granting of technical assistance are also reproduced in the Annex to the Revised Guiding Principles and General Operating Rules. [ru

  19. Sodium-glucose co-transporter-2 inhibitors, the latest residents on the block: Impact on glycaemic control at a general practice level in England.

    Science.gov (United States)

    Heald, Adrian H; Fryer, Anthony A; Anderson, Simon G; Livingston, Mark; Lunt, Mark; Davies, Mark; Moreno, Gabriela Y C; Gadsby, Roger; Young, Robert J; Stedman, Mike

    2018-03-08

    To determine, using published general practice-level data, how differences in Type 2 diabetes mellitus (T2DM) prescribing patterns relate to glycaemic target achievement levels. Multiple linear regression modelling was used to link practice characteristics and defined daily dose (DDD) of different classes of medication in 2015/2016 and changes between that year and the year 2014/2015 in medication to proportion of patients achieving target glycaemic control (glycated haemoglobin A1c [HbA1c] ≤58 mmol/mol [7.5%]) and proportion of patients at high glycaemic risk (HbA1c >86 mmol/mol [10.0%]) for practices in the National Diabetes Audit with >100 people with T2DM on their register. Overall, HbA1c outcomes were not different between the years studied. Although, in percentage terms, most practices increased their use of sodium-glucose co-transporter-2 (SGLT2) inhibitors (96%), dipeptidyl peptidase-4 (DPP-4) inhibitors (76%) and glucagon-like peptide 1 (GLP-1) analogues (53%), there was wide variation in the use of older and newer therapies. For example, 12% of practices used >200% of the national average for some newer agents. In cross-sectional analysis, greater prescribing of metformin and analogue insulin were associated with a higher proportion of patients achieving HbA1c ≤58 mmol/mol; the use of SGLT2 inhibitors and metformin was associated with a reduced proportion of patients with HbA1c >86 mol/mol; otherwise associations for sulphonylureas, GLP-1 analogues, SGLT2 inhibitors and DPP-4 inhibitors were neutral or negative. In year-on-year analysis there was ongoing deterioration in glycaemic control, which was offset to some extent by increased use of SGLT2 inhibitors and GLP-1 analogues, which were associated with a greater proportion of patients achieving HbA1c levels ≤58 mmol/mol and a smaller proportion of patients with HbA1c levels >86 mmol/mol. SGLT2 inhibitor prescribing was associated with significantly greater improvements than those found

  20. Latest results from LUNA

    Science.gov (United States)

    Depalo, Rosanna; LUNA Collaboration

    2018-01-01

    A precise knowledge of the cross section of nuclear fusion reactions is a crucial ingredient in understanding stellar evolution and nucleosynthesis. At stellar temperatures, fusion cross sections are extremely small and difficult to measure. Measuring nuclear cross sections at astrophysical energies is a challenge that triggered a huge amount of experimental work. A breakthrough in this direction was the first operation of an underground accelerator at the Laboratory for Underground Nuclear Astrophysics (LUNA) in Gran Sasso, Italy. The 1400 meters of rocks above the laboratory act as a natural shield against cosmic radiation, suppressing the background by orders of magnitude. The latest results achieved at LUNA are discussed, with special emphasis on the 22Ne(p,γ)23Na reaction. Future perspectives of the LUNA experiment are also illustrated.

  1. General discussion of feasibility study

    International Nuclear Information System (INIS)

    Calori, F.

    1976-01-01

    Fundamentals, objectives and parameters of feasibility studies in the field of nuclear power project planning are discussed in a general way. Technical and economic problems to be considered are pointed out. In special cases, IAEA offers its aid and support. (UA) [de

  2. Energy and poverty. The world needs far more electricity to power development, latest global energy study finds

    International Nuclear Information System (INIS)

    2002-01-01

    The latest edition published in September 2002 by the International IEA of the OECD, depicts a future in which energy use continues to grow inexorably, fossil fuels continue to dominate the energy mix and developing countries fast approach OECD countries as the largest consumers of commercial energy. The Earth's energy resources are undoubtedly adequate to meet rising demand for at least the next three decades. But the projections in this Outlook raise serious concerns about the security of energy supplies, investment in energy infrastructure, the threat of environmental damage caused by energy production and use and the unequal access of the world's population to modern energy. Governments will have to take strenuous action in many areas of energy use and supply if these concerns are to be met. The Outlook's core projections are derived from a Reference Scenario that takes into account only those government polices and measures that had been adopted by mid-2002. A separate Alternative Policy Scenario assesses the impact of a range of new energy and environmental policies that OECD countries are considering adopting as well as of faster deployment of new energy technologies. Both scenarios confirm the extent of the policy challenges facing governments around the world. A key result of the Outlook is that energy trade will expand rapidly. In particular, the major oil- and gas-consuming regions will see their imports grow substantially. This trade will increase mutual dependence among nations. But it will also intensify concerns about the world's vulnerability to energy supply disruptions, as production is increasingly concentrated in a small number of producing countries. Supply security has moved to the top of the energy policy agenda. The governments of oil- and gas-importing countries will need to take a more proactive role in dealing with the energy security risks inherent in fossil-fuel trade. They will need to pay more attention to maintaining will look anew

  3. Artificial sensory organs: latest progress.

    Science.gov (United States)

    Nakamura, Tatsuo; Inada, Yuji; Shigeno, Keiji

    2018-03-01

    This study introduces the latest progress on the study of artificial sensory organs, with a special emphasis on the clinical results of artificial nerves and the concept of in situ tissue engineering. Peripheral nerves have a strong potential for regeneration. An artificial nerve uses this potential to recover a damaged peripheral nerve. The polyglycolic acid collagen tube (PGA-C tube) is a bio-absorbable tube stuffed with collagen of multi-chamber structure that consists of thin collagen films. The clinical application of the PGA-C tube began in 2002 in Japan. The number of PGA-C tubes used is now beyond 300, and satisfactory results have been reported on peripheral nerve repairs. This PGA-C tube is also effective for patients suffering from neuropathic pain.

  4. Latest development in using CSSI - Carbon-13 natural abundance signatures of long-chain fatty acids - case study of Mistelbach

    International Nuclear Information System (INIS)

    Mabit, Lionel; Resch, Christian; Toloza, Arsenio; Meusburger, Katrin; Alewell, Christine; Gibbs, Max; Klik, Andreas

    2016-01-01

    For our case study, the IsoSources results are within the range of the SIAR values, confirming the main contribution of around 50% to the deposition area (at the outlet of the sub-catchment) of the sediment originating from the main grassed waterway i.e. the source 4. Our next investigation will focus on a better understanding of the soil redistribution and its linkage with the historical land use(s) of the four agricultural sources of the study area.

  5. New Bulletin: Latest News

    CERN Multimedia

    2005-01-01

    The paper version of the CERN Bulletin will be published twice a month with effect from 18 April 2005. The electronic version will be updated weekly. This year will see many changes in the Bulletin, designed to make it more economical, more compact and more attractive. From 18 April the paper version of the Bulletin will be published twice monthly, so we shall have to stop calling it the "Weekly". The purpose of this change in publication frequency is to redistribute the resources of the Publications Section of the Communications Group so that it can produce new brochures for the general public. However, so as not to compromise on topicality and communication of information, the Official News and General Information sections, the Pension Fund and training announcements and the seminar schedule will continue to be updated weekly. If you have signed up to be informed of the updates, you will continue to receive a weekly e-mail reminding you that the electronic version of the Bulletin has been updated. Offici...

  6. Conference Report: Rechtsextremismusforschung – aktuelle Tendenzen empirischer Untersuchungen [Research on Right-wing Extremism—Latest Trends in Empirical Studies

    Directory of Open Access Journals (Sweden)

    Janina Söhn

    2004-01-01

    Full Text Available During this workshop scholars presented new, mainly empirical studies which explored different aspects of right-wing extremism in Germany. While a number of talks focused on political strategies and modern forms of organization of local neo-Nazi scenes, political elites and the music industry, others had chosen a biographical view on the personal development of young right-wing extremists. Studies on the local context of and conditions for right-wing extremist actions were complemented by representative survey data on political attitudes of German citizens. Apart from discussions about the phenomenon of right-wing extremism itself, participants had the opportunity to exchange their experience of doing empirical qualitative research in a dangerous field. URN: urn:nbn:de:0114-fqs0401215

  7. Latest Developments in Probiotics

    Science.gov (United States)

    Leroy, Frédéric; Falony, Gwen; Vuyst, Luc De

    Probiotic foods are a group of health-promoting, so-called functional foods, with large commercial interest and growing market shares (Arvanitoyannis & van Houwelingen-Koukaliaroglou, 2005). In general, their health benefits are based on the presence of selected strains of lactic acid bacteria (LAB), that, when taken up in adequate amounts, confer a health benefit on the host. They are administered mostly through the consumption of fermented milks or yoghurts (Mercenier, Pavan, & Pot, 2003). In addition to their common use in the dairy industry, probiotic LAB strains may be used in other food products too, including fermented meats (Hammes & Hertel, 1998; Incze, 1998; Kröckel, 2006; Työppönen, Petäjä,& Mattila- Sandholm, 2003).

  8. Adejobi latest.pmd

    African Journals Online (AJOL)

    ACSS

    2013-05-03

    May 3, 2013 ... statistics and the logistic model. The results obtained ... addition to the reduction in the cost of production. (Diamini, 1976 ... development and growth may be studied either through the ... Considering a case of only one input flow in which a current ... firm's demand curve of an input shows the quantity which it ...

  9. Latest Surprises from Mira the Wonderful

    Science.gov (United States)

    Karovska, Margarita; Marengo, Massimo; Wood, Brian

    We report the latest results from our long-term study of Mira A and its companion Mira B. These include a study of the dust environment in mid-IR wavelengths (Marengo et al. 2001), and of the accretion processes in the Mira AB interacting system (Wood, Karovska, and Raymond 2002).

  10. Latest results from JET

    International Nuclear Information System (INIS)

    Bickerton, R.J.

    1989-01-01

    The Joint European Torus (JET) is a large tokamak designed with the essential objective of obtaining and studying plasmas with parameters close to those envisaged for an eventual power-generating, nuclear-fusion reactor. JET is situated on a site near Abingdon, Oxon, UK. JET is the largest single project of the nuclear fusion research programme of the European Atomic Energy Community (EURATOM). The tokamak started operation in mid 1983 after a five year construction period. The scientific and technical results achieved so far are summarised in this article. (orig.)

  11. SNAP Telescope Latest Developments

    Science.gov (United States)

    Lampton, M.; SNAP Collaboration

    2004-12-01

    The coming era of precision cosmology imposes new demands on space telescopes with regard to spectrophotometric accuracy and image stability. To meet these requirements for SNAP we have developed an all reflecting two-meter-class space telescope of the three-mirror anastigmat type. Our design features a large flat annular field (1.5 degrees = 580mm diameter) and a telephoto advantage of 6, delivering a 22m focal length within an optical package length of only 3.5 meters. The use of highly stable materials (Corning ULE glass and carbon-fiber reinforced cyanate ester resin for the metering structure) combined with agressive distributed thermal control and an L2 orbit location will lead to unmatched figure stability. Owing to our choice of rigid structure with nondeployable solar panels, finite-element models show no structural resonances below 10Hz. An exhaustive stray light study has been completed. Beginning in 2005, two industry studies will develop plans for fabrication, integration and test, bringing SNAP to a highly realistic level of definition. SNAP is supported by the Office of Science, US DoE, under contract DE-AC03-76SF00098.

  12. Latest results from ALICE

    CERN Document Server

    Scapparone, Eugenio

    2011-01-01

    In this paper selected results obtained by the ALICE experiment at the LHC will be presented. Data collected during the pp runs taken at sqrt(s)=0.9, 2.76 and 7 TeV and Pb-Pb runs at sqrt(s_NN)=2.76 TeV allowed interesting studies on the properties of the hadronic and nuclear matter: proton runs gave us the possibility to explore the ordinary matter at very high energy and up to very low pt, while Pb-Pb runs provided spectacular events where several thousands of particles produced in the interaction revealed how a very dense medium behaves, providing a deeper picture on the quark gluon plasma(QGP) chemical composition and dynamics.

  13. Latest results from EXO-200

    International Nuclear Information System (INIS)

    TOSI, D.

    2014-01-01

    The Enriched Xenon Observatory (EXO) is an experimental program searching for neutrino-less double beta decay in xenon-136. The first stage of this program, EXO-200, has been in operation since early 2011. I present here the latest physics results from the experiment.

  14. The latest electrical installation (I)

    International Nuclear Information System (INIS)

    Won, Jong Su

    1976-04-01

    This book deals with the latest electrical installation. The contents of this book are construction electrical installation, regulations related electrical installation, foundation and principle of wiring, main line feeder, lighting installation, power of wiring, main line feeder, lighting installation, power installation, method to read structure drawing for electrical construct drawing electric lamp wiring diagram, working drawing, material and tools and method of construction of electrical installation on types of wiring construction, metallic conduit, rigid poly-vinyl conduit wiring, bus duct work, cable work and insulation out of metal lathed.

  15. PREVAIL: latest electron optics results

    Science.gov (United States)

    Pfeiffer, Hans C.; Golladay, Steven D.; Gordon, Michael S.; Kendall, Rodney A.; Lieberman, Jon E.; Rockrohr, James D.; Stickel, Werner; Yamaguchi, Takeshi; Okamoto, Kazuya; Umemoto, Takaaki; Shimizu, Hiroyasu; Kojima, Shinichi; Hamashima, Muneki

    2002-07-01

    The PREVAIL electron optics subsystem developed by IBM has been installed at Nikon's facility in Kumagaya, Japan, for integration into the Nikon commercial EPL stepper. The cornerstone of the electron optics design is the Curvilinear Variable Axis Lens (CVAL) technique originally demonstrated with a proof of concept system. This paper presents the latest experimental results obtained with the electron optical subsystem at Nikon's facility. The results include micrographs illustrating proper CVAL operation through the spatial resolution achieved over the entire optical field of view. They also include data on the most critical issue of the EPL exposure approach: subfield stitching. The methodology of distortion correction will be described and both micrographs and metrology data of stitched subfields will be presented. This paper represents a progress report of the IBM/Nikon alliance activity on EPL.

  16. Cina Benteng: The Latest Generations and Acculturation

    Directory of Open Access Journals (Sweden)

    Billy Nathan Setiawan

    2015-05-01

    Full Text Available The aim of this paper was to investigate the acculturation process encountered by the two latest generations of Cina Benteng. A Skype interview was conducted with two young Cina Benteng descents. The analysis was also supported by insightful remark from the parents of the two interviewees. This study discovers that the two generations seem to respond to the acculturation process in different ways. However, although some traditions are no longer relevant to the later generation, their identity as a Chinese descent cannot be easily removed.

  17. The latest figures on uranium

    International Nuclear Information System (INIS)

    Vance, R.

    2010-01-01

    According to the latest figures on uranium, soon to be published by the NEA, uranium resources, production and demand are all on the rise. Exploration efforts have increased recently in line with the expected expansion of nuclear energy in the coming years. Total identified resources have grown and are now sufficient to cover 100 years of supply at 2008 rates of consumption. Costs of production have, however, also increased. This article is based on the latest edition of the 'Red Book', Uranium 2009: Resources, Production and Demand, which presents the results of the most recent biennial review of world uranium market fundamentals and a statistical profile of the world uranium industry as of 1 January 2009. It contains official data provided by OECD Nuclear Energy Agency (NEA) and International Atomic Energy Agency (IAEA) member countries on uranium exploration, resources, production and reactor-related requirements. Projections of nuclear generating capacity and reactor-related uranium requirements through 2035 are also provided as well as a discussion of long-term uranium supply and demand issues. Despite recent declines stemming from the global financial crisis, world demand for electricity is expected to continue to grow significantly over the next several decades to meet the needs of an increasing population and economic growth. The recognition by an increasing number of governments that nuclear power can produce competitively priced, base-load electricity that is essentially free of greenhouse gas emissions, coupled with the role that nuclear can play in enhancing security of energy supply, increases the prospects for growth in nuclear generating capacity, although the magnitude of that growth remains to be determined. Regardless of the role that nuclear energy ultimately plays in meeting rising electricity demand, the uranium resource base is more than adequate to meet projected requirements. Meeting even high-case requirements to 2035 would consume less

  18. Zika virus: the latest newcomer

    Directory of Open Access Journals (Sweden)

    Juan-Carlos eSaiz

    2016-04-01

    Full Text Available Since the beginning of this century, humanity has been facing a new emerging, or re-emerging, virus threat almost every year: West Nile, Influenza A, avian flu, dengue, Chikungunya, SARS, MERS, Ebola, and now Zika, the latest newcomer. Zika virus (ZIKV, a flavivirus transmitted by Aedes mosquitoes, was identified in 1947 in a sentinel monkey in Uganda, and later on in humans in Nigeria. The virus was mainly confined to the African continent until it was detected in south-east Asia the 1980´s, then in the Micronesia in 2007 and, more recently in the Americas in 2014, where it has displayed an explosive spread, as advised by the World Health Organization (WHO, which resulted in the infection of hundreds of thousands of people. ZIKV infection was characterized by causing a mild disease presented with fever, headache, rash, arthralgia, and conjunctivitis, with exceptional reports of an association with Guillain-Barre syndrome (GBS and microcephaly. However, since the end of 2015, an increase in the number of GBS associated cases and an astonishing number of microcephaly in foetus and new-borns in Brazil have been related to ZIKV infection, raising serious worldwide public health concerns. Clarifying such worrisome relationships is, thus, a current unavoidable goal. Here, we extensively review what is currently known about ZIKV, from molecular biology, transmission routes, ecology and epidemiology, to clinical manifestations, pathogenesis, diagnosis, prophylaxis and public health.

  19. Latest design of gate valves

    Energy Technology Data Exchange (ETDEWEB)

    Kurzhofer, U.; Stolte, J.; Weyand, M.

    1996-12-01

    Babcock Sempell, one of the most important valve manufacturers in Europe, has delivered valves for the nuclear power industry since the beginning of the peaceful application of nuclear power in the 1960s. The latest innovation by Babcock Sempell is a gate valve that meets all recent technical requirements of the nuclear power technology. At the moment in the United States, Germany, Sweden, and many other countries, motor-operated gate and globe valves are judged very critically. Besides the absolute control of the so-called {open_quotes}trip failure,{close_quotes} the integrity of all valve parts submitted to operational forces must be maintained. In case of failure of the limit and torque switches, all valve designs have been tested with respect to the quality of guidance of the gate. The guidances (i.e., guides) shall avoid a tilting of the gate during the closing procedure. The gate valve newly designed by Babcock Sempell fulfills all these characteristic criteria. In addition, the valve has cobalt-free seat hardfacing, the suitability of which has been proven by friction tests as well as full-scale blowdown tests at the GAP of Siemens in Karlstein, West Germany. Babcock Sempell was to deliver more than 30 gate valves of this type for 5 Swedish nuclear power stations by autumn 1995. In the presentation, the author will report on the testing performed, qualifications, and sizing criteria which led to the new technical design.

  20. The Latest Books on Globalization

    Directory of Open Access Journals (Sweden)

    Elia Zaru

    2016-12-01

    Full Text Available The latest books published on globalization raise interesting issues which reflect upon the very complexity of the process we are facing. In The Great Convergence: Information Technology and the New Globalization Richard Baldwin proposes a history of globalization divided into two stages. As Baldwin argues, the process of globalization has to be divided into “old” and “new” age. The “old” globalization took place between 1820 and 1990. It was characterized by the “great divergence”, that is by the centralization of world income in today’s wealthy nations. However, since 1990 the sharing of world income has plummeted to where it was in 1900. According to Baldwin, this reversal of fortune is a symptom of a shift in the globalization process. The “new” globalization, driven by information technology, has combined high tech with low wages, and lead simultaneously to the industrialization of developing nations and deindustrialization of developed ones. This is the “great convergence”: in the “new” globalization rich and developing nations are alike and they face equal global challenges.

  1. Lessons learned about the information activities related to local hearings in Finland, based on a university study, and the latest opinion survey results from autumn 1992

    Energy Technology Data Exchange (ETDEWEB)

    Ruuskanen, Antti [Communications, Imatran Voima Oy (Finland)

    1993-07-01

    This paper considers the results of two studies by the University of Tampere, financed by power companies (IVO, TVO and PEVO) in Finland. The first one deals with information events arranged during the application process for the fifth nuclear power plant unit. The results demonstrate both the validity of some well-known information theories and the power of local media compared to booklets issued by power companies. The second study reported is the newest part of a longitudinal energy attitude survey. The results found may hold true even in other countries, due to the general symbolic values related to energy questions. Perhaps the most amazing result is the stability of attitudes. Other findings are discussed and evaluated, too. (author)

  2. Lessons learned about the information activities related to local hearings in Finland, based on a university study, and the latest opinion survey results from autumn 1992

    International Nuclear Information System (INIS)

    Ruuskanen, Antti

    1993-01-01

    This paper considers the results of two studies by the University of Tampere, financed by power companies (IVO, TVO and PEVO) in Finland. The first one deals with information events arranged during the application process for the fifth nuclear power plant unit. The results demonstrate both the validity of some well-known information theories and the power of local media compared to booklets issued by power companies. The second study reported is the newest part of a longitudinal energy attitude survey. The results found may hold true even in other countries, due to the general symbolic values related to energy questions. Perhaps the most amazing result is the stability of attitudes. Other findings are discussed and evaluated, too. (author)

  3. Modalities of Generalization Through Single Case Studies.

    Science.gov (United States)

    Zittoun, Tania

    2017-06-01

    The value of case studies for theory building is still doubted in psychology. The paper argues for the importance of case studies and the possibility of generalizing from these for a specific sociocultural understanding of human development. The paper first clarifies the notion of abduction within case studies, drawing on pragmatists James and Peirce and expanding it with the work of Lewin, and argues that it is the core mechanism that allows generalization from case studies. The second section presents the possibility of generalizing from individual single case studies, for which not only the subjective perspective, but also the dynamics by which the social and cultural environment guide and enable the person's development, have to be accounted for. The third section elaborates the question of institutional case studies, where the challenge is to account both for institutional dynamics, and for persons' trajectories within; this is exemplified with an ongoing study on the process of obtaining citizenship in Switzerland. The paper briefly concludes by highlighting two possible implications of the paper, one concerning the process of theoretical reasoning, the other, the fact that sociocultural psychology could itself be seen as an institution in-the-making.

  4. Experimental studies of generalized parton distributions

    International Nuclear Information System (INIS)

    Kabuss, E.M.

    2014-01-01

    Generalized parton distributions (GPD) provide a new way to study the nucleon structure. Experimentally they can be accessed using hard exclusive processes such as deeply virtual Compton scattering and meson production. First insights to GPDs were already obtained from measurements at DESY, JLAB and CERN, while new ambitious studies are planned at the upgraded JLAB at 12 GeV and at CERN. Here, some emphasis will be put onto the planned COMPASS II programme. (author)

  5. General report of the Insurance Study Committee

    International Nuclear Information System (INIS)

    1988-01-01

    This general report gives the main objectives which the Insurance Study Committee intends to follow, an overview of the work undertaken from 1985-1988 and some points that the Committee considers its duty to underline, propose or recommend in the field of risk management. It concludes with the report of the Group of Experts on Third Party Liability and Nuclear Insurance, set up in 1986 to study and prepare the position to be taken by UNIPEDE on nuclear third party liability matters at the Group of Governmental Experts on Nuclear Third Party Liability and at the IAEA Standing Committee on Civil Liability for Nuclear Damage [fr

  6. Glaucoma: Symptoms, Diagnosis, Treatment and Latest Research

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Glaucoma Glaucoma: Symptoms, Diagnosis, Treatment and Latest Research Past Issues / Fall 2009 Table of Contents Symptoms and Diagnosis Glaucoma can develop in one or both eyes. Often ...

  7. Editorial: Latest methods and advances in biotechnology.

    Science.gov (United States)

    Lee, Sang Yup; Jungbauer, Alois

    2014-01-01

    The latest "Biotech Methods and Advances" special issue of Biotechnology Journal continues the BTJ tradition of featuring the latest breakthroughs in biotechnology. The special issue is edited by our Editors-in-Chief, Prof. Sang Yup Lee and Prof. Alois Jungbauer and covers a wide array of topics in biotechnology, including the perennial favorite workhorses of the biotech industry, Chinese hamster ovary (CHO) cell and Escherichia coli. Copyright © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  8. The latest from the LHC

    CERN Multimedia

    Mathew Stracy

    As promised by the Director-General, we will start a series of regular updates detailing the status of the LHC repairs, consolidation and commissioning.As of last week all magnets in the damaged area of sector 3-4 have been removed and raised to the surface. In total 39 dipoles and 14 short straight sections are now on the surface. Four replacement magnets have been lowered and installed, and by the end of this week this figure should total seven. Cold testing replacement magnets in SM18 has resumed after the Christmas shutdown. The civil engineering work to repair the slight damage to the concrete has been completed. Outside the damaged area the Vacuum Group are cleaning some of the beam screens in situ.Both sector 1-2 and sector 5-6 are also now at room temperature and accessible. As well as routine maintenance in these sectors, one magnet from sector 1-2 which was found to have high resistance (approximately 100 nano-ohms, two orders of magnitude higher than the specified resistance) has been removed and ...

  9. Agro. no 1 June Latest

    African Journals Online (AJOL)

    THE NUTRIGENETIC EFFECTS OF Moringa oleifera SEED MEAL ON THE ... not all genotypes respond equally to the same drug and/or nutritional regime., This ... This study therefore examined the effect of genotype, diet, andthe interaction of.

  10. Agro. no 1 June Latest

    African Journals Online (AJOL)

    This study was carried out to evaluate the effects of dietary levels of Moringa oleifera ... 2 range 27.67±0.60. The specific growth rate was highest in fish in tank T (0.96±0.01). ..... Makkar and Becker (1997c) who observed 23% CP in the leaves.

  11. Latest research progress on food waste management: a comprehensive review

    Science.gov (United States)

    Zhu, Shangzhen; Gao, Hetong; Duan, Lunbo

    2018-05-01

    Since a large amount of food supplying is provided as a basic line measuring increasing residents’ life standard, food waste has become progressively numeral considerable. Much attention has been drawn to this problem. This work gave an overview on latest researches about anaerobic digestion, composting, generalized management and other developments on management of food waste. Different technologies were introduced and evaluated. Further views on future research in such a field were proposed.

  12. Latest results from KLOE-2

    Directory of Open Access Journals (Sweden)

    Bloise Caterina

    2014-01-01

    Full Text Available The KLOE experiment at the Frascati φ–factory recently obtained results on i CPT and Lorentz invariance tests from the study of quantum interference of the neutral kaon pairs; ii precision measurement of the branching fraction, BR(K+ → π+π−π+(γ = 0.05565 ± 0.00031stat ± 0.00025syst, and iii on dark photon searches with the analysis of the e+e− → µµγ final state. We have also studied the transition form factors of the φ meson to the pseudoscalars, π0 and η, that is presented in a separate contribution to this volume.

  13. The Latest from the LHC

    CERN Multimedia

    In SM18 six magnets have been cold tested with good results. It has also been a good week for cyostating with five more magnets completed. In sector 3-4 interconnection work and welding has started in the area damaged on 19 September last year. Interconnection work is also ongoing on the replacement magnet for the faulty dipole removed from sector 1-2. Three separate teams are now working in the three sectors to install the new DN200 pressure release nozzles. In total 27 magnets have been completed so far, with 34 nozzles welded. A new study is also underway to include a similar pressure release system for both the stand-alone magnets (SAMs) and the triplet magnets. All about Chamonix At the public session of the LHCC (the LHC experiments committee) held Wednesday, 18 February Steve Myers, Director for Accelerators and Technology, reviewed the discussions on the LHC at the Chamonix workshop. He explained the scenarios being studied to implement the machine consolidation measures and resume operation. The ...

  14. Latest aspects of mechanical filtration

    Directory of Open Access Journals (Sweden)

    Stanislav Koláček

    2013-01-01

    Full Text Available The aim of this study was to describe and unify all knowledge about mechanic filtration. The first part deals with the parameters and properties of filtration. Here some important basic concepts are explained such as pressure gradient, filter life, etc. There’s also a description of convenient filtration technology for coarse and fine materials, such as sand, smoke or soot. The second part primarily focuses on the real use and application of filters for liquid and gaseous media. The differences in construction between different types of filters for filtration of fuels, oils, hydraulic fluids, air and cabin filters are described. The last section is focused mainly on new materials for the production of filters. These materials are ceramic or nanomaterials, which can actually be enriched for example with antibacterial silver or some fungicides.

  15. [Latest advances in acute pancreatitis].

    Science.gov (United States)

    de-Madaria, Enrique

    2013-10-01

    The present article analyzes the main presentations on acute pancreatitis (AP) in Digestive Disease Week 2013. Perfusion computed tomography allows early diagnosis of pancreatic necrosis. Neutrophil gelatinase-associated lipocalin predicts the development of acute renal failure, severe AP and death. Factors associated with greater fluid sequestration in AP are alcoholic etiology, an elevated hematocrit, and the presence of criteria of systemic inflammatory response syndrome; fluid sequestration is associated with a worse outcome. True pseudocysts (fluid collections without necrosis for more than 4 weeks) are a highly infrequent complication in AP. Patients with necrotic collections have a poor prognosis, especially if associated with infection. A meta-analysis on fluid therapy suggests that early aggressive fluid administration is associated with higher mortality and more frequent respiratory complications. According to a meta-analysis, enteral nutrition initiated within 24 hours of admission improves the outcome of AP compared with later initiation of enteral nutrition. Pentoxifylline could be a promising alternative in AP; a double-blind randomized study showed that this drug reduced the length of hospital and intensive care unit stay, as well as the need for intensive care unit admission. The association of octreotide and celecoxib seems to reduce the frequency of organ damage compared with octreotide alone. Mild AP can be managed in the ambulatory setting through hospital-at-home units after a short, 24-hour admission. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  16. General solar energy information user study

    Energy Technology Data Exchange (ETDEWEB)

    Belew, W.W.; Wood, B.L.; Marle, T.L.; Reinhardt, C.L.

    1981-03-01

    This report describes the results of a series of telephone interviews with groups of users of information on general solar energy. These results, part of a larger study on many different solar technologies, identify types of information each group needed and the best ways to get information to each group. The report is 1 of 10 discussing study results. The overall study provides baseline data about information needs in the solar community. An earlier study identified the information user groups in the solar community and the priority (to accelerate solar energy commercialization) of getting information to each group. In the current study only high-priority groups were examined. Results from 13 groups of respondents are analyzed in this report: Loan Officers, Real Estate Appraisers, Tax Assessors, Insurers, Lawyers, Utility Representatives, Public Interest Group Representatives, Information and Agricultural Representatives, Public Interest Group Representatives, Information and Agricultural Specialists at State Cooperative Extension Service Offices, and State Energy Office Representatives. The data will be used as input to the determination of information products and services the Solar Energy Research Institute, the Solar Energy Information Data Bank Network, and the entire information outreach community should be preparing and disseminating.

  17. Serum C-reactive protein in the prediction of cardiovascular diseases: Overview of the latest clinical studies and public health practice.

    Science.gov (United States)

    Avan, Amir; Tavakoly Sany, Seyedeh Belin; Ghayour-Mobarhan, Majid; Rahimi, Hamid Reza; Tajfard, Mohammad; Ferns, Gordon

    2018-06-22

    Cardiovascular disease is the most common cause of morbidity and mortality globally. Epidemiological studies using high-sensitivity assays for serum C-reactive protein have shown a consistent association between cardiovascular disease risk and serum C-reactive protein concentrations. C-reactive protein is a biomarker for inflammation, and has been established in clinical practice as an independent risk factor for cardiovascular disease events. There is evidence that serum C-reactive protein is an excellent biomarker of cardiovascular disease and is also an independent and strong predictor of adverse cardiovascular events. Further characterization of the impact and influence of lifestyle exposures and genetic variation on the C-reactive protein response to cardiovascular disease events may have implications for the therapeutic approaches to reduce cardiovascular disease events. This review summarizes the studies that have examined the association between serum C-reactive protein and the risk of cardiovascular disease. We also discuss the impact of independent factors and C-reactive protein genetic polymorphisms on baseline plasma C-reactive protein levels. © 2018 Wiley Periodicals, Inc.

  18. Latest German-English Terminology in CADCAM and Robotics

    International Nuclear Information System (INIS)

    Hussain, S M

    2014-01-01

    As a technical translator who speaks German fluently, the author would like to study and display the latest bilingual technical terminology in German being used in hardware, software and process technology involved in CADCAM and ROBOTICS. This will greatly help technical translators to correctly translate difficult texts from this area of technology

  19. Latest Insights on Adenovirus Structure and Assembly

    Directory of Open Access Journals (Sweden)

    Carmen San Martín

    2012-05-01

    Full Text Available Adenovirus (AdV capsid organization is considerably complex, not only because of its large size (~950 Å and triangulation number (pseudo T = 25, but also because it contains four types of minor proteins in specialized locations modulating the quasi-equivalent icosahedral interactions. Up until 2009, only its major components (hexon, penton, and fiber had separately been described in atomic detail. Their relationships within the virion, and the location of minor coat proteins, were inferred from combining the known crystal structures with increasingly more detailed cryo-electron microscopy (cryoEM maps. There was no structural information on assembly intermediates. Later on that year, two reports described the structural differences between the mature and immature adenoviral particle, starting to shed light on the different stages of viral assembly, and giving further insights into the roles of core and minor coat proteins during morphogenesis [1,2]. Finally, in 2010, two papers describing the atomic resolution structure of the complete virion appeared [3,4]. These reports represent a veritable tour de force for two structural biology techniques: X-ray crystallography and cryoEM, as this is the largest macromolecular complex solved at high resolution by either of them. In particular, the cryoEM analysis provided an unprecedented clear picture of the complex protein networks shaping the icosahedral shell. Here I review these latest developments in the field of AdV structural studies.

  20. Use of XenX™, the latest ureteric occlusion device with guide wire utility: results from a prospective multicentric comparative study.

    Science.gov (United States)

    Sanguedolce, Francesco; Montanari, Emanuele; Alvarez-Maestro, Mario; Macchione, Nicola; Hruby, Stephan; Papatsoris, Athanasios; Kallidonis, Panagiotis; Villa, Luca; Honeck, Patrick; Traxer, Olivier; Greco, Francesco

    2016-11-01

    This is a prospective multicentric comparative study evaluating the performance of XenX-a new dual-purpose device for the prevention of stone fragments migration during ureteroscopic lithotripsy (URS). Between March 2014 and January 2015, 41 patients undertaking URS + XenX were matched with 41 patients undergoing standard URS. Patients included had unilateral ureteric stone(s) of 0.5-1.5 cm in maximum size. Demographics, complication rates and surgical outcomes were recorded for comparison. A Likert-like 5-grade scoring system was used for surgeons' evaluation of XenX properties. Cost analysis was performed by comparing weighted mean costs of the relevant procedures. Patients' characteristics between the two groups were comparable. Lasering time was longer for XenX group (13.59 vs. 5.17 min; p = 0.0001) whilst use of basket and need of JJ stent insertion was more frequent in control group (19.5 vs. 97.6 %; p = 0.0001 and 22 vs. 35 %; p = 0.001, respectively). Intra-operative SFR was significantly higher for XenX group (100 vs. 85.4 %; p = 0.0001), but not at 4-week follow-up, after ancillary procedures were needed in 17.1 % of the control group. Surgeons' evaluations for XenX were suboptimal for "Ease of Basketing" (2/5) and "Advancement of double J stent" (3/5). The use of XenX increased costs of procedures, but spared the costs associated to ancillary procedures and stent removals. XenX confirmed to be a safe and effective device especially for the treatment of upper ureteric tract stones; moreover, XenX may reduce the risk for the need of auxiliary procedures and for the insertion of a JJ stent.

  1. The latest Light Robotics breakthroughs - Postdeadline

    DEFF Research Database (Denmark)

    Glückstad, Jesper; Palima, Darwin; Bañas, Andrew

    Contemporary nanoscopy provides functionalities, not only for observing life science on the smallest scales but also for actively reaching into and manipulating at subcellular levels. This post-deadline contribution describes the latest generation of 3D-printed micro-tools for enabling light-acti......-activated robotics on sub-diffraction scales: Light Robotics....

  2. Generalized skeletal pathology: Results of radionuclide studies

    International Nuclear Information System (INIS)

    Fueger, G.F.; Aigner, R.

    1987-01-01

    Generalized pathological changes may involve the skeleton systematically (bone tissue, bone marrow) or at multiple sites involving destruction or infiltration. Appropriate radionuclide studies include total-body bone or bone marrow scintigraphy, absorptiometry (osteodensitometry) and the 24 h whole-body retention measurement. Established radioindicators are 99m-Tc-(hydroxy)methylendiphosphonate (HMDP or MDP) and 99m-Tc-human serumalbumin-nanocolloid. Absorptiometry of the forearm, extended by computer-assisted transaxial tomography, may be expected to prove as the most efficient method of bone density measurement. The 24 h whole-body retention measurement is useful for the diagnosis and follow-up of metabolic and endocrine osteopathies, if the very same osteotropic 99m-Tc-chelate is used. Whole-body bone scintigraphy today is one of the most important radionuclide studies for diagnosis and follow-up of skeletal metastases. Scintigraphy provides evidence of skeletal metastases several months earlier than radiological examinations. In about 40 percent of patients with cancer of the prostate, scintigraphy provided positive findings of skeletal metastases in the absence of both pain and increased levels of phosphatase. In patients with a history of malignancy, 60 percent of solitary findings on skeletal scintigraphy are metastases. The frequency of false negative findings obtained by whole-body skeletal scintigraphy are metastases. The frequency of false negative findings obtained by whole-body skeletal scintigraphy ranges from 2 to 4%. Compared to skeletal scintigraphy, bone marrow scintigraphy frequently yields significant additional findings in cases of plasmocytoma, histiocytoma, lymphoma and haemoblastoses. (orig.) [de

  3. Almost No Generalizations: Reflections on Catholic Studies

    Science.gov (United States)

    Heft, James L.

    2009-01-01

    There are good reasons to be very careful about generalizations about Catholic higher education in the United States. Recall that the 220 or so Catholic colleges and universities are of very different kinds, very different sizes, with different student bodies, and are located in different parts of a country that sometimes have quite different…

  4. The latest dictionary of nuclear energy term

    International Nuclear Information System (INIS)

    1996-06-01

    This book is the latest dictionary of nuclear energy term. It deals with explanations of nuclear energy term in alphabetical order. It also lists abbreviation of nuclear energy term. This book contains symbol and unit, radiation units, greek letters, the symbol of for element, the table of an isotope and the periodic table on nuclear power term. It includes glossary of nuclear power in Korean and French and conceptual map about development of nuclear power.

  5. Latest Proterozoic stratigraphy and earth history

    Science.gov (United States)

    Knoll, Andrew H.; Walter, Malcolm R.

    1992-01-01

    Novel biostratigraphic and chemostratigraphic data furnish an improved framework for stratigraphic correlation of the Proterozoic Eon as well as tools for a chronostratigraphic division of the late Proterozoic. It is argued that, in conjunction with geochronometric data, protistan microfossils and isotope geochemistry can furnish a means for an eventual integration of the latest Proterozoic Eon. Attention is given to the emerging methodologies of fossil protists and prokaryotes and of isotopic chemostratigraphy.

  6. Supersymmetry searches with ATLAS: overview and latest results

    CERN Multimedia

    CERN. Geneva

    2013-01-01

    Despite the absence of experimental evidence, weak scale supersymmetry remains one of the best motivated and studied Standard Model extensions. The ATLAS experiment searches for signs of supersymmetry in a large variety of signatures involving events with abnormal production of missing transverse momentum, jets, leptons, photons, third generation fermions, gauge bosons or massive long-lived particles. The talk presents the latest results obtained in these searches.

  7. Latest news on SUSY from the ATLAS experiment

    CERN Multimedia

    CERN. Geneva

    2016-01-01

    Despite the absence of experimental evidence, weak scale supersymmetry remains one of the best motivated and studied Standard Model extensions. This talk reports the latest ATLAS results for searches for supersymmetric (SUSY) particles, obtained with 13 to 18 fb-1 of 13 TeV data. Weak and strong production in both R-Parity conserving and R-Parity violating SUSY scenarios are considered. The searches involved final states including jets, missing transverse momentum, light leptons, taus or photons.

  8. Turbomachinery: latest developments in a changing scene

    International Nuclear Information System (INIS)

    1991-01-01

    The contributions to the 1991 European Conference on the latest developments in turbomachinery are presented. The topics covered include: computational fluid dynamics methods applied to the aerodynamics of turbine blades; developments associated with steam turbines and gas turbines; flow patterns for turbine blades; compressor design and development; turbine test facilities; film cooling; heat transfer; theoretical treatment of transonic and unsteady flow; condensation phenomena and wet steam flow; water extraction from steam turbine blades; wetness losses in steam turbines in nuclear power plants and pressure loss reduction; aerodynamic instabilities arising from governing valves in Pressurized Water Reactor steam turbines. (UK)

  9. Latest climate changes in Romania :tornadoes

    Science.gov (United States)

    Pop, Elena

    2014-05-01

    Latest climate changes in Romania :tornadoes As climate change has been considered a research priority in the European Strategy for enduring development , I have done a detailed research with my students of the new climate change that has been going on in Romania for the past decade. More precisely I have studied together with my students the phenomenon of tornadoes that have seriously affected on some occasions some our our country's locations, such as Facaeni, in the county of Ialomita, in August 2002. A quite unusual phenomenon occurred on that location situated at 44.56 degrees northern latitude and at 27.89 degrees eastern longitude, that caused severe damage to the local environment and three persons lost their lives in the process, as well as other thirty people suffering from bad injuries. The magnitude of that strong phenomenon rose on the Fujita scale at level F3 which implied wing gusts between 252-300 km/ hour . A main cause of occurrence of such a severe weather was the difference in temperature of two huge air masses, one of Polar origin, and other coming from tropical latitudes . Their crossroads was on that precise territory of Romania. The duration of the worst part of the tornado path lasted only for two minutes, but the consequences of its passage were colossal : total destruction of 33 households, and other 395 were partially damaged, 1,000 people afflicted by the devastation and 100 acres of acacia tree forest ripped off the ground. The first ever recorded tornado phenomenon in Romania was around 1894-1896, considered at that time " a freak of nature" was seen as a cloud formation abnormality , an uncontrolled force of nature that had a huge impact , and at the same time, it vanished into "thin air " fast. The most affected areas in Romania by tornadoes are the south-eastern planes where the cloud formations can create fast columns of air rotating up to 500 km/hour. The local people compared the cloud funnels created on the planes to "serpents

  10. Latest ATLAS results on $\\phi_s$

    CERN Document Server

    AUTHOR|(INSPIRE)INSPIRE-00222462; The ATLAS collaboration

    2017-01-01

    New Physics effects beyond the predictions of the Standard Model may manifest in the $CP$-violation of $b$-hadron decays. This paper presents the latest analysis of $B^0_s \\to J/\\psi\\phi$ decay at the ATLAS experiment, measuring the $CP$-violating phase $\\phi_s$, the decay width $\\Gamma_s$ and the difference of widths between the mass eigenstates $\\Delta\\Gamma_s$. The latest results are using integrated luminosity of 14.3 fb$^{-1}$ collected by the ATLAS detector from $\\sqrt{s}$ = 8 TeV $pp$ collisions at the Large Hadron Collider, and are statistically combined with the results from 4.9 fb$^{-1}$ of $\\sqrt{s}$ = 7 TeV data, leading to: \\begin{eqnarray*} \\phi_s & = & -0.090 \\pm 0.078 \\;\\mathrm{(stat.)} \\pm 0.041 \\;\\mathrm{(syst.)~rad} ,\\;\\;\\\\ \\Delta\\Gamma_s & = & 0.085 \\pm 0.011 \\;\\mathrm{(stat.)} \\pm 0.007 \\;\\mathrm{(syst.)~ps}^{-1} ,\\;\\;\\\\ \\Gamma_s & = & 0.675 \\pm 0.003 \\;\\mathrm{(stat.)} \\pm 0.003 \\;\\mathrm{(syst.)~ps}^{-1}. \\end{eqnarray*} The results are also presented in the form...

  11. A Generalized Deforestation and Land-Use Change Scenario Generator for Use in Climate Modelling Studies

    Science.gov (United States)

    Tompkins, Adrian Mark; Caporaso, Luca; Biondi, Riccardo; Bell, Jean Pierre

    2015-01-01

    A new deforestation and land-use change scenario generator model (FOREST-SAGE) is presented that is designed to interface directly with dynamic vegetation models used in latest generation earth system models. The model requires a regional-scale scenario for aggregate land-use change that may be time-dependent, provided by observational studies or by regional land-use change/economic models for future projections. These land-use categories of the observations/economic model are first translated into equivalent plant function types used by the particular vegetation model, and then FOREST-SAGE disaggregates the regional-scale scenario to the local grid-scale of the earth system model using a set of risk-rules based on factors such as proximity to transport networks, distance weighted population density, forest fragmentation and presence of protected areas and logging concessions. These rules presently focus on the conversion of forest to agriculture and pasture use, but could be generalized to other land use change conversions. After introducing the model, an evaluation of its performance is shown for the land-cover changes that have occurred in the Central African Basin from 2001–2010 using retrievals from MODerate Resolution Imaging Spectroradiometer Vegetation Continuous Field data. The model is able to broadly reproduce the spatial patterns of forest cover change observed by MODIS, and the use of the local-scale risk factors enables FOREST-SAGE to improve land use change patterns considerably relative to benchmark scenarios used in the latest Coupled Model Intercomparison Project integrations. The uncertainty to the various risk factors is investigated using an ensemble of investigations, and it is shown that the model is sensitive to the population density, forest fragmentation and reforestation factors specified. PMID:26394392

  12. Higher education and general studies in Nigeria: A philosophical ...

    African Journals Online (AJOL)

    Higher education and general studies in Nigeria: A philosophical investigation. ... Mgbakoigba: Journal of African Studies ... national policy on education on tertiary or higher education reveals a startling chasm of gap between the goals of the policy through General Studies Programme and their expected actualizations.

  13. The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency. Latest Status (Spanish Edition); Texto Revisado de Los Principios Rectores n Normas Generales de Ejecucion Para la Prestacion de Asistencia Tecnica por el Organismo

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1979-03-15

    The Revised Guiding Principles and General Operating Rules to Govern the Provision of Technical Assistance by the Agency were approved by the Board of Governors on 21 February 1979. The test is reproduced herein for the information of all Members. The provisions established by the Board of Governors on 24 September 1977 for the application of safeguards in relation to the granting of technical assistance are also reproduced in the Annex to the Revised Guiding Principles and General Operating Rules. [Spanish] El 21 de febrero de 1979 la Junta de Gobernadores aprobo el texto revisado de los Principios rectores y normas generales de ejecucion para la prestacion de asistencia tecnica por el Organismo. Para informacion de todos los Estados Miembros, en el presente documento se transcribe dicho texto. En el Anexo del texto revisado de los Principios rectores y normas generales de ejecucion se transcriben tambien las disposiciones prescritas por la Junta de Gobernadores el 24 de septiembre de 1977 acerca de la aplicacion de salvaguardias en relacion con la asistencia tecnica.

  14. Latest ATLAS measurements on top quark properties

    CERN Document Server

    Derue, Frederic; The ATLAS collaboration

    2017-01-01

    The top quark is unique among the known quarks in that it decays before it has an opportunity to form hadronic bound states. This makes measurements of its properties particularly interesting as one can access directly the properties of a bare quark. The latest measurements of these properties with the ATLAS detector at the LHC are presented using 8 TeV and 13 TeV data, excluding results from single top production. Measurements of top quark spin observables in top-antitop events, each sensitive to a different coefficient of the spin density matrix, are presented and compared to the Standard Model predictions. The helicity of the W boson from the top decays and the production angles of the top quark are further discussed. New results on the measurment of color flow effects in $t{\\bar t}$ events are presented. Limits on the rate of flavour changing neutral currents in the production or decay of the top quark are reported. The cross-section measurement of photons produced in association with top-quark pairs is a...

  15. Latest results from CERES/NA45

    CERN Document Server

    AUTHOR|(CDS)2074200; Adamova, D; Agakichiev, G; Appelshuser, H; Belaga, V; Braun-Munzinger, P; Campagnolo, R; Castillo, A; Cherlin, A; Damjanovic, S; Dietel, T; Dietrich, L; Drees, A; Esumi, S I; Filimonov, K; Fomenko, K; Fraenkel, Zeev; Garabatos, C; Glässel, P; Hering, G; Holeczek, J; Kushpil, V; Lenkeit, B C; Ludolphs, W; Maas, A; Marin, A; Messer, F; Milosevic, J; Milov, A; Mikowiec, D; Musa, L; Panebratsev, Yu A; Petchenova, O Yu; Petracek, V; Pfeiffer, A; Rak, J; Ravinovich, I; Rehak, P; Richter, M; Sako, H; Schmitz, W; Schükraft, J; Sedykh, S; Seipp, W; Sharma, A; Shimansky, S S; Slivova, J; Specht, H J; Stachel, J; Sumbera, M; Tilsner, H; Tserruya, Itzhak; Wienold, T; Windelband, B; Wurm, J P; Xie, W; Yurevich, S; Yurevich, V; Wessels, Johannes P.

    2003-01-01

    In this talk latest results from the analysis of $e^{+}e^{-}$ pairs emitted in Pb + Au collisions at 40 AGeV/c and a combined analysis of all data available at 158 AGeV/c are presented. The enhancement of low-mass $e^{+}e^{-}$ pairs $(m_{ee}>0.2 GeV/c^{2})$ with respect to the expected yield from hadron decays first reported at 158 AGeV/c is also found at 40 AGeV/c and is even larger there. Comparing to various theoretical models based on $\\pi^{+}\\pi^{-}$ annihilation, the data can only be reproduced, if the properties of the intermediate $\\rho$ in the hot and dense medium are modified. Theoretically, the modification is linked to baryon density rather than temperature. Constraints from hadron data taken at the same beam energies indeed indicate a fireball evolution along a trajectory of higher baryon density at 40 AGeV/c, consistent with the observed larger enhancement factor.

  16. Evidence for a General ADHD Factor from a Longitudinal General School Population Study

    Science.gov (United States)

    Normand, Sebastien; Flora, David B.; Toplak, Maggie E.; Tannock, Rosemary

    2012-01-01

    Recent factor analytic studies in Attention-Deficit/Hyperactivity Disorder (ADHD) have shown that hierarchical models provide a better fit of ADHD symptoms than correlated models. A hierarchical model includes a general ADHD factor and specific factors for inattention, and hyperactivity/impulsivity. The aim of this 12-month longitudinal study was…

  17. Latest advances in high brightness disk lasers

    Science.gov (United States)

    Kuhn, Vincent; Gottwald, Tina; Stolzenburg, Christian; Schad, Sven-Silvius; Killi, Alexander; Ryba, Tracey

    2015-02-01

    In the last decade diode pumped solid state lasers have become an important tool for many industrial materials processing applications. They combine ease of operation with efficiency, robustness and low cost. This paper will give insight in latest progress in disk laser technology ranging from kW-class CW-Lasers over frequency converted lasers to ultra-short pulsed lasers. The disk laser enables high beam quality at high average power and at high peak power at the same time. The power from a single disk was scaled from 1 kW around the year 2000 up to more than 10 kW nowadays. Recently was demonstrated more than 4 kW of average power from a single disk close to fundamental mode beam quality (M²=1.38). Coupling of multiple disks in a common resonator results in even higher power. As an example we show 20 kW extracted from two disks of a common resonator. The disk also reduces optical nonlinearities making it ideally suited for short and ultrashort pulsed lasers. In a joint project between TRUMPF and IFSW Stuttgart more than 1.3 kW of average power at ps pulse duration and exceptionally good beam quality was recently demonstrated. The extremely low saturated gain makes the disk laser ideal for internal frequency conversion. We show >1 kW average power and >6 kW peak power in multi ms pulsed regime from an internally frequency doubled disk laser emitting at 515 nm (green). Also external frequency conversion can be done efficiently with ns pulses. >500 W of average UV power was demonstrated.

  18. The DAFT/FADA Survey status and latest results

    Science.gov (United States)

    Guennou, L.

    2011-12-01

    We present here the latest results obtained from the American French collaboration called the Dark energy American French Team/French American DArk energy Team (DAFT/FADA). The goal of the DAFT/FADA collaboration is to carry out a weak lensing tomography survey of z = 0.4-0.9 rich clusters of galaxies. Unlike supernovae or other methods such as cluster of galaxy counts, weak lensing tomography is purely based on geometry and does not depend on knowledge of the physics of the objects used as distance indicators. In addition, the reason for analyzing observations in the direction of clusters is that the shear signal is enhanced by about 10 over the field. Our work will eventually contain results obtained on 91 rich clusters from the HST archive combined with ground based work to obtain photo-zs. This combination of photo-z and weak lensing tomography will enable us to constrain the equation of state of dark energy. We present here the latest results obtained so far in this study.

  19. BepiColombo: Overview and latest updates

    Science.gov (United States)

    Benkhoff, J.

    2012-09-01

    BepiColombo is an interdisciplinary mission to explore the planet Mercury through a partnership between ESA and Japan's Aerospace Exploration Agency (JAXA). From their dedicated orbits two spacecraft, the ESA provided Mercury Planetary Orbiter (MPO) and the JAXA provided Mercury Magnetospheric Orbiter (MMO), will be studying the planet and its environment. Both spacecraft of BepiColombo will be launched together in summer 2015. The mission will address a comprehensive set of scientific questions in order to study the planet, its evolution and its surrounding environment. A suite of state-of-art scientific instruments, flying on the two spacecraft, allow a wide range of scientific questions to be addressed like understanding of the origin and evolution of a planet close to its parent star, the detailed study of Mercury's figure, its interior structure and composition, the investigation of the interior dynamics and origin of Mercury's magnetic field. Further science goals are trying to understand exo- and endogenic surface modifications, cratering, tectonics, and volcanism. The composition, origin and dynamics of Mercury's exosphere and Mercury's magnetosphere will be addressed by combined measurements of both spacecraft. Last but not least scientist believe that they can use the BepiColombo also as a laboratory to test Einstein's theory of general relativity, by performing high accurate positioning measurements of the spacecraft. All in all measurements performed by the instruments on BepiColombo will provide clues on the origin and formation of terrestrial planets and help to answer fundamental questions like: "How do Earth-like planets form and evolve in the Universe?"

  20. A qualitative study of collaboration in general practice: understanding the general practice nurse's role.

    Science.gov (United States)

    McInnes, Susan; Peters, Kath; Bonney, Andrew; Halcomb, Elizabeth

    2017-07-01

    To explore the nature of collaboration between registered nurses and general practitioners in Australian general practice. There is international recognition that collaboration between health professionals can improve care coordination, enhance health outcomes, optimise the work environment and reduce healthcare costs. However, effective collaboration requires a clear understanding of each team member's role. A qualitative approach guided by Naturalistic Inquiry was used to elicit and interpret participant narratives. Eight general practitioners and fourteen registered nurses working in general practice were purposefully recruited. Data were collected via individual, semi-structured face-to-face interviews during February to May 2015. Interviews were audio recorded and transcribed verbatim. Data were analysed using thematic analysis. Data revealed three overarching themes. This study presents the data for the overarching theme 'Understanding the general practice registered nurse's role'. Many general practitioner participants lacked clarity around the role and scope of practice of the registered nurse. At the same time, nursing participants often articulated their role as an assistant rather than as an independent health professional. This limited collaboration and the nurses' role within the team. Collaboration was enhanced when general practitioners actively sought an understanding of the registered nurses scope of practice. Clarifying the nurses' role promotes collaboration and supports nurses to work to the full extent of their practice. This is important in terms of optimising the nurses' role within the team and reinforcing their professional identity. Identification of key issues around understanding the nurses' role may help inform strategies that improve collaboration and workplace relations. © 2016 John Wiley & Sons Ltd.

  1. Current situation and prospect of market on the latest radiation measuring instrument

    International Nuclear Information System (INIS)

    Ha, Chang Ho; Kim, Wang Geum; Cho, Gyu Seong

    2009-12-01

    This book deals with current situation and prospect of market on the latest radiation measuring instrument. The contents of this book are basic of technology on radiation measuring instrument with basic principle of various measuring instrument, current situation of technology and prospect of radiation measuring instrument, effect of spreading and application field of radiation measuring instrument, facility for making and research and development of radiation measuring instrument, prospect of market about radiation measuring instrument, strategy for market entry with the latest radiation measuring instrument and general prospect for the future.

  2. Knowledge, attitude and assessment of general study courses by ...

    African Journals Online (AJOL)

    We set out to look at the knowledge, attitudes and assessment of GS courses by students of Nnamdi Azikiwe University, Nnewi campus whose courses of study are related to human health. It is hoped that the information gained from this study will help the School of General Studies (SGS) improve the set of GS courses ...

  3. Stakeholder experiences with general practice pharmacist services: a qualitative study.

    Science.gov (United States)

    Tan, Edwin C K; Stewart, Kay; Elliott, Rohan A; George, Johnson

    2013-09-11

    To explore general practice staff, pharmacist and patient experiences with pharmacist services in Australian general practice clinics within the Pharmacists in Practice Study. Qualitative study. Two general practice clinics in Melbourne, Australia, in which pharmacists provided medication reviews, patient and staff education, medicines information and quality assurance services over a 6-month period. Patients, practice staff and pharmacists. Semi-structured telephone interviews with patients, focus groups with practice staff and semi-structured interviews and periodic narrative reports with practice pharmacists. Data were analysed thematically and theoretical frameworks used to explain the findings. 34 participants were recruited: 18 patients, 14 practice staff (9 general practitioners, 4 practice nurses, 1 practice manager) and 2 practice pharmacists. Five main themes emerged: environment; professional relationships and integration; pharmacist attributes; staff and patient benefits and logistical challenges. Participants reported that colocation and the interdisciplinary environment of general practice enabled better communication and collaboration compared to traditional community and consultant pharmacy services. Participants felt that pharmacists needed to possess certain attributes to ensure successful integration, including being personable and proactive. Attitudinal, professional and logistical barriers were identified but were able to be overcome. The findings were explained using D'Amour's structuration model of collaboration and Roger's diffusion of innovation theory. This is the first qualitative study to explore the experiences of general practice staff, pharmacists and patients on their interactions within the Australian general practice environment. Participants were receptive of colocated pharmacist services, and various barriers and facilitators to integration were identified. Future research should investigate the feasibility and sustainability of

  4. The latest technical solutions in rail vehicles drives

    Directory of Open Access Journals (Sweden)

    Andrzejewski Maciej

    2017-01-01

    Full Text Available The article discusses the latest trends and solutions used in the offers of rail vehicles manufacturers. The study is mainly concerned with the technical solutions used in hybrid rail vehicles, whose development has become one of the priorities for the development of rail vehicles in the European Union in recent years. Stricter emissions standards for harmful compounds in the European Union have forced manufacturers to use increasingly sophisticated technology, including hybrid drives and alternative fuels. The products and solutions offered by the major manufacturers on the market, along with their capabilities and future applications are described. The predicted trends in the development of propulsion technology for rail and road-rail vehicles are also indicated in view of the current legislative aspirations among the EU Member States.

  5. Latest-Generation Transcatheter Aortic Valve Replacement Devices and Procedures.

    Science.gov (United States)

    Chamandi, Chekrallah; Puri, Rishi; Rodriguez-Gabella, Tania; Rodés-Cabau, Josep

    2017-09-01

    Transcatheter aortic valve replacement (TAVR) is a well-established treatment for patients with severe symptomatic aortic stenosis who are at high or prohibitive surgical risk. More recently, TAVR has emerged as a valid alternative to surgical aortic valve replacement for treating intermediate-risk patients, and several studies are currently evaluating the role of TAVR in low-risk patients. Transcatheter heart valve (THV) technologies have evolved considerably over time, and important iterations have been implemented in many of the latest-generation devices to (1) reduce the size and improve delivery system properties; (2) improve valve deployment, repositioning, and retrievability; and (3) reduce paravalvular leaks. This article reviews the main characteristics of, and clinical results associated with, the newer-generation THVs while providing an overview of novel TAVR indications. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  6. Latest development on the membrane formation for gas separation

    Directory of Open Access Journals (Sweden)

    Ahmad Fausi Ismail

    2002-11-01

    Full Text Available The first scientific observation related to gas separation was encountered by J.K Mitchell in 1831. However, the most remarkable and influential contribution to membrane gas separation technology was the systematic study by Thomas Graham in 1860. However only in 1979, membrane based gas separation technology was available and recognized as one of the most recent and advanced unit operations for gas separation processes. Membrane is fabricated by various methods and the parameters involved to a certain extent are very complicated. The phase inversion technique that is normally employed to produce membranes are dry/wet, wet, dry and thermal induced phase separation. Other techniques used to produce membrane are also reviewed. This paper reports the latest development in membrane formation for gas separation. The route to produce defect-free and ultrathin-skinned asymmetric membrane is also presented that represents the cutting edge technology in membrane gas separation process

  7. Multifaceted bench comparative evaluation of latest intensive care unit ventilators.

    Science.gov (United States)

    Garnier, M; Quesnel, C; Fulgencio, J-P; Degrain, M; Carteaux, G; Bonnet, F; Similowski, T; Demoule, A

    2015-07-01

    Independent bench studies using specific ventilation scenarios allow testing of the performance of ventilators in conditions similar to clinical settings. The aims of this study were to determine the accuracy of the latest generation ventilators to deliver chosen parameters in various typical conditions and to provide clinicians with a comprehensive report on their performance. Thirteen modern intensive care unit ventilators were evaluated on the ASL5000 test lung with and without leakage for: (i) accuracy to deliver exact tidal volume (VT) and PEEP in assist-control ventilation (ACV); (ii) performance of trigger and pressurization in pressure support ventilation (PSV); and (iii) quality of non-invasive ventilation algorithms. In ACV, only six ventilators delivered an accurate VT and nine an accurate PEEP. Eleven devices failed to compensate VT and four the PEEP in leakage conditions. Inspiratory delays differed significantly among ventilators in invasive PSV (range 75-149 ms, P=0.03) and non-invasive PSV (range 78-165 ms, Pventilation algorithms efficiently prevented the decrease in pressurization capacities and PEEP levels induced by leaks in, respectively, 10 and 12 out of the 13 ventilators. We observed real heterogeneity of performance amongst the latest generation of intensive care unit ventilators. Although non-invasive ventilation algorithms appear to maintain adequate pressurization efficiently in the case of leakage, basic functions, such as delivered VT in ACV and pressurization in PSV, are often less reliable than the values displayed by the device suggest. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. The latest trend of nuclear standards

    International Nuclear Information System (INIS)

    Tobioka, Toshiaki

    2000-01-01

    In Japan, the Atomic Energy Fundamental Law is enacted as a fundamental law on application of atomic energy. According to provision of the Law, various regulations essential to prevent national disaster, to protect nuclear substances and to secure public safety are carried out. From a viewpoint of disaster prevention, 'the Law on Regulation of Nuclear Raw Materials, Nuclear Fuel Substances and Nuclear Reactors' is enacted for its main law. On countermeasure to an emergency of accident formation at a nuclear facility, 'the Disaster Countermeasure Fundamental Law' is enacted as a general law for disaster countermeasure and defined obligation, organization, and so on of government, local community, and so on for the disaster containing large scale natural disaster, and recently 'the Nuclear Disaster Special Measure Act' was enacted by receiving necessity of enforced cooperation between government and local community. However, for a general tendency, these regulation rules and now transferring from the conventional system where a means to establish an object in safety is regulated in a meaning to a form required to finish a concrete safe target. (G.K.)

  9. [The latest in paediatric resuscitation recommendations].

    Science.gov (United States)

    López-Herce, Jesús; Rodríguez, Antonio; Carrillo, Angel; de Lucas, Nieves; Calvo, Custodio; Civantos, Eva; Suárez, Eva; Pons, Sara; Manrique, Ignacio

    2017-04-01

    Cardiac arrest has a high mortality in children. To improve the performance of cardiopulmonary resuscitation, it is essential to disseminate the international recommendations and the training of health professionals and the general population in resuscitation. This article summarises the 2015 European Paediatric Cardiopulmonary Resuscitation recommendations, which are based on a review of the advances in cardiopulmonary resuscitation and consensus in the science and treatment by the International Council on Resuscitation. The Spanish Paediatric Cardiopulmonary Resuscitation recommendations, developed by the Spanish Group of Paediatric and Neonatal Resuscitation, are an adaptation of the European recommendations, and will be used for training health professionals and the general population in resuscitation. This article highlights the main changes from the previous 2010 recommendations on prevention of cardiac arrest, the diagnosis of cardiac arrest, basic life support, advanced life support and post-resuscitation care, as well as reviewing the algorithms of treatment of basic life support, obstruction of the airway and advanced life support. Copyright © 2016. Publicado por Elsevier España, S.L.U.

  10. Stroke Awareness in the General Population: A Study from Jordan ...

    African Journals Online (AJOL)

    Purpose: To assess the awareness level of the Jordanian general population regarding the definition, risk factors, signs and symptoms, and consequences of stroke. Methods: This was a cross-sectional study. The questionnaire was handed to participants by trained students, the participants were chosen randomly from ...

  11. "Two Cultures" Topics for General Studies Science Courses.

    Science.gov (United States)

    Larson, James H.

    1982-01-01

    Theses proposed in C. P. Snow's book "The Two Cultures," including uncommunicative scientific and literary groups, gap between rich and poor, overpopulation, and nuclear war remain viable topics. Discusses the scientific and literary cultural gap and what can be done in general studies science courses to ameliorate the condition.…

  12. Infusing technology into general studies program: The Nnamdi ...

    African Journals Online (AJOL)

    This paper is intended to give a summary of the efforts of school of general studies, Nnamdi Azikiwe University at moving in specified dimensions to realise her present status in blended procedures. It is hoped that the measure will be introductory enough to encourage and motivate other tertiary institutions to get in step.

  13. a Model Study of Small-Scale World Map Generalization

    Science.gov (United States)

    Cheng, Y.; Yin, Y.; Li, C. M.; Wu, W.; Guo, P. P.; Ma, X. L.; Hu, F. M.

    2018-04-01

    With the globalization and rapid development every filed is taking an increasing interest in physical geography and human economics. There is a surging demand for small scale world map in large formats all over the world. Further study of automated mapping technology, especially the realization of small scale production on a large scale global map, is the key of the cartographic field need to solve. In light of this, this paper adopts the improved model (with the map and data separated) in the field of the mapmaking generalization, which can separate geographic data from mapping data from maps, mainly including cross-platform symbols and automatic map-making knowledge engine. With respect to the cross-platform symbol library, the symbol and the physical symbol in the geographic information are configured at all scale levels. With respect to automatic map-making knowledge engine consists 97 types, 1086 subtypes, 21845 basic algorithm and over 2500 relevant functional modules.In order to evaluate the accuracy and visual effect of our model towards topographic maps and thematic maps, we take the world map generalization in small scale as an example. After mapping generalization process, combining and simplifying the scattered islands make the map more explicit at 1 : 2.1 billion scale, and the map features more complete and accurate. Not only it enhance the map generalization of various scales significantly, but achieve the integration among map-makings of various scales, suggesting that this model provide a reference in cartographic generalization for various scales.

  14. Integrating postgraduate and undergraduate general practice education: qualitative study.

    Science.gov (United States)

    O'Regan, Andrew; Culhane, Aidan; Dunne, Colum; Griffin, Michael; McGrath, Deirdre; Meagher, David; O'Dwyer, Pat; Cullen, Walter

    2013-05-01

    Educational activity in general practice has increased considerably in the past 20 years. Vertical integration, whereby practices support students and trainees at different stages, may enhance general practices' capacity to fulfil this role. To explore the potential for vertical integration in undergraduate and postgraduate education in general practice, by describing the experience of (and attitudes towards) 'vertical integration in general practice education' among key stakeholder groups. Qualitative study of GPs, practice staff, GPs-in-training and medical students involving focus groups which were thematically analysed. We identified four overarching themes: (1) Important practical features of vertical integration are interaction between learners at different stages, active involvement in clinical teams and interagency collaboration; (2) Vertical integration may benefit GPs/practices, students and patients through improved practice systems, exposure to team-working and multi-morbidity and opportunistic health promotion, respectively; (3) Capacity issues may challenge its implementation; (4) Strategies such as recognising and addressing diverse learner needs and inter-agency collaboration can promote vertical integration. Vertical integration, whereby practices support students and trainees at different stages, may enhance general practices' teaching capacity. Recognising the diverse educational needs of learners at different stages and collaboration between agencies responsible for the planning and delivery of specialist training and medical degree programmes would appear to be important.

  15. Study of the properties of general relativistic Kink model (GRK)

    International Nuclear Information System (INIS)

    Oliveira, L.C.S. de.

    1980-01-01

    The stability of the general relativistic Kink model (GRK) is studied. It is shown that the model is stable at least against radial perturbations. Furthermore, the Dirac field in the background of the geometry generated by the GRK is studied. It is verified that the GRK localizes the Dirac field, around the region of largest curvature. The physical interpretation of this system (the Dirac field in the GRK background) is discussed. (Author) [pt

  16. Latest generation of ASICs for photodetector readout

    International Nuclear Information System (INIS)

    Seguin-Moreau, N.

    2013-01-01

    The OMEGA microelectronics group has designed a new generation of multichannel integrated circuits, the “ROC” family, in AustrianMicroSystem (AMS) SiGe 0.35 μm technology to read out signals from various families of photodetectors. The chip named MAROC (standing for Multi Anode ReadOut Chip) has been designed to read out MultiAnode Photomultipliers (MAPMT), Photomultiplier ARray In SiGe ReadOut Chip (PARISROC) to read out Photomultipliers (PMTs) and SiPM Integrated ReadOut Chip (SPIROC) to readout Silicon PhotoMultiplier (SiPM) detectors and which was the first ASIC to do so. The three of them fulfill the stringent requirements of the future photodetectors, in particular in terms of low noise, radiation hardness, large dynamic range, high density and high speed while keeping low power thanks to the SiGe technology. These multi-channel ASICs are real System on Chip (SoC) as they provide charge, time and photon-counting information which are digitized internally. Their complexity and versatility enable innovative frontier detectors and also cover spin off of these detectors in adjacent fields such as medical or material imaging as well as smart detectors. In this presentation, the three ASIC architectures and test results will be described to give a general panorama of the “ROC” chips

  17. Latest generation of ASICs for photodetector readout

    Science.gov (United States)

    Seguin-Moreau, N.

    2013-08-01

    The OMEGA microelectronics group has designed a new generation of multichannel integrated circuits, the "ROC" family, in AustrianMicroSystem (AMS) SiGe 0.35 μm technology to read out signals from various families of photodetectors. The chip named MAROC (standing for Multi Anode ReadOut Chip) has been designed to read out MultiAnode Photomultipliers (MAPMT), Photomultiplier ARray In SiGe ReadOut Chip (PARISROC) to read out Photomultipliers (PMTs) and SiPM Integrated ReadOut Chip (SPIROC) to readout Silicon PhotoMultiplier (SiPM) detectors and which was the first ASIC to do so. The three of them fulfill the stringent requirements of the future photodetectors, in particular in terms of low noise, radiation hardness, large dynamic range, high density and high speed while keeping low power thanks to the SiGe technology. These multi-channel ASICs are real System on Chip (SoC) as they provide charge, time and photon-counting information which are digitized internally. Their complexity and versatility enable innovative frontier detectors and also cover spin off of these detectors in adjacent fields such as medical or material imaging as well as smart detectors. In this presentation, the three ASIC architectures and test results will be described to give a general panorama of the "ROC" chips.

  18. Latest generation of ASICs for photodetector readout

    Energy Technology Data Exchange (ETDEWEB)

    Seguin-Moreau, N., E-mail: seguin@lal.in2p3.fr [Laboratoire de l’Accélérateur Linéaire, IN2P3-CNRS, Université Paris-Sud, Bâtiment 200, 91898 Orsay Cedex (France)

    2013-08-01

    The OMEGA microelectronics group has designed a new generation of multichannel integrated circuits, the “ROC” family, in AustrianMicroSystem (AMS) SiGe 0.35 μm technology to read out signals from various families of photodetectors. The chip named MAROC (standing for Multi Anode ReadOut Chip) has been designed to read out MultiAnode Photomultipliers (MAPMT), Photomultiplier ARray In SiGe ReadOut Chip (PARISROC) to read out Photomultipliers (PMTs) and SiPM Integrated ReadOut Chip (SPIROC) to readout Silicon PhotoMultiplier (SiPM) detectors and which was the first ASIC to do so. The three of them fulfill the stringent requirements of the future photodetectors, in particular in terms of low noise, radiation hardness, large dynamic range, high density and high speed while keeping low power thanks to the SiGe technology. These multi-channel ASICs are real System on Chip (SoC) as they provide charge, time and photon-counting information which are digitized internally. Their complexity and versatility enable innovative frontier detectors and also cover spin off of these detectors in adjacent fields such as medical or material imaging as well as smart detectors. In this presentation, the three ASIC architectures and test results will be described to give a general panorama of the “ROC” chips.

  19. Latest Trends in German Political Socialisation Research.

    Science.gov (United States)

    Claussen, Bernhard

    1979-01-01

    Presents an overview of the most notable among recent books on political socialization in West Germany and indicates trends among these publications in areas of research methodology, objectives, stress on empirical studies, and theoretical models. (Author/DB)

  20. VNS Therapy versus the latest antiepileptic drug.

    Science.gov (United States)

    Ben-Menachem, Elinor; French, Jacqueline A

    2005-09-01

    kept in perspective. Pro VNS Therapy: VNS Therapy is no longer a new treatment for patients with refractory epilepsy. The first implant was performed in l988, and since then more than 30,000 patients have received this therapy. It is no longer considered an unusual or dangerous procedure, but it is still used almost exclusively for refractory epilepsy patients and it has not been generally accepted for use as a first line or even second line therapy. However, compared to the new AEDs, VNS Therapy has similar efficacy results in clinical trials and in many epilepsy syndromes and the long-term efficacy results are even more positive, with continued improvement in seizure reduction for up to two years. Two of the major reasons for not using VNS Therapy early are that it is a surgical procedure, and its safety during MRI procedures, especially with 3 Tesla, has not yet been elucidated. The safety profile of VNS Therapy is very favorable; the side effects being totally different from those seen with AEDs. The most important aspects are that there have been no pharmacological interactions, cognitive or sedative side effects reported, and it is safe for use in all age groups. Side effects are restricted to local irritation, hoarseness, coughing and, in a few cases, swallowing difficulties when the stimulator is on, but these tend to disappear with time. No idiosyncratic side effect has emerged during the 16 years of use. Compliance is guaranteed. The cost of the implantation of the VNS Therapy System, when spread out over 8 years (battery life), is actually less than the cost of using a new AED over an eight-year period, and real savings as regards hospital costs due to seizures can be expected.

  1. Globanomalina luxorensis, a Tethyan biostratigraphic marker of latest Paleocene global events

    OpenAIRE

    Speijer, Robert; Samir, AM

    1997-01-01

    The lowest common occurrence (LCO) of the planktonic foraminifera Globanomalina luxorensis marks the level of the latest Paleocene global benthic extinction event (BEE) and associated negative delta(13) C excursion in various bathyal and neritic successions in the Mediterranean region. Below the BEE level, G. luxorensis is extremely rare and subordinate in abundance relative to its precursor G, chapmani. From this level onwards, G. luxorensis generally constitutes a large proportion of the pl...

  2. CMS latest results on Higgs measurements

    CERN Multimedia

    CERN. Geneva

    2014-01-01

    Since the discovery of a Higgs boson by the CMS and ATLAS Collaborations in 2012, physicists at the LHC have been making intense efforts to measure this new particle’s properties. Last week, at the 37th International Conference on High Energy Physics, the CMS Collaboration has presented a broad set of results from new studies of the Higgs boson. They are based on the full Run 1 data from pp collisions at centre-of-mass energies of 7 and 8 TeV. The analyses include the final calibration and alignment constants and contains about 25 fb−1 of data. These new results will be summarized here.

  3. Laryngopharyngeal Reflux: Diagnosis, Treatment, and Latest Research

    Directory of Open Access Journals (Sweden)

    Campagnolo, Andrea Maria

    2014-01-01

    Full Text Available Introduction Laryngopharyngeal reflux (LPR is a highly prevalent disease and commonly encountered in the otolaryngologist's office. Objective To review the literature on the diagnosis and treatment of LPR. Data Synthesis LPR is associated with symptoms of laryngeal irritation such as throat clearing, coughing, and hoarseness. The main diagnostic methods currently used are laryngoscopy and pH monitoring. The most common laryngoscopic signs are redness and swelling of the throat. However, these findings are not specific of LPR and may be related to other causes or can even be found in healthy individuals. Furthermore, the role of pH monitoring in the diagnosis of LPR is controversial. A therapeutic trial with proton pump inhibitors (PPIs has been suggested to be cost-effective and useful for the diagnosis of LPR. However, the recommendations of PPI therapy for patients with a suspicion of LPR are based on the results of uncontrolled studies, and high placebo response rates suggest a much more complex and multifactorial pathophysiology of LPR than simple acid reflux. Molecular studies have tried to identify biomarkers of reflux such as interleukins, carbonic anhydrase, E-cadherin, and mucin. Conclusion Laryngoscopy and pH monitoring have failed as reliable tests for the diagnosis of LPR. Empirical therapy with PPIs is widely accepted as a diagnostic test and for the treatment of LPR. However, further research is needed to develop a definitive diagnostic test for LPR.

  4. Latest results of the Tunka Radio Extension

    Directory of Open Access Journals (Sweden)

    Kostunin D.

    2017-01-01

    Full Text Available The Tunka Radio Extension (Tunka-Rex is an antenna array consisting of 63 antennas at the location of the TAIGA facility (Tunka Advanced Instrument for cosmic ray physics and Gamma Astronomy in Eastern Siberia, nearby Lake Baikal. Tunka-Rex is triggered by the air-Cherenkov array Tunka-133 during clear and moonless winter nights and by the scintillator array Tunka-Grande during the remaining time. Tunka-Rex measures the radio emission from the same air-showers as Tunka-133 and Tunka-Grande, but with a higher threshold of about 100 PeV. During the first stages of its operation, Tunka-Rex has proven, that sparse radio arrays can measure air-showers with an energy resolution of better than 15% and the depth of the shower maximum with a resolution of better than 40 g/cm2. To improve and interpret our measurements as well as to study systematic uncertainties due to interaction models, we perform radio simulations with CORSIKA and CoREAS. In this overview we present the setup of Tunka-Rex, discuss the achieved results and the prospects of mass-composition studies with radio arrays.

  5. Cardiovascular morbidity in COPD: A study of the general population

    DEFF Research Database (Denmark)

    Lange, Peter; Møgelvang, Rasmus; Marott, Jacob Louis

    2010-01-01

    Although there are a number of studies on the coexistence of heart disease and COPD among patients acutely admitted to hospital, this relationship has not been accurately described in the general population. Especially data on the prevalence of both reduced lung function and impaired left.......4% for moderate COPD (GOLD stage 2) and 2.5% for severe and very severe COPD (GOLD stages 3+4). Individuals with COPD were older and had a higher prevalence of cardiovascular risk factors and a higher prevalence of cardiovascular diseases. Among the echocardiographical findings, only the presence of left...... ventricular hyperthrophy was significantly more frequent among individuals with COPD (17.7%) than among participants without COPD (12.1%.), yet this relationship was no longer significant after statistical adjustment for age and gender. In the general population, subjects with COPD have a higher prevalence...

  6. Studies on general resistance to stem rust in wheat

    International Nuclear Information System (INIS)

    Knott, D.R.

    1977-01-01

    Eight cultivars that were thought to have field resistance to stem rust were selected and crossed to produce four four-cultivar hybrids. From those crosses lines were produced that lacked seedling resistance to race 15B-1 of stem rust but had good field resistance to it. They also proved to have field resistance to many other races and it is hoped that the resistance is general. Genetic studies indicated that there is some variation in the lines, but resistance is generally inherited as a quantitative character with several largely recessive genes having small additive effects. This suggests that in an induced mutation programme, no one plant is likely to accumulate sufficient mutant genes that it will appear resistant. (author)

  7. Latest developments in silica fibre luminescence dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Bradley, D. A.; Abdul S, S. F.; Jafari, S. M.; Alanazi, A. [University of Surrey, Department of Physics, GU2 7XH Guildford, Surrey (United Kingdom); Amouzad M, G. [University of Malaya, Faculty of Engineering, Department of Electrical Engineering, Integrated Lightwave Research Group, 50603 Kuala Lumpur (Malaysia); Addul R, H. A.; Mizanur R, A. K. M.; Zubair, H. T.; Begum, M.; Yusoff, Z.; Omar, N. Y. M. [Multimedia University, Faculty of Engineering, 2010 Cyberjaya, Selangor (Malaysia); Maah, M. J. [University of Malaya, Department of Chemistry, 50603 Kuala Lumpur (Malaysia); Collin, S. [National Physical Laboratory, Hampton Road, Teddington, TW11 OLW Middlesex (United Kingdom); Mat-Sharif, K. A.; Muhd-Yassin, S. Z.; Zulkifli, M. I., E-mail: d.a.bradley@surrey.ac.uk [Telekom Malaysia Research and Development Sdn Bhd., 63000 Cyberjaya, Selangor (Malaysia)

    2015-10-15

    Full text: Using tailor made sub-mm diameter doped-silica fibres, we are carrying out luminescence dosimetry studies for a range of situations, including thermoluminescence (Tl)investigations on a liquid alpha source formed of {sup 223}RaCl (the basis of the Bayer Health care product Xofigo), the Tl response to a 62 MeV proton source and Tl response to irradiation from an {sup 241}Am-Be neutron source. In regard to the former, in accord with the intrinsic high linear energy transfer (Let) and short path length (<100 um) of the α-particles in calcified tissue, the product is in part intended as a bone-seeking radionuclide for treatment of metastatic cancer, offering high specificity and efficacy. The Tl yield of Ge-doped SiO{sub 2} fibres has been investigated including for photonic crystal fibre un collapsed, flat fibres and single mode fibres, these systems offering many advantages over conventional passive dosimetry types. In particular, one can mention comparable and even superior sensitivity, an effective atomic number Z{sub eff} of the silica dosimetric material close to that of bone, and the glassy nature of the fibres offering the additional advantage of being able to place such dosimeters directly into liquid environments. Finally we review the use of our tailor made fibres for on-line radioluminescence measurements of radiotherapy beams. The outcome from these various lines of research is expected to inform development of doped fiber radiation dosimeters of versatile utility, ranging from clinical applications through to industrial studies and environmental evaluations. (Author)

  8. Latest Developments of the Isprs Student Consortium

    Science.gov (United States)

    Detchev, I.; Kanjir, U.; Reyes, S. R.; Miyazaki, H.; Aktas, A. F.

    2016-06-01

    The International Society for Photogrammetry and Remote Sensing (ISPRS) Student Consortium (SC) is a network for young professionals studying or working within the fields of photogrammetry, remote sensing, Geographical Information Systems (GIS), and other related geo-spatial sciences. The main goal of the network is to provide means for information exchange for its young members and thus help promote and integrate youth into the ISPRS. Over the past four years the Student Consortium has successfully continued to fulfil its mission in both formal and informal ways. The formal means of communication of the SC are its website, newsletter, e-mail announcements and summer schools, while its informal ones are multiple social media outlets and various social activities during student related events. The newsletter is published every three to four months and provides both technical and experiential content relevant for the young people in the ISPRS. The SC has been in charge or at least has helped with organizing one or more summer schools every year. The organization's e-mail list has over 1,100 subscribers, its website hosts over 1,300 members from 100 countries across the entire globe, and its public Facebook group currently has over 4,500 joined visitors, who connect among one another and share information relevant for their professional careers. These numbers show that the Student Consortium has grown into a significant online-united community. The paper will present the organization's on-going and past activities for the last four years, its current priorities and a strategic plan and aspirations for the future four-year period.

  9. Understanding "revolving door" patients in general practice: a qualitative study.

    Science.gov (United States)

    Williamson, Andrea E; Mullen, Kenneth; Wilson, Philip

    2014-02-13

    'Revolving door' patients in general practice are repeatedly removed from general practitioners' (GP) lists. This paper reports a qualitative portion of the first mixed methods study of these marginalised patients. We conducted qualitative semi-structured interviews with six practitioner services staff and six GPs in Scotland, utilizing Charmazian grounded theory to characterise 'revolving door' patients and their impact from professionals' perspectives. 'Revolving door' patients were reported as having three necessary characteristics; they had unreasonable expectations, exhibited inappropriate behaviours and had unmet health needs. A range of boundary breaches were reported too when 'revolving door' patients interacted with NHS staff. We utilise the 'sensitising concepts' of legitimacy by drawing on literature about 'good and bad' patients and 'dirty work designations.' We relate these to the core work of general practice and explore the role that medical and moral schemas have in how health service professionals understand and work with 'revolving door' patients. We suggest this may have wider relevance for the problem doctor patient relationship literature.

  10. Evolution system study of a generalized scheme of relativistic magnetohydrodynamic

    International Nuclear Information System (INIS)

    Mahjoub, Bechir.

    1977-01-01

    A generalized scheme of relativistic magnetohydrodynamics is studied with a thermodynamical differential relation proposed by Fokker; this scheme takes account of interaction between the fluid and the magnetic field. Taking account of an integrability condition of this relation, the evolution system corresponding to this scheme is identical to the one corresponding to the usual scheme; it has the same characteristics; it is non-strictly hyperbolic with the same hypothesis of compressibility and it has, with respect to the Cauchy problem, an unique solution in a Gevrey class of index α=3/2 [fr

  11. Latest trends and directions of development of crowdfunding

    Directory of Open Access Journals (Sweden)

    Joanna Pieniążek

    2014-09-01

    Full Text Available The article discusses the latest trends and directions of development of crowdfunding on selected examples of English-language websites.The scope of work includes topics such as aggregates of crowdfunding sites, local investing, franchise, pre-sales platforms, open source sites and leveraging the competitive advantages of e-commerce platforms which offer product crowdfunding. This article aims to discuss the latest trends and directions of crowdfunding, assess their usefulness and the chances of popularising the ideas presented. The article provides an overview of the literature on the subject and an analysis of the selected sites, comparison sites and crowdfunding search engines.

  12. A critical incident study of general practice trainees in their basic general practice term.

    Science.gov (United States)

    Diamond, M R; Kamien, M; Sim, M G; Davis, J

    1995-03-20

    To obtain information on the experiences of general practice (GP) trainees during their first general practice (GP) attachment. Critical incident technique--a qualitative analysis of open-ended interviews about incidents which describe competent or poor professional practice. Thirty-nine Western Australian doctors from the Royal Australian College of General Practitioners' (RACGP) Family Medicine Program who were completing their first six months of general practice in 1992. Doctors reported 180 critical incidents, of which just over 50% involved problems (and sometimes successes) with: difficult patients; paediatrics; the doctor-patient relationship; counselling skills; obstetrics and gynaecology; relationships with other health professionals and practice staff; and cardiovascular disorders. The major skills associated with both positive and negative critical incidents were: the interpersonal skills of rapport and listening; the diagnostic skills of thorough clinical assessment and the appropriate use of investigations; and the management skills of knowing when and how to obtain help from supervisors, hospitals and specialists. Doctors reported high levels of anxiety over difficult management decisions and feelings of guilt over missed diagnoses and inadequate management. The initial GP term is a crucial transition period in the development of the future general practitioner. An analysis of commonly recurring positive and negative critical incidents can be used by the RACGP Training Program to accelerate the learning process of doctors in vocational training and has implications for the planning of undergraduate curricula.

  13. General statistical data structure for epidemiologic studies of DOE workers

    International Nuclear Information System (INIS)

    Frome, E.L.; Hudson, D.R.

    1981-01-01

    Epidemiologic studies to evaluate the occupational risks associated with employment in the nuclear industry are currently being conducted by the Department of Energy. Data that have potential value in evaluating any long-term health effects of occupational exposure to low levels of radiation are obtained for each individual at a given facility. We propose a general data structure for statistical analysis that is used to define transformations from the data management system into the data analysis system. Statistical methods of interest in epidemiologic studies include contingency table analysis and survival analysis procedures that can be used to evaluate potential associations between occupational radiation exposure and mortality. The purposes of this paper are to discuss (1) the adequacy of this data structure for single- and multiple-facility analysis and (2) the statistical computing problems encountered in dealing with large populations over extended periods of time

  14. From novice to proficient general practitioner: a critical incident study.

    Science.gov (United States)

    Sim, M G; Kamien, M; Diamond, M R

    1996-09-01

    To obtain information about any change in the performance or perceptions of doctors undertaking the Royal Australian College of General Practitioners (RACGP) Training Program, with advancing general practice experience. The critical incident technique' was used, which is a comparative qualitative analysis. It involved interviews at 12 to 18 months after the basic term interview. Eighteen Western Australian doctors, who had been interviewed in 1992, at the end of their first 6 months of general practice training and were now completing their advanced or mentor terms in the RACGP Training Program took part in the study. Doctors reported an average of 4.4 critical incidents in their first interview and 5.0 in their second interview. The major areas of positive change included relationships with patients and other health care professionals, including supervisors; paediatrics and orthopaedics skills; the skills of developing a therapeutic relationship to enhance patient compliance and the ability to manage complex cardiovascular and psychiatric problems without reliance on specialist referral; attitudes of responsibility for and enjoyment of long term care of patients and families; and reduced levels of anxiety over difficult problems. New or continuing areas of difficulty were found in gynaecology; pharmacotherapy and dermatology; the diagnosis of common complaints with uncommon presentations; the skill of managing difficult or angry patients; the organisation for the follow-up of patients with potentially severe disorders; and in managing feelings of guilt over missed diagnoses or poor management. An analysis of commonly occurring positive and negative critical incidents shows that RACGP Training Program doctors develop competence, confidence and reduced levels of performance anxiety with advancing experience. All but one doctor found the Training Program helpful in achieving these proficiencies. However, many ongoing areas of difficulty remain. The Critical Incident

  15. Study on the nonlocality effects for generalized optical potentials

    International Nuclear Information System (INIS)

    Gurbanovich, I.S.; Zelenskaya, N.S.

    1981-01-01

    In previous studies the authors have ihown that the generalized optic potential (GOP) of particles interaction is a superposition of local and non local potentials (LP, NLP). On the example of α- particles scattering on the 8 Be nucleus at about 10-15 MeV the GOP nonlocal part is considered. For obtaining NLP the spectral decomposition of the Green function taking into account only contribution of relative motion of two α-particles in S-state is used. The locally-equivalent addition to central potential of α-particles scattering at 8 Be previously calculated is obtained. In a graphical form a total locally-equivalent potential and local GOP part are presented. It is shown that taking into account the nonlocallity effect in a locally energy approximation for precise wave function in S-state widen a potential hole without changing its depth. Such widening corresponds to the general character of behaviour of non local potentials calculated in the microscopic approach [ru

  16. Design study of general aviation collision avoidance system

    Science.gov (United States)

    Bates, M. R.; Moore, L. D.; Scott, W. V.

    1972-01-01

    The selection and design of a time/frequency collision avoidance system for use in general aviation aircraft is discussed. The modifications to airline transport collision avoidance equipment which were made to produce the simpler general aviation system are described. The threat determination capabilities and operating principles of the general aviation system are illustrated.

  17. Studies of insulin resistance in congenital generalized lipodystrophy

    DEFF Research Database (Denmark)

    Søvik, O; Vestergaard, H; Trygstad, O

    1996-01-01

    suppressed lipid oxidation in the controls. It is concluded that patients with congenital generalized lipodystrophy may present severe insulin resistance with regard to hepatic glucose production as well as muscle glycogen synthesis and lipid oxidation. The results suggest a postreceptor defect in the action......, immunoreactive protein and mRNA levels. The patients had fasting hyperinsulinaemia, and the rate of total glucose disposal was severely impaired, primarily due to a decreased non-oxidative glucose metabolism. In the patient studied with muscle biopsy, the expected activation of glycogen synthase by insulin did...... not occur. In both patients there was severely increased hepatic glucose output in the basal state, suggesting a failure of insulin to suppress hepatic gluconeogenesis. During insulin infusion a substantially elevated rate of lipid oxidation remained in the patients, in contrast to the almost completely...

  18. High vacuum general purpose scattering chamber for nuclear reaction study

    International Nuclear Information System (INIS)

    Suresh Kumar; Ojha, S.C.

    2003-01-01

    To study the nuclear reactions induced by beam from medium energy accelerators, one of the most common facility required is a scattering chamber. In the scattering chamber, projectile collides with the target nucleus and the scattered reaction products are detected with various type of nuclear detector at different angles with respect to the beam. The experiments are performed under high vacuum to minimize the background reaction and the energy losses of the charged particles. To make the chamber general purpose various requirement of the experiments are incorporated into it. Changing of targets, changing angle of various detectors while in vacuum are the most desired features. The other features like ascertaining the beam spot size and position on the target, minimizing the background counts by proper beam dump, accurate positioning of the detector as per plan etc. are some of the important requirements

  19. (The latest developments of the physical aspects of electrochemistry)

    Energy Technology Data Exchange (ETDEWEB)

    Liu, S.H.

    1990-09-24

    The author was one of 26 invited lecturers to discuss the latest developments of the physical aspects of electrochemistry. He interacted extensively with other lecturers and many participants from developing countries. He also visited with the Director of the Italian Synchrotron Radiation Source now under construction in Trieste, Italy.

  20. Advanced Propulsion System Studies for General Aviation Aircraft

    Science.gov (United States)

    Eisenberg, Joseph D. (Technical Monitor); German, Jon

    2003-01-01

    This final report addresses the following topics: Market Impact Analysis (1) assessment of general aviation, including commuter/regional, aircraft market impact due to incorporation of advanced technology propulsion system on acquisition and operating costs, job creation and/or manpower demand, and future fleet size; (2) selecting an aircraft and engine for the study by focusing on the next generation 19-passenger commuter and the Williams International FJ44 turbofan engine growth. Propulsion System Analysis Conducted mission analysis studies and engine cycle analysis to define a new commuter mission and required engine performance, define acquisition and operating costs and, select engine configuration and initiated preliminary design for hardware modifications required. Propulsion System Benefits (1) assessed and defined engine emissions improvements, (2) assessed and defined noise reduction potential and, (3) conducted a cost analysis impact study. Review of Relevant NASA Programs Conducted literature searches using NERAC and NASA RECON services for related technology in the emissions and acoustics area. Preliminary Technology Development Plans Defined plan to incorporate technology improvements for an FJ44-2 growth engine in performance, emissions, and noise suppression.

  1. General circulation and tracers: studies in the Western Indian Ocean

    International Nuclear Information System (INIS)

    Jamous, Daniel

    1991-01-01

    The main question addressed in this thesis is how to best use the information obtained from hydro-biogeochemical tracer data, to study the oceanic general circulation in the Western Indian Ocean. First, a principal component analysis is performed on a historical data set. The tracers considered are temperature, salinity, density, oxygen, phosphate and silica. The method reduces the amount of data to be considered by a factor of 5. It reproduces correctly and efficiently the large-scale distributions of these oceanic properties. The analysed data are then used in a finite-difference nonlinear inverse model. The grid has a resolution of 4 deg. by 4 deg.. Dynamical as well as tracer conservation constraints are used. These constraints are well satisfied by the obtained solutions but the associated errors remain large. Additional constraints would be required in order to discuss the different solutions in more detail. Finally, a qualitative study is done on the deep distribution of helium-3. The data show several important features linked to hydrothermal input in the Gulf of Aden and on the Central Indian Ridge, and to the origin of water masses and deep circulation characteristics. However additional data are required in order to clarify the distribution of this tracer in other key areas. (author) [fr

  2. Ocean anoxia did not cause the Latest Permian Extinction

    Science.gov (United States)

    Proemse, Bernadette C.; Grasby, Stephen E.; Wieser, Michael E.; Mayer, Bernhard; Beauchamp, Benoit

    2014-05-01

    The Latest Permian Extinction (LPE, ~252 million years ago) was a turning point in the history of life on Earth with a loss of ~96% of all marine species and ~70% of all terrestrial species. While, the event undoubtedly shaped the evolution of life its cause remains enigmatic. A leading hypothesis is that the global oceans became depleted in oxygen (anoxia). In order to test this hypothesis we investigated a proxy for marine oxygen levels (molybdenum isotopic composition) in shale across the LPE horizon located on the subtropical northwest margin of Pangea at that time. We studied two sedimentary records in the Sverdrup basin, Canadian High Arctic: Buchanan Lake (eastern Axel Heiberg Island; 79° 26.1'N, 87° 12.6'W), representing a distal deep-water slope environment, and West Blind Fiord (southwest Ellesmere Island; 78° 23.9'N, 85° 57.2'W), representing a deep outer shelf environment (below storm wave base). The molybdenum isotopic composition (δ98/95Mo) of sediments has recently become a powerful tool as a paleo-oceanographic proxy of marine oxygen levels. Sample preparation was carried out in a metal-free clean room facility in the isotope laboratory of the Department of Physics and Astronomy, University of Calgary, Canada, that is supplied by HEPA-filtered air. Molybdenum isotope ratios were determined on a Thermo Scientific multi-collector inductively coupled plasma mass spectrometer (MC-ICP-MS) with an uncertainty better than ±0.10o for δ98/95Mo values. Results from the Buchanan Lake section show a large shift in δ98/95Mo values from 2.02o to +2.23o at the extinction horizon, consistent with onset of euxinic conditions. In contrast, West Blind Fiord shales, representing the sub-storm wave base shelf environment, show little change in the molybdenum isotopic composition (1.34o to +0.05), indicating ongoing oxic conditions across the LPE (Proemse et al., 2013). Our results suggest that areas of the Pangea continental shelf (North West Pangea) experienced

  3. Postoperative laryngeal symptoms in a general surgery setting. Clinical study.

    Science.gov (United States)

    Geraci, Girolamo; Cupido, Francesco; Lo Nigro, Chiara; Sciuto, Antonio; Sciumè, Carmelo; Modica, Giuseppe

    2013-01-01

    Vocal cord injuries (VI), postoperative hoarseness (PH), dysphonia (DN), dysphagia (DG) and sore throat (ST) are common complications after general anesthesia; there is actually a lack of consensus to support the proper timing for post-operative laryngoscopy that is reliable to support the diagnosis of laryngeal or vocal fold lesions after surgery and there are no valid studies about the entity of laryngeal trauma in oro-tracheal intubation. Aim of our study is to evaluate the statistical relation between anatomic, anesthesiological and surgical variables in the case of PH, DG or impaired voice register. 50 patients (30 thyroidectomies, 8 videolaparoscopic cholecistectomies, 2 right emicolectomies, 2 left emicolectomies, 1 gastrectomy, 1 hemorrhoidectomy, 1 nefrectomy, 1 diagnostic videothoracoscopy, 1 superior right lung lobectomy, 1 appendicectomy, 1 incisional hernia repair, 1 low anterior rectal resection, 1 radical hysterectomy) underwent clinical evaluation and direct laryngoscopy before surgery, within 6 hours, after 72 hours and after 30 days, to evaluate motility and breathing space, phonatory motility, true and false vocal folds and arytenoids oedema. We evaluated also mean age (56.6 ± 3.6 years), male:female ratio (1:1.5), cigarette smoke (20%), atopic comorbidity (17/50 = 34%), Mallampati class (32% 1, 38% 2, 26% 3, 2% 4), mean duration of intubation (159 minutes, range 50 - 405 minutes), Cormack-Lehane score (34% 1, 22% 2, 22% 3, 2% 4), difficult intubation in 9 cases (18%). No complication during the laryngoscopy were registered. We investigated the statistic relationship between pre and intraoperative variables and laryngeal symptoms and lesions. In our experience, statistically significant relations were found in prevalence of vocal folds oedema in smokers (p < 0.005), self limiting DG and DN in younger patients (p < 0.005) and in thyroidectomy (p < 0.01), DG after thyroidectomy (p < 0.01). The short preoperative use of steroids and antihistaminic

  4. Study of an advanced General Aviation Turbine Engine (GATE)

    Science.gov (United States)

    Gill, J. C.; Short, F. R.; Staton, D. V.; Zolezzi, B. A.; Curry, C. E.; Orelup, M. J.; Vaught, J. M.; Humphrey, J. M.

    1979-01-01

    The best technology program for a small, economically viable gas turbine engine applicable to the general aviation helicopter and aircraft market for 1985-1990 was studied. Turboshaft and turboprop engines in the 112 to 746 kW (150 to 1000 hp) range and turbofan engines up to 6672 N (1500 lbf) thrust were considered. A good market for new turbine engines was predicted for 1988 providing aircraft are designed to capitalize on the advantages of the turbine engine. Parametric engine families were defined in terms of design and off-design performance, mass, and cost. These were evaluated in aircraft design missions selected to represent important market segments for fixed and rotary-wing applications. Payoff parameters influenced by engine cycle and configuration changes were aircraft gross mass, acquisition cost, total cost of ownership, and cash flow. Significant advantage over a current technology, small gas turbine engines was found especially in cost of ownership and fuel economy for airframes incorporating an air-cooled high-pressure ratio engine. A power class of 373 kW (500 hp) was recommended as the next frontier for technology advance where large improvements in fuel economy and engine mass appear possible through component research and development.

  5. A study on image of radiotechnologist of the general public

    International Nuclear Information System (INIS)

    Lee, Won Jin; Kim, Gyeong Geun

    1986-01-01

    This study was designed to find out the image of Radiotechnologist of the general public and ro see Radiotechnologist as a profession. The data were collected by 437 arbitrarily selected groups of college students, teachers, office workers and housewives residing in Daegu, with questionnaires from July 15 to September 30, 1985. The findings are as follows: 1. Most responds are regarded first impressions and appearance of Radiotechnologist as common of 66.6%, 54.0%, respectively. 2. 28.4% of respondents are regarded Radiotechnologist as responsibility 36.5% as skill fullness, 31.4% as overwork. 34.3% of respondants saw a Radiotechnologist as a doctor's assistant, 12.4% as a counselor about patient diseases and 52.7% as ones who have independent professional vocation. 3. For Radiotechnological education, 42.3% of respondents agreed to four year college program and 36.7% as three year Junior College program. 4. Only 13.7% of respondents wanted their children to become Radiotechnologist while 19.5% of them did not want

  6. Clinical TVA-based studies: a general review

    Directory of Open Access Journals (Sweden)

    Thomas eHabekost

    2015-03-01

    Full Text Available In combination with whole report and partial report tasks, the Theory of Visual Attention (TVA can be used to estimate individual differences in five basic attentional parameters: The visual processing speed, the storage capacity of visual short-term memory, the perceptual threshold, the efficiency of top-down selectivity, and the spatial bias of attentional weighting. TVA-based assessment has been used in about 30 studies to investigate attentional deficits in a range of neurological and psychiatric conditions: (a neglect and simultanagnosia, (b reading disturbances, (c aging and neurodegenerative diseases, and most recently (d neurodevelopmental disorders. The article introduces TVA based assessment, discusses its methodology and psychometric properties, and reviews the progress made in each of the four research fields. The empirical results demonstrate the general usefulness of TVA-based assessment for many types of clinical neuropsychological research. The method’s most important qualities are cognitive specificity and theoretical grounding, but it is also characterized by good reliability and sensitivity to minor deficits. The review concludes by pointing to promising new areas for clinical TVA-based research.

  7. General circulation model study of atmospheric carbon monoxide

    International Nuclear Information System (INIS)

    Pinto, J.P.; Yung, Y.L.; Rind, D.; Russell, G.L.; Lerner, J.A.; Hansen, J.E.; Hameed, S.

    1983-01-01

    The carbon monoxide cycle is studied by incorporating the known and hypothetical sources and sinks in a tracer model that uses the winds generated by a general circulation model. Photochemical production and loss terms, which depend on OH radical concentrations, are calculated in an interactive fashion. The computed global distribution and seasonal variations of CO are compared with observations to obtain constraints on the distribution and magnitude of the sources and sinks of CO, and on the tropospheric abundance of OH. The simplest model that accounts for available observations requires a low latitude plant source of about 1.3 x 10 15 g yr -1 , in addition to sources from incomplete combustion of fossil fuels and oxidation of methane. The globally averaged OH concentration calculated in the model is 7 x 10 5 cm -3 . Models that calculate globally averaged OH concentrations much lower than our nominal value are not consistent with the observed variability of CO. Such models are also inconsistent with measurements of CO isotopic abundances, which imply the existence of plant sources

  8. A study on generalized hesitant intuitionistic Fuzzy soft sets

    Science.gov (United States)

    Nazra, A.; Syafruddin; Wicaksono, G. C.; Syafwan, M.

    2018-03-01

    By combining the concept of hesitant intuitionistic fuzzy sets, fuzzy soft sets and fuzzy sets, we extend hesitant intuitionistic fuzzy soft sets to a generalized hesitant intuitionistic fuzzy soft sets. Some operations on generalized hesitant intuitionistic fuzzy soft sets, such as union, complement, operations “AND” and “OR”, and intersection are defined. From such operations the authors obtain related properties such as commutative, associative and De Morgan's laws. The authors also get an algebraic structure of the collection of all generalized hesitant intuitionistic fuzzy soft sets over a set.

  9. The latest development of EAST neutral beam injector

    International Nuclear Information System (INIS)

    Hu Chundong; Xu Yongjian

    2014-01-01

    As the first full superconducting non-circular cross section Tokomak in the world, EAST is used to explore the forefront physics and engineering issues on the construction of Tokomak fusion reactor. Neutral beam injection has been recognized as one of the most effective means for plasma heating. According to the research plan of the EAST physics experiment, a set of neutral beam injector (4∼8 MW, 10∼100 s)will be built and operational in 2014. The paper presents the latest development of EAST neutral beam injector and the latest experiment results of long pulse beam extraction and high power beam extraction are reported, those results show that all targets reach or almost reach the design targets. All these will lay a solid foundation for the achievement of plasma heating and current drive for EAST in 2014. (authors)

  10. Modelling and simulation SSM: latest state of the art technology

    CSIR Research Space (South Africa)

    Jahajeeah, N

    2005-10-01

    Full Text Available as one phase ? One Phase model ?Wider volume solid fraction 0 – 1 ? Implementation in Power Law Cut-Off Model (PLCO) of Procast Supporting the Manufacturing and Materials Industry in its quest for global competitiveness Assumptions of the PLCO Model... and Materials Industry in its quest for global competitiveness Modelling and Simulation SSM Latest state of the art technology N Jahajeeah Supporting the Manufacturing and Materials Industry in its quest for global competitiveness BEHAVIOUR OF THIXOTROPIC...

  11. Latest development in project site radwaste treatment facility (SRTF) Sanmen

    International Nuclear Information System (INIS)

    Mennicken, K.; Lohmann, P.

    2015-01-01

    Westinghouse Electric Germany GmbH (WEG) was successful in being awarded a contract as to the planning, delivery, installation and commissioning of radwaste treatment systems for the AP1000 units at Sanmen site, PR China. Operational low and intermediate level radioactive waste will be processed in the Site Radwaste Treatment Facility (SRTF). This paper explains the latest developments of the project, especially the experience with customer-hired Chinese planning partners, installation companies and Customer operating personnel. (authors)

  12. Mobile application for reading latest news from multiple sources

    OpenAIRE

    Watzak, Aleš

    2013-01-01

    Thesis covers development of an application for mobile devices running Android operating system. It enables users to keep up to date with the latest news, weather and traffic report. News delivery service is available wherever there is Internet access and not limited to a physical location like an office with desktop computer. To this end we developed two applications. First represents server part of the application and runs on Apache web server. The second part is a client application which ...

  13. When general practitioners meet new evidence: an exploratory ethnographic study.

    Science.gov (United States)

    Olsen, Ole

    2017-12-01

    To explore how general practitioners (GPs) think and act when presented with new evidence in relation to planned home birth and a proposal to change information practices. Exploratory ethnographic study of GPs. The GPs were encountered one or more times during a two-year period, 2011-2013, while the author tried to set up formal focus group interviews. Dialogues about the evidence, personal experiences, values and other issues unavoidably occurred. Field notes were written concomitantly. Danish GPs, primarily in Copenhagen. Fifty Danish GPs. The GPs reacted very differently, both spontaneously and later. Spontaneous reactions were often emotional involving private and professional experiences whereas later reactions were more influenced by rational deliberations. Approximately half the GPs (n = 18) who were asked whether they would personally hand out the local information leaflet about home birth were prepared to do so. The time lag between presentation of the evidence and the GPs' decision to hand out the leaflets was up to one and a half year. A significant number of GPs were prepared to change their information practices. However, for many GPs, the new evidence challenged previous perceptions, and ample time and resources for dialogue, deliberations and adaptation to local circumstances were required to accommodate change. Changing information practices on a larger scale will require a systematic approach involving key stakeholders. Key Points Current awareness•Patients and pregnant women should receive evidence-based information about possible choices of care - also in relation to place of birth. Most important results•Doctors often find the new evidence supporting planned home birth counterintuitive and spontaneously react emotionally rather than rationally to the evidence.•The new evidence challenging previous views elicits fast, emotional reactions, later deliberate reflections, perhaps cognitive dissonance and, finally, for some, change in

  14. The South African Stroke Risk in General Practice Study | Connor ...

    African Journals Online (AJOL)

    Two hundred general practices were randomly selected from lists provided by pharmaceutical .representatives. Each GP approached 50 consecutive patients aged 30 years and older. Patients completed an information sheet and the GP documented the patient's risk factors. The resulting sample is relevant.if not necessarily ...

  15. Respiratory Diseases in Children: studies in general practice

    NARCIS (Netherlands)

    J.H.J.M. Uijen (Hans)

    2011-01-01

    textabstractThe work presented in this thesis covers various aspects of the epidemiology, diagnosis and management of various respiratory symptoms and diseases in children frequently encountered in general practice. These respiratory tract symptoms and diseases can be categorized into symptoms and

  16. Study on reducing the generation of general waste

    International Nuclear Information System (INIS)

    Takahashi, Toshio; Aoki, Isao; Watahiki, Masatoshi

    2000-04-01

    On August 1999, the Director of Tokai Work proposed an activity regarding recycling and reuse of general waste generated from Tokai Works. The activity was initiated by the Waste Management and Fuel Cycle Research Center, and is now being in progress through out the Tokai Works. In the course of this activity, Plutonium Fuel Center had settled the working Group and the issues related to the waste reductive have been examined. This report collects the problems that became obvious through the survey of existing segregation method, treatment process, and the amount of the waste generation, and accounts for the concrete methodology for the recycling and reuse of general waste. In order to reduce waste, it is necessary to aware of the facing issues and adopt the countermeasures proposed in this report whenever possible. The activity will then leads us to reduce waste generation, which in turn will enable us to make 100% waste recycling possible. (author)

  17. Theory and interpretation in qualitative studies from general practice

    DEFF Research Database (Denmark)

    Malterud, Kirsti

    2016-01-01

    Objective: In this article, I want to promote theoretical awareness and commitment among qualitative researchers in general practice and suggest adequate and feasible theoretical approaches.  Approach: I discuss different theoretical aspects of qualitative research and present the basic foundations...... theory is a consistent and soundly based set of assumptions about a specific aspect of the world, predicting or explaining a phenomenon. Qualitative research is situated in an interpretative paradigm where notions about particular human experiences in context are recognized from different subject...... in qualitative analysis are presented, emphasizing substantive theories to sharpen the interpretative focus. Such approaches are clearly within reach for a general practice researcher contributing to clinical practice by doing more than summarizing what the participants talked about, without trying to become...

  18. Corrosion process studies in a nuclear waste container

    International Nuclear Information System (INIS)

    Guasp, Ruben A.; Lanzani, Liliana A.; Coronel, Pascual; Bruzzoni, Pablo; Semino, Carlos J.

    1999-01-01

    Latest results on corrosion behavior studies on high activity nuclear waste container are reported. Corrosion evaluation on lead base alloys and modeling to predict carbon steel external container cover generalized corrosion, are the main issues of these studies. (author)

  19. Choice of Study Resources in General Chemistry by Students Who Have Little Time to Study

    Science.gov (United States)

    Bunce, Diane M.; Komperda, Regis; Dillner, Debra K.; Lin, Shirley; Schroeder, Maria J.; Hartman, JudithAnn R.

    2017-01-01

    Students with an insufficient amount of time to study are becoming more prevalent in the general college population as many who enroll in college have competing responsibilities (full-time jobs, childcare, etc.). Such students are likely to choose study resources that they consider to be both effective and efficient. Students at the U.S. Naval…

  20. Latest innovations for tattoo and permanent makeup removal.

    Science.gov (United States)

    Mao, Johnny C; DeJoseph, Louis M

    2012-05-01

    The goal of this article is to reveal the latest techniques and advances in laser removal of both amateur and professional tattoos, as well as cosmetic tattoos and permanent makeup. Each pose different challenges to the removing physician, but the goal is always the same: removal without sequelae. The authors' technique is detailed, and discussion of basic principles of light reflection, ink properties, effects of laser energy and heat, and outcomes and complications of tattoo removal are presented. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. The latest full-scale PWR simulator in Japan

    International Nuclear Information System (INIS)

    Nishimuru, Y.; Tagi, H.; Nakabayashi, T.

    2004-01-01

    The latest MHI Full-scale Simulator has an excellent system configuration, in both flexibility and extendability, and has highly sophisticated performance in PWR simulation by the adoption of CANAC-II and PRETTY codes. It also has an instructive character to display the plant's internal status, such as RCS condition, through animation. Further, the simulation has been verified to meet a functional examination at model plant, and with a scale model test result in a two-phase flow event, after evaluation for its accuracy. Thus, the Simulator can be devoted to a sophisticated and broad training course on PWR operation. (author)

  2. Latest AMS Results on elementary particles in cosmic rays

    Science.gov (United States)

    Kounine, Andrei; AMS Collaboration

    2017-01-01

    AMS-02 is a particle physics detector collecting data on the International Space Station since May 2011. Precision measurements of all elementary charged cosmic ray particles have been performed by AMS using a data sample of 85 billion cosmic ray events collected during the first five years of operations on the Station. The latest AMS results on the fluxes and flux ratios of the elementary cosmic ray particles are presented. They show unique features that require accurate theoretical interpretation as to their origin, be it from dark matter collisions or new astrophysical sources. On behalf of the AMS Collaboration.

  3. General chemistry

    International Nuclear Information System (INIS)

    Kwon, Yeong Sik; Lee, Dong Seop; Ryu, Haung Ryong; Jang, Cheol Hyeon; Choi, Bong Jong; Choi, Sang Won

    1993-07-01

    The book concentrates on the latest general chemistry, which is divided int twenty-three chapters. It deals with basic conception and stoichiometry, nature of gas, structure of atoms, quantum mechanics, symbol and structure of an electron of ion and molecule, chemical thermodynamics, nature of solid, change of state and liquid, properties of solution, chemical equilibrium, solution and acid-base, equilibrium of aqueous solution, electrochemistry, chemical reaction speed, molecule spectroscopy, hydrogen, oxygen and water, metallic atom; 1A, IIA, IIIA, carbon and atom IVA, nonmetal atom and an inert gas, transition metals, lanthanons, and actinoids, nuclear properties and radioactivity, biochemistry and environment chemistry.

  4. [Dementia friendly care services in general hospitals : Representative results of the general hospital study (GHoSt)].

    Science.gov (United States)

    Hendlmeier, Ingrid; Bickel, Horst; Hessler, Johannes Baltasar; Weber, Joshua; Junge, Magdalena Nora; Leonhardt, Sarah; Schäufele, Martina

    2017-11-06

    Mostly model projects report on special care services and procedures for general hospital patients with cognitive impairment. The objective of this study was to determine the frequency of special care services and procedures in general hospitals on the basis of a representative cross-sectional study. From a list of all general hospitals in southern Germany we randomly selected a specified number of hospitals und somatic wards. The hospitals were visited and all older patients on the selected wards on that day were included in the study. Information about care services and their utilization was collected with standardized instruments. A total of 33 general hospitals and 172 wards participated in the study. The patient sample included 1469 persons over 65 (mean age 78.6 years) and 40% of the patients showed cognitive impairments. The staff reported that the most frequent measures for patients with cognitive impairments concerned patients with wandering behavior (63.1%), efforts to involve the patients' relatives to help with their daily care (60.1%), conducting nonintrusive interviews to identify cognitive impairments (59.9%), allocation to other rooms (58%) and visual aids for place orientation of patients (50.6%). In accordance with earlier studies our results show that other dementia friendly services implemented in pilot projects were rare. The existing special services for patients with cognitive impairment were rarely used by the patients or their relatives. The results demonstrate the urgent need to improve special care services and routines for identification of elderly patients with cognitive impairment and risk of delirium in general hospitals.

  5. Latest Results in SLAC 75-MW PPM Klystrons

    International Nuclear Information System (INIS)

    Sprehn, D.; Caryotakis, G.; Haase, A.; Jongewaard, E.; Laurent, L.; Pearson, C.; Phillips, R.

    2006-01-01

    75 MW X-band klystrons utilizing Periodic Permanent Magnet (PPM) focusing have been undergoing design, fabrication and testing at the Stanford Linear Accelerator Center (SLAC) for almost nine years. The klystron development has been geared toward realizing the necessary components for the construction of the Next Linear Collider (NLC). The PPM devices built to date which fit this class of operation consist of a variety of 50 MW and 75 MW devices constructed by SLAC, KEK (Tsukuba, Japan) and industry. All these tubes follow from the successful SLAC design of a 50 MW PPM klystron in 1996. In 2004 the latest two klystrons were constructed and tested with preliminary results reported at EPAC2004. The first of these two devices was tested to the full NLC specifications of 75 MW, 1.6 microseconds pulse length, and 120 Hz. This 14.4 kW average power operation came with a tube efficiency >50%. The most recent testing of these last two devices will be presented here. Design and manufacturing issues of the latest klystron, due to be tested by the Fall of 2005, are also discussed

  6. The estimation of patients' views on organizational aspects of a general dental practice by general dental practitioners: a survey study

    Directory of Open Access Journals (Sweden)

    Truin Gert-Jan

    2011-10-01

    Full Text Available Abstract Background Considering the changes in dental healthcare, such as the increasing assertiveness of patients, the introduction of new dental professionals, and regulated competition, it becomes more important that general dental practitioners (GDPs take patients' views into account. The aim of the study was to compare patients' views on organizational aspects of general dental practices with those of GDPs and with GDPs' estimation of patients' views. Methods In a survey study, patients and GDPs provided their views on organizational aspects of a general dental practice. In a second, separate survey, GDPs were invited to estimate patients' views on 22 organizational aspects of a general dental practice. Results For 4 of the 22 aspects, patients and GDPs had the same views, and GDPs estimated patients' views reasonably well: 'Dutch-speaking GDP', 'guarantee on treatment', 'treatment by the same GDP', and 'reminder of routine oral examination'. For 2 aspects ('quality assessment' and 'accessibility for disabled patients' patients and GDPs had the same standards, although the GDPs underestimated the patients' standards. Patients had higher standards than GDPs for 7 aspects and lower standards than GDPs for 8 aspects. Conclusion On most aspects GDPs and patient have different views, except for social desirable aspects. Given the increasing assertiveness of patients, it is startling the GDP's estimated only half of the patients' views correctly. The findings of the study can assist GDPs in adapting their organizational services to better meet the preferences of their patients and to improve the communication towards patients.

  7. Influences of peer facilitation in general practice - a qualitative study

    DEFF Research Database (Denmark)

    Due, Tina Drud; Kousgaard, Marius Brostrøm; Waldorff, Frans Boch

    2018-01-01

    of the visited practices to gain a more detailed understanding of how peer facilitation influenced practices and how they valued the facilitation. METHODS: The facilitation intervention was conducted in general practice in the Capital Region of Denmark with the purpose of supporting the implementation of chronic...... visits had increased their knowledge and skills as well as their motivation and confidence to change. These positive influences were ascribed to a) the facilitation approach b) the credibility and know-how associated with the facilitators' being peers c) the recurring visits providing protected time...... and invoking a sense of commitment. Despite these positive influences, both the facilitation and the change process were impeded by several challenges, e.g. competing priorities, heavy workload, problems with information technology and in some cases inadequate facilitation. CONCLUSION: Practice facilitation...

  8. General practitioners' decisions about discontinuation of medication: an explorative study.

    Science.gov (United States)

    Nixon, Michael Simon; Vendelø, Morten Thanning

    2016-06-20

    Purpose - The purpose of this paper is to investigate how general practitioners' (GPs) decisions about discontinuation of medication are influenced by their institutional context. Design/methodology/approach - In total, 24 GPs were interviewed, three practices were observed and documents were collected. The Gioia methodology was used to analyse data, drawing on a theoretical framework that integrate the sensemaking perspective and institutional theory. Findings - Most GPs, who actively consider discontinuation, are reluctant to discontinue medication, because the safest course of action for GPs is to continue prescriptions, rather than discontinue them. The authors conclude that this is in part due to the ambiguity about the appropriateness of discontinuing medication, experienced by the GPs, and in part because the clinical guidelines do not encourage discontinuation of medication, as they offer GPs a weak frame for discontinuation. Three reasons for this are identified: the guidelines provide dominating triggers for prescribing, they provide weak priming for discontinuation as an option, and they underscore a cognitive constraint against discontinuation. Originality/value - The analysis offers new insights about decision making when discontinuing medication. It also offers one of the first examinations of how the institutional context embedding GPs influences their decisions about discontinuation. For policymakers interested in the discontinuation of medication, the findings suggest that de-stigmatising discontinuation on an institutional level may be beneficial, allowing GPs to better justify discontinuation in light of the ambiguity they experience.

  9. Lathe Operator. Coordinator's Guide. Individualized Study Guide. General Metal Trades.

    Science.gov (United States)

    East Texas State Univ., Commerce. Occupational Curriculum Lab.

    This guide provides information to enable coordinators to direct learning activities for students using an individualized study guide on operating a lathe. The study material is designed for students enrolled in cooperative part-time training and employed, or desiring to be employed, as lathe operators. Contents include a sample progress chart,…

  10. Plato and the teaching of entrepreneurship studies as general ...

    African Journals Online (AJOL)

    Secondly to use Plato's model of education to stress the importance of the practical aspect of entrepreneurial studies so as to avoid the old syndrome of breeding certificate Laden, theory filled entrepreneurial studies. For Plato, education should be tailored to suit the learner specialization; that is a carpenter should be taught ...

  11. 29 CFR 1607.5 - General standards for validity studies.

    Science.gov (United States)

    2010-07-01

    ...) (hereinafter “A.P.A. Standards”) and standard textbooks and journals in the field of personnel selection. D... market and the job should be considered in the determination of when a validity study is outdated. ...

  12. A general method to study equilibrium partitioning of macromolecules

    DEFF Research Database (Denmark)

    The distribution of macromolecules between a confined microscopic solution and a macroscopic bulk solution plays an important role in understanding separation processes such as Size Exclusion Chromatography (SEC). In this study, we have developed an efficient computational algorithm for obtaining...

  13. The vehicle routing problem latest advances and new challenges

    CERN Document Server

    Golden, Bruce L; Wasil, Edward A

    2008-01-01

    The Vehicle Routing Problem (VRP) has been an especially active and fertile area of research. Over the past five to seven years, there have been numerous technological advances and exciting challenges that are of considerable interest to students, teachers, and researchers. The Vehicle Routing Problem: Latest Advances and New Challenges will focus on a host of significant technical advances that have evolved over the past few years for modeling and solving vehicle routing problems and variants. New approaches for solving VRPs have been developed from important methodological advances. These developments have resulted in faster solution algorithms, more accurate techniques, and an improvement in the ability to solve large-scale, complex problems. The book will systematically examine these recent developments in the VRP and provide the following in a unified and carefully developed presentation: Present novel problems that have arisen in the vehicle routing domain and highlight new challenges for the field; Pre...

  14. The status and latest issues on KAERI export control implementation

    International Nuclear Information System (INIS)

    Kim, Hyun Sook; Park, Ho Jun; Kim, Hyun Jo; Ko, Han Suk; Lee, Byung Doo

    2010-01-01

    There are four informal non-proliferation arrangements which seek to control the proliferation of weapons of mass destruction and their missile delivery systems and the transfer of conventional weapons and dual-use technologies. The four arrangements are Wassenaar Arrangement (WA) on export controls for conventional arms and dual use goods and technologies, Nuclear Supplies Group(NSG), Missile Technology Control Regime(MTCR) and Australia Group(AG) on chemical and biological weapons materials. ROK participates in four arrangements to seek to encourage responsible practice in the trade of strategic goods and technologies. It is achieved through the implementation of export control list. MKE Notification (Ministry of Knowledge Economy Notification No. 2009-250) specifies those items and technologies subject to control. In this paper, the status and latest issues on KAERI export control implementation are described

  15. Constraining viscous dark energy models with the latest cosmological data

    Science.gov (United States)

    Wang, Deng; Yan, Yang-Jie; Meng, Xin-He

    2017-10-01

    Based on the assumption that the dark energy possessing bulk viscosity is homogeneously and isotropically permeated in the universe, we propose three new viscous dark energy (VDE) models to characterize the accelerating universe. By constraining these three models with the latest cosmological observations, we find that they just deviate very slightly from the standard cosmological model and can alleviate effectively the current H_0 tension between the local observation by the Hubble Space Telescope and the global measurement by the Planck Satellite. Interestingly, we conclude that a spatially flat universe in our VDE model with cosmic curvature is still supported by current data, and the scale invariant primordial power spectrum is strongly excluded at least at the 5.5σ confidence level in the three VDE models as the Planck result. We also give the 95% upper limits of the typical bulk viscosity parameter η in the three VDE scenarios.

  16. Constraining viscous dark energy models with the latest cosmological data

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Deng [Nankai University, Theoretical Physics Division, Chern Institute of Mathematics, Tianjin (China); Yan, Yang-Jie; Meng, Xin-He [Nankai University, Department of Physics, Tianjin (China)

    2017-10-15

    Based on the assumption that the dark energy possessing bulk viscosity is homogeneously and isotropically permeated in the universe, we propose three new viscous dark energy (VDE) models to characterize the accelerating universe. By constraining these three models with the latest cosmological observations, we find that they just deviate very slightly from the standard cosmological model and can alleviate effectively the current H{sub 0} tension between the local observation by the Hubble Space Telescope and the global measurement by the Planck Satellite. Interestingly, we conclude that a spatially flat universe in our VDE model with cosmic curvature is still supported by current data, and the scale invariant primordial power spectrum is strongly excluded at least at the 5.5σ confidence level in the three VDE models as the Planck result. We also give the 95% upper limits of the typical bulk viscosity parameter η in the three VDE scenarios. (orig.)

  17. Latest improvements on TRACPWR six-equations thermohydraulic code

    International Nuclear Information System (INIS)

    Rivero, N.; Batuecas, T.; Martinez, R.; Munoz, J.; Lenhardt, G.; Serrano, P.

    1999-01-01

    The paper presents the latest improvements on TRACPWR aimed at adapting the code to present trends on computer platforms, architectures and training requirements as well as extending the scope of the code itself and its applicability to other technologies different from Westinghouse PWR one. Firstly major features of TRACPWR as best estimate and real time simulation code are summed, then the areas where TRACPWR is being improved are presented. These areas comprising: (1) Architecture: integrating TRACPWR and RELAP5 codes, (2) Code scope enhancement: modelling the Mid-Loop operation, (3) Code speed-up: applying parallelization techniques, (4) Code platform downswing: porting to Windows N1 platform, (5) On-line performance: allowing simulation initialisation from a Plant Process Computer, and (6) Code scope extension: using the code for modelling VVER and PHWR technology. (author)

  18. Targeting Nanomedicine to Brain Tumors: Latest Progress and Achievements.

    Science.gov (United States)

    Van't Root, Moniek; Lowik, Clemens; Mezzanotte, Laura

    2017-01-01

    Targeting nanomedicine to brain tumors is hampered by the heterogeneity of brain tumors and the blood brain barrier. These represent the main reasons of unsuccessful treatments. Nanomedicine based approaches hold promise for improved brain tissue distribution of drugs and delivery of combination therapies. In this review, we describe the recent advancements and latest achievements in the use of nanocarriers, virus and cell-derived nanoparticles for targeted therapy of brain tumors. We provide successful examples of nanomedicine based approaches for direct targeting of receptors expressed in brain tumor cells or modulation of pathways involved in cell survival as well as approaches for indirect targeting of cells in the tumor stroma and immunotherapies. Although the field is at its infancy, clinical trials involving nanomedicine based approaches for brain tumors are ongoing and many others will start in the near future. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  19. Latest NASA Instrument Cost Model (NICM): Version VI

    Science.gov (United States)

    Mrozinski, Joe; Habib-Agahi, Hamid; Fox, George; Ball, Gary

    2014-01-01

    The NASA Instrument Cost Model, NICM, is a suite of tools which allow for probabilistic cost estimation of NASA's space-flight instruments at both the system and subsystem level. NICM also includes the ability to perform cost by analogy as well as joint confidence level (JCL) analysis. The latest version of NICM, Version VI, was released in Spring 2014. This paper will focus on the new features released with NICM VI, which include: 1) The NICM-E cost estimating relationship, which is applicable for instruments flying on Explorer-like class missions; 2) The new cluster analysis ability which, alongside the results of the parametric cost estimation for the user's instrument, also provides a visualization of the user's instrument's similarity to previously flown instruments; and 3) includes new cost estimating relationships for in-situ instruments.

  20. plato and the teaching of entrepreneurship studies as general

    African Journals Online (AJOL)

    JONATHAN

    2016-08-22

    Aug 22, 2016 ... curriculum and teaching of entrepreneurial studies in Universities? .... EMPLOYMENT: the public sector is still is still the largest employer of ..... This care of the body in the case of those who are to be guardians of the .... sponsors for such program. In ... Oguejiofor (eds) African Philosophy and Public Affairs.

  1. Large General Purpose Frame for Studying Force Vectors

    Science.gov (United States)

    Heid, Christy; Rampolla, Donald

    2011-01-01

    Many illustrations and problems on the vector nature of forces have weights and forces in a vertical plane. One of the common devices for studying the vector nature of forces is a horizontal "force table," in which forces are produced by weights hanging vertically and transmitted to cords in a horizontal plane. Because some students have…

  2. [Nursing managerial approach: a study based on general management theories].

    Science.gov (United States)

    Fernandes, Marcia Simoni; Spagnol, Carla Aparecida; Trevizan, Maria Auxiliadora; Hayashida, Miyeko

    2003-01-01

    The purpose of this study was to identify nurses managerial conduct in a private maternity hospital located in the interior of the São Paulo state, Brazil. In order to collect data, authors used a questionnaire with 20 propositions related to the work of nurses in the different units of the hospital. Following, authors performed a descriptive statistical analysis of the data. Results showed a tendency toward democratization in the conduct of the nurses investigated as the majority of the responses privileged questions on team work, workers' participation and group development. Also, authors evidenced that great part of the responses did not agree with the propositions about the principles of the Classical Administration Theory.

  3. Dry Eye Post-Laser-Assisted In Situ Keratomileusis: Major Review and Latest Updates

    Science.gov (United States)

    Spierer, Oriel

    2018-01-01

    Dry eye is one of the most common complications occurring after laser-assisted in situ keratomileusis (LASIK), with virtually all patients experiencing some degree of postoperative dry eye symptoms. Enhanced understanding of the pathophysiology and mechanism of dry eye development in addition to preoperative screening of patients who are prone to dry eye is essential for better patient satisfaction and for improving short-term visual outcome postoperatively. This article reviews the latest studies published on LASIK-associated dry eye, including epidemiology, pathophysiology, risk factors, preoperative assessment, and management. PMID:29619255

  4. Trehalose Analogues: Latest Insights in Properties and Biocatalytic Production

    Directory of Open Access Journals (Sweden)

    Maarten Walmagh

    2015-06-01

    Full Text Available Trehalose (α-d-glucopyranosyl α-d-glucopyranoside is a non-reducing sugar with unique stabilizing properties due to its symmetrical, low energy structure consisting of two 1,1-anomerically bound glucose moieties. Many applications of this beneficial sugar have been reported in the novel food (nutricals, medical, pharmaceutical and cosmetic industries. Trehalose analogues, like lactotrehalose (α-d-glucopyranosyl α-d-galactopyranoside or galactotrehalose (α-d-galactopyranosyl α-d-galactopyranoside, offer similar benefits as trehalose, but show additional features such as prebiotic or low-calorie sweetener due to their resistance against hydrolysis during digestion. Unfortunately, large-scale chemical production processes for trehalose analogues are not readily available at the moment due to the lack of efficient synthesis methods. Most of the procedures reported in literature suffer from low yields, elevated costs and are far from environmentally friendly. “Greener” alternatives found in the biocatalysis field, including galactosidases, trehalose phosphorylases and TreT-type trehalose synthases are suggested as primary candidates for trehalose analogue production instead. Significant progress has been made in the last decade to turn these into highly efficient biocatalysts and to broaden the variety of useful donor and acceptor sugars. In this review, we aim to provide an overview of the latest insights and future perspectives in trehalose analogue chemistry, applications and production pathways with emphasis on biocatalysis.

  5. Latest LHCb measurements of Electroweak Boson Production in Run-1

    CERN Document Server

    CERN. Geneva

    2015-01-01

    We present the latest LHCb measurements of forward Electroweak Boson Production using proton-proton collisions recorded in LHC Run-1. The seminar shall discuss measurements of the 8 TeV W & Z boson production cross-sections. These results make use of LHCb's excellent integrated luminosity determination to provide constraints on the parton distribution functions which describe the inner structure of the proton. These LHCb measurements probe a region of phase space at low Bjorken-x where the other LHC experiments have limited sensitivity. We also present measurements of cross-section ratios, and ratios of results in 7 TeV and 8 TeV proton-proton collisions. These results provide precision tests of the Standard Model. The seminar shall also present a measurement of the forward-backward asymmetry (A_FB) in Z boson decays to two muons. This result allows for precision tests of the coupling of the Z boson to left and right handed particles, providing sensitivity to the effective weak mixing angle (...

  6. A search for sterile neutrinos with the latest cosmological observations

    Energy Technology Data Exchange (ETDEWEB)

    Feng, Lu; Zhang, Jing-Fei [Northeastern University, Department of Physics, College of Sciences, Shenyang (China); Zhang, Xin [Northeastern University, Department of Physics, College of Sciences, Shenyang (China); Peking University, Center for High Energy Physics, Beijing (China)

    2017-06-15

    We report the result of a search for sterile neutrinos with the latest cosmological observations. Both cases of massless and massive sterile neutrinos are considered in the ΛCDM cosmology. The cosmological observations used in this work include the Planck 2015 temperature and polarization data, the baryon acoustic oscillation data, the Hubble constant direct measurement data, the Planck Sunyaev-Zeldovich cluster counts data, the Planck lensing data, and the cosmic shear data. We find that the current observational data give a hint of the existence of massless sterile neutrino (as dark radiation) at the 1.44σ level, and the consideration of an extra massless sterile neutrino can indeed relieve the tension between observations and improve the cosmological fit. For the case of massive sterile neutrino, the observations give a rather tight upper limit on the mass, which implies that actually a massless sterile neutrino is more favored. Our result is consistent with the recent result of neutrino oscillation experiment done by the Daya Bay and MINOS collaborations, as well as the recent result of cosmic ray experiment done by the IceCube collaboration. (orig.)

  7. Features of the latest version of the PHITS code

    International Nuclear Information System (INIS)

    Sato, Tatsuhiko; Matsuda, Norihiro; Hashimoto, Shintaro; Iwamoto, Yosuke; Noda, Shusaku; Ogawa, Tatsuhiko; Nakajima, Hiroshi; Fukahori, Tokio; Okumura, Keisuke; Kai, Tetsuya; Chiba, Satoshi; Niita, Koji; Iwase, Hiroshi; Furuta, Takuya

    2013-01-01

    A Multi-purpose Monte Carlo Particle and Heavy Ion Transport code System, PHITS, developed through collaborations between JAEA and several institutes in Japan and Europe, and upgraded recently and released as PHITS2.52 is presented as an overview. In the new version, higher accuracy of the simulation was achieved by implementing the latest nuclear reaction models such as Liege intra-nuclear cascade version 4.6 (INCL4.6) and a statistical multi-fragmentation model including JAM and JQMD for high-energy regions. The reliability of the simulation code was improved by modifying both the algorithms for the electron-, positron-, and photon-transport simulations in terms of not only the code itself but also the contents of its package, such as the attached data libraries. More than 800 researchers have been registered as PHITS users, and they apply the code to various research and development fields such as nuclear technology, accelerator design, medical physics, and cosmic-ray research. (S. Ohno)

  8. Operating experience on radiation reduction in the latest BWRs

    International Nuclear Information System (INIS)

    Ohsumi, K.; Uchida, S.; Aizawa, M.; Takagi, K.; Amano, O.; Yamashita, K.

    1988-01-01

    In Japan, BWR plants have been operated commercially since 1970, and the reduction of radiation exposure has been an important concern. The application of the procedure for reducing occupational exposure is incorporated in Japanese Improvement and Standardization Program for LWRs. No.2 and No.4 plants in Fukushima No.2 Nuclear Power Station were designed and constructed as the latest 1,100 MWe BWRs in conformity with the Improvement and Standardization Program. No.2 plant began the commercial operation in February, 1984, and experienced three times of the scheduled annual maintenance outage. No.4 plant began the commercial operation in September, 1987, and the first annual maintenance is scheduled from September, 1988. In this paper, discussion is focused on recent radiation reduction measures, that is the control of iron and nickel in primary coolant for reducing the radiation dose rate in primary systems, based on the experience with No.2 and No.4 plants. The design concept of a low radiation dose rate nuclear power plant, the experience on water chemistry in No.2 plant, the control of iron and nickel in No.4 plant operation and so on are reported. It is believed that these operation experiences contribute to the reduction of occupational exposure in BWR plants currently in operation and in future. (Kako, I.)

  9. Latest developments for a computer aided thermohydraulic network

    International Nuclear Information System (INIS)

    Alemberti, A.; Graziosi, G.; Mini, G.; Susco, M.

    1999-01-01

    Thermohydraulic networks are I-D systems characterized by a small number of basic components (pumps, valves, heat exchangers, etc) connected by pipes and limited spatially by a defined number of boundary conditions (tanks, atmosphere, etc). The network system is simulated by the well known computer program RELAPS/mod3. Information concerning the network geometry component behaviour, initial and boundary conditions are usually supplied to the RELAPS code using an ASCII input file by means of 'input cards'. CATNET (Computer Aided Thermalhydraulic NETwork) is a graphically user interface that, under specific user guidelines which completely define its range of applicability, permits a very high level of standardization and simplification of the RELAPS/mod3 input deck development process as well as of the output processing. The characteristics of the components (pipes, valves, pumps etc), defining the network system can be entered through CATNET. The CATNET interface is provided by special functions to compute form losses in the most typical bending and branching configurations. When the input of all system components is ready, CATNET is able to generate the RELAPS/mod3 input file. Finally, by means of CATNET, the RELAPS/mod3 code can be run and its output results can be transformed to an intuitive display form. The paper presents an example of application of the CATNET interface as well as the latest developments which greatly simplified the work of the users and allowed to reduce the possibility of input errors. (authors)

  10. Latest news on Arabidopsis brassinosteroid perception and signaling

    Directory of Open Access Journals (Sweden)

    Klaus eHarter

    2011-10-01

    Full Text Available Brassinosteroids (BR are plant hormones regulating growth and development. In interaction with other hormones, they are involved in environmental cue responses. The standard BR response pathway model in Arabidopsis includes the perception of the hormone by the plasma membrane receptor BRASSINOSTEROID INSENSITIVE 1 (BRI1 and its hetero-oligomerisation with the co-receptor BRI1-ASSOCIATED RECEPTOR KINASE 1 (BAK1, followed by the activation of a signaling cascade finally resulting in the expression of BR-responsive genes. Recent findings have shed new light on the molecular mechanism of BR perception, which includes the hormone-induced formation of a platform in BRI1 extracellular domain for interaction with BAK1, and on very early events of signaling at the plasma membrane-cytoplasm interface. In addition, a fast BR response pathway that modifies the membrane potential and the expansion of the cell wall – both crucial processes preceding cell elongation growth – was identified. In this review, these latest findings are summarized and discussed against the background of the standard model of BRI1-dependent signaling.

  11. The Latest IceCube Results and the Implications

    Science.gov (United States)

    Mase, Keiichi

    IceCube was built at the South Pole and aims to detect high energy neutrinos from the universe mainly above 100 GeV. The transparent ice media allows us to build a 1 km3 large detection volume to detect the rarely interacting particles. Neutrinos are thought to be generated at astrophysical sources such as active galactic nuclei and gamma-ray bursts. Nature of the rare interaction with matters and little deflection by a magnetic field makes it possible to explore such sources located at the deep universe. Since the neutrinos are produced through collisions of hadronic particles, the observation can elucidate the origin of cosmic rays, which is still mystery after the discovery 100 years ago. The detector was completed at the end of 2010 and is running smoothly. Recently, IceCube has found the first evidence of extraterrestrial neutrinos with energies above approximately 60 TeV. IceCube also contributes to elementary particle physics by searching for neutrinos produced in self-annihilation of SUSY particles such as neutralinos and by investigating atmospheric neutrino oscillations. The latest IceCube results and the corresponding implications are presented.

  12. The role of the General Practitioner in weight management in primary care – a cross sectional study in General Practice

    Directory of Open Access Journals (Sweden)

    Young Doris

    2008-12-01

    Full Text Available Abstract Background Obesity has become a global pandemic, considered the sixth leading cause of mortality by the WHO. As gatekeepers to the health system, General Practitioners are placed in an ideal position to manage obesity. Yet, very few consultations address weight management. This study aims to explore reasons why patients attending General Practice appointments are not engaging with their General Practitioner (GP for weight management and their perception of the role of the GP in managing their weight. Methods In February 2006, 367 participants aged between 17 and 64 were recruited from three General Practices in Melbourne to complete a waiting room self – administered questionnaire. Questions included basic demographics, the role of the GP in weight management, the likelihood of bringing up weight management with their GP and reasons why they would not, and their nominated ideal person to consult for weight management. Physical measurements to determine weight status were then completed. The statistical methods included means and standard deviations to summarise continuous variables such as weight and height. Sub groups of weight and questionnaire answers were analysed using the χ2 test of significant differences taking p as Results The population sample had similar obesity co-morbidity rates to the National Heart Foundation data. 74% of patients were not likely to bring up weight management when they visit their GP. Negative reasons were time limitation on both the patient's and doctor's part and the doctor lacking experience. The GP was the least likely person to tell a patient to lose weight after partner, family and friends. Of the 14% that had been told by their GP to lose weight, 90% had cardiovascular obesity related co-morbidities. GPs (15% were 4th in the list of ideal persons to manage weight after personal trainer Conclusion Patients do not have confidence in their GPs for weight management, preferring other health

  13. Learning beyond the Classroom: Using Text Messages to Measure General Chemistry Students' Study Habits

    Science.gov (United States)

    Ye, Li; Oueini, Razanne; Dickerson, Austin P.; Lewis, Scott E.

    2015-01-01

    This study used a series of text message inquiries sent to General Chemistry students asking: "Have you studied for General Chemistry I in the past 48 hours? If so, how did you study?" This method for collecting data is novel to chemistry education research so the first research goals were to investigate the feasibility of the technique…

  14. The generalized cosmic equation of state. A revised study with cosmological standard rulers

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Yubo [Shanxi Datong University, School of Physics, Datong (China); Zhang, Jia [Weinan Normal University, Department of Physics, School of Mathematics and Physics, Weinan, Shanxi (China); Cao, Shuo; Zheng, Xiaogang; Xu, Tengpeng; Qi, Jingzhao [Beijing Normal University, Department of Astronomy, Beijing (China)

    2017-12-15

    In this paper, the generalized equation of state (GEoS) for dark energy (w{sub β} = w{sub 0} - w{sub β}[(1+z){sup -β} - 1]/β) is investigated with the combined standard ruler data from the observations of intermediate-luminosity radio quasars, galaxy clusters, BAO and CMB. The constraint results show that the best-fit EoS parameters are w{sub 0} = -0.94{sup +0.57}{sub -0.41}, w{sub β} = -0.17{sup +2.45}{sub -4.81} and β = -1.42 (with a lower limit of β > -2.70 at 68.3% C.L.), which implies that at early times the dark energy vanishes. In the framework of nine truncated GEoS models with different β parameters, our findings present very clear evidence disfavoring the case that dark energy always dominates over the other material components in the early universe. Moreover, stringent constraints can be obtained in combination with the latest measurements of Hubble parameter at different redshifts: w{sub 0} = -1.01{sup +0.56}{sub -0.31}, w{sub β} = 0.01{sup +2.33}{sub -4.52} and β = -0.42 (with a lower limit of β > -2.40 at 68.3% C.L.). Finally, the results obtained from the transition redshift (z{sub t}) and Om(z) diagnostic indicate that: (1) The above constraints on the GEoS model agree very well with the transition redshift interval 0.49 ≤ z{sub t} ≤ 0.88 within 1σ error region. (2) At the current observational level, the GEoS model is practically indistinguishable from ΛCDM, although a small deviation from ΛCDM cosmology is present in the combined standard ruler data. (orig.)

  15. An Evaluation of the Instruction of Generalization in Elementary School Social Studies Program

    Directory of Open Access Journals (Sweden)

    Mükerrem AKBULUT TAŞ

    2011-11-01

    Full Text Available Generalizations are important content materials that should be instructed in the Social Studies program. The instruction of generalizations and the causal relationships emphasized in generalizations are important for students to have meaningful learning experiences and to gain causal reasoning and critical thinking skills. Social Studies program emphasizes the acquisition of creating scientific generalization skill as a fundamental skill to be instructed directly, and the importance of generalization instruction is highlighted. Therefore, this study is important in that it draws attention to the importance of teaching generalization and creates basis for the future research in the field. In this regard, it aims at evaluating the instruction of the generalizations in the “Our Country and the World” unit in Social Studies program for 6th grades in Primary School. In line with this general purpose, the instruction of the generalizations in the unit was analyzed qualitatively. The study was conducted with three social studies teachers working in three different schools located in Seyhan, Adana. The data were collected through the observation technique with a view to obtaining in depth data about the instruction of generalization in social studies lesson. Semi-structured observation form, prepared in the light of the generalization content elements, was used as the data collection tool. These content elements consisted of four aspects: generalization statement, concepts related to generalization, cause-effect relationships between concepts, and facts about generalization. In addition to observation, document analysis was conducted with a view to supporting results and strengthening the implications. The documentary analysis was performed based on the generalizations and previously identified elements about the generalizations in the scope of the six topics in the “Our Country and the World” unit. The data collected from the observations were

  16. Determining cosmological parameters with the latest observational data

    International Nuclear Information System (INIS)

    Xia Junqing; Li Hong; Zhao Gongbo; Zhang Xinmin

    2008-01-01

    In this paper, we combine the latest observational data, including the WMAP five-year data (WMAP5), BOOMERanG, CBI, VSA, ACBAR, as well as the baryon acoustic oscillations (BAO) and type Ia supernovae (SN) ''union'' compilation (307 sample), and use the Markov Chain Monte Carlo method to determine the cosmological parameters, such as the equation of state (EoS) of dark energy, the curvature of the universe, the total neutrino mass, and the parameters associated with the power spectrum of primordial fluctuations. In a flat universe, we obtain the tight limit on the constant EoS of dark energy as w=-0.977±0.056(stat)±0.057(sys). For the dynamical dark energy models with the time evolving EoS parametrized as w de (a)=w 0 +w 1 (1-a), we find that the best-fit values are w 0 =-1.08 and w 1 =0.368, while the ΛCDM model remains a good fit to the current data. For the curvature of the universe Ω k , our results give -0.012 k de =-1. When considering the dynamics of dark energy, the flat universe is still a good fit to the current data, -0.015 k s ≥1 are excluded at more than 2σ confidence level. However, in the framework of dynamical dark energy models, the allowed region in the parameter space of (n s ,r) is enlarged significantly. Finally, we find no strong evidence for the large running of the spectral index.

  17. Latest Results from the Multi-Object Keck Exoplanet Tracker

    Science.gov (United States)

    Van Eyken, Julian C.; Ge, J.; Wan, X.; Zhao, B.; Hariharan, A.; Mahadevan, S.; DeWitt, C.; Guo, P.; Cohen, R.; Fleming, S. W.; Crepp, J.; Warner, C.; Kane, S.; Leger, F.; Pan, K.

    2006-12-01

    The W. M. Keck Exoplanet Tracker is a precision Doppler radial velocity instrument based on dispersed fixed-delay interferometry (DFDI) which takes advantage of the new technique to allow multi-object RV surveying. Installed at the 2.5m Sloan telescope at Apache Point Observatory, the combination of Michelson interferometer and medium resolution spectrograph allows design for simultaneous Doppler measurements of up to 60 targets, while maintaining high instrument throughput. Using a single-object prototype of the instrument at the Kitt Peak National Observatory 2.1m telescope, we previously discovered a 0.49MJup planet, HD 102195b (ET-1), orbiting with a 4.11d period, and other interesting targets are being followed up. From recent trial observations, the Keck Exoplanet Tracker now yields 59 usable simultaneous fringing stellar spectra, of a quality sufficient to attempt to detect short period hot-Jupiter type planets. Recent engineering improvements reduced errors by a factor of 2, and typical photon limits for stellar data are now at the 30m/s level for magnitude V 10.5 (depending on spectral type and v sin i), with a best value of 6.9m/s at V=7.6. Preliminary RMS precisions from solar data (daytime sky) are around 10m/s over a few days, with some spectra reaching close to their photon limit of 6-7m/s on the short term ( 1 hour). A number of targets showing interesting RV variability are currently being followed up independently. Additional engineering work is planned which should make for further significant gains in Doppler precision. Here we present the latest results and updates from the most recent engineering and observing runs with the Keck ET.

  18. Emollient treatment of atopic dermatitis: latest evidence and clinical considerations

    Directory of Open Access Journals (Sweden)

    Kam Lun Hon

    2018-04-01

    Full Text Available Aim: To review current classes of emollients in the market, their clinical efficacy in atopic dermatitis (AD and considerations for choice of an emollient. Methods: PubMed Clinical Queries under Clinical Study Categories (with Category limited to Therapy and Scope limited to Narrow and Systematic Reviews were used as the search engine. Keywords of ‘emollient or moisturizer’ and ‘atopic dermatitis’ were used. Overview of findings: Using the keywords of ‘emollient’ and ‘atopic dermatitis’, there were 105 and 36 hits under Clinical Study Categories (with Category limited to Therapy and Scope limited to Narrow and Systematic Reviews, respectively. Plant-derived products, animal products and special ingredients were discussed. Selected proprietary products were tabulated. Conclusions: A number of proprietary emollients have undergone trials with clinical data available on PubMed-indexed journals. Most moisturizers showed some beneficial effects, but there was generally no evidence that one moisturizer is superior to another. Choosing an appropriate emollient for AD patients would improve acceptability and adherence for emollient treatment. Physician’s recommendation is the primary consideration for patients when selecting a moisturizer/ emollient; therefore, doctors should provide evidence-based information about these emollients.

  19. Diagnostic approach to urinary tract infections in male general practice patients: a national surveillance study.

    NARCIS (Netherlands)

    Heijer, C.D.J. den; Dongen, M.C.J.M. van; Donker, G.A.; Stobberingh, E.E.

    2012-01-01

    Background: Diagnostic urinary tract infection (UTI) studies have primarily been performed among female patients. Aim: To create a diagnostic algorithm for male general practice patients suspected of UTI. Design and setting: Surveillance study in the Dutch Sentinel General Practice Network. Method:

  20. Latest experience on insertion devices at the National Synchrotron Light Source-II

    International Nuclear Information System (INIS)

    Tanabe, Toshiya; Cappadoro, Peter; Corwin, Todd

    2016-01-01

    National Synchrotron Light Source-II (NSLS-II) is the latest storage ring of 3 GeV energy with the horizontal emittance of the electron beam being 0.9 nm.rad. Nine In-Vacuum Undulators (IVUs) are utilized at the NSLS-II as of February 2016. All IVUs have a unique side window derived from the experience from the CHESS facility in Cornell University. An R and D activity called 'Vacuum Seal Test' was conducted to ensure the viability of aluminum wire seal. Another R and D activity to develop a measurement system for Cryogenic Permanent Magnet Undulator (CPMU) was also performed. Other in-air devices, namely damping wigglers (DWs) and elliptically polarizing undulators (EPUs) utilize extruded aluminum chambers with Non-Evaporable Getter (NEG) coating. The beam-based integral estimates were obtained from the virtual kicks at the upstream and downstream of the undulator that best fit the measured orbit distortion in a model lattice with Tracy. In some cases, there are fairly large discrepancies between magnetic measurement data and observed integrals by the beam. Beam studies were carried out to explain the discrepancies mentioned earlier. The latest experiences on ID development and commissioning are discussed in conjunction with related activities in the world. (author)

  1. Does adversity early in life affect general population suicide rates? a cross-national study

    OpenAIRE

    Ritesh Bhandarkar; Ajit Shah

    2011-01-01

    Abstract: Background: Adversity early in life has been suggested as a protective factor for elderly suicides. However, studies examining this relationship in general population suicide rates are scarce. Methods: The relationship between general population suicide rates and four proxy measures of adversity earlier in life was examined using data from the World Health Organization and the United Nations data banks. Results: General population suicide rates were negatively correlated with the pe...

  2. Treatment of urinary incontinence in women in general practice: observational study.

    OpenAIRE

    Seim, A.; Sivertsen, B.; Eriksen, B. C.; Hunskaar, S.

    1996-01-01

    OBJECTIVE--To examine what is attainable when treating urinary incontinence in women in general practice. DESIGN--Observational study with 12 months' follow up. Interview and clinical examination before, during, and after treatment of women seeking help for urinary incontinence in general practice. SETTING--General practice in the rural district of Rissa, Norway. SUBJECTS--105 women aged 20 or more with urinary incontinence. INTERVENTIONS--Treatment with pelvic floor exercises, electrostimula...

  3. Provision of medical student teaching in UK general practices: a cross-sectional questionnaire study

    Science.gov (United States)

    Harding, Alex; Rosenthal, Joe; Al-Seaidy, Marwa; Gray, Denis Pereira; McKinley, Robert K

    2015-01-01

    Background Health care is increasingly provided in general practice. To meet this demand, the English Department of Health recommends that 50% of all medical students should train for general practice after qualification. Currently 19% of medical students express general practice as their first career choice. Undergraduate exposure to general practice positively influences future career choice. Appropriate undergraduate exposure to general practice is therefore highly relevant to workforce planning Aim This study seeks to quantify current exposure of medical students to general practice and compare it with past provision and also with postgraduate provision. Design and setting A cross-sectional questionnaire in the UK. Method A questionnaire regarding provision of undergraduate teaching was sent to the general practice teaching leads in all UK medical schools. Information was gathered on the amount of undergraduate teaching, how this was supported financially, and whether there was an integrated department of general practice. The data were then compared with results from previous studies of teaching provision. The provision of postgraduate teaching in general practice was also examined. Results General practice teaching for medical students increased from teaching in 1968 to 13.0% by 2008; since then, the percentage has plateaued. The total amount of general practice teaching per student has fallen by 2 weeks since 2002. Medical schools providing financial data delivered 14.6% of the clinical curriculum and received 7.1% of clinical teaching funding. The number of departments of general practice has halved since 2002. Provision of postgraduate teaching has tripled since 2000. Conclusion Current levels of undergraduate teaching in general practice are too low to fulfil future workforce requirements and may be falling. Financial support for current teaching is disproportionately low and the mechanism counterproductive. Central intervention may be required to solve

  4. ["General Practice is a great job anyway" - a qualitative study with vocational trainees].

    Science.gov (United States)

    Steinhäuser, Jost; Paulus, Jan; Roos, Marco; Peters-Klimm, Frank; Ledig, Thomas; Szecsenyi, Joachim; Joos, Stefanie

    2011-01-01

    Due to the increasing lack of physicians, an ageing and thus multi-morbid society and a misdistribution of physicians in Germany primary care provided by general practitioners is at risk. Therefore, approaches to recruit more physicians for general practice are being sought. The aim of the present study was to explore individual motivations for choosing a career in general practice, vocational trainees' perspectives on the current situation of vocational training and to identify possible approaches to improve the situation with suggestions from vocational trainees in Germany. A qualitative study was conducted by interviewing 13 trainees. The interviews that were based on a predefined interview guideline were recorded and transcribed. The analysis was performed according to Mayring supported by the software Atlas.ti. In general, the reasons given for choosing general practice include the holistic view towards patients, the opportunity to see the direct impact of therapies and self-employment. Furthermore, general practice was perceived as a job with a positive work-life balance. Barriers to vocational training are the lack of structure of individual rotations and the low salaries during the rotation in practice. Furthermore, the basic conditions for working as a self-employed general practitioner in Germany were described as being a disincentive. A general suggestion for improvement was to promote professional recognition of general practice at universities. A qualification of vocational trainers was requested. Specific suggestions were: better payment, better-structured rotations and a specific preparation for the self-employed general practitioner. The results of this study reveal that a single measure is insufficient for recruiting more young doctors for general practice. In fact, a package of measures is necessary to improve aspects of the vocational training but also general conditions for the profession. Copyright © 2010. Published by Elsevier GmbH.

  5. 76 FR 75557 - Draft Environmental Impact Statement for General Management Plan/Wilderness Study, Hawaii...

    Science.gov (United States)

    2011-12-02

    ... Environmental Impact Statement for General Management Plan/ Wilderness Study, Hawaii Volcanoes National Park, Hawaii AGENCY: National Park Service, Interior. ACTION: Notice of intent. SUMMARY: The National Park... updating the General Management Plan (GMP) for Hawaii Volcanoes National Park. As part of this conservation...

  6. The Importance of Undergraduate General and Organic Chemistry to the Study of Biochemistry in Medical School.

    Science.gov (United States)

    Scimone, Anthony; Scimone, Angelina A.

    1996-01-01

    Investigates chemistry topics necessary to facilitate the study of biochemistry in U.S. medical schools. Lists topics considered especially important and topics considered especially unimportant in general chemistry and organic chemistry. Suggests that in teaching undergraduate general or organic chemistry, the topics categorized as exceptionally…

  7. Mirtazapine in generalized social anxiety disorder: a randomized, double-blind, placebo-controlled study

    NARCIS (Netherlands)

    Schutters, Sara I. J.; van Megen, Harold J. G. M.; van Veen, Jantien Frederieke; Denys, Damiaan A. J. P.; Westenberg, Herman G. M.

    2010-01-01

    This study is aimed at investigating the efficacy and tolerability of mirtazapine in a generalized social anxiety disorder. Sixty patients with generalized social anxiety disorder were randomly allocated to receive mirtazapine (30-45 mg/day) (n = 30) or placebo (n = 30) for 12 weeks in a

  8. Determinants of general practitioner’s cancer related gut feelings – a prospective cohort study

    NARCIS (Netherlands)

    Donker, G.; Wiersma, E.; Heins, M.

    2016-01-01

    Background General practitioners (GPs) use gut feelings to diagnose cancer in an early stage, but little is known about the predictive value of gut feelings and how this is influenced by patient and GP characteristics. Methods Prospective cohort study of patients in 44 general practices

  9. Patients with persistent medically unexplained physical symptoms: A descriptive study from Norwegian general practice

    OpenAIRE

    Aamland, Aase; Malterud, Kirsti; Werner, Erik L.

    2014-01-01

    Background: Further research on effective interventions for patients with peristent Medically Unexplained Physical Symptoms (MUPS) in general practice is needed. Prevalence estimates of such patients are conflicting, and other descriptive knowledge is needed for development and evaluation of effective future interventions. In this study, we aimed to estimate the consultation prevalence of patients with persistent MUPS in general practice, including patients’ characteristics and...

  10. Latest Results on Top Quark Properties: \\\\ Deciphering the DNA of the heaviest quark

    CERN Document Server

    Gallinaro, Michele

    2017-01-01

    The top quark, the heaviest known elementary particle discovered at the Fermilab Tevatron more than twenty years ago, has taken a central role in the study of fundamental interactions. Due to its large mass, the top quark provides a unique environment for tests of the standard model. With a cumulative luminosity of more than 100~fb$^{-1}$ collected at $\\sqrt{s}=7,8,13$~TeV by each of the ATLAS and CMS experiments at the Large Hadron Collider in the first ten years of operation, top quark physics is probing uncharted territories in precision and rare measurements with sensitivity to New Physics processes. This document summarizes the latest experimental measurements and studies of top quark properties.

  11. Study of General health, resiliency, and defense mechanisms in patients with migraine headache

    Directory of Open Access Journals (Sweden)

    Alireza Aghayusefi

    2013-06-01

    Full Text Available Background: Migraine is a neurological disease that the etiology, several factors affect its onset or its exacerbation. One of the factors affecting disease is psychological factors such as defense mechanisms, resiliency, and general health. This study assessed the relationship between general health, resiliency, and general defense mechanisms, and also predicts the general health of people with migraine headaches that have a high resiliency and use mature defense mechanisms. Material and Methods: 50 women with migraine headache in the city of Bushehr using defense mechanisms, resiliency, and general health questionnaires were studied. For statistical analysis, Pearson correlation and multiple regression tests were used by SPSS 17 software. Results: The results showed that most of the defense mechanisms of migraine sufferers are Immature and Neuroticism. There is significant negative correlation between the deterioration of general health and resiliency as well as the mature defense mechanism (p=0/003, and also there is a significant positive correlation between this deterioration with neuroticism (p=0/040 and immature defense mechanisms (p=0/041. On the other hand there is significant negative correlation between resiliencies with immature (p=0/009 and neuroticism defense mechanisms (p=0/04, and also with mature defense mechanism has a significant positive correlation (p=0/003. Also, as more people use the mature defense mechanism, their deterioration of general health will be reduced, but this relationship will be stronger with the presence of resiliency. So migraine people use the mature defense mechanisms with high resiliency will have more favorable general health (less deterioration of general health. Conclusion: This study showed that migraine patients use the mature defense mechanisms with high resiliency will have more favorable general health (less deterioration of general health.

  12. Power plant design: ESBWR - the latest passive BWR

    International Nuclear Information System (INIS)

    Arnold, H.; Yadigaroglu, G.; Stoop, P.C.

    1997-01-01

    When General Electric said it would end development of its 670 MWe SBWR (Simplified Boiling Water Reactor), it was not quite the end of the story. Also on the drawing board at the time was the larger ESBWR (standing for either European or Economic Simplified BWR) whose goal was to provide the improved economic performance that the SBWR could not. (UK)

  13. Validation of general job satisfaction in the Korean Labor and Income Panel Study.

    Science.gov (United States)

    Park, Shin Goo; Hwang, Sang Hee

    2017-01-01

    The purpose of this study is to assess the validity and reliability of general job satisfaction (JS) in the Korean Labor and Income Panel Study (KLIPS). We used the data from the 17th wave (2014) of the nationwide KLIPS, which selected a representative panel sample of Korean households and individuals aged 15 or older residing in urban areas. We included in this study 7679 employed subjects (4529 males and 3150 females). The general JS instrument consisted of five items rated on a scale from 1 (strongly disagree) to 5 (strongly agree). The general JS reliability was assessed using the corrected item-total correlation and Cronbach's alpha coefficient. The validity of general JS was assessed using confirmatory factor analysis (CFA) and Pearson's correlation. The corrected item-total correlations ranged from 0.736 to 0.837. Therefore, no items were removed. Cronbach's alpha for general JS was 0.925, indicating excellent internal consistency. The CFA of the general JS model showed a good fit. Pearson's correlation coefficients for convergent validity showed moderate or strong correlations. The results obtained in our study confirm the validity and reliability of general JS.

  14. The latest Paleocene benthic extinction event: Punctuated turnover in outer neritic benthic foraminiferal faunas from Gebel Aweina, Egypt

    OpenAIRE

    Speijer, Robert; Schmitz, B; Aubry, MP; Charisi, SD

    1995-01-01

    We investigated the benthic foraminiferal record of the neritic sequence at Gebel Aweina (Nile Valley, Egypt) in relation to the latest Paleocene deep-sea benthic extinction event (BEE). At Gebel Aweina an expanded sequence, spanning calcareous nannofossil Zones NP8-NPlO, is continuously exposed and yields calcareous microfauna throughout. The BEE level is situated about halfway through Zone NP9 at 17m above the base of the Esna Formation. Detailed biostratigraphic and isotopic studies have i...

  15. Latest Results of Open Heavy Flavor and Quarkonia from the PHENIX Experiment at RHIC

    International Nuclear Information System (INIS)

    Nouicer, Rachid

    2017-01-01

    The PHENIX Collaboration carries out a comprehensive physics program which studies heavy flavor production in relativistic heavy ion collisions at RHIC. The discovery at RHIC of large high-p T suppression and flow of electrons from heavy quarks flavors have altered our view of the hot and dense matter formed in central Au+Au collisions at GeV. These results suggest a large energy loss and flow of heavy quarks in the hot, dense matter. In recent years, the PHENIX has installed a silicon vertex tracker both in central rapidity (VTX) and in forward rapidity (FVTX) regions, and has collected large data samples. These two silicon trackers enhance the capability of heavy flavor measurements via precision tracking. This paper summarizes some of the latest PHENIX results concerning open heavy flavor and quarkonia production as a function of rapidity, energy and system size. (paper)

  16. A qualitative study of the barriers and enablers to fertility-awareness education in general practice.

    Science.gov (United States)

    Hampton, Kerry D; Newton, Jennifer M; Parker, Rhian; Mazza, Danielle

    2016-07-01

    To understand the barriers and enablers to fertility-awareness education in general practice. Most women along with their primary care practitioners - general practitioners and practice nurses - believe that women should be educated about fertility-awareness when first reporting trouble conceiving. To date, no in-depth study has examined the enablers and challenges of this type of education in general practice. A descriptive exploratory qualitative study using deductive content analysis. General practitioners (N = 11) and practice nurses (N = 20) were recruited from general practices in three socioculturally diverse areas in Victoria, Australia. Data were collected through semistructured interviews based on the 12 domains of a theoretical behaviour change framework from April-August 2012. The participants' responses were organized into themes that fall under the framework domains. The biggest barriers to fertility-awareness education in general practice were short consultations and time constraints faced by general practitioners together with a lack of patient educational materials and remuneration to support its delivery. The biggest enablers were a greater use of nurses trained in fertility-awareness in a collaborative team care arrangement with general practitioners. This study has identified several important barriers and enablers to fertility-awareness education in general practice. Translation into practice of our findings is imperative as the first step in establishing a primary care model in fertility-awareness. This would fill an important gap in the primary care of infertile women and build capacity in general practice to reduce infertility through women's enhanced fertility knowledge. © 2016 John Wiley & Sons Ltd.

  17. Characteristics in mineral compositions of lunar latest mare volcanism revealed from spectral data

    Science.gov (United States)

    Kato, S.; Morota, T.; Yamaguchi, Y.; Watanabe, S.; Otake, H.; Ohtake, M.; Nimura, T.

    2016-12-01

    Lunar mare basalts provide insights into the composition and thermal history of the lunar mantle. According to crater counting analysis with remote sensing data, the ages of mare basalts suggest a first peak of magma activity at 3.2-3.8 Ga and a second peak at 2 Ga. In order to understand the mechanism for causing the second peak and its magma source, we reassess the correlation between the titanium contents and the eruption ages of mare basalt units using the compositional and chronological data updated by SELENE (Kaguya). In the Procellarum KREEP Terrane, where the latest mare basalt units are concentrated, an increase in the mean titanium content is observed in the Eratosthenian Period, as reported by previous studies. We found that, however, a rapid increase in mean titanium content occurred near 2.3 Ga. This result suggests that the magma source of the mare basalts changed at this particular age. Moreover, the high-titanium basaltic eruptions are correlated with the second peak in mare volcanism at 2 Ga. The latest mare volcanism may have been induced by a super-hot plume originating from the core-mantle boundary. In this study, to reveal the difference between the volcanic activities before and after 2.3 Ga, we developed the method to estimate the mineral components and elemental compositions of lunar mare basalts by using the Kaguya Spectral Profiler data. We will introduce the detail of the method and discuss about the difference between the mineral compositions of mare basalts before and after 2.3 Ga based on our preliminary results.

  18. Private or salaried practice: how do young general practitioners make their career choice? A qualitative study.

    Science.gov (United States)

    Kinouani, Shérazade; Boukhors, Gary; Luaces, Baptiste; Durieux, William; Cadwallader, Jean-Sébastien; Aubin-Auger, Isabelle; Gay, Bernard

    2016-09-01

    Young French postgraduates in general practice increasingly prefer salaried practice to private practice in spite of the financial incentives offered by the French government or local communities to encourage the latter. This study aimed to explore the determinants of choice between private or salaried practice among young general practitioners. A qualitative study was conducted in the South West of France. Semi-structured interviews of young general practitioners were audio-recorded until data saturation. Recordings were transcribed and then analyzed according to Grounded Theory by three researchers working independently. Sixteen general practitioners participated in this study. For salaried and private doctors, the main factors governing their choice were occupational factors: working conditions, need of varied scope of practice, quality of the doctor-patient relationship or career flexibility. Other factors such as postgraduate training, having worked as a locum or self-interest were also determining. Young general practitioners all expected a work-life balance. The fee-for-service scheme or home visits may have discouraged young general practitioners from choosing private practice. National health policies should increase the attractiveness of ambulatory general practice by promoting the diversification of modes of remuneration and encouraging the organization of group exercises in multidisciplinary medical homes and community health centers.

  19. Case Studies of Mental Health in General practice(28)---HIV and Mood Disturbance

    Institute of Scientific and Technical Information of China (English)

    Fiona Judd; Leon Piterman; Grant Blashki; Hui Yang

    2014-01-01

    The Journal presents the Column of Case Studies of Mental Health in General Practice;with aca-demic support from Australian eXperts in general practice,psychology and psychiatry from Monash University and the University of Mel-bourne. The Columnˊs purpose is to respond to the increasing need for the development of mental health services in China. Through study and analysis of mental health cases,we hope to improve understanding of mental illnesses in Chinese primary health settings,and to build capaci-ty amongst community health professionals in managing mental illnesses and psychological problems in general practice. A patient - centred whole - person approach in general practice is the best way to maintain and improve the physical and mental health of residents. Our hope is that these case studies will lead the new wave of general practice and mental health service development both in practice and research. A num-ber of Australian eXperts from the disciplines of general practice,mental health and psychiatry will contribute to the Column. Professor Blash-ki,Professor Judd and Professor Piterman are authors of the teXt General Practice Psychiatry;the Chinese version of the book to be published in 2014. The Journal cases are helping to prepare for the translation and publication of a Chinese version of the book in China. We believe Chi-nese mental health in primary health care will reach new heights under this international cooperation.

  20. Astrophysics of black holes from fundamental aspects to latest developments

    CERN Document Server

    2016-01-01

    This book discusses the state of the art of the basic theoretical and observational topics related to black hole astrophysics. It covers all the main topics in this wide field, from the theory of accretion disks and formation mechanisms of jet and outflows, to their observed electromagnetic spectrum, and attempts to measure the spin of these objects. Black holes are one of the most fascinating predictions of general relativity and are currently a very hot topic in both physics and astrophysics. In the last five years there have been significant advances in our understanding of these systems, and in the next five years it should become possible to use them to test fundamental physics, in particular to predict the general relativity in the strong field regime. The book is both a reference work for researchers and a textbook for graduate students.

  1. Tumour characteristics and survival in patients with invasive interval breast cancer classified according to mammographic findings at the latest screening

    DEFF Research Database (Denmark)

    Vitak, B; Olsen, K E; Månson, J C

    1999-01-01

    with invasive interval cancer detected from May 1978 to August 1995 (n = 544). The tumours were evaluated with regard to age, radiological category, interval between the latest screen and diagnosis and tumour characteristics at the time of diagnosis. We investigated possible relationships between the survival...... screen and diagnosis were not genuine predictors of the prognosis in patients with invasive interval breast cancer. No certain prognostic difference existed between true interval cancers and overlooked or misinterpreted interval breast cancers, despite higher proportions of grade-I tumours, ER positive......The aim of this study was to investigate whether different mammographic categories of interval cancer classified according to findings at the latest screening are associated with different distributions of prognostic factors or with different survival rates. The series consisted of all patients...

  2. 'Personal Care' and General Practice Medicine in the UK: A qualitative interview study with patients and General Practitioners.

    Science.gov (United States)

    Adam, Rachel

    2007-08-31

    Recent policy and organisational changes within UK primary care have emphasised graduated access to care, speed of access to the first available general practitioner (GP) and care being provided by a range of healthcare professionals. These trends have been strengthened by the current GP contract and Quality and Outcomes Framework (QOF). Concern has been expressed that the potential for personal care is being diminished as a result and that this will reduce quality standards. This paper presents data from a study that explored with patients and GPs what personal care means and whether it has continuing importance to them. A semi-structured questionnaire was used to interview participants and Framework Analysis supported analysis of emerging themes. Twenty-nine patients, mainly women with young children, and twenty-three GPs were interviewed from seven practices in Lothian, Scotland, ranged by practice size and relative deprivation score. Personal care was defined mainly, though not exclusively, as care given within the context of a continuing relationship in which there is an interpersonal connection and the doctor adopts a particular consultation style. Defined in this way, it was reported to have benefits for both health outcomes and patients' experience of care. In particular, such care was thought to be beneficial in attending to the emotions that can be elicited when seeking and receiving health care and in enabling patients to be known by doctors as legitimate seekers of care from the health service. Its importance was described as being dependent upon the nature of the health problem and patients' wider familial and social circumstances. In particular, it was found to provide support to patients in their parenting and other familial caring roles. Personal care has continuing salience to patients and GPs in modern primary care in the UK. Patients equate the experience of care, not just outcomes, with high quality care. As it is mainly conceptualised and

  3. Aging-related trajectories of lung function in the general population-The Doetinchem Cohort Study.

    NARCIS (Netherlands)

    van Oostrom, Sandra H; Engelfriet, Peter M; Verschuren, W M Monique; Schipper, Maarten; Wouters, Inge M; Boezen, Marike; Smit, Henriëtte A; Kerstjens, Huib A M; Picavet, H Susan J

    2018-01-01

    The objective of this study was to explore trajectories of lung function decline with age in the general population, and to study the effect of sociodemographic and life style related risk factors, in particular smoking and BMI. For this purpose, we used data from the Doetinchem Cohort Study (DCS)

  4. The structure of psychopathology in adolescence : Replication of a general psychopathology factor in the TRAILS study

    NARCIS (Netherlands)

    Laceulle, O.M.; Vollebergh, W.A.M.; Ormel, J.

    2015-01-01

    This study aimed to replicate a study by Caspi and colleagues, which proposed that the structure of psychopathology is characterized by a general psychopathology factor, in addition to smaller internalizing and externalizing factors. Our study expanded the approach of the original by using

  5. Relationships of Approaches to Studying, Metacognition, and Intellectual Development of General Chemistry Students

    Science.gov (United States)

    Egenti, Henrietta N.

    2012-01-01

    This study investigated approaches to studying, intellectual developments, and metacognitive skills of general chemistry students enrolled for the spring 2011 semester at a single campus of a multi-campus community college. The three instruments used were the Approaches and Study Skills Inventory for Students (ASSIST), the Learning Environment…

  6. Changes in pathology test ordering by early career general practitioners: a longitudinal study.

    Science.gov (United States)

    Magin, Parker J; Tapley, Amanda; Morgan, Simon; Henderson, Kim; Holliday, Elizabeth G; Davey, Andrew R; Ball, Jean; Catzikiris, Nigel F; Mulquiney, Katie J; van Driel, Mieke L

    2017-07-17

    To assess the number of pathology tests ordered by general practice registrars during their first 18-24 months of clinical general practice. Longitudinal analysis of ten rounds of data collection (2010-2014) for the Registrar Clinical Encounters in Training (ReCEnT) study, an ongoing, multicentre, cohort study of general practice registrars in Australia. The principal analysis employed negative binomial regression in a generalised estimating equations framework (to account for repeated measures on registrars).Setting, participants: General practice registrars in training posts with five of 17 general practice regional training providers in five Australian states. The registrar participation rate was 96.4%. Number of pathology tests requested per consultation. The time unit for analysis was the registrar training term (the 6-month full-time equivalent component of clinical training); registrars contributed data for up to four training terms. 876 registrars contributed data for 114 584 consultations. The number of pathology tests requested increased by 11% (95% CI, 8-15%; P pathology test ordering by general practice registrars increased significantly during their first 2 years of clinical practice. This causes concerns about overtesting. As established general practitioners order fewer tests than registrars, test ordering may peak during late vocational training and early career practice. Registrars need support during this difficult period in the development of their clinical practice patterns.

  7. The factors associated to psychosocial stress among general practitioners in Lithuania. Cross-sectional study

    Directory of Open Access Journals (Sweden)

    Vanagas Giedrius

    2005-06-01

    Full Text Available Abstract Background There are number of studies showing that general practice is one of the most stressful workplace among health care workers. Since Baltic States regained independence in 1990, the reform of the health care system took place in which new role and more responsibilities were allocated to general practitioners' in Lithuania. This study aimed to explore the psychosocial stress level among Lithuanian general practitioner's and examine the relationship between psychosocial stress and work characteristics. Methods The cross-sectional study of 300 Lithuanian General practitioners. Psychosocial stress was investigated with a questionnaire based on the Reeder scale. Job demands were investigated with the R. Karasek scale. The analysis included descriptive statistics; interrelationship analysis between characteristics and multivariate logistic regression to estimate odds ratios for each of the independent variables in the model. Results Response rate 66% (N = 197. Our study highlighted highest prevalence of psychosocial stress among widowed, single and female general practitioners. Lowest prevalence of psychosocial stress was among males and older age general practitioners. Psychosocial stress occurs when job demands are high and job decision latitude is low (χ2 = 18,9; p Conclusion One half of respondents suffering from work related psychosocial stress. High psychological workload demands combined with low decision latitude has the greatest impact to stress caseness among GP's. High job demands, high patient load and young age of GP's can be assigned as significant predictors of psychosocial stress among GP's.

  8. Old persons' contact with general practitioners in relation to health: a Danish population study

    DEFF Research Database (Denmark)

    Almind, G; Holstein, B E; Holst, E

    1991-01-01

    The study describes health, social situation, and contact with general practitioners in a random sample of non-institutionalized persons 70-95 years old in Denmark. There was a strong correlation between health and contact with general practitioners. A small group, 3% of the respondents, had...... no health problems, but had been in contact with a general practitioner within the previous month. This group was characterized by a strong social network and a high degree of life satisfaction. Another small group, including 3% of the respondents, had extensive health problems, but had nevertheless...

  9. Studying emotion theories through connectivity analysis: Evidence from generalized psychophysiological interactions and graph theory.

    Science.gov (United States)

    Huang, Yun-An; Jastorff, Jan; Van den Stock, Jan; Van de Vliet, Laura; Dupont, Patrick; Vandenbulcke, Mathieu

    2018-05-15

    Psychological construction models of emotion state that emotions are variable concepts constructed by fundamental psychological processes, whereas according to basic emotion theory, emotions cannot be divided into more fundamental units and each basic emotion is represented by a unique and innate neural circuitry. In a previous study, we found evidence for the psychological construction account by showing that several brain regions were commonly activated when perceiving different emotions (i.e. a general emotion network). Moreover, this set of brain regions included areas associated with core affect, conceptualization and executive control, as predicted by psychological construction models. Here we investigate directed functional brain connectivity in the same dataset to address two questions: 1) is there a common pathway within the general emotion network for the perception of different emotions and 2) if so, does this common pathway contain information to distinguish between different emotions? We used generalized psychophysiological interactions and information flow indices to examine the connectivity within the general emotion network. The results revealed a general emotion pathway that connects neural nodes involved in core affect, conceptualization, language and executive control. Perception of different emotions could not be accurately classified based on the connectivity patterns from the nodes of the general emotion pathway. Successful classification was achieved when connections outside the general emotion pathway were included. We propose that the general emotion pathway functions as a common pathway within the general emotion network and is involved in shared basic psychological processes across emotions. However, additional connections within the general emotion network are required to classify different emotions, consistent with a constructionist account. Copyright © 2018 Elsevier Inc. All rights reserved.

  10. General practitioners' views on leadership roles and challenges in primary health care: a qualitative study

    OpenAIRE

    Spehar, Ivan; Sjøvik, Hege; Karevold, Knut Ivar; Rosvold, Elin Olaug; Frich, Jan C

    2017-01-01

    Objective To explore general practitioners? (GPs) views on leadership roles and leadership challenges in general practice and primary health care. Design We conducted focus groups (FGs) with 17 GPs. Setting Norwegian primary health care. Subjects 17 GPs who attended a 5 d course on leadership in primary health care. Results Our study suggests that the GPs experience a need for more preparation and formal training for the leadership role, and that they experienced tensions between the clinical...

  11. Study of generalized parton distributions and deeply virtual Compton scattering on the nucleon with the CLAS and CLAS12 detectors at the Jefferson Laboratory (Virginia, US)

    International Nuclear Information System (INIS)

    Guegan, B.

    2012-11-01

    The Generalized Parton Distributions (GPDs) provide a new description of the nucleon structure in terms of its elementary constituents, the quarks and the gluons. The GPDs give access to a unified picture of the nucleon, correlating the information obtained from the measurements of the Form Factors and the Parton Distribution Functions. They describe the correlation between the transverse position and the longitudinal momentum fraction of the partons in the nucleon. Deeply Virtual Compton Scattering (DVCS), the electroproduction of a real photon on a single quark of the nucleon eN → e'N'γ, is the most straightforward exclusive process allowing access to the GPDs. A dedicated experiment to study DVCS with the CLAS detector of Jefferson Lab has been carried out using a 5.883 GeV polarized electron beam and an unpolarized hydrogen target, allowing to collect DVCS events in the widest kinematic range ever explored in the valence region: 1 2 2 , 0.1 B 2 . In this work, we present the extraction of three different DVCS observables: the unpolarized cross section, the difference of polarized cross sections and the beam spin asymmetry. We present comparisons with GPD model. We show a preliminary extraction of the GPDs using the latest fitting code procedure on our data, and a preliminary interpretation of the results in terms of parton density. (author)

  12. A Comparison Study of Communication Skills between General Surgery and General Practice Residents on First-time Patient Visits

    Directory of Open Access Journals (Sweden)

    Ahmed Al Ansari

    2012-04-01

    Full Text Available Background: There is little published research about differences in doctor-patient communication of different specialties. Accordingly, we compared doctor-patient communication skills in two different specialties, general surgery (GS and general practice (GP. Methods: Twenty residents training at the Bahrain Defence Force Hospital (10 men and 10 women; mean age 28 years; 10 GS and 10 GP participated in 200 patient first visit consultations. The consultations were video-recorded and analysed by four trained observers using the MAAS Global scale. Results: 1 Internal consistency reliability of the MAAS Global (> 0.91 and Ep2 = 0.84 for raters was high, 2 GP residents spent more time (12 minutes than GS residents (7 minutes, in the visits, 3 There were several differences on the MAAS Global items between GP and GS residents (GS > GP, p GS, p < 0.05 on information giving, and 4 The present participants performed well compared to normative samples as well as to criterion-referenced cut-off scores. The general level of communication skills in both specialties, however, was ‘unsatisfactory’ and ‘doubtful’, as it is for normative samples. Conclusion: Excellent doctor-patient communication is essential but does not appear to receive the amount of attention that it deserves in practice settings. There are some differences between specialties as well as unsatisfactory communication skills for both specialties, since residents from both programs spent less time than recommended on each consultation. Our findings emphasize the need to improve the communication skills of physicians in general and for surgeons in particular.

  13. Attitudes of newly qualified doctors towards a career in general practice: a qualitative focus group study.

    Science.gov (United States)

    Merrett, Alexandra; Jones, Daniel; Sein, Kim; Green, Trish; Macleod, Una

    2017-04-01

    A key element of the NHS is universal access to a GP. Recently, UK general practice has been described as being in crisis, with training places unfilled and multiple practices reporting vacancies or facing closure. The recruitment of GPs continues to be a key focus for both the Royal College of General Practitioners (RCGP) and the government. To understand the attitudes of newly qualified doctors towards a career in general practice, to appreciate potential reasons for the crisis in GP recruitment, and to recommend ways to improve recruitment. A qualitative study comprising five focus groups with 74 Foundation Year 1 (FY1) doctors from one Yorkshire deanery. Audio recordings were transcribed verbatim and thematic analysis undertaken. Foundation Year 1 doctors' thoughts towards a career in general practice were summarised in four themes: quality of life, job satisfaction, uncertainty surrounding the future of general practice, and the lack of respect for GPs among both doctors and the public. Participants felt that general practice could provide a good work-life balance, fair pay, and job stability. Job satisfaction, with the ability to provide care from the cradle to the grave, and to work within a community, was viewed positively. Uncertainties around future training, skill levels, pay, and workload, together with a perceived stigma experienced in medical schools and hospitals, were viewed as a deterrent to a career in general practice. This study has gathered the opinions of doctors at a critical point in their careers, before they choose a future specialty. Findings highlight areas of concern and potential deterrents to a career in general practice, together with recommendations to address these issues. © British Journal of General Practice 2017.

  14. Latest news from the YETS: all restarting except the LHC

    CERN Multimedia

    Antonella Del Rosso

    2016-01-01

    With the closure of the SPS at 3 p.m. on Friday, 19 February, maintenance work is now ongoing only at the LHC. All activities are on track for a smooth restart in a few weeks’ time.   At the LHC, all general maintenance activities are proceeding well and according to schedule. In particular, the electrical tests on the general emergency stops have been completed, while the cooling and ventilation maintenance, including leak repairs at various points, will be completed by the end of this week for the whole machine. By the end of next week, the teams will also have completed the bakeout and commissioning of all the collimators, while the installation of coaxial cable for clock distribution for CMS TOTEM has been postponed to the Extended Year-End Technical Stop (EYETS), scheduled to start in December. Following a recent decision, additional electrical tests of the circuits (ELQA and energy extraction insulation tests) for the whole machine have been added to the schedule. The SPS is currentl...

  15. The process of patient enablement in general practice nurse consultations: a grounded theory study.

    Science.gov (United States)

    Desborough, Jane; Banfield, Michelle; Phillips, Christine; Mills, Jane

    2017-05-01

    The aim of this study was to gain insight into the process of patient enablement in general practice nursing consultations. Enhanced roles for general practice nurses may benefit patients through a range of mechanisms, one of which may be increasing patient enablement. In studies with general practitioners enhanced patient enablement has been associated with increases in self-efficacy and skill development. This study used a constructivist grounded theory design. In-depth interviews were conducted with 16 general practice nurses and 23 patients from 21 general practices between September 2013 - March 2014. Data generation and analysis were conducted concurrently using constant comparative analysis and theoretical sampling focussing on the process and outcomes of patient enablement. Use of the storyline technique supported theoretical coding and integration of the data into a theoretical model. A clearly defined social process that fostered and optimised patient enablement was constructed. The theory of 'developing enabling healthcare partnerships between nurses and patients in general practice' incorporates three stages: triggering enabling healthcare partnerships, tailoring care and the manifestation of patient enablement. Patient enablement was evidenced through: 1. Patients' understanding of their unique healthcare requirements informing their health seeking behaviours and choices; 2. Patients taking an increased lead in their partnership with a nurse and seeking choices in their care and 3. Patients getting health care that reflected their needs, preferences and goals. This theoretical model is in line with a patient-centred model of health care and is particularly suited to patients with chronic disease. © 2016 John Wiley & Sons Ltd.

  16. Latest data shows long-term security of uranium supply

    International Nuclear Information System (INIS)

    2010-01-01

    Full text: According to Uranium 2009: Resources, Production and Demand just published by the OECD Nuclear En ergy Agency (NEA) and the International Atomic Energy Agency (IAEA), uranium resources, production and demand are all on the rise. Exploration efforts have increased recently in line with the expected expansion of nuclear energy in the coming years. Total identified resources have grown but so too have costs of production. Worldwide exploration and mine development expenditures have more than doubled since the publication of the previous edition, Uranium 2007: Resources, Production and Demand. These expenditures have increased despite declining uranium market prices since mid- 2007. The uranium resources presented in this edition, reflecting the situation as of 1 January 2009, show that total identified resources amounted to 6 306 300 tU, an increase of about 15% compared to 2007, including those reported in the high-cost category (< USD 260/kgU or < USD 100/lbU O), reintroduced for the first time since the 1980s. This high-cost 3 8 category was used in the 2009 edition in response to the generally increased market prices for uranium in recent years, despite the decline since mid-2007, expectations of increasing demand as new nuclear power plants are being planned and built, and increased mining costs. Although total identified resources have increased overall, there has been a significant reduction in lower-cost resources owing to increased mining costs. At 2008 rates of consumption, total identified resources are sufficient for over 100 years of supply. The recognition by an increasing number of governments that nuclear power can produce competitively priced, baseload electricity that is essentially free of greenhouse gas emissions, coupled with the role that nuclear can play in enhancing security of energy supply, increases the prospects for growth in nuclear generating capacity, although the magnitude of that growth remains to be determined. According to

  17. Information Seeking Behaviour of Senior High School Student on General Election: Case Study In Indonesia

    Directory of Open Access Journals (Sweden)

    Margareta Aulia Rachman

    2018-01-01

    Full Text Available The development of information technology affects students in searching and finding information, particularly information regarding the General Election. The explosion of information on mass media about the elections resulted impact (both positive and negative to the potential voters. Nowadays, media plays role as a tool for political parties to lead public opinion to support their parties. Based on the data provided by General Election Commission (KPU in 2014, 20% of voters were identified as students (teens. This is a qualitative research with case study method which aims to gain insight about interpretation, understanding, perceptions and feelings of teenage voters’ behavior in searching and finding information about general election in Indonesia year 2014. The data were collected by conducting interview and observation. Informants in this study were students, aged 17-18 years, who studying in government senior high school in Depok. The results of this study indicates that informants using social media to keep update about general election. Besides, they also gain information from their parents and close friends. Unfortunatelly, they were not able to identify which information which are correct or not, so they rely on people around them to make sure whether they did right decision. Therefore, this study also suggest that KPU needs to develop promotion strategy that suitable for teens about general election.

  18. Understanding general practice: a conceptual framework developed from case studies in the UK NHS.

    Science.gov (United States)

    Checkland, Kath

    2007-01-01

    General practice in the UK is undergoing a period of rapid and profound change. Traditionally, research into the effects of change on general practice has tended to regard GPs as individuals or as members of a professional group. To understand the impact of change, general practices should also be considered as organisations. To use the organisational studies literature to build a conceptual framework of general practice organisations, and to test and develop this empirically using case studies of change in practice. This study used the implementation of National Service Frameworks (NSFs) and the new General Medical Services (GMS) contract as incidents of change. In-depth, qualitative case studies. The design was iterative: each case study was followed by a review of the theoretical ideas. The final conceptual framework was the result of the dynamic interplay between theory and empirical evidence. Five general practices in England, selected using purposeful sampling. Semi-structured interviews with all clinical and managerial personnel in each practice, participant and nonparticipant observation, and examination of documents. A conceptual framework was developed that can be used to understand how and why practices respond to change. This framework enabled understanding of observed reactions to the introduction of NSFs and the new GMS contract. Important factors for generating responses to change included the story that the practice members told about their practice, beliefs about what counted as legitimate work, the role played by the manager, and previous experiences of change. Viewing general practices as small organisations has generated insights into factors that influence responses to change. Change tends to occur from the bottom up and is determined by beliefs about organisational reality. The conceptual framework suggests some questions that can be asked of practices to explain this internal reality.

  19. High resolution sea-level curve for the latest Frasnian and earliest Famennian derived for high frequency sequences in the Appalachian Basin

    Energy Technology Data Exchange (ETDEWEB)

    Filer, J.K. (Washington and Lee Univ., Lexington, VA (United States). Dept. of Geology)

    1992-01-01

    Siliciclastic sequences have been mapped in the subsurface and outcrop of much of the Appalachian basin in facies ranging from shale in the basin plain to shelf sandstone. Eleven transgressive/regressive cycles have been defined in an estimated 1.5 to 2.0 Ma period in the latest Frasnian and earliest Famennian, and range in duration from about 75,000 to 400,000 years. Lithofacies maps, covering most of the basin, were prepared for each sequence. These maps show both the area of basinal black shale deposition, which defines the base of each cycle, and the areal extent of subsequent clinoform siltstone and shelf sandstone deposition in the upper portion of each cycle. The stratigraphic patterns show two stacked sets of progradational basinwide sequences. Geographic scale of the study precludes autocyclic controls of cycles. Sea-level/climate cycles, probably superimposed on longer term tectonic cycles, are the proposed cause of these observed depositional patterns. Removal of the long-term progradational trend of Upper Devonian basin filling results in a proposed eustatic sea-level curve (Johnson and others (1985)) reveals correspondence of three regressive maxima in both models. The curve presented here reveals that an ongoing process of higher frequency sea-level modification was active at this time. Higher frequency sea-level events, nested within previously interpreted lower frequency global events, are inferred to also be eustatic. Models of a biotic crises which occurs at this time should consider the implications of these high frequency sea-level cycles. The patterns observed are consistent with latest Frasnian initiation of glaciation in South America. This would be somewhat earlier than has generally been accepted.

  20. A Reliability Generalization Study of the Marlowe-Crowne Social Desirability Scale.

    Science.gov (United States)

    Beretvas, S, Natasha; Meyers, Jason L.; Leite, Walter L.

    2002-01-01

    Conducted a reliability generalization study of the Marlowe-Crowne Social Desirability Scale (D. Crowne and D. Marlowe, 1960). Analysis of 93 studies show that the predicted score reliability for male adolescents was 0.53, and reliability for men's responses was lower than for women's. Discusses the need for further analysis of the scale. (SLD)

  1. A Reliability Generalization Study of Scores on Rotter's and Nowicki-Strickland's Locus of Control Scales

    Science.gov (United States)

    Beretvas, S. Natasha; Suizzo, Marie-Anne; Durham, Jennifer A.; Yarnell, Lisa M.

    2008-01-01

    The most commonly used measures of locus of control are Rotter's Internality-Externality Scale (I-E) and Nowicki and Strickland's Internality-Externality Scale (NSIE). A reliability generalization study is conducted to explore variability in I-E and NSIE score reliability. Studies are coded for aspects of the scales used (number of response…

  2. The Benchmarking Capacity of a General Outcome Measure of Academic Language in Science and Social Studies

    Science.gov (United States)

    Mooney, Paul; Lastrapes, Renée E.

    2016-01-01

    The amount of research evaluating the technical merits of general outcome measures of science and social studies achievement is growing. This study targeted criterion validity for critical content monitoring. Questions addressed the concurrent criterion validity of alternate presentation formats of critical content monitoring and the measure's…

  3. Barriers to the implementation of preconception care guidelines as perceived by general practitioners: a qualitative study

    Directory of Open Access Journals (Sweden)

    Mazza Danielle

    2013-01-01

    Full Text Available Abstract Background Despite strong evidence of the benefits of preconception interventions for improving pregnancy outcomes, the delivery and uptake of preconception care and periconceptional folate supplementation remain low. General practitioners play a central role in the delivery of preconception care. Understanding general practitioners’ perceptions of the barriers and enablers to implementing preconception care allows for more appropriate targeting of quality improvement interventions. Consequently, the aim of this study was to examine the barriers and enablers to the delivery and uptake of preconception care guidelines from general practitioners’ perspective using theoretical domains related to behaviour change. Methods We conducted a qualitative study using focus groups consisting of 22 general practitioners who were recruited from three regional general practice support organisations. Questions were based on the theoretical domain framework, which describes 12 domains related to behaviour change. General practitioners’ responses were classified into predefined themes using a deductive process of thematic analysis. Results Beliefs about capabilities, motivations and goals, environmental context and resources, and memory, attention and decision making were the key domains identified in the barrier analysis. Some of the perceived barriers identified by general practitioners were time constraints, the lack of women presenting at the preconception stage, the numerous competing preventive priorities within the general practice setting, issues relating to the cost of and access to preconception care, and the lack of resources for assisting in the delivery of preconception care guidelines. Perceived enablers identified by general practitioners included the availability of preconception care checklists and patient brochures, handouts, and waiting room posters outlining the benefits and availability of preconception care consultations

  4. Work related stress, burnout, job satisfaction and general health of nurses: A follow-up study.

    Science.gov (United States)

    Khamisa, Natasha; Peltzer, Karl; Ilic, Dragan; Oldenburg, Brian

    2016-12-01

    Nurses experience high levels of work related stress and burnout as well as low job satisfaction and poor general health owing to the nature of their work. This paper seeks to provide a better understanding of the nature of relationships between work related stress, burnout, job satisfaction and general health of nurses over one year. This study involved a longitudinal design. Two hundred and seventy seven nurses from four hospitals completed a follow up survey consisting of five questionnaires. Data were collected between 2013 and 2014. The data were analysed using generalized estimation equation analysis. Lack of support was associated with burnout, patient care was associated with job satisfaction and staff issues were associated with general health of nurses. Burnout is more strongly related to job satisfaction than general health. The findings of this study could inform evidence based policy and practice through interventions aimed at improving job satisfaction and reducing the impact of burnout on general health of nurses. © 2016 John Wiley & Sons Australia, Ltd.

  5. Latest developments in the utilization of coal mining wastes

    Energy Technology Data Exchange (ETDEWEB)

    Canibano, J G [HUNOSA, Oviedo (Spain)

    1996-12-31

    This report summarizes recent studies carried out on coal mining wastes (minestones) of Spain. These studies proved that such wastes can be used as filling materials in reinforced earth structures, capping layers of roads, substratum in hydroponic cultures and fuel.

  6. Surgery or general medicine: a study of the reasons underlying the choice of medical specialty

    Directory of Open Access Journals (Sweden)

    Patrícia Lacerda Bellodi

    Full Text Available CONTEXT: The reality of medical services in Brazil points towards expansion and diversification of medical knowledge. However, there are few Brazilian studies on choosing a medical specialty. OBJECTIVE: To investigate and characterize the process of choosing the medical specialty among Brazilian resident doctors, with a comparison of the choice between general medicine and surgery. TYPE OF STUDY: Stratified survey. SETTING: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HC-FMUSP. METHODS: A randomized sample of resident doctors in general medicine (30 and surgery (30 was interviewed. Data on sociodemographic characteristics and the moment, stability and reasons for the choice of specialty were obtained. RESULTS: The moment of choice between the two specialties differed. Surgeons (30% choose the specialty earlier, while general doctors decided progressively, mainly during the internship (43%. Most residents in both fields (73% general medicine, 70% surgery said they had considered another specialty before the current choice. The main reasons for general doctors' choice were contact with patients (50%, intellectual activities (30% and knowledge of the field (27%. For surgeons the main reasons were practical intervention (43%, manual activities (43% and the results obtained (40%. Personality was important in the choice for 20% of general doctors and for 27% of surgeons. DISCUSSION: The reasons found for the choice between general medicine and surgery were consistent with the literature. The concepts of wanting to be a general doctor or a surgeon are similar throughout the world. Personality characteristics were an important influencing factor for all residents, without statistical difference between the specialties, as was lifestyle. Remuneration did not appear as a determinant. CONCLUSION: The results from this group of Brazilian resident doctors corroborated data on choosing a medical specialty from other countries

  7. Sport nutrition: A review of the latest guidelines for exercise and ...

    African Journals Online (AJOL)

    Sport nutrition: A review of the latest guidelines for exercise and sport nutrition from the American College of Sport Nutrition, the International Olympic Committee and the International Society for Sports Nutrition.

  8. Industrial production of SC RF accelerating cavities at CERCA. Latest results

    International Nuclear Information System (INIS)

    Boutes, J.L.; Maccioni, P.

    1996-01-01

    CERCA is one of the most experienced companies throughout the world for the manufacture of superconducting RF accelerating devices. The latest results obtained during the past 2 years on CERCA's superconducting cavities are presented. (K.A.)

  9. General siting study 95. Siting of a deep repository for spent nuclear fuel

    International Nuclear Information System (INIS)

    1995-10-01

    General Siting Study 95 is a detailed description of the work carried out to put the siting of a deep repository in a national and regional context. The report is based on SKB's siting factors, which have been applied on a national scale. Different factors of importance or of possible importance for the long-term radiological safety, technology, land and environment as well as society are described and evaluated. This report is the overall description on general siting studies which the government considered that SKB should report in connection with the RD and D Programme 95. 121 refs, 40 figs

  10. Integrated logistic support studies using behavioral Monte Carlo simulation, supported by Generalized Stochastic Petri Nets

    International Nuclear Information System (INIS)

    Garnier, Robert; Chevalier, Marcel

    2000-01-01

    Studying large and complex industrial sites, requires more and more accuracy in modeling. In particular, when considering Spares, Maintenance and Repair / Replacement processes, determining optimal Integrated Logistic Support policies requires a high level modeling formalism, in order to make the model as close as possible to the real considered processes. Generally, numerical methods are used to process this kind of study. In this paper, we propose an alternate way to process optimal Integrated Logistic Support policy determination when dealing with large, complex and distributed multi-policies industrial sites. This method is based on the use of behavioral Monte Carlo simulation, supported by Generalized Stochastic Petri Nets. (author)

  11. General siting study 95. Siting of a deep repository for spent nuclear fuel

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-10-01

    General Siting Study 95 is a detailed description of the work carried out to put the siting of a deep repository in a national and regional context. The report is based on SKB`s siting factors, which have been applied on a national scale. Different factors of importance or of possible importance for the long-term radiological safety, technology, land and environment as well as society are described and evaluated. This report is the overall description on general siting studies which the government considered that SKB should report in connection with the RD and D Programme 95. 121 refs, 40 figs.

  12. Providing floating capabilities in latest-generation sand screens

    Energy Technology Data Exchange (ETDEWEB)

    Bowen, E.G.; Coronado, M.P. [Society of Petroleum Engineers, Richardson, TX (United States)]|[Baker Hughes, Houston, TX (United States)

    2008-10-15

    Alternative production methods are needed for the massive reserves located in the bitumen region of Canada's tar sands. The area has over 100 installations of sand screens/slotted liners in both injection and production legs using steam-assisted gravity drainage (SAGD) technology. Multiple wells must be drilled from a single pad because of the sensitive nature of the environment. With significant depths of these wells, a floating sand screen provides assurance that the sand screen will reach the desired depth. Paraffin is generally used to plug the flow access of the screen during installation. This paper discussed a new technology that has been developed to allow for sand screen installations without relying on paraffin wax to withstand differential pressure. The new technology uses a hydro-mechanical valving system incorporated into the screen design to temporarily close off the screen while being run in the hole. The paper described how the technology could provide a reliable, time-saving solution for SAGD installations when floating sand control screens are needed. The paper discussed current technology and its limitations, sand screen installation, screen design for floating applications, and additional applications. It was concluded that this technology solution provides a unique alternative to the methods currently used to install sand screens with SAGD technology in the fast growing Canadian market for bitumen recovery. 2 refs., 5 figs.

  13. Numerical modelling of river morphodynamics: Latest developments and remaining challenges

    Science.gov (United States)

    Siviglia, Annunziato; Crosato, Alessandra

    2016-07-01

    Numerical morphodynamic models provide scientific frameworks for advancing our understanding of river systems. The research on involved topics is an important and socially relevant undertaking regarding our environment. Nowadays numerical models are used for different purposes, from answering questions about basic morphodynamic research to managing complex river engineering problems. Due to increasing computer power and the development of advanced numerical techniques, morphodynamic models are now more and more used to predict the bed patterns evolution to a broad spectrum of spatial and temporal scales. The development and the success of application of such models are based upon a wide range of disciplines from applied mathematics for the numerical solution of the equations to geomorphology for the physical interpretation of the results. In this light we organized this special issue (SI) soliciting multidisciplinary contributions which encompass any aspect needed for the development and applications of such models. Most of the papers in the SI stem from contributions to session HS9.5/GM7.11 on numerical modelling and experiments in river morphodynamics at the European Geosciences Union (EGU) General Assembly held in Vienna, April 27th to May 2nd 2014.

  14. General Health Status Among Students of Islamic Azad University: A Cross-Sectional Study from Iran

    Directory of Open Access Journals (Sweden)

    Mohammad Taghi Savadpour

    2015-06-01

    Full Text Available Background & Aims of the Study: Health is one of the basic needs of human. There is a close relationship between physical and mental health. Human psyche is directly affected by his physical condition, and mutually his body and actions of human systems are influenced by psychological and mental space. Students because of their particular circumstances are vulnerable to mental health problems. The purpose of this study is to determine the general health status of students of Islamic Azad University. Materials & Methods: This descriptive analytical research was conducted on 478 students of Khalkhal Islamic Azad University. Simple random sampling method was used. General health questionnaire (GHQ-28 was used as research tool. Following data collection, data were analyzed using SPSS Software 13. Results: The results show that mean score of general health of the subjects is higher than cutoff. In this study, 21.3 percent of students were suspected of impaired health. Also, status of general health of female students was worse than male students and significant statistical relationship was observed between general health status and all its sub-scales except depression and gender (P < 0.5. Conclusions: G eneral health of students especially female students is impaired which may considerably affect their learning and performance and academic achievement.

  15. The presence of resuscitation equipment and influencing factors at General Practitioners' offices in Denmark: a cross-sectional study.

    Science.gov (United States)

    Niegsch, Mark L; Krarup, Nikolaj T; Clausen, Niels Erikstrup

    2014-01-01

    Automated external defibrillators (AEDs) have proven effective when used by GPs. Despite this and the latest guidelines from the European Resuscitation Council, there are no recommendations for Danish GPs regarding proper equipment to treat cardiac arrest. Currently, there are no published data on the distribution of AEDs among GPs in Denmark. To assess the prevalence of resuscitation equipment and educated staff among Danish GPs and the parameters influencing the absence of AEDs at GP offices. A cross-sectional questionnaire-based survey among the 2030 GPs registered in Denmark. Questions concerned demographics, occurrence of resuscitation equipment and attitude towards acquisition of an AED. With a response rate >70%, we found that the prevalence of AEDs in GP offices is low (31.7%). Limited financial possibilities and relevant treatment by ambulance personnel were stated as the primary causes for not having an AED. In general, Danish primary care physicians believe that AEDs should be governmentally sponsored. Positive influential factors on the acquisition of an AED were education, number of physicians in the GP office and previous experience of cardiac arrest. Danish primary care physicians are generally not equipped with AEDs despite the proven effect of AEDs in GP offices. The main reasons for not acquiring an AED are financial considerations and believing that response time by ambulance services and nearby health facilities are the optimal treatment. We recommend better education and information in order to facilitate future acquisition of AEDs among GPs. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  16. The impact of general anesthesia on child development and school performance: a population-based study.

    Science.gov (United States)

    Schneuer, Francisco J; Bentley, Jason P; Davidson, Andrew J; Holland, Andrew Ja; Badawi, Nadia; Martin, Andrew J; Skowno, Justin; Lain, Samantha J; Nassar, Natasha

    2018-04-27

    There has been considerable interest in the possible adverse neurocognitive effects of exposure to general anesthesia and surgery in early childhood. The aim of this data linkage study was to investigate developmental and school performance outcomes of children undergoing procedures requiring general anesthesia in early childhood. We included children born in New South Wales, Australia of 37+ weeks' gestation without major congenital anomalies or neurodevelopmental disability with either a school entry developmental assessment in 2009, 2012, or Grade-3 school test results in 2008-2014. We compared children exposed to general anesthesia aged <48 months to those without any hospitalization. Children with only 1 hospitalization with general anesthesia and no other hospitalization were assessed separately. Outcomes included being classified developmentally high risk at school entry and scoring below national minimum standard in school numeracy and reading tests. Of 211 978 children included, 82 156 had developmental assessment and 153 025 had school test results, with 12 848 (15.7%) and 25 032 (16.4%) exposed to general anesthesia, respectively. Children exposed to general anesthesia had 17%, 34%, and 23% increased odds of being developmentally high risk (adjusted odds ratio [aOR]: 1.17; 95% CI: 1.07-1.29); or scoring below the national minimum standard in numeracy (aOR: 1.34; 95% CI: 1.21-1.48) and reading (aOR: 1.23; 95% CI: 1.12-1.36), respectively. Although the risk for being developmentally high risk and poor reading attenuated for children with only 1 hospitalization and exposure to general anesthesia, the association with poor numeracy results remained. Children exposed to general anesthesia before 4 years have poorer development at school entry and school performance. While the association among children with 1 hospitalization with 1 general anesthesia and no other hospitalization was attenuated, poor numeracy outcome remained. Further investigation of

  17. Raiders of the Latest Art: American Treasure Trove.

    Science.gov (United States)

    May, Mary Jo

    1986-01-01

    Lists writing exercises based on observations students can make in a shopping mall. Notes that the exercises are intended to become a springboard for study, description, conjecture, evidence, example, and innovation, and can be combined, expanded, or shortened. (EL)

  18. [A competency model of rural general practitioners: theory construction and empirical study].

    Science.gov (United States)

    Yang, Xiu-Mu; Qi, Yu-Long; Shne, Zheng-Fu; Han, Bu-Xin; Meng, Bei

    2015-04-01

    To perform theory construction and empirical study of the competency model of rural general practitioners. Through literature study, job analysis, interviews, and expert team discussion, the questionnaire of rural general practitioners competency was constructed. A total of 1458 rural general practitioners were surveyed by the questionnaire in 6 central provinces. The common factors were constructed using the principal component method of exploratory factor analysis and confirmatory factor analysis. The influence of the competency characteristics on the working performance was analyzed using regression equation analysis. The Cronbach 's alpha coefficient of the questionnaire was 0.974. The model consisted of 9 dimensions and 59 items. The 9 competency dimensions included basic public health service ability, basic clinical skills, system analysis capability, information management capability, communication and cooperation ability, occupational moral ability, non-medical professional knowledge, personal traits and psychological adaptability. The rate of explained cumulative total variance was 76.855%. The model fitting index were Χ(2)/df 1.88, GFI=0.94, NFI=0.96, NNFI=0.98, PNFI=0.91, RMSEA=0.068, CFI=0.97, IFI=0.97, RFI=0.96, suggesting good model fitting. Regression analysis showed that the competency characteristics had a significant effect on job performance. The rural general practitioners competency model provides reference for rural doctor training, rural order directional cultivation of medical students, and competency performance management of the rural general practitioners.

  19. [Violence for educational purpose: Representations of general practitioners in the Paris area, France. A qualitative study].

    Science.gov (United States)

    de Brie, Claire; Piet, Emmanuelle; Chariot, Patrick

    2018-03-01

    Violence for educational purpose refers to a modality of education that includes threats, verbal abuse, physical abuse and humiliations. Twenty European countries, not including France, have abolished corporal punishment through explicit laws and regulations. The position of general practitioners in the screening and care of violence for educational purpose in France is unknown. In this study, we aimed to assess the representations of this form of violence among general practitioners. We have performed semi-directed interviews of general practitioners in the Paris, France region (Île-de-France). Interviews were conducted until data saturation was achieved. Interviews were recorded, transcribed and analysed by two investigators. Interviews were conducted with 20 physicians (November 2015-January 2016). General practitioners considered that physical, verbal or psychological abuse had possible negative consequences on children. Uncertainty regarding the consequences of violence was a cause of tolerance towards violence for educational purpose, depending on the act committed and the context, as perceived by nearly all practitioners. General practitioners expressed interest in the field. They cited their own education and experience as the main obstacles to action. Most of them expressed a feeling of failure when they screened or took care of violence for educational purpose. This study suggests that doctors can participate in supporting the parents in the prevention of violence for educational purpose. Support to parents would need specific medical training as well as a societal change. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  20. Nonallergic rhinitis and its association with smoking and lower airway disease: A general population study

    DEFF Research Database (Denmark)

    Håkansson, Kåre; von Buchwald, Christian; Thomsen, Simon F

    2011-01-01

    The cause of nonallergic rhinitis (NAR) and its relation to lower airway disease remains unclear. The purpose of this study was to perform a descriptive analysis of the occurrence of rhinitis in a Danish general population with focus on NAR and its association with smoking and lower airway disease....

  1. Reader reaction on the generalized Kruskal-Wallis test for genetic association studies incorporating group uncertainty.

    Science.gov (United States)

    Wu, Baolin; Guan, Weihua

    2015-06-01

    Acar and Sun (2013, Biometrics 69, 427-435) presented a generalized Kruskal-Wallis (GKW) test for genetic association studies that incorporated the genotype uncertainty and showed its robust and competitive performance compared to existing methods. We present another interesting way to derive the GKW test via a rank linear model. © 2014, The International Biometric Society.

  2. Reader Reaction On the generalized Kruskal-Wallis test for genetic association studies incorporating group uncertainty

    OpenAIRE

    Wu, Baolin; Guan, Weihua

    2014-01-01

    Acar and Sun (2013, Biometrics, 69, 427-435) presented a generalized Kruskal-Wallis (GKW) test for genetic association studies that incorporated the genotype uncertainty and showed its robust and competitive performance compared to existing methods. We present another interesting way to derive the GKW test via a rank linear model.

  3. A Study of Some General Problems of Dieudonné-Rashevski Type

    Directory of Open Access Journals (Sweden)

    Ariana Pitea

    2012-01-01

    Full Text Available We use a method of investigation based on employing adequate variational calculus techniques in the study of some generalized Dieudonné-Rashevski problems. This approach allows us to state and prove optimality conditions for such kind of vector multitime variational problems, with mixed isoperimetric constraints. We state and prove efficiency conditions and develop a duality theory.

  4. Patient demands, lack of reciprocity, and burnout: a five-year longitudinal study about general practitioners.

    NARCIS (Netherlands)

    Bakker, A.B.; Schaufeli, W.B.; Sixma, H.J.; Bosveld, W.; Dierendonck, D. van

    2000-01-01

    This study among a sample of 207 general practitioners (GPs) uses a five-year longitudinal design to test a process model of burnout. On the basis of social exchange and equity theory, it is hypothesized and found that demanding patient contacts produce a lack of reciprocity in the GP-patient

  5. Care complexity in the general hospital - Results from a European study

    NARCIS (Netherlands)

    de Jonge, P; Huyse, FJ; Slaets, JPJ; Herzog, T; Lobo, A; Lyons, JS; Opmeer, BC; Stein, B; Arolt, [No Value; Balogh, N; Cardoso, G; Fink, P; Rigatelli, M; van Dijck, R; Mellenbergh, GJ

    2001-01-01

    There is increasing pressure to effectively treat patients with complex care needs from the moment of admission to the general hospital. In this study, the authors developed a measurement strategy for hospital-based care complexity. The authors' four-factor model describes the interrelations between

  6. Does Empathy Predict Instructional Assignment-Related Stress? A Study in Special and General Education Teachers

    Science.gov (United States)

    Platsidou, Maria; Agaliotis, Ioannis

    2017-01-01

    The role of empathy in the teaching profession has been vastly investigated in relation to its effect on students, but research on how teachers' empathy affects their own well-being at work is limited. This study investigated empathy and instructional assignment-related stress factors of primary school teachers serving in general or special…

  7. Vaginal symptoms of unknown etiology - a study in dutch general-practice

    NARCIS (Netherlands)

    Dekker, Janny H.; Boeke, A. Joan P.; Janssens, J; van Eijk, J.Th.M.

    Vaginal symptoms are frequently presented by women to general practitioners. In many cases, the aetiology of these symptoms remains unknown. This study focused on the factors associated with microbiologically unexplained vaginal symptoms, the course of symptoms and signs in these cases, and factors

  8. Can They Succeed? Exploring At-Risk Students' Study Habits in College General Chemistry

    Science.gov (United States)

    Ye, Li; Shuniak, Constantine; Oueini, Razanne; Robert, Jenay; Lewis, Scott

    2016-01-01

    A well-established literature base identifies a portion of students enrolled in post-secondary General Chemistry as at-risk of failing the course based on incoming metrics. Learning about the experiences and factors that lead to this higher failure rate is essential toward improving retention in this course. This study examines the relationship…

  9. A Case Study of the Flipped Classroom in a Korean University General English Course

    Science.gov (United States)

    Choe, Erika; Seong, Myeong-Hee

    2016-01-01

    Research has proven the effectiveness of Flipped Classrooms (FC) for a variety of settings. However, more exploration needs to be done in regards to how FC can be used effectively in foreign language classrooms. The purpose of this study was to 1) explore student perceptions of FC in a Korean university general English course and 2) provide…

  10. Comparative Study of Bullying Victimization among Students in General and Special Education

    Science.gov (United States)

    Hartley, Michael T.; Bauman, Sheri; Nixon, Charisse L.; Davis, Stan

    2015-01-01

    Research on bullying is an important avenue for understanding the social integration of students in special education. Focused on 3,305 students who self-reported victimization of two to three times per month or more, this study compared the pattern of verbal, relational, and physical bullying among students in general education and special…

  11. Generalized canonical correlation analysis of matrices with missing rows : A simulation study

    NARCIS (Netherlands)

    van de Velden, Michel; Bijmolt, Tammo H. A.

    A method is presented for generalized canonical correlation analysis of two or more matrices with missing rows. The method is a combination of Carroll's (1968) method and the missing data approach of the OVERALS technique (Van der Burg, 1988). In a simulation study we assess the performance of the

  12. Acceptance of online audio-visual cultural heritage archive services: a study of the general public

    NARCIS (Netherlands)

    Ongena, G.; van de Wijngaert, Lidwien; Huizer, E.

    2013-01-01

    Introduction. This study examines the antecedents of user acceptance of an audio-visual heritage archive for a wider audience (i.e., the general public) by extending the technology acceptance model with the concepts of perceived enjoyment, nostalgia proneness and personal innovativeness. Method. A

  13. [Tests and scales: restrains to use them by general practitioners. Descriptive transversal study].

    Science.gov (United States)

    Cario, Camille; Levesque, Jean-Louis; Bouche, Gauthier

    2010-12-20

    Tests, even though recommended, are only few used by general practitioners (GP's). The aim of this study was to understand the reasons of this underuse. Descriptive transversal study, to explore knowledge, use and restrains to using ten tests related in the first 50 results of consultation in general practice. We questioned 121 GP's from Charente, selected ad random. The oldest tests (MMS, MNA, Fagerström, mini-GDS, IPSS, depression) are known by more than half of the GP's. Only one third is familiar with more recent tests devoted to ambulatory care (TSTS, FACE, venous thromboembolic risk), which are also used less (20% at most). Systematic use of all tests mixed up, never exceeds 30% of all GP's. The principal restrain to use these tests is lack of training (53%), which seems indeed to be inefficient in this domain; 20 to 60% of GP's who know the tests, do not use them, mainly because of doubts regarding their usefulness (38%). What really is the utility of these tests in ambulatory care? Their validity in general practice shows some gaps: their validation results seldom on studies conducted in primary care, impact studies to evaluate the benefits for patients are lacking, and tests designed for specific use by GP's are rare and lacking in validity. Development of research in primary care in this field would be desirable in order to develop relevant, feasible and acceptable tools to help decision making in general practice.

  14. Geometrical optics in general relativity: A study of the higher order corrections

    International Nuclear Information System (INIS)

    Anile, A.M.

    1976-01-01

    The higher order corrections to geometrical optics are studied in general relativity for an electromagnetic test wave. An explicit expression is found for the average energy--momentum tensor which takes into account the first-order corrections. Finally the first-order corrections to the well-known area-intensity law of geometrical optics are derived

  15. Validation of the Maslach Burnout Inventory - general survey : an Internet study

    NARCIS (Netherlands)

    Bakker, A.B.; Demerouti, E.; Schaufeli, W.B.

    2002-01-01

    This study examined the factorial validity of the Maslach Burnout Inventory - General Survey (MBI-GS; Schaufeli et al., Maslach Burnout Inventory Manual, pp. 19-26. Consulting Psychologists Press, CA) in eight different occupational groups of employees (N=2919), who were recruited through the

  16. HISTORIOGRAPHY GENERAL, REGIONAL AND SPECIAL STUDIES OF JUDICIAL REFORM IN RUSSIA 1864

    Directory of Open Access Journals (Sweden)

    Sergei Evgenievich Strakhov

    2014-10-01

    Full Text Available In today's world, a crucial role is played by the judiciary. In the period lasting judicial reform, it is important to explore this institution not only at the present stage, but also to trace the history of its development, including - through analysis and synthesis of existing studies of the judiciary and judicial reforms.The purpose of this study - to explore the historiography of general, special and regional studies of judicial reform of1864 inRussia, to classify research on history and on the subject of the study.Scientific, theoretical and practical significance of the work lies in the fact that the study of this topic will summarize the significant weight of the studies of the judicial reform of 1864 and classified by facilitating orientation interested in individuals in the study subjects.The author uses historical, comparative, hermeneutical, mathematical methods, as well as general methods of scientific research.The author analyzes the historiography of general, special and regional studies of the judicial reform of1864 inRussia, introducing a classification of such studies in chronological order (pre-revolutionary, Soviet and modern stages and subject matter (common - affecting all aspects of judicial reform, special - dedicated to a particular aspect (legal agencies, prosecutors, legal, etc. and regional - dedicated to judicial reform, or some aspects of it in some regions of Russia.The results of this study are scientific and practical value, because they can be useful for teaching students - in industry disciplines "judiciary", "advocacy", "notary public", "public prosecutor's supervision" and general theoretical "History of State and Law," "History of the fatherland" ; in science - by picking up information about the historiography of the judicial reform, and in practice - said work can serve as a guide to research judicial reform, which may be useful to practitioners of judicial and investigative bodies, as well as - prosecutors

  17. Strength in power sports: the latest scientific results

    Directory of Open Access Journals (Sweden)

    MÁRIO C. MARQUES

    2011-06-01

    Full Text Available Problem Statement: During the last decades, strength and power training has been a major issue for, coaches,athletes and researchers. Unfortunately, despite the increasing professionalization of coaches and athletes, thereis little research data concerning performance in elite athletes. Several studies showed that a specific strengthtraining program can improve athletes’ maximal force and power production, reduce the incidence of injury, andcontribute to faster injury recovery times, thereby minimizing the number of missed practice sessions andcompetitions. To our best knowledge, however, there is no apparent consensus on the appropriate method ofstrength and muscular power training to enhance performance, especially in typically power sports. On this,some questions remain unresolved and there have focused objective of our study: How much strength does anathlete need? Is the maximum strength the key for success? Is the muscular power the main issue?Approach: Therefore, the aim of this study focuses on a literature scientific search extended about strength inpower sports specifically.Results: Studies in this area continue to contradict because they differ markedly in terms of design factors,including mode, frequency, intensity, frequency of training, and training history of subjects.Conclusions/Recommendations: We can conclude that once a given level of strength training intensity hasbeen reached in trained athletes, the appropriate physiological adaptations may well be optimized and thattraining beyond this limit provides no further benefits

  18. Foundations and latest advances in replica exchange transition interface sampling

    NARCIS (Netherlands)

    Cabriolu, R.; Refsnes, K.M.S; Bolhuis, P.G.; van Erp, T.S.

    2017-01-01

    Nearly 20 years ago, transition path sampling (TPS) emerged as an alternative method to free energy based approaches for the study of rare events such as nucleation, protein folding, chemical reactions, and phase transitions. TPS effectively performs Monte Carlo simulations with relatively short

  19. Do wild chimpanzee populations develop diverse cultures? [Latest Thinking

    OpenAIRE

    Boesch, C.

    2017-01-01

    Humans pride themselves on having extensive and diverse cultures. However, cultures can also be observed in animals. The research presented in this video aims at understanding the cultures of wild chimpanzee populations in several African countries and how they differ from each other. As chimpanzees avoid human contact, CHRISTOPHE BOESCH explains, the research team conducted the study by setting up camera traps to catch chimpanzee behavior on video. Forty locations were carefully selected to ...

  20. A generalized Kruskal-Wallis test incorporating group uncertainty with application to genetic association studies.

    Science.gov (United States)

    Acar, Elif F; Sun, Lei

    2013-06-01

    Motivated by genetic association studies of SNPs with genotype uncertainty, we propose a generalization of the Kruskal-Wallis test that incorporates group uncertainty when comparing k samples. The extended test statistic is based on probability-weighted rank-sums and follows an asymptotic chi-square distribution with k - 1 degrees of freedom under the null hypothesis. Simulation studies confirm the validity and robustness of the proposed test in finite samples. Application to a genome-wide association study of type 1 diabetic complications further demonstrates the utilities of this generalized Kruskal-Wallis test for studies with group uncertainty. The method has been implemented as an open-resource R program, GKW. © 2013, The International Biometric Society.

  1. Body dysmorphic disorder: Latest neuroanatomical and neuropsychological findings.

    Science.gov (United States)

    Tasios, K; Michopoulos, I

    2017-01-01

    Body dysmorphic disorder (BDD) is characterized by a preoccupation with a perceived defect or flaw in physical appearance that is not observable or appears slight to others. It leads to severe distress and functional impairment. Cognitive-behavioural and neurobiological similarities to obsessive compulsive disorder (OCD) have led to its newly conceived classification as an obsessive compulsive related disorder (OCRD). In the process of investigating the neurobiology of BDD, neuroimaging and neuropsychological studies have been conducted. This review presents the most recent research findings and their connection with BDD clinical features. Imaging studies have shown increased total white matter volume and caudate volume asymmetry in BDD patients. These findings are consistent with the striatal topography model of OCRDs. Other studies have showed perfusion deficits in bilateral anterior-medial temporal and occipital regions and asymmetric perfusion in parietal lobes. In addition, correlation between symptom severity and left inferior frontal gyrus volume reflects the degree of detailed, analytic encoding that occurs on day-to-day basis when viewing others and themselves, and that likely underlies their symptoms. Finally, positive correlation between right amygdala volume and symptom severity signifies pathological fear circuitry engagement, hypervigilance and heightened sensitivity to social situations. Neuropsychological studies of BDD reveal deficits in strategic organization, learning and free recall after short and long delays. Executive function deficits are related to spatial working memory and subsequent thinking speed as well as impaired higher level planning ability. BDD patients' organizational strategies tend to focus on detail rather than on larger, global clustering features. They are characterized by abnormal visual processing of both details and global elements, inaccurate processing of global elements and reduced flexibility in switching visual

  2. Evaluation of MR issues for the latest standard brands of orthopedic metal implants: plates and screws.

    Science.gov (United States)

    Zou, Yue-Fen; Chu, Bin; Wang, Chuan-Bing; Hu, Zhi-Yi

    2015-03-01

    The study was performed to evaluate magnetic resonance (MR) issues for the latest standard brands of plates and screws used in orthopedic surgery at a 1.5-T MR system, including the safety and metallic artifacts. The plates and screws (made of titanium alloy and stainless steel materials, according to the latest standard brands) were assessed for displacement in degrees, MRI-related heating and artifacts at a 1.5-T MR system. The displacement in degrees of the plates and screws was evaluated on an angel-measurement instrument at the entrance of the MR scanner. The MRI-related heating was assessed on a swine leg fixed with a plate by using a "worst-case" pulse sequence. A rectangular water phantom was designed to evaluate metallic artifacts of a screw on different sequences (T1/T2-weighted FSE, STIR, T2-FSE fat saturation, GRE, DWI) and then artifacts were evaluated on T2-weighted FSE sequence by modifying the scanning parameters including field of view (FOV), echo train length (ETL) and bandwidth to identify the influence of parameters on metallic artifacts. 15 volunteers with internal vertebral fixation (titanium alloy materials) were scanned with MR using axial and sagittal T2-FSE, sagittal T2-FSE fat suppression and STIR with conventional and optimized parameters, respectively. Then all images were graded by two experienced radiologists having the experience of more than 7 years under double-blind studies that is neither of them knew which was conventional parameter group and optimized parameter group. The average deflection angle of titanium alloy and stainless steel implants were 4.3° and 7.7°, respectively, (less than 45°) which indicated that the magnetically induced force was less than the weight of the object. The deflection angle of the titanium alloy implants was less than the stainless steel one (t=9.69, Ptitanium alloy before and after the scan was 0.48°C and stainless steel implants was 0.74°C, respectively, with the background temperature

  3. Reasons of repeat dental treatment under general anaesthesia: A retrospective study.

    Science.gov (United States)

    Guidry, J; Bagher, S; Felemban, O; Rich, A; Loo, C

    2017-12-01

    The purpose of this chart review study was to investigate the common factors that exist in paediatric patients requiring a repeat dental treatment under general anaesthesia (GA2) within four years after the initial dental treatment under general anaesthesia (GA1). The Electronic Health Records of one to 12 year-old children who received dental treatment under general anaesthesia (GA) between April 2004 and October 2009 were identified and analysed by a single examiner. Children who had GA2, within a four year period following GA1 were categorised as cases. Children who had only one dental treatment under GA were considered the control pool. Each case was matched to three controls based on sex and age range at GA1 of ± 6 months. Other recorded variables included: date of birth, date of GAs (GA1 and GA2 for cases; GA1 for controls), type of payment, dmfs before GA1, dental treatments provided under GA, return of 1-week post-GA1 follow-up, frequency of recare/recall visits following one-year post-GA1 visit and the type and frequency of post GA1 emergency visits. Out of 581 subjects, 29 (4.99%) cases were matched to 87 controls. Medically compromised patients had four times the risk of GA2. At GA1, cases received statistically significant less sealants (p=0.026), less extractions (pdental treatment under general anaesthesia were more likely to have a repeat dental treatment under general anaesthesia within 4 years.

  4. Does adversity early in life affect general population suicide rates? A cross-national study.

    Science.gov (United States)

    Shah, Ajit; Bhandarkar, Ritesh

    2011-01-01

    Adversity early in life has been suggested as a protective factor for elderly suicides. However, studies examining this relationship in general population suicide rates are scarce. The relationship between general population suicide rates and four proxy measures of adversity earlier in life was examined using data from the World Health Organization and the United Nations data banks. General population suicide rates were negatively correlated with the percentage of children under the age of 5 years who were underweight, the percentage of children under the age of 5 years who were under height, the percentage of infants with low birth weight babies, and the percentage of the general population that was undernourished. The only independent predictor general population suicide rates in both sexes, on multiple regression analysis, was the Gini coefficient (a measure of income inequality). Income inequality may lead to low birth weight, undernourishment, underweight and under height because income inequality results in poor access to healthcare and nutrition. These adversities may increase child mortality rates and reduce life expectancy. Those surviving into adulthood in countries with greater adversity early in life may be at reduced risk of suicide because of selective survival of those at reduced risk of suicide due to constitutional or genetic factors and development of greater tolerance to hardship in adulthood. ‎

  5. Does adversity early in life affect general population suicide rates? a cross-national study

    Directory of Open Access Journals (Sweden)

    Ritesh Bhandarkar

    2011-01-01

    Full Text Available BACKGROUND: Adversity early in life has been suggested as a protective factor for elderly suicides. However, studies examining this relationship in general population suicide rates are scarce. METHODS: The relationship between general population suicide rates and four proxy measures of adversity earlier in life was examined using data from the World Health Organization and the United Nations data banks. RESULTS: General population suicide rates were negatively correlated with the percentage of children under the age of 5 years who were underweight, the percentage of children under the age of 5 years who were under height, the percentage of infants with low birth weight babies, and the percentage of the general population that was undernourished. The only independent predictor general population suicide rates in both sexes, on multiple regression analysis, was the Gini coefficient (a measure of income inequality. CONCLUSIONS: Income inequality may lead to low birth weight, undernourishment, underweight and under height because income inequality results in poor access to healthcare and nutrition. These adversities may increase child mortality rates and reduce life expectancy. Those surviving into adulthood in countries with greater adversity early in life may be at reduced risk of suicide because of selective survival of those at reduced risk of suicide due to constitutional or genetic factors and development of greater tolerance to hardship in adulthood.

  6. Early detection of COPD: a case finding study in general practice.

    Science.gov (United States)

    Vandevoorde, Jan; Verbanck, Sylvia; Gijssels, Lieve; Schuermans, Daniel; Devroey, Dirk; De Backer, Joan; Kartounian, Jan; Vincken, Walter

    2007-03-01

    To estimate the prevalence of undiagnosed chronic obstructive pulmonary disease (COPD) in a population of general practice patients at risk for developing COPD. A further aim was to evaluate the presence of respiratory symptoms as a predictor for the diagnosis of COPD. This study was conducted by eight general practitioners (GP) in six semi-rural general practices. During two consecutive months all patients attending their GP were included if they met the following criteria: current smokers between 40 and 70 yr of age, and a smoking history of at least 15 pack-years. A questionnaire regarding smoking history, respiratory symptoms, exposure to dust or chemical fumes, and history of respiratory diseases was completed for all patients. Subjects without known COPD were invited for spirometric testing. Off the 146 general practice patients included, 17.1% already had an established COPD diagnosis. Screening by spirometry revealed a 46.6% prevalence of COPD. Underdiagnosis of COPD was more frequent in the younger age categories (40-49 Yr; 50-59 Yr). Objective wheezing was the only sign that was significantly more frequent in COPD patients than in non-COPD patients (Pfatigue than newly detected patients. Almost half of a general practice population of current smokers between 40 and 70 years of age, with a smoking history of at least 15 pack-years, was diagnosed with COPD, and roughly two thirds of these were newly detected as a result of the case finding programme.

  7. A Generalized Kruskal-Wallis Test Incorporating Group Uncertainty with Application to Genetic Association Studies

    OpenAIRE

    Acar, Elif F.; Sun, Lei

    2012-01-01

    Motivated by genetic association studies of SNPs with genotype uncertainty, we propose a generalization of the Kruskal-Wallis test that incorporates group uncertainty when comparing k samples. The extended test statistic is based on probability-weighted rank-sums and follows an asymptotic chi-square distribution with k-1 degrees of freedom under the null hypothesis. Simulation studies confirm the validity and robustness of the proposed test in finite samples. Application to a genome-wide asso...

  8. A Comparative Study between Intramuscular Midazolam and Oral Clonidine As A Premedication For General Anesthesia

    OpenAIRE

    Jignasa J Patel; Kalpana A Desai

    2015-01-01

    Background: Most anesthesiologists agree on the need for efficient pre-medication. The pattern of desired effects of a pre-medication is however, complex and includes relief of anxiety, sedation and relaxation of the patient. The present study was undertaken to compare the effects of Midazolam and clonidine as premedication. Methodology: A comparative study between midazolam and clonidine as a premedication for general anesthesia was conducted. Patients were divided in two groups: Group I: In...

  9. STUDIES OF ADVERSE DRUG REACTION PROFILE OF ANTISNAKE VENOM AT DISTRICT GENERAL HOSPITAL

    OpenAIRE

    Mulchand Shende *, Sneha Gawali , Kanchan Bhongade , Vivek Bhuskade , Abhijit Nandgaonkar

    2017-01-01

    Snake bite is a common predominant problem of the rural and periurban areas, neglected and frequently devastating environmental and occupational disease, especially in rural areas of tropical developing countries. This study aimed to investigate of the adverse drug reaction profile of anti-snake venom (ASV) in a district general hospital. An observational study was conducted in hospital for six months. A total number of 142 indoor case papers of snake bite from October 2016 to April 2017 were...

  10. Automotive emission standards. (Latest citations from Pollution Abstracts). Published Search

    International Nuclear Information System (INIS)

    1993-07-01

    The bibliography contains citations concerning emission standards and air quality standards applied to automobile emissions. Included are federal and state regulations and policies regarding these emission standards. Techniques to meet emission standards are also addressed, involving fuel injection, catalysts, alternate engines, and automotive fuel refinery operations. Studies concerning implementation of automobile emission standards explore economic and environmental effects, testing and inspection procedures, and the automobile industry point of view. Most of the citations refer to gasoline engines, but a few pertain to diesel and other fuels. (Contains 250 citations and includes a subject term index and title list.)

  11. Metabolic correlates of general cognitive function in nondemented elderly subjects: an FDG PET study

    International Nuclear Information System (INIS)

    Cho, Sang Soo; Kwak, Young Bin; Lee, Eun Ju; Ryu, Chang Hyung; Chey, Jean Yung; Kim, Sang Eun

    2004-01-01

    While many studies examined the neural correlates of individual cognitive functions, few made efforts to identify the neural networks associated with general cognitive function. General cognitive function decline in the elderly population is not infrequent. This study examined the brain areas associated with general cognitive function in the elderly subjects. Community-dwelling 116 elderly subjects without dementing illnesses (age, 71±5 y; 13 males and 103 females) participated. General cognitive ability was assessed with the Dementia Rating Scale (K-DRS), which is composed of five subtests of attention, initiation and perseveration, construction, conceptualization, and memory. The EVLT (Elderly Verbal Learning Test), a nine-word list learning test, was used for general memory assessment. Brain FDG PET scans were acquired in all subjects. Brain regions where metabolic levels are correlated with the total scores of K-DRS and EVLT were examined using SPM99. There was a significant positive correlation (P < 0.01 uncorrected, k=100) between the total score of K-DRS and glucose metabolism in the bilateral posterior cingulate gyri, bilateral inferior frontal gyri, left caudate, left inferior parietal lobule, right precuneus, bilateral unci, right parahippocampal gyrus, and right anterior cingulate gyrus. A significant positive correlation between the total score of EVLT and glucose metabolism was shown in the right precuneus, right posterior cingulate gyrus, left insula, bilateral inferior parietal lobules, left anterior cingulate gyrus, left caudate, right inferior frontal gyrus (P < 0.01 uncorrected, k=100). Our data showed the brain regions that are associated with general cognitive function in the elderly. Those regions may serve as the neural substrated of cognitive dysfunction associated with neurodegenerative and cerebrovascular diseases in elderly subjects

  12. Latest progress of research on acute abdominal injuries

    Directory of Open Access Journals (Sweden)

    Ionut Negoi

    2016-01-01

    Full Text Available Major abdominal trauma, both blunt and penetrating, is commonly seen nowadays, being particularly difficult to manage due to the frequent altered mental status of the patients and severity of associated injuries. The review article aims to make an uptodate study of the current strategies for therapeutic approach of abdominal injuries in polytrauma setting. Review of the medical literature is up to 2015, by using the PubMed/Medline, Science Direct, Cochrane Library and Web of Science databases. We have used different combinations of the keywords of “abdominal trauma”, “liver”, “spleen”, “renal”, to review the reference list of retrieved articles for further relevant studies. Nowadays, we are facing a major change in abdominal trauma therapeutic approach, due to the continuous extending indications and very high successful rate of selective nonoperative management, completed or not with minimally invasive techniques like angiography and angiographic embolization. New imaging methods offer a high-quality characterization of solid organ injuries, being a secure support for decision algorithm in polytrauma patients. After a continuous decrease in number of laparotomies for trauma, new techniques should be developed for maintaining and developing the trauma surgeons' skills. According to the current standards, for a low morbidity and mortality, the trauma patients may be approached by a multidisciplinary and experienced trauma team. Even if nonoperative management is continuously expanding, this may be applied only by a trained and skillful trauma surgeon, who is able to perform difficult surgical techniques at any moments.

  13. [Changing to a career in general practice - a qualitative study reveals motives of specialists].

    Science.gov (United States)

    Schwill, Simon; Magez, Julia; Jäger, Cornelia; von Meißner, Wolfgang Cg; Szecsenyi, Joachim; Flum, Elisabeth

    2016-12-01

    In 2011, the national German Medical Association (Bundesärztekammer) published guidelines for a slim-lined training program in general practice (Quereinstieg) for qualified medical specialists in other fields (e. g., surgeons, internists or anesthesiologists). This step is part of a strategy to prevent further shortages of general practitioners in Germany. In the state of Baden-Wuerttemberg, qualified medical specialists are allowed to complete their general practice training in approximately two years instead of five. The aim of this study was to understand the reasons of specialists for changing to a career in general practice. The postgraduate training program Verbundweiterbildung plus Baden-Württemberg had 597 trainees at the time of the study in December 2015. Previously qualified specialists in another medical discipline were identified and invited to participate in this study. Qualitative data was gathered using semi-structured interviews with content analysis of the interviews performed by three independent members of the research team. In total, 36 out of 597 trainees were identified as previously qualified specialists in another medical discipline. All 36 were invited to take part and 15 agreed to participate in this study. Overall, 15 interviews were performed, with a mean time of 24.19minutes. Participants with a median age of 40 years (33-59 years) - mainly anesthesiologists (n=7), surgeons (n=3) and internists (n=3) - presented with an average of 6.5 years of professional experience in their specialty. First, the participants' motivation to switch career arose from the wish to intensify the quality of patient contacts with a holistic approach including family and social background and from the infinite variety of general practice. Another reason given for a career change was self-employment opportunities. Finally, feelings of frustration over poor working conditions in hospitals resulted in a job search elsewhere in medicine, taking account of

  14. Gambling, Risk-Taking, and Antisocial Behavior: A Replication Study Supporting the Generality of Deviance.

    Science.gov (United States)

    Mishra, Sandeep; Lalumière, Martin L; Williams, Robert J

    2017-03-01

    Research suggests that high frequency gambling is a component of the "generality of deviance", which describes the observation that various forms of risky and antisocial behavior tend to co-occur among individuals. Furthermore, risky and antisocial behaviors have been associated with such personality traits as low self-control, and impulsivity, and sensation-seeking. We conducted a replication (and extension) of two previous studies examining whether high frequency gambling is part of the generality of deviance using a large and diverse community sample (n = 328). This study was conducted as a response to calls for more replication studies in the behavioral and psychological sciences (recent systematic efforts suggest that a significant proportion of psychology studies do not replicate). The results of the present study largely replicate those previously found, and in many cases, we observed stronger associations among measures of gambling, risk-taking, and antisocial behavior in this diverse sample. Together, this study provides evidence for the generality of deviance inclusive of gambling (and, some evidence for the replicability of research relating to gambling and individual differences).

  15. LATEST CHALLENGES IN EFFICIENCY CONVERGENCE IN BALKAN AND BALTIC COUNTRIES

    Directory of Open Access Journals (Sweden)

    Mihăiță-Cosmin M. POPOVICI

    2013-12-01

    Full Text Available The efficiency of banks has been widely and extensively studied in the past few decades. Using a sample of Balkan and Baltic countries and by employing a Data Envelopment Analysis model, we want to highlight the main challenges for the highly concentrated banking system. Over the period 2007 - 2011, these countries have coped with the worst financial crisis from the Great Depression, which has severe effects on the banking systems. Our sample includes the least developed countries in the EU and for reference purpose, Luxembourg, with the highest GDP per capita. We expect to find similarities between Balkan countries and Baltic countries and we can draw lessons from Luxembourg`s results.

  16. Latest Results from the Daya Bay Reactor Neutrino Experiment

    CERN Multimedia

    CERN. Geneva

    2014-01-01

    Among all the fundamental particles that have been experimentally observed, neutrinos remain one of the least understood. The Daya Bay Reactor Neutrino Experiment in China consists of eight identical detectors placed underground at different baselines from three groups of nuclear reactors, a configuration that is ideally suited for studying the properties of these elusive particles. This talk will present three sets of results that have just recently been released by the Daya Bay Collaboration: (i) a precision measurement of the oscillation parameters that drive the disappearance of electron antineutrinos at short baselines, (ii) a search for sterile neutrino mixing, and (iii) a high-statistics determination of the absolute flux and spectrum of reactor-produced electron antineutrinos. All of these results extend the limits of our knowledge in their respective areas and thus shed new light on neutrinos and the physics that surround them.

  17. [Scope of the latest RE-LY substudies: clinical implications].

    Science.gov (United States)

    Ruiz-Giménez Arrieta, N

    2012-03-01

    The approval of the use of dabiatran in stroke prevention in patients with nonvalvular atrial fibrilation (NVAF) is based on the results of the RE-LY (Randomized Evaluation of Long-Term Anticoagulation Therapy) trial, one of the largest studies to date in this entity. In this trial, dabigatran showed similar safety and efficacy to warfarin in primary and secondary prevention of stroke in patients with AF. At a dose of 150 mg twice daily, dabigatran was superior to warfarin in the prevention of stroke or systemic embolism and the 110 mg dose twice daily showed similar efficacy and greater safety, given the lower incidence of hemorrhage. These results were consistently found in the various subanalyses, with some slight differences of interest for clinical practice. The ideal candidates for dabiatran are patients with NVAF suitable for cardioversion, who require short periods of anticoagulation, patients in remote geographical areas with difficulty in achieving good anticoagulation control or good control with anti-vitamin K treatment due to IRN fluctuations, and patients with a low risk of hemorrhage and a CHADS score ≥ 3 and/or with prior stroke, whenever there are no contraindications. The choice of dabigatran dose should be evaluated according to the patient's individual characteristics (caution must be exercised when prescribing this drug in the elderly and in renal insufficiency) and embolic and/or hemorrhagic risk. Studies of the long-term safety of this drug, pharmacoeconomic analyses in Spain and post-commercialization pharmacovigilance data are required before the definitive uses of this drug can be established. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  18. Latest Minimum Bias and Underlying Event Measurements at ATLAS

    CERN Document Server

    Kar, Deepak; The ATLAS collaboration

    2017-01-01

    While the modelling of Minimum Bias (MB) is a crucial ingredient to learn about the description of soft QCD processes, the studies of the Underlying Event (UE) shed light on the description of both soft and hard QCD processes at hadron colliders. The ATLAS collaboration has provided measurements of the inclusive charged-particle multiplicity and its dependence on transverse momentum and pseudorapidity in special data sets with low LHC beam currents, recorded at center-of-mass energies of 8 TeV and 13 TeV. Moreover, results on the number and transverse-momentum sum of charged particles as a function of the leading high pT track in events taken at a center-of-mass energy of 13 TeV are presented. These results are separated in the towards, transverse, and away from the leading track and allow to test the modelling of the Underlying Event in modern MC generators. Furthermore, event-shape variables based on charged particles have been measured in Z-events and have been compared with the predictions of different st...

  19. Foundations and latest advances in replica exchange transition interface sampling

    Science.gov (United States)

    Cabriolu, Raffaela; Skjelbred Refsnes, Kristin M.; Bolhuis, Peter G.; van Erp, Titus S.

    2017-10-01

    Nearly 20 years ago, transition path sampling (TPS) emerged as an alternative method to free energy based approaches for the study of rare events such as nucleation, protein folding, chemical reactions, and phase transitions. TPS effectively performs Monte Carlo simulations with relatively short molecular dynamics trajectories, with the advantage of not having to alter the actual potential energy surface nor the underlying physical dynamics. Although the TPS approach also introduced a methodology to compute reaction rates, this approach was for a long time considered theoretically attractive, providing the exact same results as extensively long molecular dynamics simulations, but still expensive for most relevant applications. With the increase of computer power and improvements in the algorithmic methodology, quantitative path sampling is finding applications in more and more areas of research. In particular, the transition interface sampling (TIS) and the replica exchange TIS (RETIS) algorithms have, in turn, improved the efficiency of quantitative path sampling significantly, while maintaining the exact nature of the approach. Also, open-source software packages are making these methods, for which implementation is not straightforward, now available for a wider group of users. In addition, a blooming development takes place regarding both applications and algorithmic refinements. Therefore, it is timely to explore the wide panorama of the new developments in this field. This is the aim of this article, which focuses on the most efficient exact path sampling approach, RETIS, as well as its recent applications, extensions, and variations.

  20. Global-scale projection and its sensitivity analysis of the health burden attributable to childhood undernutrition under the latest scenario framework for climate change research

    International Nuclear Information System (INIS)

    Ishida, Hiroyuki; Kobayashi, Shota; Kanae, Shinjiro; Hasegawa, Tomoko; Fujimori, Shinichiro; Takahashi, Kiyoshi; Masui, Toshihiko; Shin, Yonghee; Tanaka, Akemi; Honda, Yasushi

    2014-01-01

    This study assessed the health burden attributable to childhood underweight through 2050 focusing on disability-adjusted life years (DALYs), by considering the latest scenarios for climate change studies (representative concentration pathways and shared socioeconomic pathways (SSPs)) and conducting sensitivity analysis. A regression model for estimating DALYs attributable to childhood underweight (DAtU) was developed using the relationship between DAtU and childhood stunting. We combined a global computable general equilibrium model, a crop model, and two regression models to assess the future health burden. We found that (i) world total DAtU decreases from 2005 by 28 ∼ 63% in 2050 depending on the socioeconomic scenarios. Per capita DAtU also decreases in all regions under either scenario in 2050, but the decreases vary significantly by regions and scenarios. (ii) The impact of climate change is relatively small in the framework of this study but, on the other hand, socioeconomic conditions have a great impact on the future health burden. (iii) Parameter uncertainty of the regression models is the second largest factor on uncertainty of the result following the changes in socioeconomic condition, and uncertainty derived from the difference in global circulation models is the smallest in the framework of this study. (letters)

  1. The Learning Preferences of Applicants Who Interview for General Surgery Residency: A Multiinstitutional Study.

    Science.gov (United States)

    Kim, Roger H; Kurtzman, Scott H; Collier, Ashley N; Shabahang, Mohsen M

    Learning styles theory posits that learners have distinct preferences for how they assimilate new information. The VARK model categorizes learners based on combinations of 4 learning preferences: visual (V), aural (A), read/write (R), and kinesthetic (K). A previous single institution study demonstrated that the VARK preferences of applicants who interview for general surgery residency are different from that of the general population and that learning preferences were associated with performance on standardized tests. This multiinstitutional study was conducted to determine the distribution of VARK preferences among interviewees for general surgery residency and the effect of those preferences on United States Medical Licensing Examination (USMLE) scores. The VARK learning inventory was administered to applicants who interviewed at 3 general surgery programs during the 2014 to 2015 academic year. The distribution of VARK learning preferences among interviewees was compared with that of the general population of VARK respondents. Performance on USMLE Step 1 and Step 2 Clinical Knowledge was analyzed for associations with VARK learning preferences. Chi-square, analysis of variance, and Dunnett's test were used for statistical analysis, with p learning modality. The distribution of VARK preferences of interviewees was different than that of the general population (p = 0.02). By analysis of variance, there were no overall differences in USMLE Step 1 and Step 2 Clinical Knowledge scores by VARK preference (p = 0.06 and 0.21, respectively). However, multiple comparison analysis using Dunnett's test revealed that interviewees with R preferences had significantly higher scores than those with multimodal preferences on USMLE Step 1 (239 vs. 222, p = 0.02). Applicants who interview for general surgery residency have a different pattern of VARK preferences than that of the general population. Interviewees with preferences for read/write learning modalities have higher scores

  2. Intermittent transport across the scrape-off layer: latest results from ASDEX Upgrade

    International Nuclear Information System (INIS)

    Kočan, M.; Müller, H.W.; Lunt, T.; Bernert, M.; Conway, G.D.; De Marné, P.; Eich, T.; Herrmann, A.; Kallenbach, A.; Maraschek, M.; Müller, S.; Nold, B.; Huang, Z.; Adámek, J.; Horacek, J.; Komm, M.; Allan, S.Y.; Elmore, S.; Gennrich, F.P; Mehlmann, F.

    2013-01-01

    We report the latest results of turbulence and transport studies in the ASDEX Upgrade scrape-off layer (SOL). Dissimilarity between the plasma and the floating potential fluctuations is studied experimentally and by gyrofluid simulations. Measurements by a retarding field analyser reveal that both, edge-localized mode (ELM) and turbulent filaments, convey hot ions over large radial distances in the SOL. The measured far SOL ELM ion temperature increases with the ELM energy, consistent with earlier observations that large ELMs deposit a large fraction of their energy outside the divertor. In the SOL, the ELM suppression by magnetic perturbations (MPs) results in lower ELM ion energy in the far SOL. At the same time, large filaments of ion saturation current are replaced by more continuous bursts. Splitting of the divertor strike zones observed by the infrared imaging in H-mode with MPs agree with predictions from the EMC3-Eirene simulations. This suggests that the ‘lobe’ structures due to perturbation fields observed near the X-point are not significantly affected by plasma screening, and can be described by a vacuum approach, as in the EMC3-Eirene. Finally, some effects of the MPs on the L-mode SOL are addressed. (paper)

  3. Review of Rifaximin: Latest Treatment Frontier for Irritable Bowel Syndrome Mechanism of Action and Clinical Profile

    Directory of Open Access Journals (Sweden)

    Kamesh Gupta

    2017-08-01

    Full Text Available Background: Irritable bowel syndrome is classified as a functional gastrointestinal disorder with the primary symptom of abdominal pain in conjunction with bloating and bowel movement disorder. It affects up to 15% of the world’s population. Among its subtypes, the most common is diarrhoea predominant. However, the current treatment options for diarrhoea-predominant irritable bowel syndrome have had not very promising results; most, such as antispasmodics, only provide partial symptomatic relief. Treatment with antidepressants and alosetron (a 5HT3 antagonist has shown the most promise to date. The latest drug to be approved for the treatment of irritable bowel syndrome-diarrhoea is rifaximin, which was approved in May 2015. It is a minimally absorbed antibiotic that is used to change the gut microbiota. Small intestinal bacterial overgrowth is one of the causes suggested for irritable bowel syndrome, particularly for the diarrhoea-predominant type. There are various methods for detecting bacterial overgrowth, the simplest of which is breath tests. Rifaximin has been shown to be of benefit to these patients. Purpose: The purpose of the study is to discuss the potential mechanism of action of rifaximin, a minimally absorbed antibiotic. In addition, we evaluate the various clinical trials undertaken to study the efficacy and safety profile of rifaximin.

  4. Job satisfaction of practice assistants in general practice in Germany: an observational study.

    Science.gov (United States)

    Goetz, Katja; Campbell, Stephen; Broge, Bjoern; Brodowski, Marc; Steinhaeuser, Jost; Wensing, Michel; Szecsenyi, Joachim

    2013-08-01

    Job satisfaction of practice staff is important for optimal health care delivery and for minimizing the turnover of non-medical professions. To document the job satisfaction of practice assistants in German general practice and to explore associations between job satisfaction, staff characteristics and culture in general practice organizations. The study was based on data from the European Practice Assessment accreditation scheme for general practices and used an observational design. The study population consisted of 1158 practice assistants from 345 general practices across Germany. Job satisfaction was measured with the 10-item Warr-Cook-Wall questionnaire. Organizational culture was evaluated with four items. A linear regression analysis was performed in which each of the job satisfaction items was handled as dependent variable. Out of 1716 staff member questionnaires handed out to practice assistants, 1158 questionnaires were completed (response rate: 67.5%). Practice assistants were most satisfied with their colleagues and least satisfied with their income. Higher job satisfaction was associated with issues of organizational culture, particularly a good working atmosphere, opportunities to suggest and influence areas for improvement and clear responsibilities within the practice team. Prioritizing initiatives to maintain high levels of, or to improve the job satisfaction of practice assistants, is important for recruitment and retention. It will also help to improve working conditions for both practice assistants and GPs and create an environment to provide better quality care.

  5. A comparative study of pain following endodontic treatment under general anesthesia

    Directory of Open Access Journals (Sweden)

    Feizi Ghader

    2015-01-01

    Full Text Available   Background and Aims: Postoperativee endodontic pain is an outstanding problem for dental patients. Therefore, a successful management of endodontic pain has become as one of the main dental objectives. The aim of the present study was to compare the postoperative endodontic pain in patients under general anesthesia versus local anesthesia.   Materials and Methods: For conducting this clinical trial study, 50 patients having mandibular molars candidate for root canal therapy were selected. Twenty-five patients treated under general anesthesia because of their fear, anxiety or gag reflex. Other 25 patients treated under local anesthesia. All teeth were prepared using engine-driven rotary system in a crown-down technique and filled using lateral condensation technique. Heft- parker visual analog scale was used to measure the degree of pain at 6, 12, 24, and 48 hours after the treatment. Mann-Whitney, Chi-square, and T-tests were used to compare the intensity of postoperative pain between the groups.   Results: The mean intensity of postoperative pain in local and general anesthesia groups at 6, 12 and 24 hours had statistically significant difference (P<0.05.   Conclusion: Postoperative pain in patients who treated under general anesthesia was significantly less than the patients who treated under local anesthesia.

  6. A comparative study on scapular static position between females with and without generalized joint hyper mobility.

    Science.gov (United States)

    Moghadam, Afsun Nodehi; Salimee, Maryam Moghadam

    2012-08-01

    Generalized joint hyper mobility predisposes some individuals to a wide variety of musculoskeletal complaints. Given the critical role of scapular position in function of shoulder, the aim of this study was to compare scapular position between persons with and without general joint hyper mobility. By nonprobability sampling 30 hyper mobile persons at average of 22.86 ±2.77 years of age and 30 non hyper mobile persons (age 23.6 ± 2.73years) through a case-control design participated in the study. Scapular position was assessed according to the lateral scapular slide test. Independent t test and repeated measures ANOVA were used to statistically analyze scapular position differences between groups. Compared to non hyper mobile persons, those with General joint hyper mobility demonstrated a significantly higher superior scapula slide in dependent arm position (p = 0.03). However, no significant difference was found between another scores between two groups (p > 0.05). The results suggest that altered scapular position may be an important aspect of General joint hyper mobility.

  7. A comparative study on scapular static position between femaleswith and without generalized joint hyper mobility

    Directory of Open Access Journals (Sweden)

    Afsun Nodehi Moghadam

    2012-08-01

    Full Text Available Abstract Background: Generalized joint hyper mobility predisposes some individuals to a wide variety of musculoskeletal complaints. Given the critical role of scapular position in function of shoulder, the aim of this study was to compare scapular position between persons with and without general joint hyper mobility. Methods: By nonprobability sampling 30 hyper mobile persons at average of 22.86 ±2.77 years of age and 30 non hyper mobile persons (age 23.6 ± 2.73years through a case-control design participated in the study. Scapular position was assessed according to the lateral scapular slide test. Independent t test and repeated measures ANOVA were used to statistically analyze scapular position differences between groups.  Results: Compared to non hyper mobile persons, those with General joint hyper mobility demonstrated a significantly higher superior scapula slide in dependent arm position (p=0.03. However, no significant difference was found between another scores between two groups (p>0.05. Conclusion: The results suggest that altered scapular position may be an important aspect of General joint hyper mobility.

  8. Estimating Latest Cretaceous and Tertiary Atmospheric PCO2 from Stomatal Indices

    Science.gov (United States)

    Royer, D. L.; Wing, S. L.; Beerling, D. J.

    2001-05-01

    Most modern C3 seed plants show an inverse relationship between PCO2 and stomatal index (SI), where SI is the proportion of epidermal cells that are stomatal packages. This plant-atmosphere response therefore provides a reliable approach for estimating paleo-CO2 levels. Since stomatal responses to CO2 are generally species-specific, one is limited in paleo-reconstructions to species that exist both in the fossil record and living today. Fossils morphologically similar to living Ginkgo biloba and Metasequoia glyptostroboides extend back to the early and late Cretaceous, respectively, indicating that the fossil and living forms are very closely related. Measurements of SI made on fossil Ginkgo and Metasequoia were calibrated with historical collections of G. biloba and M. glyptostroboides leaves from sites that developed during the anthropogenically-driven CO2 increases of the past 145 years (288-369 ppmv) and with saplings of G. biloba and M. glyptostroboides grown in CO2 controlled growth chambers (350-800 ppmv). Both nonlinear regressions are highly significant (Ginkgo: n = 40, r2 = 0.91; Metasequoia: n = 18; r2 = 0.85). Results from a sequence of 23 latest Cretaceous to early Eocene-aged Ginkgo-bearing sites indicate that CO2 remained between 300 and 450 ppmv with the exception of one high estimate ( ~800 ppmv) near the Paleocene/Eocene boundary, and results from 4 middle Miocene-aged Ginkgo- and Metasequoia-bearing sites indicate that CO2 was between 320 and 400 ppmv. If correct, the CO2 values estimated here are too low to explain via the CO2 greenhouse effect alone the higher global mean temperatures (e.g., 3-4 ° C for the early Eocene) inferred from models and geological data for these two intervals.

  9. Evaluation of the Latest Generic Data for PSA Applications of Domestic Nuclear Plants

    International Nuclear Information System (INIS)

    Hwang, Seok Won; Oh, Ji Yong; Lee, Byung Sik

    2009-01-01

    Generic data of domestic PSAs have mostly referred to 'Advanced Light Water Reactor (ALWR) Utility Requirements Document (URD) 'issued by EPRI. Generally, current data of domestic PSA have been customized with the generic and plant specific data through Bayesian analysis. The generic reference has established by collecting US nuclear plant practices from mid 1980s to early 1990s. Over the decade, US plants had showed low performances and capabilities in operation. On the other hand, the current domestic nuclear plants shows world class performance in operation and maintenance compared with the corresponding US nuclear plants in URD. Therefore, it is necessary to apply proper generic sources which can represent the current domestic plant performances and status. In 2007, the latest generic source (NUREG/CR-6928) is published by US NRC, which deals with new types of failure modes and analysis methods. A fundamental improvement in NUREG/CR-6928 compared with previous data source is the distinction between standby and alternating/running component basic events, which shows different failure mechanisms. Significant differences were also noted running failure events occurred within and beyond the first hour for emergency diesel generators, cooling units, and pumps. This was done because the historical perspective on running failure rates indicated approximately a factor of 15 differences between the two failure rates for several component types. ALWR URD uses lognormal distribution in the estimation of failure rates. On the contrary, NUREG/CR-6928 uses beta and gamma distributions for demand and running failures, respectively. This work has proposed an approach to the application of NUREG/CR-6928 to current PSA practice by comparing it with URD data. Moreover, this attempt results in eliciting substantial insights of the establishment of the domestic generic database

  10. Developing the Blueprint for a General Surgery Technical Skills Certification Examination: A Validation Study.

    Science.gov (United States)

    de Montbrun, Sandra; Louridas, Marisa; Szasz, Peter; Harris, Kenneth A; Grantcharov, Teodor P

    There is a recognized need to develop high-stakes technical skills assessments for decisions of certification and resident promotion. High-stakes examinations requires a rigorous approach in accruing validity evidence throughout the developmental process. One of the first steps in development is the creation of a blueprint which outlines the potential content of examination. The purpose of this validation study was to develop an examination blueprint for a Canadian General Surgery assessment of technical skill certifying examination. A Delphi methodology was used to gain consensus amongst Canadian General Surgery program directors as to the content (tasks or procedures) that could be included in a certifying Canadian General Surgery examination. Consensus was defined a priori as a Cronbach's α ≥ 0.70. All procedures or tasks reaching a positive consensus (defined as ≥80% of program directors rated items as ≥4 on the 5-point Likert scale) were then included in the final examination blueprint. Two Delphi rounds were needed to reach consensus. Of the 17 General Surgery Program directors across the country, 14 (82.4%) and 10 (58.8%) program directors responded to the first and second round, respectively. A total of 59 items and procedures reached positive consensus and were included in the final examination blueprint. The present study has outlined the development of an examination blueprint for a General Surgery certifying examination using a consensus-based methodology. This validation study will serve as the foundational work from which simulated model will be developed, pilot tested and evaluated. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  11. Holocene and latest Pleistocene climate and glacier fluctuations in Iceland

    Science.gov (United States)

    Geirsdóttir, Áslaug; Miller, Gifford H.; Axford, Yarrow; Ólafsdóttir, Sædís

    2009-10-01

    Multiproxy climate records from Iceland document complex changes in terrestrial climate and glacier fluctuations through the Holocene, revealing some coherent patterns of change as well as significant spatial variability. Most studies on the Last Glacial Maximum and subsequent deglaciation reveal a dynamic Iceland Ice Sheet (IIS) that responded abruptly to changes in ocean currents and sea level. The IIS broke up catastrophically around 15 ka as the Polar Front migrated northward and sea level rose. Indications of regional advance or halt of the glaciers are seen in late Alleröd/early Younger Dryas time and again in PreBoreal time. Due to the apparent rise of relative sea level in Iceland during this time, most sites contain evidence for fluctuating, tidewater glacier termini occupying paleo fjords and bays. The time between the end of the Younger Dryas and the Preboreal was characterized by repeated jökulhlaups that eroded glacial deposits. By 10.3 ka, the main ice sheet was in rapid retreat across the highlands of Iceland. The Holocene thermal maximum (HTM) was reached after 8 ka with land temperatures estimated to be 3 °C higher than the 1961-1990 reference, and net precipitation similar to modern. Such temperatures imply largely ice-free conditions across Iceland in the early to mid-Holocene. Several marine and lacustrine sediment climate proxies record substantial summer temperature depression between 8.5 and 8 ka, but no moraines have been detected from that time. Termination of the HTM and onset of Neoglacial cooling took place sometime after 6 ka with increased glacier activity between 4.5 and 4.0 ka, intensifying between 3.0 and 2.5 ka. Although a distinct warming during the Medieval Warm Period is not dramatically apparent in Icelandic records, the interval from ca AD 0 to 1200 is commonly characterized by relative stability with slow rates of change. The literature most commonly describes Little Ice Age moraines (ca AD 1250-1900) as representing the

  12. Package performance evaluation: our latest 30-year experience

    International Nuclear Information System (INIS)

    Malesys, Pierre; Gagner, Laurent

    2006-01-01

    Packages for the transport of radioactive material have to comply with national and / or international regulations. These regulations are widely based on the requirements set forth by the International Atomic Energy Agency (IAEA) in the 'Regulations for the Safe Transport of Radioactive Material'. The packages designed to transport the most demanding contents are submitted to tests for demonstrating their ability to withstand accident conditions of transport. These tests are typically: - a nine-meter drop onto a flat and unyielding surface, - a one-meter drop onto a punch, - a 800 deg. C / 30 minutes fire, and an immersion under a head of water of either 0.9 m, or 15 m or 200 m (depending of the criteria to be considered). During the last 20 years, on several of its package designs, COGEMA LOGISTICS has performed tests and analyses to simulate extremely severe accidents. These tests and analysis include: 1. long duration fire test and deep immersion test on a package designed to transport plutonium oxide powder; - 2. deep immersion tests on scale model of packages designed to transport spent fuel, high level vitrified waste and fresh MOX (uranium and plutonium mixed oxide) fuel; - 3. burial in a soft ground of packages designed to transport spent fuel; - 4. numerical study of the thermal behaviour of packages designed to transport spent fuel and high level vitrified waste; - 5. aircraft crash test on scale models of dual-purpose packages for the transport and storage of spent fuel. The paper will: - review the tests and analysis which were performed; - show that our designs are able to withstand extremely severe conditions; - demonstrate that there is no cliff effect: should a failure occurs, it appears gradually and there is no sudden collapse of the package; - explain how compliance with all the regulatory requirements lead to high performances regarding each of them (for instance, in many cases, the need to meet radiation exposure criteria induces a mechanical

  13. Patient and professional attitudes towards research in general practice: the RepR qualitative study.

    Science.gov (United States)

    Cadwallader, Jean-Sébastien; Lebeau, Jean-Pierre; Lasserre, Evelyne; Letrilliart, Laurent

    2014-07-21

    Since the 1990s, professional institutions worldwide have emphasised the need to develop research in general practice to improve the health of the population. The recent creation of professorships in general practice in French Universities should foster research in this field. Our aim was to explore the views of patients and relevant professionals on research in general practice. Qualitative study, using the grounded theory approach according to Strauss and Corbin, conducted in 2010 in three French regions. Nine focus groups were run to data saturation, and included 57 participants in four different categories: patients, non-academic GPs, academic GPs, academics in other disciplines. Most of the participants in the four categories described research in general practice as specific to the population managed and relevant for health care. They considered that its grounding in day-to-day practice enabled pragmatic approaches. The influence of the pharmaceutical industry, rivalries between university disciplines and a possible gap between research and practice were considered as pitfalls. The barriers identified were representations of the medical researcher as a "laboratory worker", the lack of awareness of any research in the discipline, and lack of time and training. While the views of patients and non-academic GPs are mostly focused on professional issues and the views of academics other than GPs on technical issues, academic GPs are in a position to play a role of interface between the universities and general practices. Although the role of GPs in research is perceived differently by the various protagonists, research in general practice has an undisputed legitimacy in France. Solutions for overcoming the identified barriers include research networks with appropriate resources and training and scientifically sound collaborative research projects, as already implemented in leading countries.

  14. Assessment of the Future Health Burden Attributable to Undernutrition under the Latest Scenario Framework for Climate Change Research

    Science.gov (United States)

    Ishida, Hiroyuki; Kobayashi, Shota; Yoshikawa, Sayaka; Kanae, Shinjiro; Hasegawa, Tomoko; Fujimori, Shinichiro; Shin, Yonghee; Takahashi, Kiyoshi; Masui, Toshihiko; Tanaka, Akemi; Honda, Yasushi

    2014-05-01

    There are growing concerns that future food security will be negatively affected by various factors, such as changes in socioeconomic and climate conditions. The health burden attributable to childhood undernutrition is among the most severe problems related to food crisis in the world. This study assessed the health burden attributable to childhood underweight through 2050 focusing on disability-adjusted life years (DALYs), by considering the latest scenarios for climate change studies (Representative Concentration Pathways (RCPs) and Shared Socioeconomic Pathways (SSPs)) and conducting sensitivity analysis. We used three SSPs (SSP1, SSP2 and SSP3) as future population and gross domestic products (GDP), three RCPs (RCP2.6, RCP4.5 and RCP8.5) for a greenhouse gas emissions constraint, and 12 Global Circulation Models (12 GCMs) to estimate climate conditions. A regression model for estimating DALYs attributable to childhood underweight (DAtU) was developed using the relationship between DAtU and childhood stunting. A logarithmic relationship was proposed for the regression model. We combined a global computable general equilibrium model, a crop model (M-GAEZ), and two regression models to assess the future health burden. We found that i) world total DAtU decreases from 2005 by 23 ~ 60% in 2030 depending on the socioeconomic scenarios. DAtU decreases further by 2050 for SSP1 and SSP2 scenario, whereas it slightly increases for SSP3. Per capita DAtU also decreases in all regions under either scenario in 2050, but the decreases vary significantly by regions and scenarios. ii) the impact of climate change is relatively small in the framework of this study but, on the other hand, socioeconomic conditions have a great impact on the future health burden. The impact of changes in socioeconomic conditions on the health burden is greater in the regions where current health burden is high. iii) parameter uncertainty of the regression models is the second largest factor on

  15. The causes of prescribing errors in English general practices: a qualitative study.

    Science.gov (United States)

    Slight, Sarah P; Howard, Rachel; Ghaleb, Maisoon; Barber, Nick; Franklin, Bryony Dean; Avery, Anthony J

    2013-10-01

    Few detailed studies exist of the underlying causes of prescribing errors in the UK. To examine the causes of prescribing and monitoring errors in general practice and provide recommendations for how they may be overcome. Qualitative interview and focus group study with purposive sampling of English general practices. General practice staff from 15 general practices across three PCTs in England participated in a combination of semi-structured interviews (n = 34) and six focus groups (n = 46). Thematic analysis informed by Reason's Accident Causation Model was used. Seven categories of high-level error-producing conditions were identified: the prescriber, the patient, the team, the working environment, the task, the computer system, and the primary-secondary care interface. These were broken down to reveal various error-producing conditions: the prescriber's therapeutic training, drug knowledge and experience, knowledge of the patient, perception of risk, and their physical and emotional health; the patient's characteristics and the complexity of the individual clinical case; the importance of feeling comfortable within the practice team was highlighted, as well as the safety implications of GPs signing prescriptions generated by nurses when they had not seen the patient for themselves; the working environment with its extensive workload, time pressures, and interruptions; and computer-related issues associated with mis-selecting drugs from electronic pick-lists and overriding alerts were all highlighted as possible causes of prescribing errors and were often interconnected. Complex underlying causes of prescribing and monitoring errors in general practices were highlighted, several of which are amenable to intervention.

  16. General Intelligence, Emotional Intelligence and Academic Knowledge as Predictors of Creativity Domains: A Study of Gifted Students

    Science.gov (United States)

    Sahin, Feyzullah

    2016-01-01

    Creativity of the individual is dependent on numerous factors, such as knowledge, general intelligence and emotional intelligence. The general purpose of this study is to investigate the effect of general intelligence, emotional intelligence and academic knowledge on the emerging of domain-specific creativity. The study was conducted on 178…

  17. Recommendations for describing statistical studies and results in general readership science and engineering journals.

    Science.gov (United States)

    Gardenier, John S

    2012-12-01

    This paper recommends how authors of statistical studies can communicate to general audiences fully, clearly, and comfortably. The studies may use statistical methods to explore issues in science, engineering, and society or they may address issues in statistics specifically. In either case, readers without explicit statistical training should have no problem understanding the issues, the methods, or the results at a non-technical level. The arguments for those results should be clear, logical, and persuasive. This paper also provides advice for editors of general journals on selecting high quality statistical articles without the need for exceptional work or expense. Finally, readers are also advised to watch out for some common errors or misuses of statistics that can be detected without a technical statistical background.

  18. A report on workshops: General circulation model study of climate- chemistry interaction

    International Nuclear Information System (INIS)

    Wei-Chyung, Wang; Isaksen, I.S.A.

    1993-01-01

    This report summarizes the discussion on General Circulation Model Study of Climate-Chemistry Interaction from two workshops, the first held 19--21 August 1992 at Oslo, Norway and the second 26--27 May 1993 at Albany, New York, USA. The workshops are the IAMAP activities under the Trace Constituent Working Group. The main objective of the two workshops was to recommend specific general circulation model (GCM) studies of the ozone distribution and the climatic effect of its changes. The workshops also discussed the climatic implications of increasing sulfate aerosols because of its importance to regional climate. The workshops were organized into four working groups: observation of atmospheric O 3 ; modeling of atmospheric chemical composition; modeling of sulfate aerosols; and aspects of climate modeling

  19. General practitioners’ assessment practices of patients' need for lifestyle intervention. A vignette study on the impact of social distance on general practitioners’ patient assessments

    DEFF Research Database (Denmark)

    Ilsvard, Sofie

    2015-01-01

    discretion, especially in preventive contexts with no clear-cut guidelines. However, despite its potential influence, few studies have focused on whether social distance has an impact on general practitioners’ assessment practices of patients, which thus seems to be a blind spot in the literature. To study...... the mechanisms facilitating the process of social distance systematically, I apply the vignette method. Drawing on Bourdieu’s theoretical framework of social distance, I examine how general practitioners assess different socially positioned patients as needy for preventive lifestyle intervention. I expect social...

  20. Error Analysis and Evaluation of the Latest GSMap and IMERG Precipitation Products over Eastern China

    Directory of Open Access Journals (Sweden)

    Shaowei Ning

    2017-01-01

    Full Text Available The present study comprehensively analyzes error characteristics and performance of the two latest GPM-era satellite precipitation products over eastern China from April 2014 to March 2016. Analysis results indicate that the two products have totally different spatial distributions of total bias. Many of the underestimations for the GSMap-gauged could be traced to significant hit bias, with a secondary contribution from missed precipitation. For IMERG, total bias illustrates significant overestimation over most of the eastern part of China, except upper reaches of Yangtze and Yellow River basins. GSMap-gauged tends to overestimate light precipitation (<16 mm/day and underestimate precipitation with rain rate larger than 16 mm/day; however, IMERG underestimates precipitation at rain rate between 8 and 64 mm/day and overestimates precipitation at rain rate more than 64 mm/day. IMERG overestimates extreme precipitation indices (RR99P and R20TOT, with relative bias values of 17.9% and 11.5%, respectively. But GSMap-gauged shows significant underestimation of these indices. In addition, both products performed well in the Huaihe, Liaohe, and Yangtze River basins for extreme precipitation detection. At basin scale comparisons, the GSMap-gauged data has a relatively higher accuracy than IMERG, especially at the Haihe, Huaihe, Liaohe, and Yellow River basins.

  1. [Latest trends in the surgical management of mandibular condyle fractures in France, 2005-2012].

    Science.gov (United States)

    Trost, O; Péron, J-M

    2013-12-01

    The surgical treatment of mandibular condylar fractures is commonly performed. We had for aim to present the latest trends in the surgical management of condylar fractures in France, between 2005 and 2012. A survey was performed among the 49 members of the French college of oral and maxillofacial surgeons between January and September 2012, with a questionnaire sent by email. We analyzed the therapeutic management, the surgical indications; the techniques used according to the fracture, and the postoperative treatment protocols. The data was compared to that of a similar study performed in 2005. The overall reply rate was 86%. Low subcondylar fractures were operated on in all institutions (100%), compared to 76% in 2005. The most popular technique was the high submandibular approach with intraoral miniplate fixation osteosynthesis. High subcondylar and diacapitular fractures were operated on in respectively 82% and 35% of the cases compared to 29% and 10% in 2005 with various surgical techniques and postoperative management. French maxillofacial surgeons operated on more mandibular condylar fractures in 2012 than in 2005. As observed in 2005, the lower and the more dislocated the fractures were, the more they were operated on. The high submandibular approach has become the most popular approach. The use of miniplates for bone fixation has become common. Diacapitular fractures were usually treated functionally. The postoperative management varied greatly from one team to the other. Copyright © 2013. Published by Elsevier Masson SAS.

  2. The infrared imaging spectrograph (IRIS) for TMT: latest science cases and simulations

    Science.gov (United States)

    Wright, Shelley A.; Walth, Gregory; Do, Tuan; Marshall, Daniel; Larkin, James E.; Moore, Anna M.; Adamkovics, Mate; Andersen, David; Armus, Lee; Barth, Aaron; Cote, Patrick; Cooke, Jeff; Chisholm, Eric M.; Davidge, Timothy; Dunn, Jennifer S.; Dumas, Christophe; Ellerbroek, Brent L.; Ghez, Andrea M.; Hao, Lei; Hayano, Yutaka; Liu, Michael; Lopez-Rodriguez, Enrique; Lu, Jessica R.; Mao, Shude; Marois, Christian; Pandey, Shashi B.; Phillips, Andrew C.; Schoeck, Matthias; Subramaniam, Annapurni; Subramanian, Smitha; Suzuki, Ryuji; Tan, Jonathan C.; Terai, Tsuyoshi; Treu, Tommaso; Simard, Luc; Weiss, Jason L.; Wincentsen, James; Wong, Michael; Zhang, Kai

    2016-07-01

    The Thirty Meter Telescope (TMT) first light instrument IRIS (Infrared Imaging Spectrograph) will complete its preliminary design phase in 2016. The IRIS instrument design includes a near-infrared (0.85 - 2.4 micron) integral field spectrograph (IFS) and imager that are able to conduct simultaneous diffraction-limited observations behind the advanced adaptive optics system NFIRAOS. The IRIS science cases have continued to be developed and new science studies have been investigated to aid in technical performance and design requirements. In this development phase, the IRIS science team has paid particular attention to the selection of filters, gratings, sensitivities of the entire system, and science cases that will benefit from the parallel mode of the IFS and imaging camera. We present new science cases for IRIS using the latest end-to-end data simulator on the following topics: Solar System bodies, the Galactic center, active galactic nuclei (AGN), and distant gravitationally-lensed galaxies. We then briefly discuss the necessity of an advanced data management system and data reduction pipeline.

  3. Laparoscopic colorectal surgery: Current status and implementation of the latest technological innovations.

    Science.gov (United States)

    Pascual, Marta; Salvans, Silvia; Pera, Miguel

    2016-01-14

    The introduction of laparoscopy is an example of surgical innovation with a rapid implementation in many areas of surgery. A large number of controlled studies and meta-analyses have shown that laparoscopic colorectal surgery is associated with the same benefits than other minimally invasive procedures, including lesser pain, earlier recovery of bowel transit and shorter hospital stay. On the other hand, despite initial concerns about oncological safety, well-designed prospective randomized multicentre trials have demonstrated that oncological outcomes of laparoscopy and open surgery are similar. Although the use of laparoscopy in colorectal surgery has increased in recent years, the percentages of patients treated with surgery using minimally invasive techniques are still reduced and there are also substantial differences among centres. It has been argued that the limiting factor for the use of laparoscopic procedures is the number of surgeons with adequate skills to perform a laparoscopic colectomy rather than the tumour of patients' characteristics. In this regard, future efforts to increase the use of laparoscopic techniques in colorectal surgery will necessarily require more efforts in teaching surgeons. We here present a review of recent controversies of the use of laparoscopy in colorectal surgery, such as in rectal cancer operations, the possibility of reproducing complete mesocolon excision, and the benefits of intra-corporeal anastomosis after right hemicolectomy. We also describe the results of latest innovations such as single incision laparoscopic surgery, robotic surgery and natural orifice transluminal endoscopic surgery for colon and rectal diseases.

  4. The latest succession of dinosaur tracksites in Europe: Hadrosaur ichnology, track production and palaeoenvironments.

    Directory of Open Access Journals (Sweden)

    Bernat Vila

    Full Text Available A comprehensive review and study of the rich dinosaur track record of the Tremp Formation in the southern Pyrenees of Spain (Southwestern Europe shows a unique succession of footprint localities prior to the end-Cretaceous mass extinction event. A description of some 30 new tracksites and data on sedimentary environments, track occurrence and preservation, ichnology and chronostratigraphy are provided. These new track localities represent various facies types within a diverse set of fluvial environments. The footprint discoveries mostly represent hadrosaurian and, less abundantly, to sauropod dinosaurs. The hadrosaur tracks are significantly smaller in size than, but morphologically similar to, those of North America and Asia and are attributable to the ichnogenus Hadrosauropodus. The track succession, with more than 40 distinct track levels, indicates that hadrosaur footprints in the Ibero-Armorican region occur predominantly in the late Maaastrichtian (at least above the early Maastrichtian-late Maastrichtian boundary. The highest abundance is found noticeably found in the late Maastrichtian, with tracks occurring in the C29r magnetochron, within about the latest 300,000 years of the Cretaceous.

  5. Interprofessional Collaboration between General Physicians and Emergency Department Teams in Belgium: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Marlène Karam

    2017-10-01

    Full Text Available This study aimed to assess interprofessional collaboration between general physicians and emergency departments in the French speaking regions of Belgium. Eight group interviews were conducted both in rural and urban areas, including in Brussels. Findings showed that the relational components of collaboration, which are highly valued by individuals involved, comprise mutual acquaintanceship and trust, shared power and objectives. The organizational components of collaboration included out-of-hours services, role clarification, leadership and overall environment. Communication and patient’s role were also found to be key elements in enhancing or hindering collaboration across these two levels of care. Relationships between general physicians and emergency departments’ teams were tightly linked to organizational factors and the general macro-environment. Health system regulation did not appear to play a significant role in promoting collaboration between actors. A better role clarification is needed in order to foster multidisciplinary team coordination for a more efficient patient management. Finally, economic power and private practice impeded interprofessional collaboration between the care teams. In conclusion, many challenges need to be addressed for achievement of a better collaboration and more efficient integration. Not only should integration policies aim at reinforcing the role of general physicians as gatekeepers, also they should target patients’ awareness and empowerment.

  6. Study on sampling of continuous linear system based on generalized Fourier transform

    Science.gov (United States)

    Li, Huiguang

    2003-09-01

    In the research of signal and system, the signal's spectrum and the system's frequency characteristic can be discussed through Fourier Transform (FT) and Laplace Transform (LT). However, some singular signals such as impulse function and signum signal don't satisfy Riemann integration and Lebesgue integration. They are called generalized functions in Maths. This paper will introduce a new definition -- Generalized Fourier Transform (GFT) and will discuss generalized function, Fourier Transform and Laplace Transform under a unified frame. When the continuous linear system is sampled, this paper will propose a new method to judge whether the spectrum will overlap after generalized Fourier transform (GFT). Causal and non-causal systems are studied, and sampling method to maintain system's dynamic performance is presented. The results can be used on ordinary sampling and non-Nyquist sampling. The results also have practical meaning on research of "discretization of continuous linear system" and "non-Nyquist sampling of signal and system." Particularly, condition for ensuring controllability and observability of MIMO continuous systems in references 13 and 14 is just an applicable example of this paper.

  7. Medical students' perceptions of general practice as a career; a phenomenological study using socialisation theory.

    Science.gov (United States)

    Reid, Katherine; Alberti, Hugh

    2018-04-23

    The ageing population and push to community care has significantly increased the workload of General Practitioners (GPs) in the UK and internationally. In an attempt to tackle this, NHS England has promised 5000 more GPs by 2020/21; however, recruitment is in crisis with GP training posts remaining unfilled. Little research has been carried out to assess the fundamental questions of what medical students' perceptions of General Practice are and what shapes their perceptions at medical school. We aimed to explore medical students' conceptualisations of being a GP and specifically the role of the medical school in shaping their perceptions. Two focus groups of year one and year four medical students were undertaken using an interpretive phenomenological approach. Our study has revealed that medical students perceive General Practice to lack prestige and challenge. These perceptions come, at least in part, from a process of socialisation within medical school, whereby medical students internalise and adopt their role models' perceptions and values, and the values portrayed by the hidden curriculum in their medical school culture. Perceived external pressures to pursue a career in General Practice can have a negative influence and medical schools should be made aware of this.

  8. Nurse prescribing in general practice: a qualitative study of job satisfaction and work-related stress.

    Science.gov (United States)

    Cousins, Rosanna; Donnell, Christine

    2012-04-01

    Studies examining the impact nurse prescribing have largely focused on the efficacy of the service. It was suggested in pro-prescribing policy arguments that extending the nursing role to include prescribing would increase job satisfaction. This assertion has not been fully explored. To investigate the impact of independent prescribing for experienced nurse practitioners (NPs) working in general practice. In-depth interviews were conducted with six NPs who each had at least 3 years experience of independent prescribing in a busy inner city general practice. Analysis of interview data yielded two main themes: as independent prescribers NPs experienced increased levels of both job satisfaction and work-related stress. Increased satisfaction was associated with having greater autonomy and being able to provide more holistic care. Increased work-related stress emerged from greater job demands, perceived insufficient support and perceived effort-reward imbalance that centred upon the enhanced role not being recognized in terms of an increase in grade and pay. Independent prescribing increases job satisfaction for NPs in general practice, but there is also evidence of stressors associated with the role. It is important that NPs in general practice are encouraged and supported towards providing the effective patient-centred care in the community envisaged by current UK government. We acknowledge that the results presented in this paper are based on a sample limited to one city; however, it provides information that has important implications for the well being of NPs and ultimately patient care.

  9. Theory and interpretation in qualitative studies from general practice: Why and how?

    Science.gov (United States)

    Malterud, Kirsti

    2016-03-01

    In this article, I want to promote theoretical awareness and commitment among qualitative researchers in general practice and suggest adequate and feasible theoretical approaches. I discuss different theoretical aspects of qualitative research and present the basic foundations of the interpretative paradigm. Associations between paradigms, philosophies, methodologies and methods are examined and different strategies for theoretical commitment presented. Finally, I discuss the impact of theory for interpretation and the development of general practice knowledge. A scientific theory is a consistent and soundly based set of assumptions about a specific aspect of the world, predicting or explaining a phenomenon. Qualitative research is situated in an interpretative paradigm where notions about particular human experiences in context are recognized from different subject positions. Basic theoretical features from the philosophy of science explain why and how this is different from positivism. Reflexivity, including theoretical awareness and consistency, demonstrates interpretative assumptions, accounting for situated knowledge. Different types of theoretical commitment in qualitative analysis are presented, emphasizing substantive theories to sharpen the interpretative focus. Such approaches are clearly within reach for a general practice researcher contributing to clinical practice by doing more than summarizing what the participants talked about, without trying to become a philosopher. Qualitative studies from general practice deserve stronger theoretical awareness and commitment than what is currently established. Persistent attention to and respect for the distinctive domain of knowledge and practice where the research deliveries are targeted is necessary to choose adequate theoretical endeavours. © 2015 the Nordic Societies of Public Health.

  10. Implementing evidence-based medicine in general practice: a focus group based study

    Directory of Open Access Journals (Sweden)

    Aertgeerts Bert

    2005-09-01

    Full Text Available Abstract Background Over the past years concerns are rising about the use of Evidence-Based Medicine (EBM in health care. The calls for an increase in the practice of EBM, seem to be obstructed by many barriers preventing the implementation of evidence-based thinking and acting in general practice. This study aims to explore the barriers of Flemish GPs (General Practitioners to the implementation of EBM in routine clinical work and to identify possible strategies for integrating EBM in daily work. Methods We used a qualitative research strategy to gather and analyse data. We organised focus groups between September 2002 and April 2003. The focus group data were analysed using a combined strategy of 'between-case' analysis and 'grounded theory approach'. Thirty-one general practitioners participated in four focus groups. Purposeful sampling was used to recruit participants. Results A basic classification model documents the influencing factors and actors on a micro-, meso- as well as macro-level. Patients, colleagues, competences, logistics and time were identified on the micro-level (the GPs' individual practice, commercial and consumer organisations on the meso-level (institutions, organisations and health care policy, media and specific characteristics of evidence on the macro-level (policy level and international scientific community. Existing barriers and possible strategies to overcome these barriers were described. Conclusion In order to implement EBM in routine general practice, an integrated approach on different levels needs to be developed.

  11. Generalized functions

    CERN Document Server

    Gelfand, I M; Graev, M I; Vilenkin, N Y; Pyatetskii-Shapiro, I I

    Volume 1 is devoted to basics of the theory of generalized functions. The first chapter contains main definitions and most important properties of generalized functions as functional on the space of smooth functions with compact support. The second chapter talks about the Fourier transform of generalized functions. In Chapter 3, definitions and properties of some important classes of generalized functions are discussed; in particular, generalized functions supported on submanifolds of lower dimension, generalized functions associated with quadratic forms, and homogeneous generalized functions are studied in detail. Many simple basic examples make this book an excellent place for a novice to get acquainted with the theory of generalized functions. A long appendix presents basics of generalized functions of complex variables.

  12. Pain, power and patience - A narrative study of general practitioners' relations with chronic pain patients

    OpenAIRE

    Hemborg Kristiansson, Mia; Brorsson, Annika; Wachtler, Caroline; Troein, Margareta

    2011-01-01

    Abstract Background Chronic pain patients are common in general practice. In this study "chronic pain" is defined as diffuse musculoskeletal pain not due to inflammatory diseases or cancer. Effective patient-physician relations improve treatment results. The relationship between doctors and chronic pain patients is often dysfunctional. Consultation training for physicians and medical students can improve the professional ability to build effective relations, but this demands a thorough unders...

  13. A qualitative study on nurses' reactions to inpatient suicide in a general hospital

    Directory of Open Access Journals (Sweden)

    Shujie Wang

    2016-12-01

    Conclusions: Nurses who experienced inpatient suicide became stressed. Effective interventions must be implemented to improve the coping mechanisms of nurses against the negative consequences of inpatient suicide. The findings of this study will allow administrators to gain insight into the impacts of inpatient suicides on nurses in general hospitals. Such information can be used to develop effective strategies and provide individual support and ongoing education. Consequently, nurses will acquire suicide prevention skills and help patients achieve swift recovery.

  14. Marital status and generalized trust in other people: A population-based study

    OpenAIRE

    Lindström, Martin

    2012-01-01

    The association between marital status and generalized trust in other people was investigated. The public health survey in Skane 2008 is a cross-sectional study including 28,198 persons (55% participation rate) aged 18-80 in southern Sweden. Logistic regression models investigated associations between marital status and trust, adjusting for age, country of birth, education, emotional support, instrumental support and economic stress. 33.9% of the men and 35.7% of the women had low trust. The ...

  15. Pension benefits of executive directors : A comparative study of general retailers between 2006-2010

    OpenAIRE

    Condric, Tomislav; Tomic, Katarina

    2012-01-01

    Several recent corporate governance scandals relate to non-disclosure or high amounts of pension benefits given to executive directors. The lack of disclosure and transparency has gained pensions benefits greater attention as a significant part of the total remuneration received by executive directors. Due to the associated problems there is a greater need for better disclosure and in turn heightened transparency towards shareholders.   This qualitative case study focuses on general retailers...

  16. Latest News

    CERN Multimedia

    Miele, P.

    B0 TOROID MODEL COIL The B0 toroid model coil was successfully tested with magnetic mirror at nominal current I=20.5 kA, up to a maximum current Imax=24 kA to verify a 10% BT force load current. An extensive campaign of measurements act to characterize the mechanical, thermal, electrical and magnetic properties of the coil was performed in the period April-Dec 2001, and handling and assembly trials to exercise BT underground installation were done in the period Jan-Feb 2002. NEW LAYOUT OF BT INTEGRATION - TESTING IN BUILDING 180 Integration 1 and Integration 2 of the BT coils, which are the assembly of the double pancakes into the coil casing (cold mass), and the assembly of the cold mass and related components into the vacuum vessel respectively, are both performed in Building 180. Thereafter the integrated coils are tested with magnetic mirror in the test bench. A new organizational scheme and detailed working plan are under definition to prepare and optimize the space available. BT PRODUCTION ...

  17. Patients' evaluations of patient safety in English general practices: a cross-sectional study.

    Science.gov (United States)

    Ricci-Cabello, Ignacio; Marsden, Kate S; Avery, Anthony J; Bell, Brian G; Kadam, Umesh T; Reeves, David; Slight, Sarah P; Perryman, Katherine; Barnett, Jane; Litchfield, Ian; Thomas, Sally; Campbell, Stephen M; Doos, Lucy; Esmail, Aneez; Valderas, Jose M

    2017-07-01

    Description of safety problems and harm in general practices has previously relied on information from health professionals, with scarce attention paid to experiences of patients. To examine patient-reported experiences and outcomes of patient safety in primary care. Cross-sectional study in 45 general practices across five regions in the north, centre, and south of England. A version of the Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) questionnaire was sent to a random sample of 6736 patients. Main outcome measures included 'practice activation' (what a practice does to create a safe environment); 'patient activation' (how proactive are patients in ensuring safe healthcare delivery); 'experiences of safety events' (safety errors); 'outcomes of safety' (harm); and 'overall perception of safety' (how safe patients rate their practice). Questionnaires were returned by 1244 patients (18.4%). Scores were high for 'practice activation' (mean [standard error] = 80.4 out of 100 [2.0]) and low for 'patient activation' (26.3 out of 100 [2.6]). Of the patients, 45% reported experiencing at least one safety problem in the previous 12 months, mostly related to appointments (33%), diagnosis (17%), patient provider communication (15%), and coordination between providers (14%). Twenty-three per cent of the responders reported some degree of harm in the previous 12 months. The overall assessment of level of safety of practices was generally high (86.0 out of 100 [16.8]). Priority areas for patient safety improvement in general practices in England include appointments, diagnosis, communication, coordination, and patient activation. © British Journal of General Practice 2017.

  18. Experiences of using email for general practice consultations: a qualitative study.

    Science.gov (United States)

    Atherton, Helen; Pappas, Yannis; Heneghan, Carl; Murray, Elizabeth

    2013-11-01

    Reports suggest approximately 21-23% of GPs in the UK have consulted with patients using email, but little is known about the nature of this use and what it means for clinicians and patients in general practice. To understand the use of email consultation in general practice by investigating the experiences of existing users and views of experts. A qualitative study conducted in 2010 using purposive sampling and semi-structured interviews in general practice and community settings in some London boroughs. A maximum variation sample of GPs and patients who had used email for consultation in general practice were recruited, as were policy and/or implementation experts. Interviews continued until saturation was achieved. In total 10 GPs, 14 patients, and six experts were interviewed. Consultation by email was often triggered by logistic or practical issues; motivators for ongoing use were the benefits, such as convenience, for GPs and patients. Both GPs and patients reported concerns about safety and lack of guidance about the 'rules of engagement' in email consultations, with GPs also concerned about workload. In response, both groups attempted to introduce their own rules, although this only went some way to addressing uncertainty. Long term, participants felt there was a need for regulation and guidance. Consultations by email in general practice occur in an unregulated and unstructured way. Current UK policy is to promote consultations by email, making it crucial to consider the responsibility and workload faced by clinicians, and the changes required to ensure safe use; not doing so may risk safety breaches and result in suboptimal care for patients.

  19. Patient characteristics, resource use and outcomes associated with general internal medicine hospital care: the General Medicine Inpatient Initiative (GEMINI) retrospective cohort study.

    Science.gov (United States)

    Verma, Amol A; Guo, Yishan; Kwan, Janice L; Lapointe-Shaw, Lauren; Rawal, Shail; Tang, Terence; Weinerman, Adina; Cram, Peter; Dhalla, Irfan A; Hwang, Stephen W; Laupacis, Andreas; Mamdani, Muhammad M; Shadowitz, Steven; Upshur, Ross; Reid, Robert J; Razak, Fahad

    2017-12-11

    The precise scope of hospital care delivered under general internal medicine services remains poorly quantified. The purpose of this study was to describe the demographic characteristics, medical conditions, health outcomes and resource use of patients admitted to general internal medicine at 7 hospital sites in the Greater Toronto Area. This was a retrospective cohort study involving all patients who were admitted to or discharged from general internal medicine at the study sites between Apr. 1, 2010, and Mar. 31, 2015. Clinical data from hospital electronic information systems were linked to administrative data from each hospital. We examined trends in resource use and patient characteristics over the study period. There were 136 208 admissions to general internal medicine involving 88 121 unique patients over the study period. General internal medicine admissions accounted for 38.8% of all admissions from the emergency department and 23.7% of all hospital bed-days. Over the study period, the number of admissions to general internal medicine increased by 32.4%; there was no meaningful change in the median length of stay or cost per hospital stay. The median patient age was 73 (interquartile range [IQR] 57-84) years, and the median number of coexisting conditions was 6 (IQR 3-9). The median acute length of stay was 4.6 (IQR 2.5-8.6) days, and the median total cost per hospital stay was $5850 (IQR $3915-$10 061). Patients received at least 1 computed tomography scan in 52.2% of admissions. The most common primary discharge diagnoses were pneumonia (5.0% of admissions), heart failure (4.7%), chronic obstructive pulmonary disease (4.1%), urinary tract infection (4.0%) and stroke (3.6%). Patients admitted to general internal medicine services represent a large, heterogeneous, resource-intensive and growing population. Understanding and improving general internal medicine care is essential to promote a high-quality, sustainable health care system. Copyright 2017

  20. Burnout syndrome in surgical oncology and general surgery nurses: a cross-sectional study.

    Science.gov (United States)

    Książek, Ilona; Stefaniak, Tomasz J; Stadnyk, Magdalena; Książek, Janina

    2011-09-01

    The occurrence of burnout syndrome is strongly associated with and modulated by multiple personality and environmental factors. In Poland, nurses experience a discrepancy between the demands, expectations and social status of the position of their profession and low salaries. Such a situation provokes frustration and depression, and further leads to problems of adaptation including burnout syndrome. The aim of this study was to evaluate the occurrence of burnout syndrome among nurses working in general surgery and surgical oncology specialties. The study was designed as a cross-sectional questionnaire survey. It was undertaken in the largest Hospital in the Pomeranian region of Poland. The participants included 60 nurses working in two departments: General Surgery and Surgical Oncology. The study was based upon an anonymous self-test composed of a questionnaire and three psychological measures: Maslach Burnout Inventory (MBI), Psychological Burden Scale and a self-constructed questionnaire on job satisfaction. Intensity of burnout syndrome was significantly higher among oncology nurses than among surgical ones. There was also a strong but not significant trend towards higher Psychological Burden Scale in the group of oncology nurses. The study revealed a high degree of emotional burden and burnout in nurses working in the study hospital suggesting that nurses are at great occupational risk. The findings of the study provide evidence of the potential need to restructure the system and suggest that nurses need more control of their work including a higher degree of involvement in clinical decision-making. Copyright © 2010 Elsevier Ltd. All rights reserved.

  1. [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.

  2. General self-efficacy and posttraumatic stress after a natural disaster: a longitudinal study.

    Science.gov (United States)

    Nygaard, Egil; Hussain, Ajmal; Siqveland, Johan; Heir, Trond

    2016-04-06

    Self-efficacy may be an important factor in individuals' recovery from posttraumatic stress reactions after a natural disaster. However, few longitudinal studies have investigated whether self-efficacy predicts the course of posttraumatic recovery beyond lower initial levels of distress. The purpose of the present study was to investigate whether general self-efficacy is related to recovery from posttraumatic stress reactions from a longitudinal perspective. A total of 617 Norwegians exposed to the 2004 Southeast Asian tsunami completed self-report questionnaires measuring their level of disaster exposure and general self-efficacy at 6 months and posttraumatic stress reactions 6 months and 2 years post-disaster. Predictors of changes in posttraumatic stress reactions were analyzed with multivariate mixed effects models. Self-efficacy at 6 months post-disaster was unrelated to trauma exposure and inversely related to posttraumatic stress reactions at 6 months and 2 years post-disaster. However, self-efficacy was not related to recovery from posttraumatic stress reactions between 6 months and 2 years post-disaster. In conclusion, general self-efficacy is related to lower levels of posttraumatic stress reactions in the first months after a disaster but does not appear to be related to improved recovery rates over the longer term.

  3. Organising medication discontinuation: a qualitative study exploring the views of general practitioners toward discontinuing statins.

    Science.gov (United States)

    Nixon, Michael; Kousgaard, Marius Brostrøm

    2016-07-07

    Discontinuing medications is a complex decision making process and an important medical practice. It is a tool in reducing polypharmacy, reducing health system expenditure and improving patient quality of life. Few studies have looked at how general practitioners (GPs) discontinue a medication, in agreement with the patients, from a professional perspective. Three research questions were examined in this study: when does medication discontinuation occur in general practice, how is discontinuing medication handled in the GP's practice and how do GPs make decisions about discontinuing medication? Twenty four GPs were interviewed using a maximum variation sample strategy. Participant observations were done in three general practices, for one day each, totalling approximately 30 consultations. The results show that different discontinuation cues (related to the type of consultation, medical records and the patient) create situations of dissonance that can lead to the GP considering the option of discontinuation. We also show that there is a lot of ambiguity in situations of discontinuing and that some GPs trialled discontinuing as means of generating more information that could be used to deal with the ambiguity. We conclude that the practice of discontinuation should be conceptualised as a continually evaluative process and one that requires sustained reflection through a culture of systematically scheduled check-ups, routinely eliciting the patient's experience of taking drugs and trialling discontinuation. Some policy recommendations are offered including supporting GPs with lists or handbooks that directly address discontinuation and by developing more person centred clinical guidelines that discuss discontinuation more explicitly.

  4. General practitioners’ views on leadership roles and challenges in primary health care: a qualitative study

    Science.gov (United States)

    Spehar, Ivan; Sjøvik, Hege; Karevold, Knut Ivar; Rosvold, Elin Olaug; Frich, Jan C.

    2017-01-01

    Objective To explore general practitioners’ (GPs) views on leadership roles and leadership challenges in general practice and primary health care. Design We conducted focus groups (FGs) with 17 GPs. Setting Norwegian primary health care. Subjects 17 GPs who attended a 5 d course on leadership in primary health care. Results Our study suggests that the GPs experience a need for more preparation and formal training for the leadership role, and that they experienced tensions between the clinical and leadership role. GPs recognized the need to take on leadership roles in primary care, but their lack of leadership training and credentials, and the way in which their practices were organized and financed were barriers towards their involvement. Conclusions GPs experience tensions between the clinical and leadership role and note a lack of leadership training and awareness. There is a need for a more structured educational and career path for GPs, in which doctors are offered training and preparation in advance. Key points Little is known about doctors’ experiences and views about leadership in general practice and primary health care. Our study suggests that: There is a lack of preparation and formal training for the leadership role. GPs experience tensions between the clinical and leadership role. GPs recognize leadership challenges at a system level and that doctors should take on leadership roles in primary health care. PMID:28277051

  5. General practitioners' views on leadership roles and challenges in primary health care: a qualitative study.

    Science.gov (United States)

    Spehar, Ivan; Sjøvik, Hege; Karevold, Knut Ivar; Rosvold, Elin Olaug; Frich, Jan C

    2017-03-01

    To explore general practitioners' (GPs) views on leadership roles and leadership challenges in general practice and primary health care. We conducted focus groups (FGs) with 17 GPs. Norwegian primary health care. 17 GPs who attended a 5 d course on leadership in primary health care. Our study suggests that the GPs experience a need for more preparation and formal training for the leadership role, and that they experienced tensions between the clinical and leadership role. GPs recognized the need to take on leadership roles in primary care, but their lack of leadership training and credentials, and the way in which their practices were organized and financed were barriers towards their involvement. GPs experience tensions between the clinical and leadership role and note a lack of leadership training and awareness. There is a need for a more structured educational and career path for GPs, in which doctors are offered training and preparation in advance. KEY POINTS Little is known about doctors' experiences and views about leadership in general practice and primary health care. Our study suggests that: There is a lack of preparation and formal training for the leadership role. GPs experience tensions between the clinical and leadership role. GPs recognize leadership challenges at a system level and that doctors should take on leadership roles in primary health care.

  6. Sickness certification in the general practice consultation: the patients' perspective, a qualitative study.

    Science.gov (United States)

    O'Brien, Kathryn; Cadbury, Naomi; Rollnick, Stephen; Wood, Fiona

    2008-02-01

    Up to a third of general practice consultations involve issuing sickness certificates. Recent research has looked at the GPs' perspective of sickness certification but there has been no in-depth research exploring patients' views of these consultations. To explore patients' views of sickness certification within general practice consultations, and how these could be improved. A qualitative study was carried out with 12 general practices in South Wales; interview study of 19 patients who had recently received a sick note from a GP. Patients rarely attended just for a sick note, more often wanting advice or an opportunity to ask questions. Patients valued continuity of care, a good doctor-patient relationship, adequate consultation time and discussion about their illness, social situation and work-related issues when consulting with their GP for a sick note. Many patients felt doctors did not have enough time or knowledge of the patient to the able to address this issue adequately and this increased feelings of anxiety. Patients did not feel that being questioned by their GP or discussing return to work threatened the doctor-patient relationship. GPs who simply give out sick notes without question or discussion are not necessarily giving the patient what they want. More time should be spent discussing work and illness-related issues. Policy makers should recognize that continuity of care a good doctor-patient relationship and adequate consultation time are important to patients and any initiatives aimed at GPs to improve return to work rates should take these into consideration.

  7. Study of Confinement/Deconfinement Transition in AdS/QCD with Generalized Warp Factors

    Directory of Open Access Journals (Sweden)

    Shobhit Sachan

    2014-01-01

    Full Text Available We study analytical solutions of charged black holes and thermally charged AdS with generalized warped factors in Einstein-Maxwell-Dilaton system. We calculate Euclidean action for charged AdS and thermally charged AdS. The actions in both backgrounds are regularized by the method of background subtraction. The study of phase transition between charged black hole and thermally charged AdS gives an insight into the confinement/deconfinement transition. The plots of grand potential versus temperature and chemical potential versus transition temperature are obtained.

  8. Inspection Regulation between General Procedural Codification and Field Specifics – a Case Study of Slovenia

    Directory of Open Access Journals (Sweden)

    Kovač Polonca

    2016-03-01

    Full Text Available Inspection, as the authoritative supervision of private liable persons to comply their activities with sector-specific laws, should ensure the full implementation of public policies. Slovenia adopted the Inspection Act (IA in 2002, in order to conduct efficient inspection, and simultaneously guarantee the defence rights of the supervised parties pursuant to the fundamental principles of the EU, the national Constitution, and general Administrative Procedure Act. This article addresses the search for a balance between general codification and sector-related specifics as stipulated by the IA, applying normative, constitutional case law and comparative methods. Special attention is dedicated to the IA rules regarding participants, their legal protection and stages of respective proceedings. It has been concluded that the most of the IA specifics are justified in order to efficiently serve the public interest. This study reveals that the Slovene IA can represent a role model for efficient yet democratic supervision in other MS as well.

  9. Heterogeneity of the jealousy phenomenon in the general population: an Italian study.

    Science.gov (United States)

    Marazziti, Donatella; Sbrana, Alfredo; Rucci, Paola; Cherici, Luca; Mungai, Francesco; Gonnelli, Chiara; Massimetti, Enrico; Raimondi, Francesca; Doria, Maria Rosaria; Spagnolli, Sabrina; Ravani, Laura; Consoli, Giorgio; Catena Dell Osso, Mario

    2010-01-01

    Despite the general agreement that normal jealousy is heterogenous, little is known about this specific topic. In the present study, we explored the possibility of distinguishing between four subtypes of "normal" jealousy (depressive, anxious, obsessive, and paranoid) amongst a cohort of 500 healthy university students by means of a specifically designed questionnaire, "Ouestionario della gelosia" (QUEGE). QUEGE is a self-report instrument of 30 items which explores the presence, frequency, and duration of feelings and behaviors related to jealousy. It was devised to investigate four hypothetical psychopathological profiles: depressive, paranoid, obsessive, and anxious. The factor analysis identified five rather than four clear-cut factors: self-esteem, paranoia, interpersonal Sensitivity, fear of being abandoned, and obsessionality. Women showed statistically significant lower levels of self-esteem and higher levels of obsessionality than men. Younger age (jealousy phenomenon in the general population.

  10. Broken-pair, generalized seniority and interacting boson approximations in a spectroscopic study of Sn nuclei

    International Nuclear Information System (INIS)

    Bonsignori, K.; Allaart, K.; Egmond, A. van

    1983-01-01

    A broken-pair study of Sn nuclei is reported in which the model space includes two broken pair states. It is shown that for even Sn nuclei, with a rather simple Gaussian interaction and with single-particle-energies derived from data on odd nuclei, the main features of the excitation spectra up to about 3.5 MeV may be reproduced in this way. The idea of the generalized seniority scheme, that the composition of S-pair operator and that of the D-pair operator may be independent of the total number of pairs, is confirmed by the pair structures which result from energy minimization and diagonalization for each number of pairs separately. A general procedure is described to derive IBA parameters when the valence orbits are nondegenerate. Numerical results for Sn nuclei are given. (U.K.)

  11. Application of generalized estimating equations to a study in vitro of radiation sensitivity

    International Nuclear Information System (INIS)

    Cologne, J.B.; Carter, R.L.; Fujita, Shoichiro; Ban, Sadayuki.

    1993-08-01

    We describes an application of the generalized estimating equation (GEE) method (Liang K-Y, Zeger SL: Longitudinal data analysis using generalized linear models. Biometrika 73:13-22, 1986) for regression analyses of correlated Poisson data. As an alternative to the use of an arbitrarily chosen working correlation matrix, we demonstrate the use of GEE with a reasonable model for the true covariance structure among repeated observations within individuals. We show that, under such a split-plot design with large clusters, the asymptotic relative efficiency of GEE with simple (independence or exchangeable) working correlation matrices is rather low. We also illustrate the use of GEE with an empirically estimated model for overdispersion in a large study of radiation sensitivity where cluster size is small and a simple working correlation structure is sufficient. We conclude by summarizing issues and needs for further work concerning efficiency of the GEE parameter estimates in practice. (author)

  12. High workload and job stress are associated with lower practice performance in general practice: an observational study in 239 general practices in the Netherlands.

    NARCIS (Netherlands)

    Hombergh, P. van den; Kunzi, B.; Elwyn, G.; Doremalen, J.H.M. van; Akkermans, R.P.; Grol, R.P.T.M.; Wensing, M.J.P.

    2009-01-01

    BACKGROUND: The impact of high physician workload and job stress on quality and outcomes of healthcare delivery is not clear. Our study explored whether high workload and job stress were associated with lower performance in general practices in the Netherlands. METHODS: Secondary analysis of data

  13. Alternatives to the face-to-face consultation in general practice: focused ethnographic case study.

    Science.gov (United States)

    Atherton, Helen; Brant, Heather; Ziebland, Sue; Bikker, Annemieke; Campbell, John; Gibson, Andy; McKinstry, Brian; Porqueddu, Tania; Salisbury, Chris

    2018-04-01

    NHS policy encourages general practices to introduce alternatives to the face-to-face consultation, such as telephone, email, e-consultation systems, or internet video. Most have been slow to adopt these, citing concerns about workload. This project builds on previous research by focusing on the experiences of patients and practitioners who have used one or more of these alternatives. To understand how, under what conditions, for which patients, and in what ways, alternatives to face-to-face consultations present benefits and challenges to patients and practitioners in general practice. Focused ethnographic case studies took place in eight UK general practices between June 2015 and March 2016. Non-participant observation, informal conversations with staff, and semi-structured interviews with staff and patients were conducted. Practice documents and protocols were reviewed. Data were analysed through charting and the 'one sheet of paper' mind-map method to identify the line of argument in each thematic report. Case study practices had different rationales for offering alternatives to the face-to-face consultation. Beliefs varied about which patients and health issues were suitable. Co-workers were often unaware of each other's practice; for example, practice policies for use of e-consultations systems with patients were not known about or followed. Patients reported benefits including convenience and access. Staff and some patients regarded the face-to-face consultation as the ideal. Experience of implementing alternatives to the face-to-face consultation suggests that changes in patient access and staff workload may be both modest and gradual. Practices planning to implement them should consider carefully their reasons for doing so and involve the whole practice team. © British Journal of General Practice 2018.

  14. Student performance of the general physical examination in internal medicine: an observational study

    Science.gov (United States)

    2014-01-01

    Background Many practicing physicians lack skills in physical examination. It is not known whether physical examination skills already show deficiencies after an early phase of clinical training. At the end of the internal medicine clerkship students are expected to be able to perform a general physical examination in every new patient encounter. In a previous study, the basic physical examination items that should standardly be performed were set by consensus. The aim of the current observational study was to assess whether medical students were able to correctly perform a general physical examination regarding completeness as well as technique at the end of the clerkship internal medicine. Methods One hundred students who had just finished their clerkship internal medicine were asked to perform a general physical examination on a standardized patient as they had learned during the clerkship. They were recorded on camera. Frequency of performance of each component of the physical examination was counted. Adequacy of performance was determined as either correct or incorrect or not assessable using a checklist of short descriptions of each physical examination component. A reliability analysis was performed by calculation of the intra class correlation coefficient for total scores of five physical examinations rated by three trained physicians and for their agreement on performance of all items. Results Approximately 40% of the agreed standard physical examination items were not performed by the students. Students put the most emphasis on examination of general parameters, heart, lungs and abdomen. Many components of the physical examination were not performed as was taught during precourses. Intra-class correlation was high for total scores of the physical examinations 0.91 (p internal medicine clerkship. Possible causes and suggestions for improvement are discussed. PMID:24712683

  15. Comparison of progressive addition lenses for general purpose and for computer vision: an office field study.

    Science.gov (United States)

    Jaschinski, Wolfgang; König, Mirjam; Mekontso, Tiofil M; Ohlendorf, Arne; Welscher, Monique

    2015-05-01

    Two types of progressive addition lenses (PALs) were compared in an office field study: 1. General purpose PALs with continuous clear vision between infinity and near reading distances and 2. Computer vision PALs with a wider zone of clear vision at the monitor and in near vision but no clear distance vision. Twenty-three presbyopic participants wore each type of lens for two weeks in a double-masked four-week quasi-experimental procedure that included an adaptation phase (Weeks 1 and 2) and a test phase (Weeks 3 and 4). Questionnaires on visual and musculoskeletal conditions as well as preferences regarding the type of lenses were administered. After eight more weeks of free use of the spectacles, the preferences were assessed again. The ergonomic conditions were analysed from photographs. Head inclination when looking at the monitor was significantly lower by 2.3 degrees with the computer vision PALs than with the general purpose PALs. Vision at the monitor was judged significantly better with computer PALs, while distance vision was judged better with general purpose PALs; however, the reported advantage of computer vision PALs differed in extent between participants. Accordingly, 61 per cent of the participants preferred the computer vision PALs, when asked without information about lens design. After full information about lens characteristics and additional eight weeks of free spectacle use, 44 per cent preferred the computer vision PALs. On average, computer vision PALs were rated significantly better with respect to vision at the monitor during the experimental part of the study. In the final forced-choice ratings, approximately half of the participants preferred either the computer vision PAL or the general purpose PAL. Individual factors seem to play a role in this preference and in the rated advantage of computer vision PALs. © 2015 The Authors. Clinical and Experimental Optometry © 2015 Optometry Australia.

  16. Glutathione S-transferase genotypes modify lung function decline in the general population: SAPALDIA cohort study

    Directory of Open Access Journals (Sweden)

    Ackermann-Liebrich Ursula

    2007-01-01

    Full Text Available Abstract Background Understanding the environmental and genetic risk factors of accelerated lung function decline in the general population is a first step in a prevention strategy against the worldwide increasing respiratory pathology of chronic obstructive pulmonary disease (COPD. Deficiency in antioxidative and detoxifying Glutathione S-transferase (GST gene has been associated with poorer lung function in children, smokers and patients with respiratory diseases. In the present study, we assessed whether low activity variants in GST genes are also associated with accelerated lung function decline in the general adult population. Methods We examined with multiple regression analysis the association of polymorphisms in GSTM1, GSTT1 and GSTP1 genes with annual decline in FEV1, FVC, and FEF25–75 during 11 years of follow-up in 4686 subjects of the prospective SAPALDIA cohort representative of the Swiss general population. Effect modification by smoking, gender, bronchial hyperresponisveness and age was studied. Results The associations of GST genotypes with FEV1, FVC, and FEF25–75 were comparable in direction, but most consistent for FEV1. GSTT1 homozygous gene deletion alone or in combination with GSTM1 homozygous gene deletion was associated with excess decline in FEV1 in men, but not women, irrespective of smoking status. The additional mean annual decline in FEV1 in men with GSTT1 and concurrent GSTM1 gene deletion was -8.3 ml/yr (95% confidence interval: -12.6 to -3.9 relative to men without these gene deletions. The GSTT1 effect on the FEV1 decline comparable to the observed difference in FEV1 decline between never and persistent smoking men. Effect modification by gender was statistically significant. Conclusion Our results suggest that genetic GSTT1 deficiency is a prevalent and strong determinant of accelerated lung function decline in the male general population.

  17. Patients with persistent medically unexplained physical symptoms: a descriptive study from Norwegian general practice.

    Science.gov (United States)

    Aamland, Aase; Malterud, Kirsti; Werner, Erik L

    2014-05-29

    Further research on effective interventions for patients with peristent Medically Unexplained Physical Symptoms (MUPS) in general practice is needed. Prevalence estimates of such patients are conflicting, and other descriptive knowledge is needed for development and evaluation of effective future interventions. In this study, we aimed to estimate the consultation prevalence of patients with persistent MUPS in general practice, including patients' characteristics and symptom pattern, employment status and use of social benefits, and the general practitioners' (GPs) management strategy. During a four-week period the participating Norwegian GPs (n=84) registered all consultations with patients who met a strict definition of MUPS (>3 months duration and function loss), using a questionnaire with simple tick-off questions. Analyses were performed with descriptive statistics for all variables and split analysis on gender and age. The GPs registered 526 patients among their total of 17 688 consultations, giving a consultation prevalence of persistent MUPS of 3%. The mean age of patients was 46 years, and 399 (76%) were women. The most frequent group of symptoms was musculoskeletal problems, followed by asthenia/fatigue. There was no significant gender difference in symptom pattern. Almost half of the patients were currently working (45%), significantly more men. The major GP management strategy was supportive counseling. A consultation prevalence rate of 3% implies that patients with persistent MUPS are common in general practice. Our study disclosed heterogeneity among the patients such as differences in employment status, which emphasizes the importance of personalized focus rather than unsubstantiated stereotyping of "MUPS patients" as a group.

  18. Prospective, observational study comparing automated and visual point-of-care urinalysis in general practice.

    Science.gov (United States)

    van Delft, Sanne; Goedhart, Annelijn; Spigt, Mark; van Pinxteren, Bart; de Wit, Niek; Hopstaken, Rogier

    2016-08-08

    Point-of-care testing (POCT) urinalysis might reduce errors in (subjective) reading, registration and communication of test results, and might also improve diagnostic outcome and optimise patient management. Evidence is lacking. In the present study, we have studied the analytical performance of automated urinalysis and visual urinalysis compared with a reference standard in routine general practice. The study was performed in six general practitioner (GP) group practices in the Netherlands. Automated urinalysis was compared with visual urinalysis in these practices. Reference testing was performed in a primary care laboratory (Saltro, Utrecht, The Netherlands). Analytical performance of automated and visual urinalysis compared with the reference laboratory method was the primary outcome measure, analysed by calculating sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) and Cohen's κ coefficient for agreement. Secondary outcome measure was the user-friendliness of the POCT analyser. Automated urinalysis by experienced and routinely trained practice assistants in general practice performs as good as visual urinalysis for nitrite, leucocytes and erythrocytes. Agreement for nitrite is high for automated and visual urinalysis. κ's are 0.824 and 0.803 (ranked as very good and good, respectively). Agreement with the central laboratory reference standard for automated and visual urinalysis for leucocytes is rather poor (0.256 for POCT and 0.197 for visual, respectively, ranked as fair and poor). κ's for erythrocytes are higher: 0.517 (automated) and 0.416 (visual), both ranked as moderate. The Urisys 1100 analyser was easy to use and considered to be not prone to flaws. Automated urinalysis performed as good as traditional visual urinalysis on reading of nitrite, leucocytes and erythrocytes in routine general practice. Implementation of automated urinalysis in general practice is justified as automation is expected to reduce

  19. Collaborative care for depression in general practice: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Brinck-Claussen, Ursula Ødum; Curth, Nadja Kehler; Davidsen, Annette Sofie; Mikkelsen, John Hagel; Lau, Marianne Engelbrecht; Lundsteen, Merete; Csillag, Claudio; Christensen, Kaj Sparle; Hjorthøj, Carsten; Nordentoft, Merete; Eplov, Lene Falgaard

    2017-07-21

    Depression is a common illness with great human costs and a significant burden on the public economy. Previous studies have indicated that collaborative care (CC) has a positive effect on symptoms when provided to people with depression, but CC has not yet been applied in a Danish context. We therefore developed a model for CC (the Collabri model) to treat people with depression in general practice in Denmark. Since systematic identification of patients is an "active ingredient" in CC and some literature suggests case finding as the best alternative to standard detection, the two detection methods are examined as part of the study. The aim is to investigate if treatment according to the Collabri model has an effect on depression symptoms when provided to people with depression in general practice in Denmark, and to examine if case finding is a better method to detect depression in general practice than standard detection. The trial is a cluster-randomised, clinical superiority trial investigating the effect of treatment according to the Collabri model for CC, compared to treatment as usual for 480 participants diagnosed with depression in general practice in the Capital Region of Denmark. The primary outcome is depression symptoms (Beck's Depression Inventory (BDI-II)) after 6 months. Secondary outcomes include depression symptoms (BDI-II) after 15 months, anxiety symptoms (Beck's Anxiety Inventory (BAI)), level of functioning (Global Assessment of Function (GAF)) and psychological stress (Symptom Checklist-90-Revised (SCL-90-R)). In addition, case finding (with the recommended screening tool Major Depression Inventory (MDI)) and standard detection of depression is examined in a cluster-randomized controlled design. Here, the primary outcome is the positive predictive value of referral diagnosis. If the Collabri model is shown to be superior to treatment as usual, the study will contribute with important knowledge on how to improve treatment of depression in

  20. Paediatric palliative home care by general paediatricians: a multimethod study on perceived barriers and incentives

    Directory of Open Access Journals (Sweden)

    Fischbach Thomas

    2010-06-01

    Full Text Available Abstract Background Non-specialist palliative care, as it is delivered by general practitioners, is a basic component of a comprehensive palliative care infrastructure for adult patients with progressive and far advanced disease. Currently palliative care for children and adolescents is recognized as a distinct entity of care, requiring networks of service providers across different settings, including paediatricians working in general practice. In Germany, the medical home care for children and adolescents is to a large extent delivered by general paediatricians working in their own practice. However, these are rarely confronted with children suffering from life-limiting diseases. The aim of this study was therefore to examine potential barriers, incentives, and the professional self-image of general paediatricians with regard to paediatric palliative care. Methods Based on qualitative expert interviews, a questionnaire was designed and a survey among general paediatricians in their own practice (n = 293 was undertaken. The survey has been developed and performed in close cooperation with the regional professional association of paediatricians. Results The results showed a high disposition on part of the paediatricians to engage in palliative care, and the majority of respondents regarded palliative care as part of their profile. Main barriers for the implementation were time restrictions (40.7% and financial burden (31.6%, sole responsibility without team support (31.1%, as well as formal requirements such as forms and prescriptions (26.6%. Major facilitations were support by local specialist services such as home care nursing service (83.0%, access to a specialist paediatric palliative care consultation team (82.4%, as well as an option of exchange with colleagues (60.1%. Conclusions Altogether, the high commitment to this survey reflects the relevance of the issue for paediatricians working in general practice. Education in basic palliative

  1. Characteristics of qualitative studies in influential journals of general medicine: a critical review.

    Science.gov (United States)

    Yamazaki, Hiroshi; Slingsby, Brian Taylor; Takahashi, Miyako; Hayashi, Yoko; Sugimori, Hiroki; Nakayama, Takeo

    2009-12-01

    Although qualitative studies have increased since the 1990s, some reports note that relatively few influential journals published them up until 2000. This study critically reviewed the characteristics of qualitative studies published in top tier medical journals since 2000. We assessed full texts of qualitative studies published between 2000 and 2004 in the Annals of Internal Medicine, BMJ, JAMA, Lancet, and New England Journal of Medicine. We found 80 qualitative studies, of which 73 (91%) were published in BMJ. Only 10 studies (13%) combined qualitative and quantitative methods. Sixty-two studies (78%) used only one method of data collection. Interviews dominated the choice of data collection. The median sample size was 36 (range: 9-383). Thirty-three studies (41%) did not specify the type of analysis used but rather described the analytic process in detail. The rest indicated the mode of data analysis, in which the most prevalent methods were the constant comparative method (23%) and the grounded theory approach (22%). Qualitative data analysis software was used by 33 studies (41%). Among influential journals of general medicine, only BMJ consistently published an average of 15 qualitative study reports between 2000 and 2004. These findings lend insight into what qualities and characteristics make a qualitative study worthy of consideration to be published in an influential journal, primarily BMJ.

  2. 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.

  3. How to overcome hurdles in opiate substitution treatment? A qualitative study with general practitioners in Belgium.

    Science.gov (United States)

    Fraeyman, Jessica; Symons, Linda; Van Royen, Paul; Van Hal, Guido; Peremans, Lieve

    2016-06-01

    Opiate substitution treatment (OST) is the administration of opioids (methadone or buprenorphine) under medical supervision for opiate addiction. Several studies indicate a large unmet need for OST in general practice in Antwerp, Belgium. Some hurdles remain before GPs engage in OST prescribing. Formulate recommendations to increase engagement of GPs in OST, applicable to Belgium and beyond. In 2009, an exploratory qualitative research was performed using focus group discussions and interviews with GPs. During data collection and analysis, purposive sampling, open and axial coding was applied. The script was composed around the advantages, disadvantages and conditions of engaging in OST in general practice. We conducted six focus groups and two interviews, with GPs experienced in prescribing OST (n = 13), inexperienced GPs (n = 13), and physicians from addiction centres (n = 5). Overall, GPs did not seem very willing to prescribe OST for opiate users. A lack of knowledge about OST and misbehaving patients creates anxiety and makes the GPs reluctant to learn more about OST. The GPs refer to a lack of collaboration with the addiction centres and a need of support (from either addiction centres or experienced GP-colleagues for advice). Important conditions for OST are acceptance of only stable opiate users and more support in emergencies. Increasing GPs' knowledge about OST and improving collaboration with addiction centres are essential to increase the uptake of OST in general practice. Special attention could be paid to the role of more experienced colleagues who can act as advising physicians for inexperienced GPs.

  4. COMPARATIVE STUDY OF MODIFIED RADICAL MASTECTOMY PERFORMED UNDER LOCAL ANAESTHESIA WITH DEXMEDETOMIDINE INFUSION VS. GENERAL ANAESTHESIA

    Directory of Open Access Journals (Sweden)

    Ramesan Chayampurath

    2016-11-01

    Full Text Available BACKGROUND The incidence of breast cancer is on the rise in developing countries. Though, there have been significant advances in general anaesthesia, surgery in elderly and those with comorbid illness still have an attendant morbidity and mortality. After the introduction of local anaesthesia by Kolher in 1884 and in spite of steady refinement, local anaesthesia is still not being widely used in major general surgical procedures. MATERIALS AND METHODS The study was conducted in Government Medical College, Calicut, a tertiary care centre in Kerala. The outcome of Modified Radical Mastectomy performed under Local Anaesthesia (LA and dexmedetomidine infusion was compared to similar cases done under General Anaesthesia (GA. RESULTS Rapid recovery from sedation leading to early restoration of normal physical activity was observed in the LA group when compared to GA group. Early initiation of oral feeds was possible in the former group as Postoperative Nausea and Vomiting (PONV was significantly less. Effective postoperative pain relief and significant reduction in respiratory complications was observed in the LA group compared to GA group. CONCLUSION Modified Radical Mastectomy under LA and procedural sedation with dexmedetomidine was significantly better in selected cases when compared to similar cases done under GA with respect to early recovery pain relief and decreased incidence of respiratory complications.

  5. Compatibility of scientific research and specialty training in general practice. A cross-sectional study.

    Science.gov (United States)

    Kötter, Thomas; Carmienke, Solveig; Herrmann, Wolfram J

    2014-01-01

    In many departments of General Practice (GP) in Germany, young doctors who are trainees also work as researchers. Often these trainees work part time at the university and part time as a trainee in clinical practice. However, little is known about the situation of the actors involved. The aim of the study was to investigate the perspectives of GP trainees, heads of departments and GP trainers regarding the combination of research and GP training. We conducted a web-based survey with the heads of all German departments of General Practice, GP trainees who also conduct research and their GP trainers. The questionnaires consisted of open and closed questions. The results were analyzed using descriptive statistics and qualitative methods. 28 heads of GP departments and 20 GP trainees responded. The trainees were mostly very satisfied with their situation as a trainee. However, the trainees considered the combination of research and GP training as difficult. The respondents name as problems the coordination of multiple jobs and the lack of credibility given to research in General Practice. They name as solutions research-enabling training programs and uniform requirements in training regarding research. The combination of GP training and scientific research activity is perceived as difficult. However, well-organized and designed programs can improve the quality of the combination.

  6. Comprehensive Geriatric Assessment (CGA in general practice: Results from a pilot study in Vorarlberg, Austria

    Directory of Open Access Journals (Sweden)

    Mann Eva

    2004-05-01

    Full Text Available Abstract Background Most comprehensive geriatric assessment (CGA programs refer to hospital-based settings. However the body of geriatric healthcare is provided by general practitioners in their office. Structured geriatric problem detection by means of assessment instruments is crucial for efficient geriatric care giving in the community. Methods We developed and pilot tested a German language geriatric assessment instrument adapted for general practice. Nine general practices in a rural region of Austria participated in this cross-sectional study and consecutively enrolled 115 persons aged over 75 years. The prevalence of specific geriatric problems was assessed, as well as the frequency of initiated procedures following positive and negative tests. Whether findings were new to the physician was studied exemplarily for the items visual and hearing impairment and depression. The acceptability was recorded by means of self-administered questionnaires. Results On average, each patient reported 6.4 of 14 possible geriatric problems and further consequences resulted in 43.7% (27.5% to 59.8% of each problem. The items with either the highest prevalence and/or the highest number of initiated actions by the GPs were osteoporosis risk, urinary incontinence, decreased hearing acuity, missing pneumococcal vaccination and fall risk. Visual impairment was newly detected in only 18% whereas hearing impairment and depression was new to the physician in 74.1% and 76.5%, respectively. A substantial number of interventions were initiated not only following positive tests (43.7% per item; 95% CI 27.5% to 59.8%, but also as a consequence of negative test results (11.3% per item; 95% CI 1.7% to 20.9%. The mean time expenditure to accomplish the assessment was 31 minutes (SD 10 min. Patients (89% and all physicians confirmed the CGA to provide new information in general on the patient's health status. All physicians judged the CGA to be feasible in everyday

  7. General practitioners uses and perceptions of voluntary electronic feedback on treatment outcomes - a qualitative study.

    Science.gov (United States)

    Lippert, Maria Laura; Kousgaard, Marius Brostrøm; Bjerrum, Lars

    2014-11-30

    Currently, there is a strong focus on the diffusion and implementation of indicator-based technologies for assessing and improving the quality of care in general practice. The aim of this study was to explore how and for what purposes indicator-based feedback is used by the general practitioners (GPs) and how they perceive it to contribute to their work. Qualitative interviews with nine GPs in two regions in Denmark. The main selection criterion was that the informants had experience with retrieving electronic feedback. The data generation was explorative and open-ended and the analysis took an iterative approach with continuous refinement of themes that emerged from the data. The study identified two main uses of feedback: i) Administration of a regular disease control schedule for patients with chronic disease and ii) Routine monitoring of outcomes for purposes of resource prioritisation and medication management. Both uses were deemed valuable by the GPs, but also as an additional extra to the clinical core task. All the GPs experienced the feedback to be of limited relevance to the most central and challenging aspects of clinical work understood as the care for individuals. This led to different reactions: Some GPs would use the feedback as a point of departure for broader deliberations about individual patient needs and treatment approaches. For others, the perceived limitations decreased their overall motivation to seek feedback. The study points to the importance of clarifying limitations as well as possibilities with respect to different aspects of clinical quality when introducing indicator-based technologies to practitioners. The results also emphasize that an indicator-based approach to quality improvement should not stand alone in general practice since some of the most central and challenging aspects of clinical work are not covered by this approach.

  8. Sport nutrition: A review of the latest guidelines for exercise and ...

    African Journals Online (AJOL)

    Sport nutrition: A review of the latest guidelines for exercise and sport nutrition from the American College of Sport Nutrition, the International Olympic Committee ... Habitual carbohydrate intake is essential for physically active individuals and should be timed according to training sessions to ensure optimal pre-, during, and ...

  9. LATEST TOURNAISIAN (EARLY CARBONIFEROUS CONODONTS FROM THE TABAI LIMESTONE, TIRAH, NORTHWESTERN PAKISTAN

    Directory of Open Access Journals (Sweden)

    FAZL-I-RABBI KHAN

    2004-11-01

    Full Text Available A new stratigraphic unit, the Tabai Limestone of the poorly known Tirah area of northwest Pakistan, is one of several Early Carboniferous carbonate units distributed along the North Gondwana margin, some connected with transgressive interludes. The Tabai Limestone has produced latest Tournaisian (Early Carboniferous conodonts indicative of the middle of the anchoralis-latus Zone.

  10. Latest status of manufacturing activity of ITER divertor and engineering issues on tungsten divertor

    International Nuclear Information System (INIS)

    Suzuki, Satoshi

    2011-01-01

    Divertors for ITER are now in construction. In the present chapter, the specification and the latest status of manufacturing of ITER divertors are presented. In addition, issues in the development of divertors for the fusion demo reactor are given on the basis of experiences on the ITER divertor development. (J.P.N.)

  11. School Issues Under [Section] 504 and the ADA: The Latest and Greatest.

    Science.gov (United States)

    Aleman, Steven R.

    This paper highlights recent guidance and rulings from the Office of Civil Rights (OCR) of interest to administrators, advocates, and attorneys. It is a companion piece to Student Issues on SectionNB504/ADA: The Latest and Greatest. Compliance with SectionNB504 and the Americans with Disabilities Act (ADA) continues to involve debate and dialog on…

  12. Non-Formal Education Implementations in Turkey: Issues and Latest Challenges

    Science.gov (United States)

    Bilir, Mehmet

    2007-01-01

    The aim of this article is to analyse the latest implementations and issues raised in Turkish non-formal education from a historical perspective in Turkey. The high population rate and lack of adequate educational opportunities for adults and migration from rural areas to urban areas caused many educational, social and cultural problems in…

  13. Latest polarization and beam characterization results of the Orsay polarized electron source

    International Nuclear Information System (INIS)

    Arianer, J.; Cohen, S.; Essabaa, S.; Frascaria, R.; Zerhouni, O.

    1995-01-01

    The Orsay polarized electron source based on the chemi-ionization of aligned He(2 3 S 1 ) atoms and CO 2 molecules is briefly described. The latest results concerning electron polarization and beam emittance are presented. The present development status is also discussed. (K.A.)

  14. The Category of Personality in the Semantics of Latest English Borrowings in the Russian Idiomatics

    Directory of Open Access Journals (Sweden)

    Вадим Викторович Дементьев

    2014-12-01

    Full Text Available The article examines some of the latest Russian idioms by English origin. The semantics of these idioms has been seen on the material of the informal (including informal political discourse, in terms of opposition personality - impersonality, in connection with some of the new trends in public life.

  15. Latest Cretaceous climatic and environmental change in the South Atlantic region

    NARCIS (Netherlands)

    Woelders, L.; Vellekoop, J.; Kroon, D.; Smit, J.; Casadío, S.; Prámparo, M. B.; Dinarès-Turell, J.; Peterse, F.; Sluijs, A.; Lenaerts, J.T.M.; Speijer, R. P.

    Latest Maastrichtian climate change caused by Deccan volcanism has been invoked as a cause of mass extinction at the Cretaceous-Paleogene (K-Pg) boundary (~66.0 Ma). Yet late Maastrichtian climate and ecological changes are poorly documented, in particular on the Southern Hemisphere. Here we present

  16. Latest Cretaceous climatic and environmental change in the South Atlantic region

    NARCIS (Netherlands)

    Woelders, L.; Vellekoop, J.; Kroon, D.; Smit, J.; Casadío, S.; Prámparo, M. B.; Dinarès-Turell, J.; Peterse, F.; Sluijs, A.; Lenaerts, J. T.M.; Speijer, R. P.

    2017-01-01

    Latest Maastrichtian climate change caused by Deccan volcanism has been invoked as a cause of mass extinction at the Cretaceous-Paleogene (K-Pg) boundary (~66.0 Ma). Yet late Maastrichtian climate and ecological changes are poorly documented, in particular on the Southern Hemisphere. Here we present

  17. U.S. Strategic Command Chief Talks Deterrence, Partnerships During Latest SGL

    OpenAIRE

    Ochoa, Victoria

    2017-01-01

    Today@NPS The Naval Postgraduate School (NPS) welcomed U.S. Air Force Gen. John E. Hyten, Commander, U.S. Strategic Command (USSTRATCOM), for its latest Secretary of the Navy Guest Lecture (SGL), May 18 in King Auditorium. Hyten spoke about the importance of maintaining strategic deterrence and NPS' inclusion into the USSTRATCOM's Academic Alliance.

  18. Generalized product

    OpenAIRE

    Greco, Salvatore; Mesiar, Radko; Rindone, Fabio

    2014-01-01

    Aggregation functions on [0,1] with annihilator 0 can be seen as a generalized product on [0,1]. We study the generalized product on the bipolar scale [–1,1], stressing the axiomatic point of view. Based on newly introduced bipolar properties, such as the bipolar increasingness, bipolar unit element, bipolar idempotent element, several kinds of generalized bipolar product are introduced and studied. A special stress is put on bipolar semicopulas, bipolar quasi-copulas and bipolar copulas.

  19. Numerical study on general dispersion relation of anisotropic and weakly relativistic plasma

    International Nuclear Information System (INIS)

    Ke Fujiu; Chen Yanping

    1987-01-01

    The key problem in heating and instability studies in plasma physics is to obtain dispersive equation and its solution. This paper presents the general dispersive equation and corresponding procedure for electromagnetic wave which nearly poloidally impinges on anisotropic, weakly relativistic Maxwellian plasma with inhomogeneous density in nonuniform magnetic field (such as plasma in TOKAMAK). The double index function F ij , significant in plasma physics, was expanded as single index function F 1 , and then the values were calculated by means of dispersive function. It was also pointed out that the severe error would be involved in the calculation of F ij from recurrence relation of F 11

  20. Guide to General Atomic studies of hypothetical nuclear driven accidents for the Fort St. Vrain reactor

    International Nuclear Information System (INIS)

    Wei, T.; Tobias, M.

    1974-03-01

    The work of the General Atomic Company (GAC) in preparing those portions of the Final Safety Analysis Report for the Fort St. Vrain Reactor (FSV) having to do with hypothetical nuclear driven accidents has been reviewed and a guide to this literature has been prepared. The sources for this study are the Final Safety Analysis Report itself, the Quarterly and Monthly Progress Reports, Topical Reports, and Technical Specifications. The problems considered and the methods used are outlined. An appendix gives a systematic analysis which was used as a guide in organizing the references. (U.S.)

  1. General conceptual design study for a high-level radioactive waste repository in a granite formation

    International Nuclear Information System (INIS)

    1982-01-01

    The object of the general conceptual design study for a high level radioactive wastes repository in a deep lying granite formation is to ensure that technology available in 1980 is suitable for building, operating and finally closing such a repository. It is feasible to build and operate a 1000 m deep repository, located in a granite batholith, receiving 30000 AVM canisters (after 30 years surface cooling), the disposal rate being 1000 canisters per year. Cost of the operation amounts to 1,3% of the corresponding amount of electricity. The building, operating and final closing phases will take 81 years

  2. Reconstruction of the Dark Energy Equation of State from the Latest Observations

    Science.gov (United States)

    Dai, Ji-Ping; Yang, Yang; Xia, Jun-Qing

    2018-04-01

    Since the discovery of the accelerating expansion of our universe in 1998, studying the features of dark energy has remained a hot topic in modern cosmology. In the literature, dark energy is usually described by w ≡ P/ρ, where P and ρ denote its pressure and energy density. Therefore, exploring the evolution of w is the key approach to understanding dark energy. In this work, we adopt three different methods, polynomial expansion, principal component analysis, and the correlated prior method, to reconstruct w with a collection of the latest observations, including the type-Ia supernova, cosmic microwave background, large-scale structure, Hubble measurements, and baryon acoustic oscillations (BAOs), and find that the concordance cosmological constant model (w = ‑1) is still safely consistent with these observational data at the 68% confidence level. However, when we add the high-redshift BAO measurement from the Lyα forest (Lyα FB) of BOSS DR11 quasars into the calculation, there is a significant impact on the reconstruction result. In the standard ΛCDM model, since the Lyα FB data slightly prefer a negative dark energy density, in order to avoid this problem, a dark energy model with a w significantly smaller than ‑1 is needed to explain this Lyα FB data. In this work, we find the consistent conclusion that there is a strong preference for the time-evolving behavior of dark energy w at high redshifts, when including the Lyα FB data. Therefore, we think that this Lyα FB data needs to be watched carefully attention when studying the evolution of the dark energy equation of state.

  3. Latest Pleistocene and Holocene surficial deposits and landforms of Yosemite Valley, California

    Science.gov (United States)

    Haddon, E. K.; Stock, G. M.; Booth, D. B.

    2016-12-01

    Field studies on the surficial geology and geomorphology of Yosemite Valley since the 1870's formed an early basis for our understanding of Quaternary landscape evolution in the central Sierra Nevada. These landmark studies described the erosional origin of Yosemite's iconic scenery, but left details of the latest Pleistocene and Holocene sedimentary record for later investigation. We combined mapping of deposits and landforms with geochronology to reconstruct the geomorphic evolution of Yosemite Valley since the 15 ka retreat of the Last Glacial Maximum (LGM) valley glacier. We document a sustained period of relative landscape stability, characterized by valley-bottom aggradation of glacial till, fluvial sediments, and lacustrine silts, as well as valley-margin accumulation of talus and fan alluvium. Recessional moraines, episodically emplaced rock avalanches, and alluvial fans impeded surface flow and controlled the local base level. This predominantly aggradational regime then shifted to incision in the earliest Holocene, likely due to a diminishing supply of glacial sediment, and created a flight of fluvial terraces inset by up to 9 m. The volume of fringing talus and fan alluvium in comparison with fluvial terrace sequences emphasizes the importance of valley-wall erosion as a sediment source. Cosmogenic 10Be exposure ages from rock avalanche boulders and 14C charcoal ages from deltaic sequences and inset fluvial gravels suggest variable rates of Holocene river incision. Although some incision events likely record local base level changes at the El Capitan LGM recessional moraine, the presence of perched, well-developed outwash terraces downstream indicates a more regional climatic forcing. These findings, including the depositional record of land-use disturbances over the past two centuries, help illuminate the geologic evolution of this celebrated landscape and inform ongoing river-restoration work.

  4. Epidemiological studies of general population groups exposed to low-level radiation

    International Nuclear Information System (INIS)

    Davies, J.M.; Inskip, H.

    1986-01-01

    The exposure of man to radiation and the resulting risk of carcinogenesis continue to be of concern to the public. In this context, there is often a tendency to carry out epidemiological studies concerning the induction of cancer in radiation workers and members of the public which are not supported by a statistically valid data base or whose result are misinterpreted or misused. To assist national authorities in evaluating radiological risks, the Nuclear Energy Agency has sponsored a critical review of the methodologies for, and the limitations of, these epidemiological studies, and of the precautions to be adopted in interpreting their results. Prepared by two consultants, Dr. Joan M. Davies and Dr. Hazel Inskip, the review focuses on the problems encountered when carrying out epidemiological studies on groups of the general population exposed to radiation, and using their results for radiological protection purposes. The primary objective is to provide background material for national authorities who have responsibilities in the field of radiological protection, as well as to other persons interested in this subject. It is published under the responsibility of the Secretary General of the OECD, and does not necessarily reflect the views of Member Governments

  5. Prospective study of use of perioperative antimicrobial therapy in general surgery.

    LENUS (Irish Health Repository)

    Fennessy, Brendan G

    2012-02-03

    BACKGROUND: Perioperative antimicrobial therapy has demonstrated efficacy in reducing the rate of surgical site infections in clinical trials. With the emergence of antibiotic resistance, the risk of reaction, and the inevitable financial repercussions, use of prophylactic antibiotics is not a panacea, and their misuse may have considerable implications. The aim of this study was to assess the use of antibiotics in the perioperative period in both general and vascular surgery procedures. METHODS: A prospective study was undertaken of 131 patients with a mean age of 43 years (range one month-88 years), of whom 68 (51%) were male, who underwent twenty-seven different general or vascular surgery procedures over a four-week period. Each patient was evaluated from the time of antibiotic commencement through their operative procedure until the treatment was discontinued. RESULTS: A total of 73 patients (54%) received ten antibiotics, with 71 (97%) of these uses being prophylactic. Of the 15 appendectomies performed for uncomplicated appendicitis, the mean number of prophylactic antibiotic doses was 5.3 (range 1-12). Where they were documented, written postoperative directives were not adhered to in 18\\/27 prescriptions (66%). CONCLUSION: This study has demonstrated a lack of adherence to guidelines in the perioperative administration of antimicrobial agents. In addition, it calls attention to the economic implications of unnecessary prophylaxis.

  6. The Generalized Higher Criticism for Testing SNP-Set Effects in Genetic Association Studies

    Science.gov (United States)

    Barnett, Ian; Mukherjee, Rajarshi; Lin, Xihong

    2017-01-01

    It is of substantial interest to study the effects of genes, genetic pathways, and networks on the risk of complex diseases. These genetic constructs each contain multiple SNPs, which are often correlated and function jointly, and might be large in number. However, only a sparse subset of SNPs in a genetic construct is generally associated with the disease of interest. In this article, we propose the generalized higher criticism (GHC) to test for the association between an SNP set and a disease outcome. The higher criticism is a test traditionally used in high-dimensional signal detection settings when marginal test statistics are independent and the number of parameters is very large. However, these assumptions do not always hold in genetic association studies, due to linkage disequilibrium among SNPs and the finite number of SNPs in an SNP set in each genetic construct. The proposed GHC overcomes the limitations of the higher criticism by allowing for arbitrary correlation structures among the SNPs in an SNP-set, while performing accurate analytic p-value calculations for any finite number of SNPs in the SNP-set. We obtain the detection boundary of the GHC test. We compared empirically using simulations the power of the GHC method with existing SNP-set tests over a range of genetic regions with varied correlation structures and signal sparsity. We apply the proposed methods to analyze the CGEM breast cancer genome-wide association study. Supplementary materials for this article are available online. PMID:28736464

  7. Study of Life Events and Personality Dimensions in Generalized Anxiety Disorder.

    Science.gov (United States)

    Arul, A Sri Sennath J

    2016-04-01

    Life events, recognized as stressors, due to their unanticipated nature, can cause psychiatric illness. Also there is some line of continuity between neurotic illness and antecedent personality traits. To study generalized anxiety disorder in relation to Life events and personality dimensions. Certain hypotheses were tested in two groups, namely 30 Generalized Anxiety Disorder patients (GAD) and 30 matched controls, by utilizing assessment tools. These include: GAD patients experience more undesirable Life events than normal; GAD patients with high level of anxiety experience more undesirable Life events; Neuroticism is related to the severity of anxiety; Extroverts experience more anxiety; Level of anxiety in females is higher; GAD patients with higher education level experience more anxiety, while those with lower education level somatize more. The group differences were examined using Chi-Square test, Student t-test and ANOVA. Pearson's Correlation Co-efficient was used to find the correlation between anxiety and the undesirable Life events. The level of statistical significance was set at panxiety experienced more undesirable Life events, with the coefficient of correlation being quite high. A significant association between Neuroticism scale and GAD was observed. The study suggests a possible causative link between the undesirable Life events and GAD; and a significant association between Neuroticism dimension and the anxiety disorder. Role of environmental stressors and personality traits in treatment outcome among GAD patients awaits further, prospective studies.

  8. Investigation of fatigue by Australian general practice registrars: a cross-sectional study.

    Science.gov (United States)

    Morgan, Simon; Henderson, Kim M; Tapley, Amanda; Thomson, Allison; Wilson, Jessica; Scott, John; Spike, Neil A; McArthur, Lawrie; van Driel, Mieke L; Magin, Parker J

    2015-06-01

    Fatigue is the most common undifferentiated problem presenting in general practice. Previous studies have shown that this presentation leads to multiple investigations. There is no published literature describing the management of patients with fatigue by general practice (GP) registrars. To document the investigation-ordering behaviour of GP registrars in managing patients with a new diagnosis of unexplained fatigue. This was a cross-sectional analysis of data from Registrar Clinical Encounters in Training (ReCEnT), an ongoing cohort study of GP registrars' consultations. We established the prevalence of new diagnoses of unexplained fatigue and associations with that diagnosis, the rate of test ordering and the number and types of investigations ordered. 644 registrars contributed data from 68 986 encounters. In 0.78% of patient encounters, a new diagnosis of unexplained fatigue was made. Pathology was ordered in 78.4% of these problems (versus 18.1% in non-fatigue problems), at a rate of 488 tests per 100 new fatigue problems. Our study suggests that unexplained fatigue elicits a non-rational approach to test ordering by registrars. These findings contribute to the understanding of GP registrar management of fatigue, and undifferentiated presentations more broadly, and suggest educational approaches to improve practice, including dealing with uncertainty.

  9. Ethical issues for radiographers: General observations and a pilot qualitative study

    International Nuclear Information System (INIS)

    Gruppetta, E.

    2009-01-01

    This paper is based on general observation arising from many years experience in managing and delivering radiography services in the health service. In addition, it presents the results of a pilot qualitative study based on unstructured interviews. The interviews were undertaken with a view to identifying the reasons for radiography that may not be well justified. The study was undertaken in the public and private sectors and many of the reasons are shared by both. The reasons for poor justification include: inadequate radiation protection education for referrers; avoidance of medical litigation; defensive medicine attitude by referrers and, in the private sector, pursuit of profit. The study provides a starting point for further more quantitative investigations that are clearly required in the area. (authors)

  10. Chronic disease management in general practice: results from a national study.

    Science.gov (United States)

    Darker, C; Martin, C; O'Dowd, T; O'Kelly, F; O'Shea, B

    2012-04-01

    The aim of this study was to provide baseline data on chronic disease management (CDM) provision in Irish general practice (GP). The survey instrument was previously used in a study of primary care physicians in 11 countries, thus allowing international comparisons. The response rate was 72% (380/527).The majority of GPs (240/380; 63%) reported significant changes are needed in our health care system to make CDM work better. Small numbers of routine clinical audits are being performed (95/380; 25%). Irish GPs use evidence based guidelines for treatment of diabetes (267/380; 71%), asthma / COPD (279/380; 74%) and hypertension (297/380; 79%), to the same extent as international counterparts. Barriers to delivering chronic care include increased workload (379/380; 99%), lack of appropriate funding (286/380; 76%), with GPs interested in targeted payments (244/380; 68%). This study provides baseline data to assess future changes in CDM.

  11. Diversity and ambivalence in general practitioners' attitudes towards preventive health checks - a qualitative study

    DEFF Research Database (Denmark)

    Søndergaard, Anne; Christensen, Bo; Maindal, Helle Terkildsen

    2012-01-01

    .The purpose of our study is to describe GPs' attitudes towards and concerns about providing preventive health checks and to describe their experiences with the health checks that they provide in daily practice. METHODS: A qualitative descriptive study was conducted based on three semi-structured focus group...... practice. CONCLUSIONS: Our study revealed that health checks are performed differently. Their quality differs, and the GPs perform the health check based on their personal attitude towards this service and prevention in general. Our analysis suggests that the doctors are basically uncertain about the best...... that there was great diversity in the content. The GPs were somewhat ambivalent towards health checks. Many GPs found the service beneficial for the patients. Concurrently, they had reservations about promoting ill-health, they questioned whether the health checks were a core mission of primary care, and they were...

  12. Audit and account billing process in a private general hospital: a case study

    Directory of Open Access Journals (Sweden)

    Raquel Silva Bicalho Zunta

    2017-12-01

    Full Text Available Our study aimed to map, describe and, validate the audit, account billing and billing reports processes in a large, private general hospital.  An exploratory, descriptive, case report study. We conducted non-participatory observation moments in Internal Audit Sectors and  Billing Reports from the hospital, aiming to map the processes which were the study objects. The data obtained was validated by internal and external audit specialists in hospital bills. The described and illustrated processes in three flow-charts favor professionals to rationalize their activities and the time spent in hospital billing, avoiding or minimizing the occurrence of flaws and, generating more effective financial results. The mapping, the description and the audit validation process and billing and, the billing reports propitiated more visibility and legitimacy to actions developed by auditor nurses.

  13. Chronic disease management in general practice: results from a national study.

    LENUS (Irish Health Repository)

    Darker, C

    2012-04-01

    The aim of this study was to provide baseline data on chronic disease management (CDM) provision in Irish general practice (GP). The survey instrument was previously used in a study of primary care physicians in 11 countries, thus allowing international comparisons. The response rate was 72% (380\\/527).The majority of GPs (240\\/380; 63%) reported significant changes are needed in our health care system to make CDM work better. Small numbers of routine clinical audits are being performed (95\\/380; 25%). Irish GPs use evidence based guidelines for treatment of diabetes (267\\/380; 71%), asthma \\/ COPD (279\\/380; 74%) and hypertension (297\\/380; 79%), to the same extent as international counterparts. Barriers to delivering chronic care include increased workload (379\\/380; 99%), lack of appropriate funding (286\\/380; 76%), with GPs interested in targeted payments (244\\/380; 68%). This study provides baseline data to assess future changes in CDM.

  14. An Outcomes Study on the Effects of the Singapore General Hospital Burns Protocol.

    Science.gov (United States)

    Liang, Weihao; Kok, Yee Onn; Tan, Bien Keem; Chong, Si Jack

    2018-01-01

    The Singapore General Hospital Burns Protocol was implemented in May 2014 to standardize treatment for all burns patients, incorporate new techniques and materials, and streamline the processes and workflow of burns management. This study aims to analyze the effects of the Burns Protocol 2 years after its implementation. Using a REDCap electronic database, all burns patients admitted from May 2013 to April 2016 were included in the study. The historical preimplementation control group composed of patients admitted from May 2013 to April 2014 (n = 96). The postimplementation prospective study cohort consisted of patients admitted from May 2014 to April 2016 (n = 243). Details of the patients collected included age, sex, comorbidities, total body surface area (TBSA) burns, time until surgery, number of surgeries, number of positive tissue and blood cultures, and length of hospital stay. There was no statistically significant difference in the demographics of both groups. The study group had a statistically significant shorter time to surgery compared with the control group (20.8 vs 38.1, P burns, was statistically significant (number of surgeries/TBSA, 0.324 vs 0.506; P = 0.0499). The study group also had significantly shorter length of stay (12.5 vs 16.8, P = 0.0273), a shorter length of stay/TBSA burns (0.874 vs 1.342, P = 0.0101), and fewer positive tissue cultures (0.6 vs 1.3, P = 0.0003). The study group also trended toward fewer positive blood culture results (0.09 vs 0.35, P = 0.0593), although the difference was just shy of statistical significance. The new Singapore General Hospital Burns Protocol had revolutionized Singapore burns care by introducing a streamlined, multidisciplinary burns management, resulting in improved patient outcomes, lowered health care costs, and improved system resource use.

  15. Studies about strength recovery and generalized relaxation behavior of rock (4)

    International Nuclear Information System (INIS)

    Sanada, Masanori; Kishi, Hirokazu; Hayashi, Katsuhiko; Takebe, Atsuji; Okubo, Seisuke

    2011-11-01

    Surrounding rock failure occurs due to the increasing stress with tunnel excavation and extent of the failure depends on rock strength and rock stress. The NATM (New Austrian Tunneling Method) assumes that supporting effects by shotcrete and rock bolt prevent rock failure maximizing the potential capability of rock mass. Recently, it was found that failed rock just behind tunnel support recovers its strength. This phenomenon should take into account in evaluation of tunnel stability and long-term mechanical behavior of rock mass after closure of a repository for high-level radioactive waste (HLW). Visco-elastic behavior of rock is frequently studied by creep testing, but creep occasionally occurs together with relaxation in-situ due to the effect of various supports and rock heterogeneity. Therefore generalized stress relaxation in which both load and displacement are controlled is proper to study such behavior under the complicated conditions. It is also important to understand rock behavior in tensile stress field which may be developed in the surrounding rock of deposition hole or tunnel by swelling of bentonite or volume expansion of overpack with corrosion after the repository closure. Cores sampled at 'Horonobe Underground Research Laboratory' has been tested to reveal the above-mentioned behavior. Quantitative evaluation and modeling of the rock behavior, however, have not been established mainly because of large scatter of data. As a factor of the large scatter of data, it was expected that the evaporation of moisture from the surface of the test piece influences the test outcome because it tested in the nature. In this study, strength recovery, generalized stress relaxation and two tensile strength tests were carried out using shale sampled in the Wakkanai-formation. As the results, recovery of failed rocks in strength and hydraulic conductivity were observed under a certain condition. We believe this result is very important for the stability evaluation

  16. Promoting chlamydia screening with posters and leaflets in general practice--a qualitative study.

    Science.gov (United States)

    Freeman, Elaine; Howell-Jones, Rebecca; Oliver, Isabel; Randall, Sarah; Ford-Young, William; Beckwith, Philippa; McNulty, Cliodna

    2009-10-12

    General practice staff are reluctant to discuss sexual health opportunistically in all consultations. Health promotion materials may help alleviate this barrier. Chlamydia screening promotion posters and leaflets, produced by the English National Chlamydia Screening Programme (NCSP), have been available to general practices, through local chlamydia screening offices, since its launch. In this study we explored the attitudes of general practice staff to these screening promotional materials, how they used them, and explored other promotional strategies to encourage chlamydia screening. Twenty-five general practices with a range of screening rates, were purposively selected from six NCSP areas in England. In focus groups doctors, nurses, administrative staff and receptionists were encouraged to discuss candidly their experiences about their use and opinions of posters, leaflets and advertising to promote chlamydia screening. Researchers observed whether posters and leaflets were on display in reception and/or waiting areas. Data were collected and analysed concurrently using a stepwise framework analytical approach. Although two-thirds of screening practices reported that they displayed posters and leaflets, they were not prominently displayed in most practices. Only a minority of practices reported actively using screening promotional materials on an ongoing basis. Most staff in all practices were not following up the advertising in posters and leaflets by routinely offering opportunistic screening to their target population. Some staff in many practices thought posters and leaflets would cause offence or embarrassment to their patients. Distribution of chlamydia leaflets by receptionists was thought to be inappropriate by some practices, as they thought patients would be offended when being offered a leaflet in a public area. Practice staff suggested the development of pocket-sized leaflets. The NCSP should consider developing a range of more discrete but eye

  17. Promoting chlamydia screening with posters and leaflets in general practice - a qualitative study

    Science.gov (United States)

    Freeman, Elaine; Howell-Jones, Rebecca; Oliver, Isabel; Randall, Sarah; Ford-Young, William; Beckwith, Philippa; McNulty, Cliodna

    2009-01-01

    Background General practice staff are reluctant to discuss sexual health opportunistically in all consultations. Health promotion materials may help alleviate this barrier. Chlamydia screening promotion posters and leaflets, produced by the English National Chlamydia Screening Programme (NCSP), have been available to general practices, through local chlamydia screening offices, since its launch. In this study we explored the attitudes of general practice staff to these screening promotional materials, how they used them, and explored other promotional strategies to encourage chlamydia screening. Methods Twenty-five general practices with a range of screening rates, were purposively selected from six NCSP areas in England. In focus groups doctors, nurses, administrative staff and receptionists were encouraged to discuss candidly their experiences about their use and opinions of posters, leaflets and advertising to promote chlamydia screening. Researchers observed whether posters and leaflets were on display in reception and/or waiting areas. Data were collected and analysed concurrently using a stepwise framework analytical approach. Results Although two-thirds of screening practices reported that they displayed posters and leaflets, they were not prominently displayed in most practices. Only a minority of practices reported actively using screening promotional materials on an ongoing basis. Most staff in all practices were not following up the advertising in posters and leaflets by routinely offering opportunistic screening to their target population. Some staff in many practices thought posters and leaflets would cause offence or embarrassment to their patients. Distribution of chlamydia leaflets by receptionists was thought to be inappropriate by some practices, as they thought patients would be offended when being offered a leaflet in a public area. Practice staff suggested the development of pocket-sized leaflets. Conclusion The NCSP should consider developing

  18. Promoting chlamydia screening with posters and leaflets in general practice - a qualitative study

    Directory of Open Access Journals (Sweden)

    Ford-Young William

    2009-10-01

    Full Text Available Abstract Background General practice staff are reluctant to discuss sexual health opportunistically in all consultations. Health promotion materials may help alleviate this barrier. Chlamydia screening promotion posters and leaflets, produced by the English National Chlamydia Screening Programme (NCSP, have been available to general practices, through local chlamydia screening offices, since its launch. In this study we explored the attitudes of general practice staff to these screening promotional materials, how they used them, and explored other promotional strategies to encourage chlamydia screening. Methods Twenty-five general practices with a range of screening rates, were purposively selected from six NCSP areas in England. In focus groups doctors, nurses, administrative staff and receptionists were encouraged to discuss candidly their experiences about their use and opinions of posters, leaflets and advertising to promote chlamydia screening. Researchers observed whether posters and leaflets were on display in reception and/or waiting areas. Data were collected and analysed concurrently using a stepwise framework analytical approach. Results Although two-thirds of screening practices reported that they displayed posters and leaflets, they were not prominently displayed in most practices. Only a minority of practices reported actively using screening promotional materials on an ongoing basis. Most staff in all practices were not following up the advertising in posters and leaflets by routinely offering opportunistic screening to their target population. Some staff in many practices thought posters and leaflets would cause offence or embarrassment to their patients. Distribution of chlamydia leaflets by receptionists was thought to be inappropriate by some practices, as they thought patients would be offended when being offered a leaflet in a public area. Practice staff suggested the development of pocket-sized leaflets. Conclusion The NCSP

  19. General practitioners' views on reattribution for patients with medically unexplained symptoms: a questionnaire and qualitative study

    Directory of Open Access Journals (Sweden)

    Salmon Peter

    2008-08-01

    Full Text Available Abstract Background The successful introduction of new methods for managing medically unexplained symptoms in primary care is dependent to a large degree on the attitudes, experiences and expectations of practitioners. As part of an exploratory randomised controlled trial of reattribution training, we sought the views of participating practitioners on patients with medically unexplained symptoms, and on the value of and barriers to the implementation of reattribution in practice. Methods A nested attitudinal survey and qualitative study in sixteen primary care teams in north-west England. All practitioners participating in the trial (n = 74 were invited to complete a structured survey. Semi-structured interviews were undertaken with a purposive sub-sample of survey respondents, using a structured topic guide. Interview transcripts were used to identify key issues, concepts and themes, which were grouped to construct a conceptual framework: this framework was applied systematically to the data. Results Seventy (95% of study participants responded to the survey. Survey respondents often found it stressful to work with patients with medically unexplained symptoms, though those who had received reattribution training were more optimistic about their ability to help them. Interview participants trained in reattribution (n = 12 reported that reattribution increased their confidence to practice in a difficult area, with heightened awareness, altered perceptions of these patients, improved opportunities for team-building and transferable skills. However general practitioners also reported potential barriers to the implementation of reattribution in routine clinical practice, at the level of the patient, the doctor, the consultation, diagnosis and the healthcare context. Conclusion Reattribution training increases practitioners' sense of competence in managing patients with medically unexplained symptoms. However, barriers to its implementation are

  20. Techniques and Behaviors Associated with Exemplary Inpatient General Medicine Teaching: An Exploratory Qualitative Study.

    Science.gov (United States)

    Houchens, Nathan; Harrod, Molly; Moody, Stephanie; Fowler, Karen; Saint, Sanjay

    2017-07-01

    Clinician educators face numerous obstacles to their joint mission of facilitating high-quality learning while also delivering patient-centered care. Such challenges necessitate increased attention to the work of exemplary clinician educators, their respective teaching approaches, and the experiences of their learners. To describe techniques and behaviors utilized by clinician educators to facilitate excellent teaching during inpatient general medicine rounds. An exploratory qualitative study of inpatient teaching conducted from 2014 to 2015. Inpatient general medicine wards in 11 US hospitals, including university-affiliated hospitals and Veterans Affairs medical centers. Participants included 12 exemplary clinician educators, 57 of their current learners, and 26 of their former learners. In-depth, semi-structured interviews of exemplary clinician educators, focus group discussions with their current and former learners, and direct observations of clinical teaching during inpatient rounds. Interview data, focus group data, and observational field notes were coded and categorized into broad, overlapping themes. Each theme elucidated a series of actions, behaviors, and approaches that exemplary clinician educators consistently demonstrated during inpatient rounds: (1) they fostered positive relationships with all team members by building rapport, which in turn created a safe learning environment; (2) they facilitated patient-centered teaching points, modeled excellent clinical exam and communication techniques, and treated patients as partners in their care; and (3) they engaged in coaching and collaboration through facilitation of discussion, effective questioning strategies, and differentiation of learning among team members with varied experience levels. This study identified consistent techniques and behaviors of excellent teaching during inpatient general medicine rounds. © 2017 Society of Hospital Medicine

  1. Fasting for weight loss: an effective strategy or latest dieting trend?

    Science.gov (United States)

    Johnstone, A

    2015-05-01

    With the increasing obesity epidemic comes the search for effective dietary approaches for calorie restriction and weight loss. Here I examine whether fasting is the latest 'fad diet' as portrayed in popular media and discuss whether it is a safe and effective approach or whether it is an idiosyncratic diet trend that promotes short-term weight loss, with no concern for long-term weight maintenance. Fasting has long been used under historical and experimental conditions and has recently been popularised by 'intermittent fasting' or 'modified fasting' regimes, in which a very low-calorie allowance is allowed, on alternate days (ADF) or 2 days a week (5:2 diet), where 'normal' eating is resumed on non-diet days. It is a simple concept, which makes it easy to follow with no difficult calorie counting every other day. This approach does seem to promote weight loss, but is linked to hunger, which can be a limiting factor for maintaining food restriction. The potential health benefits of fasting can be related to both the acute food restriction and chronic influence of weight loss; the long-term effect of chronic food restriction in humans is not yet clear, but may be a potentially interesting future dietary strategy for longevity, particularly given the overweight epidemic. One approach does not fit all in the quest to achieve body weight control, but this could be a dietary strategy for consideration. With the obesity epidemic comes the search for dietary strategies to (i) prevent weight gain, (ii) promote weight loss and (iii) prevent weight regain. With over half of the population of the United Kingdom and other developed countries being collectively overweight or obese, there is considerable pressure to achieve these goals, from both a public health and a clinical perspective. Certainly not one dietary approach will solve these complex problems. Although there is some long-term success with gastric surgical options for morbid obesity, there is still a requirement

  2. General health influences episodes of xerostomia: a prospective population-based study.

    Science.gov (United States)

    da Silva, Luciana; Kupek, Emil; Peres, Karen G

    2017-04-01

    The aim of this study was to investigate the associated factors of changes in symptoms of xerostomia (SOX) in adults aged 20-59. A prospective population-based study was conducted in 2009 (n = 1720) and 2012 (n = 1222) in the urban area of Florianópolis, SC, Brazil. Information on SOX was collected in both years together with age, family income, years of schooling, smoking habit, alcohol consumption, changes in the body mass index (BMI; kg/m²), medicine use, self-reported diagnosis of chronic diseases, change in hypertension status and in the use and need for dentures, and number of remaining teeth. Associated factors with changes in SOX were investigated using multinomial logistic regression, considering those who had never reported this symptom as the reference. Prevalence of regular SOX was equal to 3.8% (95% CI: 2.9-5.1) and irregular (one period only) equal to 12.2% (95% CI: 10.2-14.5). Age, smoking habit, medicine use, self-reported diagnosis of depression, and weight gain increased the probability of regular SOX, whereas highest schooling level was associated with lower probability of this symptom. General and psychosocial health influenced the number of episodes of xerostomia symptoms, calling for multidisciplinary actions to prevent common risk behaviors for oral and general diseases. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Usage patterns of aromatherapy among the French general population: A descriptive study focusing on dermal exposure.

    Science.gov (United States)

    Dornic, N; Ficheux, A S; Roudot, A C; Saboureau, D; Ezzedine, K

    2016-04-01

    Although likely benefits of aromatherapy are well documented, little is known about essential oils consumption and exposure to molecules present in the oils. The aim of our study was to determine usage patterns of 12 types of essential oils among a quite large panel, sorted per sex and quintile of age from birth to 70. A survey was conducted in September 2014 among 1507 French individuals, selected to build a representative panel of the general population. The key point of our study, apart from the fact that it has never been done among general population, was the focus on dermal exposure. Information about types of essential oils used, skin areas exposed, frequencies and quantities were collected. Our work revealed that some sub-populations could be significantly exposed to molecules of toxicological concern, especially in terms of skin sensitization. This work is the first step to assess human exposure to these molecules, and will help safety authorities and risk managers to protect the population. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Generalized ensemble method applied to study systems with strong first order transitions

    Science.gov (United States)

    Małolepsza, E.; Kim, J.; Keyes, T.

    2015-09-01

    At strong first-order phase transitions, the entropy versus energy or, at constant pressure, enthalpy, exhibits convex behavior, and the statistical temperature curve correspondingly exhibits an S-loop or back-bending. In the canonical and isothermal-isobaric ensembles, with temperature as the control variable, the probability density functions become bimodal with peaks localized outside of the S-loop region. Inside, states are unstable, and as a result simulation of equilibrium phase coexistence becomes impossible. To overcome this problem, a method was proposed by Kim, Keyes and Straub [1], where optimally designed generalized ensemble sampling was combined with replica exchange, and denoted generalized replica exchange method (gREM). This new technique uses parametrized effective sampling weights that lead to a unimodal energy distribution, transforming unstable states into stable ones. In the present study, the gREM, originally developed as a Monte Carlo algorithm, was implemented to work with molecular dynamics in an isobaric ensemble and coded into LAMMPS, a highly optimized open source molecular simulation package. The method is illustrated in a study of the very strong solid/liquid transition in water.

  5. Adoption of telemedicine in Scottish remote and rural general practices: a qualitative study.

    Science.gov (United States)

    King, Gerry; Richards, Helen; Godden, David

    2007-01-01

    We conducted a qualitative interview study to explore the factors that have facilitated and prevented the adoption of telemedicine in general practice in remote and rural Scotland. Face-to-face interviews were carried out with general practitioners (GPs) and practice nurses in 26 of Scotland's most remote practices and five of the seven most rural health boards. The interview study found that GPs were more positive about the use of computers and telemedicine than nurses. Although electronic access to simple data, such as laboratory results, had become widely accepted, most respondents had very little experience of more sophisticated telemedicine applications, such as videoconferencing. There was widespread scepticism about the potential usefulness of clinical applications of telemedicine, although it was perceived to have potential benefit in facilitating access to educational resources. A number of barriers to the adoption of telemedicine were reported, including concerns that videoconferencing could diminish the quality of communication in educational and clinical settings, and that telemedicine would not fit easily with the organizational routines of the practices. Policy-makers should prioritize strategies to develop educational programmes, as these are more likely to succeed than clinical initiatives. It may then follow that clinicians will see opportunities for use in their clinical work.

  6. General practitioners' beliefs about effectiveness and intentions to prescribe smoking cessation medications: qualitative and quantitative studies

    Directory of Open Access Journals (Sweden)

    Marteau Theresa M

    2006-11-01

    Full Text Available Abstract Background General practitioners' (GPs negative beliefs about nicotine dependence medications may act as barriers to prescribing them. Methods Study1: Twenty-five GPs from 16 practices across London were interviewed in this qualitative study. Framework analysis was used to identify key themes. Study 2: A convenience sample of 367 GPs completed an internet-based survey. Path-analysis was used to examine the relations between beliefs and intentions to prescribe smoking cessation medications. Results Study 1: Whilst nicotine replacement therapy (NRT and bupropion were generally perceived as effective and cost-effective, the effectiveness of NRT was seen as critically dependent on behavioural support for smoking cessation. This dependence appeared to be influenced by perceptions that without support smokers would neglect psychological aspects of smoking and use NRT incorrectly. GPs perceived bupropion as dangerous and were concerned about its side-effects. Study 2: GPs' beliefs had medium (NRT, f2 = .23 to large (bupropion, f2=.45; NRT without support, f2=.59 effects on their intentions to prescribe medications. Beliefs about effectiveness of NRT and bupropion and the perceived danger of bupropion were the key predictors of intentions to prescribe NRT and bupropion, respectively. Beliefs about neglecting psychological aspects of smoking and incorrect use had indirect effects on intentions to prescribe NRT without support, operating via beliefs about effectiveness. Conclusion GPs vary in their beliefs about the effectiveness and safety of smoking cessation medications. Their intentions to prescribe these medications vary in line with these beliefs. Interventions aimed at increasing the likelihood with which GPs prescribe these medications may be more effective if they addressed these beliefs.

  7. Evaluation of MR issues for the latest standard brands of orthopedic metal implants: Plates and screws

    Energy Technology Data Exchange (ETDEWEB)

    Zou, Yue-fen, E-mail: zou_yf@163.com [Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing (China); Chu, Bin, E-mail: 18262636700@163.com [Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing (China); Wang, Chuan-bing, E-mail: wangchuanb_csr@163.com [Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing (China); Hu, Zhi-yi, E-mail: huzhiyi@medmail.com.cn [Department of Spine Surgery, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing (China)

    2015-03-15

    Highlights: •Although previous studies have indicated that most of the orthopedic implants are compatible in MR imaging system especially for titanium alloy, there are still concerns about the safety of patients with stainless steel implants, who were refused to a MR scan in most cases in our country. •In this study, it was verified that both titanium alloy and stainless steel materials (plates and screws) cause a weak force and low MRI-related heating at a 1.5-T or less, which do not pose an additional hazard or risk to patients. In addition, we also had explored the influence of different sequences and parameters on size of metallic artifacts to obtain optimized pulse sequences with appropriate parameters for reducing artifacts, which would be convenient and useful in clinical work. -- Abstract: Purpose: The study was performed to evaluate magnetic resonance (MR) issues for the latest standard brands of plates and screws used in orthopedic surgery at a 1.5-T MR system, including the safety and metallic artifacts. Methods: The plates and screws (made of titanium alloy and stainless steel materials, according to the latest standard brands) were assessed for displacement in degrees, MRI-related heating and artifacts at a 1.5-T MR system. The displacement in degrees of the plates and screws was evaluated on an angel-measurement instrument at the entrance of the MR scanner. The MRI-related heating was assessed on a swine leg fixed with a plate by using a “worst-case” pulse sequence. A rectangular water phantom was designed to evaluate metallic artifacts of a screw on different sequences (T1/T2-weighted FSE, STIR, T2-FSE fat saturation, GRE, DWI) and then artifacts were evaluated on T2-weighted FSE sequence by modifying the scanning parameters including field of view (FOV), echo train length (ETL) and bandwidth to identify the influence of parameters on metallic artifacts. 15 volunteers with internal vertebral fixation (titanium alloy materials) were scanned

  8. Evaluation of MR issues for the latest standard brands of orthopedic metal implants: Plates and screws

    International Nuclear Information System (INIS)

    Zou, Yue-fen; Chu, Bin; Wang, Chuan-bing; Hu, Zhi-yi

    2015-01-01

    Highlights: •Although previous studies have indicated that most of the orthopedic implants are compatible in MR imaging system especially for titanium alloy, there are still concerns about the safety of patients with stainless steel implants, who were refused to a MR scan in most cases in our country. •In this study, it was verified that both titanium alloy and stainless steel materials (plates and screws) cause a weak force and low MRI-related heating at a 1.5-T or less, which do not pose an additional hazard or risk to patients. In addition, we also had explored the influence of different sequences and parameters on size of metallic artifacts to obtain optimized pulse sequences with appropriate parameters for reducing artifacts, which would be convenient and useful in clinical work. -- Abstract: Purpose: The study was performed to evaluate magnetic resonance (MR) issues for the latest standard brands of plates and screws used in orthopedic surgery at a 1.5-T MR system, including the safety and metallic artifacts. Methods: The plates and screws (made of titanium alloy and stainless steel materials, according to the latest standard brands) were assessed for displacement in degrees, MRI-related heating and artifacts at a 1.5-T MR system. The displacement in degrees of the plates and screws was evaluated on an angel-measurement instrument at the entrance of the MR scanner. The MRI-related heating was assessed on a swine leg fixed with a plate by using a “worst-case” pulse sequence. A rectangular water phantom was designed to evaluate metallic artifacts of a screw on different sequences (T1/T2-weighted FSE, STIR, T2-FSE fat saturation, GRE, DWI) and then artifacts were evaluated on T2-weighted FSE sequence by modifying the scanning parameters including field of view (FOV), echo train length (ETL) and bandwidth to identify the influence of parameters on metallic artifacts. 15 volunteers with internal vertebral fixation (titanium alloy materials) were scanned

  9. Influence of radiotherapy on the latest generation of implantable cardioverter-defibrillators

    International Nuclear Information System (INIS)

    Hurkmans, Coen W.; Scheepers, Egon; Springorum, Bob G.F.; Uiterwaal, Hans

    2005-01-01

    Purpose: Radiotherapy can influence the functioning of pacemakers and implantable cardioverter-defibrillators (ICDs). ICDs offer the same functionality as pacemakers, but are also able to deliver a high-voltage shock to the heart if needed. Guidelines for radiotherapy treatment of patients with an implanted rhythm device have been published in 1994 by The American Association of Physicists in Medicine, and are based only on experience with pacemakers. Data on the influence of radiotherapy on ICDs are limited. The objective of our study is to determine the influence of radiotherapy on the latest generation of ICDs. Methods and Materials: Eleven modern ICDs have been irradiated in our department. The irradiation was performed with a 6-MV photon beam. The given dose was fractionated up to a cumulative dose of 120 Gy. Two to 5 days passed between consecutive irradiations. Frequency, output, sensing, telemetry, and shock energy were monitored. Results: Sensing interference by ionizing radiation on all ICDs has been demonstrated. For four ICDs, this would have caused the inappropriate delivery of a shock because of interference. At the end of the irradiation sessions, all devices had reached their point of failure. Complete loss of function was observed for four ICDs at dose levels between 0.5 Gy and 1.5 Gy. Conclusions: The effect of radiation therapy on the newest generation of ICDs varies widely. If tachycardia monitoring and therapy are functional (programmed on) during irradiation, the ICD might inappropriately give antitachycardia therapy, often resulting in a shock. Although most ICDs did not fail below 80 Gy, some devices had already failed at doses below 1.5 Gy. Guidelines are formulated for the treatment of patients with an ICD

  10. Innovative swine nutrition: some present and potential applications of latest scientific findings for safe pork production

    Directory of Open Access Journals (Sweden)

    Veronika Halas

    2010-01-01

    Full Text Available One of the biggest challenges facing animal agriculture in the 21st century is to produce safe and traceable foodstuffs of animal origin in sufficient volumes and quality besides the lowest possible load on the environment. A point to consider is how animal feeding and nutrition can contribute to the solution of this challenge. Another question is, that the results of which new scientific fields should be used in the area of innovation to achieve the desired product quality. The article answers these questions based on the latest data in the scientific literature and on the authors’ own research results. Having reviewed and processed the data, the authors drew the following conclusions: 1. The impact of climate changes on crop production and consequently on animal nutrition needs to be studied in comprehensive, systematic research programs, and based on their results animal feeding systems should be modified if necessary. 2. The role of molecular nutrition and the immunological role of nutrition for enhancing the efficiency of production will gain in importance. 3. The cooperation between nutritionists and geneticists needs to be strengthened in order to satisfy the nutrient requirements more accurately, and thus to improve the profitability of production. 4. New mathematical growth models, also incorporating the quality of animal products, need to be developed for better production estimates. 5. The integrated “from farm to fork” programs will be essential in the production of safe and high quality animal food products. Animal nutrition will play a key role in these product development and monitoring programs. 6. The production of environmentally friendly animal products will become a social imperative. Animal nutrition still has huge unexploited reserves in this field, for instance in the development of novel animal feeding systems and technologies. 7. T he practical implementation of precision nutrition can be of great help in achieving

  11. Prevention of NSAID gastropathy in elderly patients. An observational study in general practice and nursing homes.

    Science.gov (United States)

    van Leen, M W F; van der Eijk, I; Schols, J M G A

    2007-07-01

    The objectives of this study were to (i) survey the risk factors for NSAID gastropathy in outpatients (elderly patients in the community), compared to those living in old people's homes or nursing homes, (ii) study the prescription of medication prophylaxis during use of NSAIDs conform the current national guidelines and (iii) survey the influence on gastrointestinal symptoms and safety of pantoprazole 20 mg as prophylaxis for NSAID gastropathy. Patients over 65 years of age, using an NSAID without prophylaxis or newly starting NSAID treatment were included in the study. Pantoprazole 20 mg was prescribed as prophylaxis. Patients using an NSAID with prophylaxis being a proton pump inhibitor at the first visit were registered for epidemiological reasons. Demographic data, risk factors, gastrointestinal complaints, and adverse events were collected at t = 0, t = 2 weeks, t = 3 months and t = 6 months. Differences between groups were analysed with Chi-square tests and Mann-Whitney U tests; changes in time in GI symptoms were tested using Wilcoxon signed ranks tests and McNemar tests. One hundred eighty one general practitioners (treating outpatients and patients in old people's homes)and five nursing home physicians participated in the study and a total of 615 patients were included (522 patients treated by general practitioners (GP) and 93 patients in nursing homes). Four hundred thirty two patients were using NSAIDs without prophylaxis or started using an NSAID at the first visit; 269 (62.1%) and 163 (37.9%) patients respectively. 65.3% of the outpatients (224 out of 343) did not receive indicated prophylaxis, versus 76.2% (16 out of 21) in old people's homes and 42.6% in nursing homes (29 out of 69) (P NSAID prior to the study complained of gastrointestinal symptoms compared to new users (P NSAIDs caused these symptoms. After 2 weeks of treatment with pantoprazole, there was no statistical difference between the two groups. Moreover, both groups showed improvement

  12. First Clarkforkian equivalent Land Mammal Age in the latest Paleocene basal Sparnacian facies of Europe: fauna, flora, paleoenvironment and (bio)stratigraphy.

    Science.gov (United States)

    Smith, Thierry; Quesnel, Florence; De Plöeg, Gaël; De Franceschi, Dario; Métais, Grégoire; De Bast, Eric; Solé, Floréal; Folie, Annelise; Boura, Anaïs; Claude, Julien; Dupuis, Christian; Gagnaison, Cyril; Iakovleva, Alina; Martin, Jeremy; Maubert, François; Prieur, Judicaël; Roche, Emile; Storme, Jean-Yves; Thomas, Romain; Tong, Haiyan; Yans, Johan; Buffetaut, Eric

    2014-01-01

    The Paleocene-Eocene Thermal Maximum (PETM) is correlated with the first occurrences of earliest modern mammals in the Northern Hemisphere. The latest Paleocene Clarkforkian North American Land Mammal Age, that has yielded rodents and carnivorans, is the only exception to this rule. However, until now no pre-PETM localities have yielded modern mammals in Europe or Asia. We report the first Clarkforkian equivalent Land Mammal Age in the latest Paleocene deposits of the basal Sparnacian facies at Rivecourt, in the north-central part of the Paris Basin. The new terrestrial vertebrate and macroflora assemblages are analyzed through a multidisciplinary study including sedimentologic, stratigraphic, isotopic, and palynological aspects in order to reconstruct the paleoenvironment and to evaluate biochronologic and paleogeographic implications. The mammals are moderately diverse and not abundant, contrary to turtles and champsosaurs. The macroflora is exceptional in preservation and diversity with numerous angiosperms represented by flowers, fruits, seeds and wood preserved as lignite material, revealing an abundance of Arecaceae, Betulaceae, Icacinaceae, Menispermaceae, Vitaceae and probably Cornaceae. Results indicate a Late Paleocene age based on carbon isotope data, palynology and vertebrate occurrences such as the choristoderan Champsosaurus, the arctocyonid Arctocyon, and the plesiadapid Plesiadapis tricuspidens. However, several mammal species compare better with the earliest Eocene. Among these, the particular louisinid Teilhardimys musculus, also recorded from the latest Paleocene of the Spanish Pyrenees, suggests a younger age than the typical MP6 reference level. Nevertheless, the most important aspect of the Rivecourt fauna is the presence of dental remains of a rodent and a "miacid" carnivoran, attesting to the presence of two modern mammalian orders in the latest Paleocene of Europe. Interestingly, these two groups are also the only modern groups recorded

  13. Developing COPD: a 25 year follow up study of the general population

    DEFF Research Database (Denmark)

    Løkke, Anders; Lange, Peter; Scharling, H

    2006-01-01

    BACKGROUND: Smokers are more prone to develop chronic obstructive pulmonary disease (COPD) than non-smokers, but this finding comes from studies spanning 10 years or less. The aim of this study was to determine the 25 year absolute risk of developing COPD in men and women from the general...... of men with normal lung function ranged from 96% of never smokers to 59% of continuous smokers; for women the proportions were 91% and 69%, respectively. The 25 year incidence of moderate and severe COPD was 20.7% and 3.6%, respectively, with no apparent difference between men and women. Smoking...... cessation, especially early in the follow up period, decreased the risk of developing COPD substantially compared with continuous smoking. During the follow up period there were 2912 deaths, 109 of which were from COPD. 92% of the COPD deaths occurred in subjects who were current smokers at the beginning...

  14. Self-study program on HTML browser--application to Clinical Nursing General Remarks Course.

    Science.gov (United States)

    Ochiai, N; Sota, Y; Ezumi, H

    1997-01-01

    We created a self-study program using HTML browser on the Clinical Nursing General Remarks Course, Eighty-three students each selected a published book on a personal history (written personal reflections from individuals who had undergone medical treatment and hospitalization), read it and submitted reports of their impressions of the histories. Their reports were arranged from a nursing perspective and entered on the home page of our college using HTML browser. We intended that the students would become more interested in reading of the personal histories, and that they would acquire new self-study skills and increase their interest in Internet through use of our program. In addition, we hoped that this program would encourage positive communication and mutual sharing of information. The students were able to easily refer to a personal history according to their interest from a nursing perspective. Therefore this program realized the mutual learning among students and other users.

  15. A Generalized Estimating Equations Approach to Model Heterogeneity and Time Dependence in Capture-Recapture Studies

    Directory of Open Access Journals (Sweden)

    Akanda Md. Abdus Salam

    2017-03-01

    Full Text Available Individual heterogeneity in capture probabilities and time dependence are fundamentally important for estimating the closed animal population parameters in capture-recapture studies. A generalized estimating equations (GEE approach accounts for linear correlation among capture-recapture occasions, and individual heterogeneity in capture probabilities in a closed population capture-recapture individual heterogeneity and time variation model. The estimated capture probabilities are used to estimate animal population parameters. Two real data sets are used for illustrative purposes. A simulation study is carried out to assess the performance of the GEE estimator. A Quasi-Likelihood Information Criterion (QIC is applied for the selection of the best fitting model. This approach performs well when the estimated population parameters depend on the individual heterogeneity and the nature of linear correlation among capture-recapture occasions.

  16. Feasibility and acceptance of electronic quality of life assessment in general practice: an implementation study

    Directory of Open Access Journals (Sweden)

    Kochen Michael M

    2009-06-01

    Full Text Available Abstract Background Patients' health related quality of life (HRQoL has rarely been systematically monitored in general practice. Electronic tools and practice training might facilitate the routine application of HRQoL questionnaires. Thorough piloting of innovative procedures is strongly recommended before the conduction of large-scale studies. Therefore, we aimed to assess i the feasibility and acceptance of HRQoL assessment using tablet computers in general practice, ii the perceived practical utility of HRQoL results and iii to identify possible barriers hindering wider application of this approach. Methods Two HRQoL questionnaires (St. George's Respiratory Questionnaire SGRQ and EORTC QLQ-C30 were electronically presented on portable tablet computers. Wireless network (WLAN integration into practice computer systems of 14 German general practices with varying infrastructure allowed automatic data exchange and the generation of a printout or a PDF file. General practitioners (GPs and practice assistants were trained in a 1-hour course, after which they could invite patients with chronic diseases to fill in the electronic questionnaire during their waiting time. We surveyed patients, practice assistants and GPs regarding their acceptance of this tool in semi-structured telephone interviews. The number of assessments, HRQoL results and interview responses were analysed using quantitative and qualitative methods. Results Over the course of 1 year, 523 patients filled in the electronic questionnaires (1–5 times; 664 total assessments. On average, results showed specific HRQoL impairments, e.g. with respect to fatigue, pain and sleep disturbances. The number of electronic assessments varied substantially between practices. A total of 280 patients, 27 practice assistants and 17 GPs participated in the telephone interviews. Almost all GPs (16/17 = 94%; 95% CI = 73–99%, most practice assistants (19/27 = 70%; 95% CI = 50–86% and the majority of

  17. Systematic review of general burden of disease studies using disability-adjusted life years

    Directory of Open Access Journals (Sweden)

    Polinder Suzanne

    2012-11-01

    Full Text Available Abstract Objective To systematically review the methodology of general burden of disease studies. Three key questions were addressed: 1 what was the quality of the data, 2 which methodological choices were made to calculate disability adjusted life years (DALYs, and 3 were uncertainty and risk factor analyses performed? Furthermore, DALY outcomes of the included studies were compared. Methods Burden of disease studies (1990 to 2011 in international peer-reviewed journals and in grey literature were identified with main inclusion criteria being multiple-cause studies that quantified the burden of disease as the sum of the burden of all distinct diseases expressed in DALYs. Electronic database searches included Medline (PubMed, EMBASE, and Web of Science. Studies were collated by study population, design, methods used to measure mortality and morbidity, risk factor analyses, and evaluation of results. Results Thirty-one studies met the inclusion criteria of our review. Overall, studies followed the Global Burden of Disease (GBD approach. However, considerable variation existed in disability weights, discounting, age-weighting, and adjustments for uncertainty. Few studies reported whether mortality data were corrected for missing data or underreporting. Comparison with the GBD DALY outcomes by country revealed that for some studies DALY estimates were of similar magnitude; others reported DALY estimates that were two times higher or lower. Conclusions Overcoming “error” variation due to the use of different methodologies and low-quality data is a critical priority for advancing burden of disease studies. This can enlarge the detection of true variation in DALY outcomes between populations or over time.

  18. Sleep deficiency and motor vehicle crash risk in the general population: a prospective cohort study.

    Science.gov (United States)

    Gottlieb, Daniel J; Ellenbogen, Jeffrey M; Bianchi, Matt T; Czeisler, Charles A

    2018-03-20

    Insufficient sleep duration and obstructive sleep apnea, two common causes of sleep deficiency in adults, can result in excessive sleepiness, a well-recognized cause of motor vehicle crashes, although their contribution to crash risk in the general population remains uncertain. The objective of this study was to evaluate the relation of sleep apnea, sleep duration, and excessive sleepiness to crash risk in a community-dwelling population. This was a prospective observational cohort study nested within the Sleep Heart Health Study, a community-based study of the health consequences of sleep apnea. The participants were 1745 men and 1456 women aged 40-89 years. Sleep apnea was measured by home polysomnography and questionnaires were used to assess usual sleep duration and daytime sleepiness. A follow-up questionnaire 2 years after baseline ascertained driving habits and motor vehicle crash history. Logistic regression analysis was used to examine the relation of sleep apnea and sleep duration at baseline to the occurrence of motor vehicle crashes during the year preceding the follow-up visit, adjusting for relevant covariates. The population-attributable fraction of motor vehicle crashes was estimated from the sample proportion of motor vehicle crashes and the adjusted odds ratios for motor vehicle crash within each exposure category. Among 3201 evaluable participants, 222 (6.9%) reported at least one motor vehicle crash during the prior year. A higher apnea-hypopnea index (p vehicle crashes was 10% due to sleep apnea and 9% due to sleep duration less than 7 hours. Sleep deficiency due to either sleep apnea or insufficient sleep duration is strongly associated with motor vehicle crashes in the general population, independent of self-reported excessive sleepiness.

  19. Relationship between Metabolic Syndrome Components and Periodontal Disease in a Japanese General Population: the Suita Study.

    Science.gov (United States)

    Kikui, Miki; Kokubo, Yoshihiro; Ono, Takahiro; Kida, Momoyo; Kosaka, Takayuki; Yamamoto, Masaaki; Watanabe, Makoto; Maeda, Yoshinobu; Miyamoto, Yoshihiro

    2017-05-01

    A positive association between metabolic syndrome (MetS) and periodontal status has recently been noted. However, no study has evaluated the relationship by sex and in a general urban population using the uniform definition proposed in the 2009 Joint Interim Statement. The aim of this study was to clarify the relationship between MetS and periodontal status using the uniform definition in a general urban Japanese population. A total of 1,856 Japanese men and women (mean age: 66.4 years) were studied using data from the Suita study. Periodontal status was evaluated by the Community Periodontal Index (CPI). MetS was defined using the 2009 Joint Interim Statement. The associations of the MetS and its components with periodontal disease were investigated using multiple logistic regression analysis adjusting for age, drinking, and smoking. Among the components of the MetS, low HDL cholesterol level was significantly associated with periodontal disease in men and women [odds ratios (OR)=2.39 and 1.53; 95% confidence intervals=1.36-4.19 and 1.06-2.19]. Furthermore, the risk of periodontal disease showed 1.43-, 1.42-, and 1.89-fold increases in those with 2, 3, and ≥4 components, respectively, compared with those having no components (P trend <0.001). For the analysis by sex, the risk of periodontal disease was increased 2.27- and 1.76-fold in those with ≥4 components in men and women, respectively (both P trend =0.001). These findings suggest that MetS and lower HDL cholesterol are associated with periodontal disease. Subjects with two or more MetS components had a significantly higher prevalence of periodontal disease.

  20. Are general surgery residents adequately prepared for hepatopancreatobiliary fellowships? A questionnaire-based study

    Science.gov (United States)

    Osman, Houssam; Parikh, Janak; Patel, Shirali; Jeyarajah, D Rohan

    2015-01-01

    Background The present study was conducted to assess the preparedness of hepatopancreatobiliary (HPB) fellows upon entering fellowship, identify challenges encountered by HPB fellows during the initial part of their HPB training, and identify potential solutions to these challenges that can be applied during residency training. Methods A questionnaire was distributed to all HPB fellows in accredited HPB fellowship programmes in two consecutive academic years (n = 42). Reponses were then analysed. Results A total of 19 (45%) fellows responded. Prior to their fellowship, 10 (53%) were in surgical residency and the rest were in other surgical fellowships or surgical practice. Thirteen (68%) were graduates of university-based residency programmes. All fellows felt comfortable in performing basic laparoscopic procedures independently at the completion of residency and less comfortable in performing advanced laparoscopy. Eight (42%) fellows cited a combination of inadequate case volume and lack of autonomy during residency as the reasons for this lack of comfort. Thirteen (68%) identified inadequate preoperative workup and management as their biggest fear upon entering practice after general surgery training. A total of 17 (89%) fellows felt they were adequately prepared to enter HPB fellowship. Extra rotations in transplant, vascular or minimally invasive surgery were believed to be most helpful in preparing general surgery residents pursing HPB fellowships. Conclusions Overall, HPB fellows felt themselves to be adequately prepared for fellowship. Advanced laparoscopic procedures and the perioperative management of complex patients are two of the challenges facing HPB fellows. General surgery residents who plan to pursue an HPB fellowship may benefit from spending extra rotations on certain subspecialties. Focus on perioperative workup and management should be an integral part of residency and fellowship training. PMID:25387852

  1. The impact of general practitioner morale on patient satisfaction with care: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    McKinstry Brian

    2007-09-01

    Full Text Available Abstract Background The association between stress and morale among general practitioners (GP is well documented. However, the impact of GP stress or low morale on patient care is less clear. GPs in the UK now routinely survey patients about the quality of their care including organizational issues and consultation skills and the General Practice Assessment Questionnaire (GPAQ is widely used for this purpose. We aimed to see if there was a relationship between doctor morale as measured by a validated instrument, the Morale Assessment in General Practice Index (MAGPI and scores in the GPAQ. Methods All GPs in Lothian, Scotland who were collecting GPAQ data were approached and asked to complete the MAGPI. Using an anonymised linkage system, individual scores on the MAGPI were linked to the doctors' GPAQ scores. Levels of association between the scores were determined by calculating rank correlations at the level of the individual doctor. Hypothesised associations between individual MAGPI and GPAQ items were also assessed. Results 276 of 475 GPs who were approached agreed to complete a MAGPI questionnaire and successfully collected anonymous GPAQ data from an average of 49.6 patients. There was no significant correlation between the total MAGPI score and the GPAQ communication or enablement scale. There were weak correlations between "control of work" in the MAGPI scale and GPAQ items on waiting times to see doctors (r = 0.24 p Conclusion This study showed no relationship between overall GP morale and patient perception of performance. There was a weak relationship between patients' perceptions ofquality and doctors' beliefs about their workload and whether patients value them. Further research is required to elucidate the complex relationship between workload, morale and patients' perception of care.

  2. Travel Medicine Encounters of Australian General Practice Trainees-A Cross-Sectional Study.

    Science.gov (United States)

    Morgan, Simon; Henderson, Kim M; Tapley, Amanda; Scott, John; van Driel, Mieke L; Spike, Neil A; McArthur, Lawrie A; Davey, Andrew R; Catzikiris, Nigel F; Magin, Parker J

    2015-01-01

    Travel medicine is a common and challenging area of clinical practice and practitioners need up-to-date knowledge and experience in a range of areas. Australian general practitioners (GPs) play a significant role in the delivery of travel medicine advice. We aimed to describe the rate and nature of travel medicine consultations, including both the clinical and educational aspects of the consultations. A cross-sectional analysis from an ongoing cohort study of GP trainees' clinical consultations was performed. Trainees contemporaneously recorded demographic, clinical, and educational details of consecutive patient consultations. Proportions of all problems/diagnoses managed in these consultations that were coded "travel-related" and "travel advice" were both calculated with 95% confidence intervals (CIs). Associations of a problem/diagnosis being "travel-related" or "travel advice" were tested using simple logistic regression within the generalized estimating equations (GEE) framework. A total of 856 trainees contributed data on 169,307 problems from 108,759 consultations (2010-2014). Travel-related and travel advice problems were managed at a rate of 1.1 and 0.5 problems per 100 encounters, respectively. Significant positive associations of travel-related problems were younger trainee and patient age; new patient to the trainee and practice; privately billing, larger, urban, and higher socioeconomic status practices; and involvement of the practice nurse. Trainees sought in-consultation information and generated learning goals in 34.7 and 20.8% of travel advice problems, respectively, significantly more than in non-travel advice problems. Significant positive associations of travel advice problems were seeking in-consultation information, generation of learning goals, longer consultation duration, and more problems managed. Our findings reinforce the importance of focused training in travel medicine for GP trainees and adequate exposure to patients in the practice

  3. Use of hyperlinks in electronic test result communication: a survey study in general practice

    Directory of Open Access Journals (Sweden)

    Mukai Thomas

    2012-10-01

    Full Text Available Abstract Background Information is essential in healthcare. Recording, handling and sharing healthcare information is important in order to ensure high quality of delivered healthcare. Information and communication technology (ICT may be a valuable tool for handling these challenges. One way of enhancing the exchange of information could be to establish a link between patient-specific and general information sent to the general practitioner (GP. The aim of the present paper is to study GPs' use of a hyperlink inserted into electronic test result communication. Methods We inserted a hyperlink into the electronic test result communication sent to the patients’ GPs who participated in a regional, systematic breast cancer screening program. The hyperlink target was a web-site with information on the breast cancer screening program and breast cancer in general. Different strategies were used to increase the GPs’ use of this hyperlink. The outcome measure was the GPs’ self-reported use of the link. Data were collected by means of a one-page paper-based questionnaire. Results The response rate was 73% (n=242. In total, 108 (45% of the GPs reported to have used the link. In all, 22% (n=53 of the GPs used the web-address from a paper letter and 37% (n=89 used the hyperlink in the electronic test result communication (Δ = 15%[95%confidence  int erval(CI = 8 − 22%P  Conclusions The results suggest that hyperlinks in electronic test result communication could be a feasible strategy for combining and sharing different types of healthcare information.

  4. Fee Splitting among General Practitioners: A Cross-Sectional Study in Iran.

    Science.gov (United States)

    Parsa, Mojtaba; Larijani, Bagher; Aramesh, Kiarash; Nedjat, Saharnaz; Fotouhi, Akbar; Yekaninejad, Mir Saeed; Ebrahimian, Nejatollah; Kandi, Mohamad Jafar

    2016-12-01

    Fee splitting is a process whereby a physician refers a patient to another physician or a healthcare facility and receives a portion of the charge in return. This survey was conducted to study general practitioners' (GPs) attitudes toward fee splitting as well as the prevalence, causes, and consequences of this process. This is a cross-sectional study on 223 general practitioners in 2013. Concerning the causes and consequences of fee splitting, an unpublished qualitative study was conducted by interviewing a number of GPs and specialists and the questionnaire options were the results of the information obtained from this study. Of the total 320 GPs, 247 returned the questionnaires. The response rate was 77.18%. Of the 247 returned questionnaires, 223 fulfilled the inclusion criteria. Among the participants, 69.1% considered fee splitting completely wrong and 23.2% (frequently or rarely) practiced fee splitting. The present study showed that the prevalence of fee splitting among physicians who had positive attitudes toward fee splitting was 4.63 times higher than those who had negative attitudes. In addition, this study showed that, compared to private hospitals, fee splitting is less practiced in public hospitals. The major cause of fee splitting was found to be unrealistic/unfair tariffs and the main consequence of fee splitting was thought to be an increase in the number of unnecessary patient referrals. Fee splitting is an unethical act, contradicts the goals of the medical profession, and undermines patient's best interest. In Iran, there is no code of ethics on fee splitting, but in this study, it was found that the majority of GPs considered it unethical. However, among those who had negative attitudes toward fee splitting, there were physicians who did practice fee splitting. The results of the study showed that physicians who had a positive attitude toward fee splitting practiced it more than others. Therefore, if physicians consider fee splitting unethical

  5. A study of the linear free energy model for DNA structures using the generalized Hamiltonian formalism

    Energy Technology Data Exchange (ETDEWEB)

    Yavari, M., E-mail: yavari@iaukashan.ac.ir [Islamic Azad University, Kashan Branch (Iran, Islamic Republic of)

    2016-06-15

    We generalize the results of Nesterenko [13, 14] and Gogilidze and Surovtsev [15] for DNA structures. Using the generalized Hamiltonian formalism, we investigate solutions of the equilibrium shape equations for the linear free energy model.

  6. Genome-wide association study of autistic-like traits in a general population study of young adults

    Directory of Open Access Journals (Sweden)

    Rachel Maree Jones

    2013-10-01

    Full Text Available Research has proposed that autistic-like traits in the general population lie on a continuum, with clinical Autism Spectrum Disorder (ASD representing the extreme end of this distribution. Inherent in this proposal is that biological mechanisms associated with clinical ASD may also underpin variation in autistic-like traits within the general population. A genome-wide association study using 2,462,046 single nucleotide polymorphisms (SNPs was undertaken for ASD in 965 individuals from the Western Australian Pregnancy Cohort (Raine Study. No SNP associations reached genome-wide significance (p < 5.0 x 10-8. However, investigations into nominal observed SNP associations (p < 1.0 x 10-5 add support to two positional candidate genes previously implicated in ASD aetiology, PRKCB1 and CBLN1.The rs198198 SNP (p = 9.587 x 10-6, is located within an intron of the protein kinase C, beta 1 (PRKCB1 gene on chromosome 16p11. The PRKCB1 gene has been previously reported in linkage and association studies for ASD, and its mRNA expression has been shown to be significantly down regulated in ASD cases compared with controls. The rs16946931 SNP (p = 1.78 x 10-6 is located in a region flanking the Cerebellin 1 (CBLN1 gene on chromosome 16q12.1. The CBLN1 gene is involved with synaptogenesis and is part of a gene family previously implicated in ASD. This GWA study is only the second to examine SNPs associated with autistic-like traits in the general population, and provides evidence to support roles for the PRKCB1 and CBLN1 genes in risk of clinical ASD.

  7. Chronic care management in Danish general practice - a cross‒sectional study of workload and multimorbidity

    Directory of Open Access Journals (Sweden)

    Moth Grete

    2012-06-01

    Full Text Available Abstract Background About 30% of the Danish population has one or more chronic conditions, and general practitioners (GPs play a key role in effective chronic care management. However, little is known about these encounters in general practice. The aim was to describe the frequency of patients with one or more chronic conditions in general practice and how these consultations were experienced by the GPs. Methods All GPs in the Central Denmark Region were invited to register all contacts during one day in the 12‒month study period from December; 404 (46% accepted. For each patient contact, the GPs were asked to fill in a one‒page registration form covering information on chronic disease, reason for encounter, diagnosis, number of additional psychosocial problems raised by the patient during the consultation, time consumption, experienced burden of the consultation, referral to specialized care, and whether a nurse could have substituted the GP. Patients were categorized according to the number of chronic conditions (none, one, two, three or more and the categories compared with regard to the GP‒experienced burden of the contacts. Moreover, we examined which chronic conditions posed the the greatest challenge to the GPs. Results Patients aged 40 years or more had a total of 8,236 contacts. Among these patients 2,849 (34.6%; 95% CI 33.6‒35.6 had one and 2,596 (31.5%; CI 30.5‒32.5 had more than one chronic disease. The time consumption and the burden of their contacts tended to rise with the number of chronic conditions. Being present in 22.9% (CI 21.6‒24.3 of all face‒to‒face contacts, hypertension was the most common chronic condition. The burden of the contacts was experienced as particularly heavy for patients with depression and dementia due to more additional psychosocial problems and the time consumption. Conclusion General practitioners considered consultations with multimorbid patients demanding and not easily delegated to

  8. Prevalence of rosacea in the general population of Germany and Russia - The RISE study.

    Science.gov (United States)

    Tan, J; Schöfer, H; Araviiskaia, E; Audibert, F; Kerrouche, N; Berg, M

    2016-03-01

    There is an unmet need for general population-based epidemiological data on rosacea based on contemporary diagnostic criteria and validated population survey methodology. To evaluate the prevalence of rosacea in the general population of Germany and Russia. General population screening was conducted in 9-10 cities per country to ensure adequate geographic representation. In Part I of this two-phase study, screening of a representative sample of the general population (every fifth person or every fifth door using a fixed-step procedure on a random route sample) was expedited with use of a questionnaire and algorithm based on current diagnostic criteria for rosacea. Of the subjects that screened positive in the initial phase, a randomly selected sample (every third subject) t`hen underwent diagnostic confirmation by a dermatologist in Part II. A total of 3052 and 3013 subjects (aged 18-65 years) were screened in Germany and Russia respectively. Rosacea prevalence was 12.3% [95%CI, 10.2-14.4] in Germany and 5.0% [95%CI, 2.8-7.2] in Russia. The profile of subjects with rosacea (75% women; mean age of 40 years; mainly skin phototype II or III, majority of subjects with sensitive facial skin) and subtype distribution were similar. Overall, 18% of subjects diagnosed with rosacea were aged 18-30 years. Over 80% were not previously diagnosed. Within the previous year, 47.5% of subjects had received no rosacea care and 23.7% had received topical and/or systemic drugs. Over one-third (35% Germany, 43% Russia) of rosacea subjects reported a moderate to severe adverse impact on quality of life. Rosacea is highly prevalent in Germany (12.3%) and Russia (5.0%). The demographic profile of rosacea subjects was similar between countries and the majority were previously undiagnosed. © 2016 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.

  9. Challenges in the care for consanguineous couples: an exploratory interview study among general practitioners and midwives

    Directory of Open Access Journals (Sweden)

    Teeuw Marieke E

    2012-10-01

    Full Text Available Abstract Background It is often suggested that an effort must be made to increase awareness among consanguineous couples of their reproductive risk, and to refer them for genetic counseling if needed. Primary care professionals are considered most appropriate for addressing the subject and identifying couples at risk during consultations in their practice. This Dutch study aims to explore the experiences, attitudes and beliefs of such professionals regarding their care for consanguineous couples. Methods Sixteen semi-structured interviews were conducted with midwives and general practitioners. Results Although most primary care professionals considered it their task to inform couples about the risks of consanguinity, during consultations the topic was generally only briefly touched upon and quickly abandoned. Important reasons for this were professionals’ beliefs about religious and social values of couples, their low perception of the couples’ reproductive risk and expected limited feasibility of referral. Feelings of embarrassment regarding addressing consanguinity did not seem to play a significant role. Conclusions Primary care professional beliefs about their clients’ religious and social values, their attitudes toward the risk, and perceived limited options for referral seem to conflict with the professional norm to address the topic of consanguinity.

  10. Perioperative management of patients for osteo-odonto-kreatoprosthesis under general anaesthesia: A retrospective study.

    Science.gov (United States)

    Garg, Rakesh; Khanna, Puneet; Sinha, Renu

    2011-05-01

    An osteo-odonto-keratoprosthesis (OOKP) procedure is indicated in patients with failed corneal transplant but having intact retina for visual improvement. We studied perioperative concerns of patients who underwent the staged OOKP procedure. This was a retrospective analysis of patients who underwent OOKP. The information regarding symptoms, associated comorbidities, perioperative events including anaesthetic management were collected. Eight patients (five females and three males) underwent the staged OOKP procedure. The median age was 18 years. The median weight was 45 kg. The median duration of loss of vision was 4 years. The aetiology of blindness included Stevens-Johnson's syndrome (SJS) (7) and chemical burn (1). Four patients had generalized skin problem due to SJS. All cases were managed under general anaesthesia, and airway management included nasotracheal intubation for stage I and orotracheal intubation for stage II. The median mallampati classification was I prior to OOKP stage I procedure while it changed to II at stage II procedure. Two patients required fibreoptic nasotracheal intubation. One patient had excessive oozing from the mucosal harvest site and was managed conservatively. In one patient, tooth harvesting was done twice as the first tooth was damaged during creating a hole in it. We conclude that OOKP requires multidisciplinary care. Anaesthesiologist should evaluate the airway carefully and disease-associated systemic involvements. The use of various drugs requires caution and steroid supplementation should be done. Airway difficulty should be anticipated, mandating thorough evaluation. Re-evaluation of airway is prudent as it may become difficult during the staged OOKP procedure.

  11. How can a postgraduate professional education and development course benefit general practitioners?: a qualitative study

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    Steven Agius

    2015-06-01

    Full Text Available Purpose: The rationale for ‘professional education and development’ (PED courses is to support general practitioners, enabling them to access a range of theoretical and practical skills within a supportive schema. It aims to identify whether and how a regional PED course has had a beneficial impact upon participants. Methods: The study comprised a qualitative investigation of participants’ assessed coursework portfolios. The content of each portfolio gives individual accounts of the impact of the course on personal and practice development. Permission to access extant portfolios was obtained from 16 recent alumni of the course. The anonymous written material was analysed by the research team for recurring discourses and themes using a thematic framework analysis. Results: Seven major thematic categories were extrapolated from the data: leadership, resilience, quality improvement, change management, development of new services, educational expertise, and patient safety. In each category, we found evidence that the course enabled development of practitioners by enhancing knowledge and skills which had a positive impact upon their self-perceived effectiveness and motivation. Conclusion: Extended specialty training is on the horizon but such courses may still serve a valuable purpose for current trainees and the existing general practitioners workforce which will be responsible for leading the shift towards community-based service delivery.

  12. Managing patient demand: a qualitative study of appointment making in general practice.

    Science.gov (United States)

    Gallagher, M; Pearson, P; Drinkwater, C; Guy, J

    2001-04-01

    Managing patients' requests for appointments is an important general practice activity. No previous research has systematically observed how patients and receptionists negotiate appointments. To observe appointment making and investigate patients' and professionals' experiences of appointment negotiations. A qualitative study using participant observation. Three general practices on Tyneside; a single-handed practice, a practice comprising three doctors, and a seven-doctor practice. Participant observation sessions, consisting of 35 activity recordings and 34 periods of observation and 38 patient and 15 professional interviews, were set up. Seven groups of patients were selected for interview. These included patients attending an 'open access' surgery, patients who complained about making an appointment, and patients who complimented the receptionists. Appointment making is a complex social process. Outcomes are dependent on the process of negotiation and factors, such as patients' expectations and appointment availability. Receptionists felt that patients in employment, patients allocated to the practice by the Health Authority, and patients who did not comply with practice appointment rules were most demanding. Appointment requests are legitimised by receptionists enforcing practice rules and requesting clinical information. Patients volunteer information to provide evidence that their complaint is appropriate and employ strategies, such as persistence, assertiveness, and threats, to try and persuade receptionists to grant appointments. Appointment making is a complex social process where outcomes are negotiated. Receptionists have an important role in managing patient demand. Practices should be explicit about how appointments are allocated, including publishing practice criteria.

  13. Arousal Predisposition as a Vulnerability Indicator for Psychosis: A General Population Online Stress Induction Study

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    Annika Clamor

    2015-01-01

    Full Text Available Explanatory models ascribe to arousability a central role for the development of psychotic symptoms. Thus, a disposition to hyperarousal (i.e., increased arousal predisposition (AP may serve as an underlying vulnerability indicator for psychosis by interacting with stressors to cause symptoms. In this case, AP, stress-response, and psychotic symptoms should be linked before the development of a diagnosable psychotic disorder. We conducted a cross-sectional online study in a population sample (N=104; Mage=27.7 years, SD=11.2, range 18–70. Participants rated their AP and subclinical psychotic symptoms. Participants reported their stress-levels before and after two stress inductions including an arithmetic and a social stressor. The participants with an increased AP generally felt more stressed. However, AP was not associated with the specific stress-response. As expected, positive psychotic symptoms were significantly associated with AP, but this was not mediated by general stress-levels. Its association to subtle, nonclinical psychotic symptoms supports our assumption that AP could be a vulnerability indicator for psychosis. The trait is easily accessible via a short self-report and could facilitate the identification of people at risk and be a promising target for early stress-management. Further research is needed to clarify its predictive value for stress-responses.

  14. Assessing the Accuracy of Generalized Inferences From Comparison Group Studies Using a Within-Study Comparison Approach: The Methodology.

    Science.gov (United States)

    Jaciw, Andrew P

    2016-06-01

    Various studies have examined bias in impact estimates from comparison group studies (CGSs) of job training programs, and in education, where results are benchmarked against experimental results. Such within-study comparison (WSC) approaches investigate levels of bias in CGS-based impact estimates, as well as the success of various design and analytic strategies for reducing bias. This article reviews past literature and summarizes conditions under which CGSs replicate experimental benchmark results. It extends the framework to, and develops the methodology for, situations where results from CGSs are generalized to untreated inference populations. Past research is summarized; methods are developed to examine bias in program impact estimates based on cross-site comparisons in a multisite trial that are evaluated against site-specific experimental benchmarks. Students in Grades K-3 in 79 schools in Tennessee; students in Grades 4-8 in 82 schools in Alabama. Grades K-3 Stanford Achievement Test (SAT) in reading and math scores; Grades 4-8 SAT10 reading scores. Past studies show that bias in CGS-based estimates can be limited through strong design, with local matching, and appropriate analysis involving pretest covariates and variables that represent selection processes. Extension of the methodology to investigate accuracy of generalized estimates from CGSs shows bias from confounders and effect moderators. CGS results, when extrapolated to untreated inference populations, may be biased due to variation in outcomes and impact. Accounting for effects of confounders or moderators may reduce bias. © The Author(s) 2016.

  15. Subjective memory complaints in general practice predicts future dementia: a 4-year follow-up study

    DEFF Research Database (Denmark)

    Waldorff, Frans Boch; Vogel, Asmus Mejling; Siersma, Volkert Dirk

    2012-01-01

    Many older patients in general practice have subjective memory complaints (SMC); however, not all share this information with their general practitioner (GP). The association between SMC and future cognitive decline or dementia is not clear, especially in a general practice population. The aim...

  16. Objective Sleep Structure and Cardiovascular Risk Factors in the General Population: The HypnoLaus Study

    Science.gov (United States)

    Haba-Rubio, José; Marques-Vidal, Pedro; Andries, Daniela; Tobback, Nadia; Preisig, Martin; Vollenweider, Peter; Waeber, Gérard; Luca, Gianina; Tafti, Mehdi; Heinzer, Raphaël

    2015-01-01

    Study Objectives: To evaluate the association between objective sleep measures and metabolic syndrome (MS), hypertension, diabetes, and obesity. Design: Cross-sectional study. Setting: General population sample. Participants: There were 2,162 patients (51.2% women, mean age 58.4 ± 11.1). Interventions: Patients were evaluated for hypertension, diabetes, overweight/obesity, and MS, and underwent a full polysomnography (PSG). Measurements and Results: PSG measured variables included: total sleep time (TST), percentage and time spent in slow wave sleep (SWS) and in rapid eye movement (REM) sleep, sleep efficiency and arousal index (ArI). In univariate analyses, MS was associated with decreased TST, SWS, REM sleep, and sleep efficiency, and increased ArI. After adjustment for age, sex, smoking, alcohol, physical activity, drugs that affect sleep and depression, the ArI remained significantly higher, but the difference disappeared in patients without significant sleep disordered breathing (SDB). Differences in sleep structure were also found according to the presence or absence of hypertension, diabetes, and overweight/obesity in univariate analysis. However, these differences were attenuated after multivariate adjustment and after excluding subjects with significant SDB. Conclusions: In this population-based sample we found significant associations between sleep structure and metabolic syndrome (MS), hypertension, diabetes, and obesity. However, these associations were cancelled after multivariate adjustment. We conclude that normal variations in sleep contribute little if any to MS and associated disorders. Citation: Haba-Rubio J, Marques-Vidal P, Andries D, Tobback N, Preisig M, Vollenweider P, Waeber G, Luca G, Tafti M, Heinzer R. Objective sleep structure and cardiovascular risk factors in the general population: the HypnoLaus study. SLEEP 2015;38(3):391–400. PMID:25325467

  17. Social capital and frequent attenders in general practice: a register-based cohort study.

    Science.gov (United States)

    Pasgaard, Alexander A; Mæhlisen, Maiken H; Overgaard, Charlotte; Ejlskov, Linda; Torp-Pedersen, Christian; Bøggild, Henrik

    2018-03-02

    Frequent attendance to primary care constitutes a large use of resources for the health care system. The association between frequent attendance and illness-related factors has been examined in several studies, but little is known about the association between frequent attendance and individual social capital. The aim of this study is to explore this association. The analysis is conducted on responders to the North Denmark Region Health Profile 2010 (n = 23,384), individually linked with information from administrative registers. Social capital is operationalized at the individual level, and includes cognitive (interpersonal trust and norms of reciprocity) as well as structural (social network and civic engagement) dimensions. Frequent attendance is defined as the upper-quartile of the total number of measured consultations with a general practitioner over a period of 148 weeks. Using multiple logistic regression, we found that frequent attendance was associated with a lower score in interpersonal trust [OR 0.86 (0.79-0.94)] and social network [OR 0.88 (0.79-0.98)] for women, when adjusted for age, education, income and SF12 health scores. Norms of reciprocity and civic engagement were not significantly associated with frequent attendance for women [OR 1.05 (0.99-1.11) and OR 1.01 (0.92-1.11) respectively]. None of the associations were statistically significant for men. This study suggests that for women, some aspects of social capital are associated with frequent attendance in general practice, and the statistically significant dimensions belonged to both cognitive and structural aspects of social capital. This association was not seen for men. This indicates a multifaceted and heterogeneous relationship between social capital and frequent attendance among genders.

  18. General Physicians’ Viewpoints Towards Nutrition Course in the Medical School: a Cross-Sectional Study

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    Ebrahim Fallahi

    2009-02-01

    Full Text Available Background and Purpose: Although nutrition has a very important role in individual and society’s health and disease, it has not yet received proper attention in the medical curricula. The objective of this study is to assess the opinions of general physician who worked at private offices in Khorramabadcity about nutrition course in Iranian medical schools.Methods: In this cross-sectional study the data were collected by posting a self-administrated questionnaire to all GPs who worked at private offices in Khorramabad city of Lorestan province in 2005. Participants were asked to state their opinions about each topic considering the following issues: the appropriate phase for introduction of the topic (in basic sciences, pathophysiology, or clinical training; need for learning it (low, moderate, high; and the time devoted to instruction of that topic (inadequate, appropriate, or excessive.GPs opinions were also surveyed to determinetheir reference for the topics not included in current nutrition course. Study data were processed by SPSS version 11 software and analyzed using descriptive and Chi-square statistics with a level of significance of less than 0.05. Results Most of participants believed that clinical teaching periods (clerkship and internship are the appropriate stage for teaching disease- related or clinical aspects of nutrition. They also valued most of the topics listed in the questionnaire as important learning needs as well as 15 new nutrition topicsConclusions: Our results clearly indicate that there is a need to include clinical nutritional topics in the clinical training of medical students. New topics such as nutritional consideration in hypelipidemia, and heart disease should also be included in the nutrition education of physicians.Key words: NUTRITION EDUCATION, MEDICAL CURRICULUM. GENERAL PHYSICIANt 

  19. General and specialized brain correlates for analogical reasoning: A meta-analysis of functional imaging studies.

    Science.gov (United States)

    Hobeika, Lucie; Diard-Detoeuf, Capucine; Garcin, Béatrice; Levy, Richard; Volle, Emmanuelle

    2016-05-01

    Reasoning by analogy allows us to link distinct domains of knowledge and to transfer solutions from one domain to another. Analogical reasoning has been studied using various tasks that have generally required the consideration of the relationships between objects and their integration to infer an analogy schema. However, these tasks varied in terms of the level and the nature of the relationships to consider (e.g., semantic, visuospatial). The aim of this study was to identify the cerebral network involved in analogical reasoning and its specialization based on the domains of information and task specificity. We conducted a coordinate-based meta-analysis of 27 experiments that used analogical reasoning tasks. The left rostrolateral prefrontal cortex was one of the regions most consistently activated across the studies. A comparison between semantic and visuospatial analogy tasks showed both domain-oriented regions in the inferior and middle frontal gyri and a domain-general region, the left rostrolateral prefrontal cortex, which was specialized for analogy tasks. A comparison of visuospatial analogy to matrix problem tasks revealed that these two relational reasoning tasks engage, at least in part, distinct right and left cerebral networks, particularly separate areas within the left rostrolateral prefrontal cortex. These findings highlight several cognitive and cerebral differences between relational reasoning tasks that can allow us to make predictions about the respective roles of distinct brain regions or networks. These results also provide new, testable anatomical hypotheses about reasoning disorders that are induced by brain damage. Hum Brain Mapp 37:1953-1969, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  20. MRSA model of learning and adaptation: a qualitative study among the general public

    Science.gov (United States)

    2012-01-01

    Background More people in the US now die from Methicillin Resistant Staphylococcus aureus (MRSA) infections than from HIV/AIDS. Often acquired in healthcare facilities or during healthcare procedures, the extremely high incidence of MRSA infections and the dangerously low levels of literacy regarding antibiotic resistance in the general public are on a collision course. Traditional medical approaches to infection control and the conventional attitude healthcare practitioners adopt toward public education are no longer adequate to avoid this collision. This study helps us understand how people acquire and process new information and then adapt behaviours based on learning. Methods Using constructivist theory, semi-structured face-to-face and phone interviews were conducted to gather pertinent data. This allowed participants to tell their stories so their experiences could deepen our understanding of this crucial health issue. Interview transcripts were analysed using grounded theory and sensitizing concepts. Results Our findings were classified into two main categories, each of which in turn included three subthemes. First, in the category of Learning, we identified how individuals used their Experiences with MRSA, to answer the questions: What was learned? and, How did learning occur? The second category, Adaptation gave us insights into Self-reliance, Reliance on others, and Reflections on the MRSA journey. Conclusions This study underscores the critical importance of educational programs for patients, and improved continuing education for healthcare providers. Five specific results of this study can reduce the vacuum that currently exists between the knowledge and information available to healthcare professionals, and how that information is conveyed to the public. These points include: 1) a common model of MRSA learning and adaptation; 2) the self-directed nature of adult learning; 3) the focus on general MRSA information, care and prevention, and antibiotic

  1. Diagnostic approach to urinary tract infections in male general practice patients: a national surveillance study

    Science.gov (United States)

    den Heijer, Casper DJ; van Dongen, Martien CJM; Donker, Gé A; Stobberingh, Ellen E

    2012-01-01

    Background Diagnostic urinary tract infection (UTI) studies have primarily been performed among female patients. Aim To create a diagnostic algorithm for male general practice patients suspected of UTI. Design and setting Surveillance study in the Dutch Sentinel General Practice Network. Method Clinical information and dipstick results were collected from 603 patients. Algorithm-predicted care was compared with care as usual in terms of sensitivity (antibiotic recommended when UTI was confirmed) and specificity (no antibiotic recommended when no UTI was observed). Results Complete information was available from 490/603 (81%) males, of whom 66% (321/490) had a UTI. A diagnostic algorithm recommending antimicrobial prescription in the case of a positive nitrite test or a positive leukocyte esterase test in males aged ≥60 years, had a positive predictive value (PPV) of 83% (95% confidence interval [CI] = 78 to 87) and a negative predictive value (NPV) of 60% (95% CI = 52 to 66), respectively (area under the ROC curve: 0.78, 95% CI = 0.74 to 0.82). When both dipstick results were positive in males aged ≥60 years, PPV increased to 90% (95% CI = 83 to 94), whereas NPV was highest in males Sensitivity and specificity of predicted UTI care and usual care did not differ (75% versus 79%, P = 0.30, and 70% versus 63%, P = 0.17, respectively). Conclusion UTI care provided to Dutch male GP patients is as accurate as predicted care from a diagnostic algorithm. The studied clinical information and dipstick tests are useful for ruling in UTI in males, but have limited value in ruling out this diagnosis. PMID:23211182

  2. MRSA model of learning and adaptation: a qualitative study among the general public

    Directory of Open Access Journals (Sweden)

    Rohde Rodney E

    2012-04-01

    Full Text Available Abstract Background More people in the US now die from Methicillin Resistant Staphylococcus aureus (MRSA infections than from HIV/AIDS. Often acquired in healthcare facilities or during healthcare procedures, the extremely high incidence of MRSA infections and the dangerously low levels of literacy regarding antibiotic resistance in the general public are on a collision course. Traditional medical approaches to infection control and the conventional attitude healthcare practitioners adopt toward public education are no longer adequate to avoid this collision. This study helps us understand how people acquire and process new information and then adapt behaviours based on learning. Methods Using constructivist theory, semi-structured face-to-face and phone interviews were conducted to gather pertinent data. This allowed participants to tell their stories so their experiences could deepen our understanding of this crucial health issue. Interview transcripts were analysed using grounded theory and sensitizing concepts. Results Our findings were classified into two main categories, each of which in turn included three subthemes. First, in the category of Learning, we identified how individuals used their Experiences with MRSA, to answer the questions: What was learned? and, How did learning occur? The second category, Adaptation gave us insights into Self-reliance, Reliance on others, and Reflections on the MRSA journey. Conclusions This study underscores the critical importance of educational programs for patients, and improved continuing education for healthcare providers. Five specific results of this study can reduce the vacuum that currently exists between the knowledge and information available to healthcare professionals, and how that information is conveyed to the public. These points include: 1 a common model of MRSA learning and adaptation; 2 the self-directed nature of adult learning; 3 the focus on general MRSA information, care and

  3. The Identity Crisis of Osteoarthritis in General Practice: A Qualitative Study Using Video-Stimulated Recall.

    Science.gov (United States)

    Paskins, Zoe; Sanders, Tom; Croft, Peter R; Hassell, Andrew B

    2015-11-01

    Patients and doctors report marked disenchantment with primary care consultation experiences relating to osteoarthritis. This study aimed to observe and analyze interactions between general practitioners (GPs) and patients presenting with osteoarthritis (OA) to identify how to improve care for OA. We conducted an observational study in general practices in the United Kingdom using video-recorded real-life consultations of unselected patients and their GPs. Postconsultation interviews were conducted using video-stimulated recall. Both consultations and interviews were analyzed thematically. Three key themes were identified in an analysis of 19 OA consultations and the matched GP and patient interviews: complexity, dissonance, and prioritization. The topic of osteoarthritis arises in the consultation in complex contexts of multimorbidity and multiple, often not explicit, patient agendas. Dissonance between patient and doctor was frequently observed and reported; this occurred when GPs normalized symptoms of OA as part of life and reassured patients who were not seeking reassurance. GPs used wear and tear in preference to osteoarthritis or didn't name the condition at all. GPs subconsciously made assumptions that patients did not consider OA a priority and that symptoms raised late in the consultation were not troublesome. The lack of a clear illness profile results in confusion between patients and doctors about what OA is and its priority in the context of multimorbidity. This study highlights generic communication issues regarding the potential negative consequences of unsought reassurance and the importance of validation of symptoms and raises new arguments for tackling OA's identity crisis by developing a clearer medical language with which to explain OA. © 2015 Annals of Family Medicine, Inc.

  4. THE GENERAL CONTEXTUAL FRAME FOR PLACING SUPERIOR STUDIES GRADUATES IN THE WORK MARKET

    Directory of Open Access Journals (Sweden)

    FELICIA ANDRIONI

    2013-12-01

    Full Text Available Integration in a workplace is an interaction rapport between the individual and the environment. The process of professional integration is strongly linked to the professional aspiration, individual expectations, motivation, and work satisfaction. Placing young graduates of superior studies on the labour market is a challenge for contemporary society. Identifying a suitable work place as well as the certainty of the attained work place are very important elements for young superior studies graduates in the current context of economic crysis. The difficulties in getting a job for superior studies graduates are most frequently associated with lacks in what regards the speciality practical skills and generally, insertion in the work market is achived by getting a position in fields that are related or even different from the speciality field. In an extremely unstable social and economic context, people’s ability to quickly adapt to the requirements of the labour market is fundamental. In this respect, education and professional training have an important role, contributing to the update of knowledge, skills and qualifications of superior studies graduates or future superior studies graduates, eventually allowing them to stay active, flexible, adapted to the situations and requirements of the labour market.

  5. Anorectal pathology amongst HIV infected patients attending the Douala General Hospital: a cross-sectional study.

    Science.gov (United States)

    Luma, Henry Namme; Eloumou, Servais Albert Fiacre Bagnaka; Fualefeh-Morfaw, Ellis Atemlefeh; Malongue, Agnes; Temfack, Elvis; Lekpa, Fernando Kemta; Donfack-Sontsa, Olivier; Ndip, Lucy; Ditah, Ivo Che

    2017-03-01

    While gastrointestinal disease is common among HIV infected individuals, the prevalence and distribution of ano-rectal pathology has not been well studied in our setting. The objective of this study therefore was to determine the prevalence and determinants of ano-rectal pathology in HIV infected patients attending the Douala General Hospital HIV treatment centre. A hospital-based cross-sectional study was undertaken. We collected socio-demographic, clinical and laboratory data using a structured questionnaire and patients' files. Each study participant had a full physical and ano-rectal examination. We further studied factors associated with having at least one ano-rectal lesion by logistic regression reporting odds ratios (ORs) and their 95% confidence intervals (CI). We included 390 HIV infected patients. The mean age was 41 (SD: 8) years and 48% were men. Median duration since HIV diagnosis was 3 (interquartile range: 2-5) years and median CD4 cell count was 411 (interquartile range: 234-601) cells/mm 3 . Prevalence of ano-rectal pathology was 22.8% (95% CI: 18.7-27.3). Hemorrhoids and proctitis were most common lesions found; each in 10% of patients. From multivariate logistic regression, factors associated with ano-rectal pathology were CD4 HIV infected patients. Care givers should actively investigate and treat them as this will improve the quality of life of people living with HIV/AIDS.

  6. Receptionist input to quality and safety in repeat prescribing in UK general practice: ethnographic case study.

    Science.gov (United States)

    Swinglehurst, Deborah; Greenhalgh, Trisha; Russell, Jill; Myall, Michelle

    2011-11-03

    To describe, explore, and compare organisational routines for repeat prescribing in general practice to identify contributors and barriers to safety and quality. Ethnographic case study. Four urban UK general practices with diverse organisational characteristics using electronic patient records that supported semi-automation of repeat prescribing. 395 hours of ethnographic observation of staff (25 doctors, 16 nurses, 4 healthcare assistants, 6 managers, and 56 reception or administrative staff), and 28 documents and other artefacts relating to repeat prescribing locally and nationally. Potential threats to patient safety and characteristics of good practice. Observation of how doctors, receptionists, and other administrative staff contributed to, and collaborated on, the repeat prescribing routine. Analysis included mapping prescribing routines, building a rich description of organisational practices, and drawing these together through narrative synthesis. This was informed by a sociological model of how organisational routines shape and are shaped by information and communications technologies. Results Repeat prescribing was a complex, technology-supported social practice requiring collaboration between clinical and administrative staff, with important implications for patient safety. More than half of requests for repeat prescriptions were classed as "exceptions" by receptionists (most commonly because the drug, dose, or timing differed from what was on the electronic repeat list). They managed these exceptions by making situated judgments that enabled them (sometimes but not always) to bridge the gap between the idealised assumptions about tasks, roles, and interactions that were built into the electronic patient record and formal protocols, and the actual repeat prescribing routine as it played out in practice. This work was creative and demanded both explicit and tacit knowledge. Clinicians were often unaware of this input and it did not feature in policy

  7. General Practitioners' Concerns About Online Patient Feedback: Findings From a Descriptive Exploratory Qualitative Study in England.

    Science.gov (United States)

    Patel, Salma; Cain, Rebecca; Neailey, Kevin; Hooberman, Lucy

    2015-12-08

    The growth in the volume of online patient feedback, including online patient ratings and comments, suggests that patients are embracing the opportunity to review online their experience of receiving health care. Very little is known about health care professionals' attitudes toward online patient feedback and whether health care professionals are comfortable with the public nature of the feedback. The aim of the overall study was to explore and describe general practitioners' attitudes toward online patient feedback. This paper reports on the findings of one of the aims of the study, which was to explore and understand the concerns that general practitioners (GPs) in England have about online patient feedback. This could then be used to improve online patient feedback platforms and help to increase usage of online patient feedback by GPs and, by extension, their patients. A descriptive qualitative approach using face-to-face semistructured interviews was used in this study. A topic guide was developed following a literature review and discussions with key stakeholders. GPs (N=20) were recruited from Cambridgeshire, London, and Northwest England through probability and snowball sampling. Interviews were transcribed verbatim and analyzed in NVivo using the framework method, a form of thematic analysis. Most participants in this study had concerns about online patient feedback. They questioned the validity of online patient feedback because of data and user biases and lack of representativeness, the usability of online patient feedback due to the feedback being anonymous, the transparency of online patient feedback because of the risk of false allegations and breaching confidentiality, and the resulting impact of all those factors on them, their professional practice, and their relationship with their patients. The majority of GPs interviewed had reservations and concerns about online patient feedback and questioned its validity and usefulness among other things

  8. Psychometrics Matter in Health Behavior: A Long-term Reliability Generalization Study.

    Science.gov (United States)

    Pickett, Andrew C; Valdez, Danny; Barry, Adam E

    2017-09-01

    Despite numerous calls for increased understanding and reporting of reliability estimates, social science research, including the field of health behavior, has been slow to respond and adopt such practices. Therefore, we offer a brief overview of reliability and common reporting errors; we then perform analyses to examine and demonstrate the variability of reliability estimates by sample and over time. Using meta-analytic reliability generalization, we examined the variability of coefficient alpha scores for a well-designed, consistent, nationwide health study, covering a span of nearly 40 years. For each year and sample, reliability varied. Furthermore, reliability was predicted by a sample characteristic that differed among age groups within each administration. We demonstrated that reliability is influenced by the methods and individuals from which a given sample is drawn. Our work echoes previous calls that psychometric properties, particularly reliability of scores, are important and must be considered and reported before drawing statistical conclusions.

  9. A preliminary study for the implementation of general accident management strategies

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Soo Hyung; Kim, Soo Hyung; Jeong, Young Hoon; Chang, Soon Heung [Korea Advanced Institute of Science and Technology, Taejon (Korea, Republic of)

    1997-12-31

    To enhance the safety of nuclear power plants, implementation of accident management has been suggested as one of most important programs. Specially, accident management strategies are suggested as one of key elements considered in development of the accident management program. In this study, generally applicable accident management strategies to domestic nuclear power plants are identified through reviewing several accident management programs for the other countries and considering domestic conditions. Identified strategies are as follows; 1) Injection into the Reactor Coolant System, 2) Depressurize the Reactor Coolant System, 3) Depressurize the Steam Generator, 4) Injection into the Steam Generator, 5) Injection into the Containment, 6) Spray into the Containment, 7) Control Hydrogen in the Containment. In addition, the systems and instrumentation necessary for the implementation of each strategy are also investigated. 11 refs., 3 figs., 3 tabs. (Author)

  10. Electronic and Optical Properties of TiS_2 Determined from Generalized Gradient Approximation Study

    International Nuclear Information System (INIS)

    El-Kouch, Hamza; Farh, Larbi El; Sayah, Jamal; Challioui, Allal

    2015-01-01

    The electronic and optical properties of TiS_2 are studied by using an ab-initio calculation within the frame of density functional theory. A linearized and augmented plane wave basis set with the generalized gradient approximation as proposed by Perdew et al. is used for the energy exchange-correlation determination. The results show a metallic character of TiS_2, and the plots of total and partial densities of states of TiS_2 show the metallic character of the bonds and a strong hybridization between the states d of Ti and p of S below the Fermi energy. The optical properties of the material such as real and imaginary parts of dielectric constant (ϵ(ω) = ϵ_1(ω) + iϵ_2(ω)), refractive index n(ω), optical reflectivity R(ω), for E//x and E//z are performed for the energy range of 0–14 eV. (paper)

  11. A preliminary study for the implementation of general accident management strategies

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Soo Hyung; Kim, Soo Hyung; Jeong, Young Hoon; Chang, Soon Heung [Korea Advanced Institute of Science and Technology, Taejon (Korea, Republic of)

    1998-12-31

    To enhance the safety of nuclear power plants, implementation of accident management has been suggested as one of most important programs. Specially, accident management strategies are suggested as one of key elements considered in development of the accident management program. In this study, generally applicable accident management strategies to domestic nuclear power plants are identified through reviewing several accident management programs for the other countries and considering domestic conditions. Identified strategies are as follows; 1) Injection into the Reactor Coolant System, 2) Depressurize the Reactor Coolant System, 3) Depressurize the Steam Generator, 4) Injection into the Steam Generator, 5) Injection into the Containment, 6) Spray into the Containment, 7) Control Hydrogen in the Containment. In addition, the systems and instrumentation necessary for the implementation of each strategy are also investigated. 11 refs., 3 figs., 3 tabs. (Author)

  12. A preliminary study for the implementation of general accident management strategies

    International Nuclear Information System (INIS)

    Yang, Soo Hyung; Kim, Soo Hyung; Jeong, Young Hoon; Chang, Soon Heung

    1997-01-01

    To enhance the safety of nuclear power plants, implementation of accident management has been suggested as one of most important programs. Specially, accident management strategies are suggested as one of key elements considered in development of the accident management program. In this study, generally applicable accident management strategies to domestic nuclear power plants are identified through reviewing several accident management programs for the other countries and considering domestic conditions. Identified strategies are as follows; 1) Injection into the Reactor Coolant System, 2) Depressurize the Reactor Coolant System, 3) Depressurize the Steam Generator, 4) Injection into the Steam Generator, 5) Injection into the Containment, 6) Spray into the Containment, 7) Control Hydrogen in the Containment. In addition, the systems and instrumentation necessary for the implementation of each strategy are also investigated

  13. General practitioners learning qualitative research: A case study of postgraduate education.

    Science.gov (United States)

    Hepworth, Julie; Kay, Margaret

    2015-10-01

    Qualitative research is increasingly being recognised as a vital aspect of primary healthcare research. Teaching and learning how to conduct qualitative research is especially important for general practitioners and other clinicians in the professional educational setting. This article examines a case study of postgraduate professional education in qualitative research for clinicians, for the purpose of enabling a robust discussion around teaching and learning in medicine and the health sciences. A series of three workshops was delivered for primary healthcare academics. The workshops were evaluated using a quantitative survey and qualitative free-text responses to enable descriptive analyses. Participants found qualitative philosophy and theory the most difficult areas to engage with, and learning qualitative coding and analysis was considered the easiest to learn. Key elements for successful teaching were identified, including the use of adult learning principles, the value of an experienced facilitator and an awareness of the impact of clinical subcultures on learning.

  14. Study of pollutant transport in surface boundary layer by generalized integral transform technique

    International Nuclear Information System (INIS)

    Guerrero, Jesus S.P.; Heilbron Filho, Paulo F.L.; Pimentel, Luiz C.G.; Cataldi, Marcio

    2001-01-01

    A theoretical study was developed to obtain solutions of the atmospheric diffusion equation for various point source, considering radioactive decay and axial diffusion, under neutral atmospheric conditions. It was used an algebraic turbulence model available in the literature, based on Monin-Obukhov similarity theory, for the representation of the turbulent transport in the vertical direction, in the longitudinal directions was considered a constant mass eddy diffusivity . The bi-dimensional transient partial differential equation, representative of the physical phenomena, was transformed into a coupled one-dimensional transient equation system by applying the Generalized Integral Transform Technique. The coupled system was solved numerically using a subroutine based in the lines method. In order to evaluate the computational algorithm were analyzed some representative physical situations. (author)

  15. The Association between Infections and General Cognitive Ability in Young Men - A Nationwide Study

    DEFF Research Database (Denmark)

    Benros, Michael E; Sørensen, Holger Jelling; Nielsen, Philip Finn Rising

    2015-01-01

    nationwide registers were linked to establish a cohort of all 161,696 male conscripts during the years 2006-2012 who were tested for cognitive ability, which was based on logical, verbal, numerical and spatial reasoning at a mean age of 19.4 years. Test scores were converted to a mean of 100.......00 and with a standard deviation (SD) of 15. Data were analyzed as a cohort study with severe infections requiring hospitalization as exposure using linear regression. RESULTS: Adjusted effect sizes were calculated with non-exposure to severe infections as reference, ranging from 0.12 SD to 0.63 SD on general cognitive...... of infections (Mean: -9.44; 95%CI: -13.2 to -5.69; corresponding to 0.63 SD). Hospital contacts with infections had occurred in 35% of the individuals prior to conscription. CONCLUSIONS: Independent of a wide range of possible confounders, significant associations between infections and cognitive ability were...

  16. Association of General and Abdominal Obesity With Hypertension, Dyslipidemia and Prediabetes in the PREDAPS Study.

    Science.gov (United States)

    Sangrós, F Javier; Torrecilla, Jesús; Giráldez-García, Carolina; Carrillo, Lourdes; Mancera, José; Mur, Teresa; Franch, Josep; Díez, Javier; Goday, Albert; Serrano, Rosario; García-Soidán, F Javier; Cuatrecasas, Gabriel; Igual, Dimas; Moreno, Ana; Millaruelo, J Manuel; Carramiñana, Francisco; Ruiz, Manuel Antonio; Pérez, Francisco Carlos; Iriarte, Yon; Lorenzo, Ángela; González, María; Álvarez, Beatriz; Barutell, Lourdes; Mayayo, M Soledad; Del Castillo, Mercedes; Navarro, Emma; Malo, Fernando; Cambra, Ainhoa; López, Riánsares; Gutiérrez, M Ángel; Gutiérrez, Luisa; Boente, Carmen; Mediavilla, J Javier; Prieto, Luis; Mendo, Luis; Mansilla, M José; Ortega, Francisco Javier; Borras, Antonia; Sánchez, L Gabriel; Obaya, J Carlos; Alonso, Margarita; García, Francisco; Gutiérrez, Ángela Trinidad; Hernández, Ana M; Suárez, Dulce; Álvarez, J Carlos; Sáenz, Isabel; Martínez, F Javier; Casorrán, Ana; Ripoll, Jazmín; Salanova, Alejandro; Marín, M Teresa; Gutiérrez, Félix; Innerárity, Jaime; Álvarez, M Del Mar; Artola, Sara; Bedoya, M Jesús; Poveda, Santiago; Álvarez, Fernando; Brito, M Jesús; Iglesias, Rosario; Paniagua, Francisca; Nogales, Pedro; Gómez, Ángel; Rubio, José Félix; Durán, M Carmen; Sagredo, Julio; Gijón, M Teresa; Rollán, M Ángeles; Pérez, Pedro P; Gamarra, Javier; Carbonell, Francisco; García-Giralda, Luis; Antón, J Joaquín; de la Flor, Manuel; Martínez, Rosario; Pardo, José Luis; Ruiz, Antonio; Plana, Raquel; Macía, Ramón; Villaró, Mercè; Babace, Carmen; Torres, José Luis; Blanco, Concepción; Jurado, Ángeles; Martín, José Luis; Navarro, Jorge; Sanz, Gloria; Colas, Rafael; Cordero, Blanca; de Castro, Cristina; Ibáñez, Mercedes; Monzón, Alicia; Porta, Nuria; Gómez, María Del Carmen; Llanes, Rafael; Rodríguez, J José; Granero, Esteban; Sánchez, Manuel; Martínez, Juan; Ezkurra, Patxi; Ávila, Luis; de la Sen, Carlos; Rodríguez, Antonio; Buil, Pilar; Gabriel, Paula; Roura, Pilar; Tarragó, Eduard; Mundet, Xavier; Bosch, Remei; González, J Carles; Bobé, M Isabel; Mata, Manel; Ruiz, Irene; López, Flora; Birules, Marti; Armengol, Oriol; de Miguel, Rosa Mar; Romera, Laura; Benito, Belén; Piulats, Neus; Bilbeny, Beatriz; Cabré, J José; Cos, Xavier; Pujol, Ramón; Seguí, Mateu; Losada, Carmen; de Santiago, A María; Muñoz, Pedro; Regidor, Enrique

    2018-03-01

    Some anthropometric measurements show a greater capacity than others to identify the presence of cardiovascular risk factors. This study estimated the magnitude of the association of different anthropometric indicators of obesity with hypertension, dyslipidemia, and prediabetes (altered fasting plasma glucose and/or glycosylated hemoglobin). Cross-sectional analysis of information collected from 2022 participants in the PREDAPS study (baseline phase). General obesity was defined as body mass index ≥ 30kg/m 2 and abdominal obesity was defined with 2 criteria: a) waist circumference (WC) ≥ 102cm in men/WC ≥ 88cm in women, and b) waist-height ratio (WHtR) ≥ 0.55. The magnitude of the association was estimated by logistic regression. Hypertension showed the strongest association with general obesity in women (OR, 3.01; 95%CI, 2.24-4.04) and with abdominal obesity based on the WHtR criterion in men (OR, 3.65; 95%CI, 2.66-5.01). Hypertriglyceridemia and low levels of high-density lipoprotein cholesterol showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.49; 95%CI, 1.68-3.67 and OR, 2.70; 95%CI, 1.89-3.86) and with general obesity in men (OR, 2.06; 95%CI, 1.56-2.73 and OR, 1.68; 95%CI, 1.21-2.33). Prediabetes showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.48; 95%CI, 1.85-3.33) and with abdominal obesity based on the WC criterion in men (OR, 2.33; 95%CI, 1.75-3.08). Abdominal obesity indicators showed the strongest association with the presence of prediabetes. The association of anthropometric indicators with hypertension and dyslipidemia showed heterogeneous results. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  17. Care provided by general practitioners to patients with psychotic disorders: a cohort study

    Directory of Open Access Journals (Sweden)

    Slooff Cees J

    2010-11-01

    Full Text Available Abstract Background Patients suffering from psychotic disorders have an increased risk of comorbid somatic diseases such as cardiovascular disorders and diabetes mellitus. Doctor-related factors, such as unfamiliarity with these patients, as well as patient-related factors, such as cognitive disturbance and negative symptoms, contribute to suboptimal health care for these patients. General practitioners (GPs could play a key role in diagnosing and treating this somatic comorbidity as in the Netherlands, almost all residents are registered at a general practice. This study aims to find out whether there are any differences between the levels of health care provided by GPs to patients with psychotic disorders, compared to other types of patients. Methods A cohort of patients with an ICPC code of psychosis and two matched control groups, one consisting of patients with other mental problems and the other one of patients without any mental problems, were followed over a period of 5 years. Results Patients with psychotic disorders (N = 734 contacted the GP practice more often than patients in the control groups. These patients, both adults (p = 0.051 and the elderly (p 65 years old (p = 0.007. With regard to chronic illnesses, elderly psychosis patients had fewer contacts related to cardiovascular diseases or chronic lung diseases. Conclusion Patients with psychotic disorders contact the GP practice more frequently than other types of patients. Adult psychosis patients with diabetes mellitus, cardiovascular diseases or chronic lung diseases receive the same amount of health care for these diseases as other primary care patients. The finding that older patients with psychotic disorders are diagnosed with cardiovascular diseases and obstructive lung diseases less frequently than other types of elderly patients requires further study.

  18. Care provided by general practitioners to patients with psychotic disorders: a cohort study.

    Science.gov (United States)

    Oud, Marian J T; Schuling, Jan; Groenier, Klaas H; Verhaak, Peter F M; Slooff, Cees J; Dekker, Janny H; Meyboom-de Jong, Betty

    2010-11-25

    Patients suffering from psychotic disorders have an increased risk of comorbid somatic diseases such as cardiovascular disorders and diabetes mellitus. Doctor-related factors, such as unfamiliarity with these patients, as well as patient-related factors, such as cognitive disturbance and negative symptoms, contribute to suboptimal health care for these patients.General practitioners (GPs) could play a key role in diagnosing and treating this somatic comorbidity as in the Netherlands, almost all residents are registered at a general practice. This study aims to find out whether there are any differences between the levels of health care provided by GPs to patients with psychotic disorders, compared to other types of patients. A cohort of patients with an ICPC code of psychosis and two matched control groups, one consisting of patients with other mental problems and the other one of patients without any mental problems, were followed over a period of 5 years. Patients with psychotic disorders (N = 734) contacted the GP practice more often than patients in the control groups. These patients, both adults (p = 0.051) and the elderly (p 65 years old (p = 0.007). With regard to chronic illnesses, elderly psychosis patients had fewer contacts related to cardiovascular diseases or chronic lung diseases. Patients with psychotic disorders contact the GP practice more frequently than other types of patients. Adult psychosis patients with diabetes mellitus, cardiovascular diseases or chronic lung diseases receive the same amount of health care for these diseases as other primary care patients. The finding that older patients with psychotic disorders are diagnosed with cardiovascular diseases and obstructive lung diseases less frequently than other types of elderly patients requires further study.

  19. General and crevice corrosion study of the in-wall shielding materials for ITER vacuum vessel

    Science.gov (United States)

    Joshi, K. S.; Pathak, H. A.; Dayal, R. K.; Bafna, V. K.; Kimihiro, Ioki; Barabash, V.

    2012-11-01

    Vacuum vessel In-Wall Shield (IWS) will be inserted between the inner and outer shells of the ITER vacuum vessel. The behaviour of IWS in the vacuum vessel especially concerning the susceptibility to crevice of shielding block assemblies could cause rapid and extensive corrosion attacks. Even galvanic corrosion may be due to different metals in same electrolyte. IWS blocks are not accessible until life of the machine after closing of vacuum vessel. Hence, it is necessary to study the susceptibility of IWS materials to general corrosion and crevice corrosion under operations of ITER vacuum vessel. Corrosion properties of IWS materials were studied by using (i) Immersion technique and (ii) Electro-chemical Polarization techniques. All the sample materials were subjected to a series of examinations before and after immersion test, like Loss/Gain weight measurement, SEM analysis, and Optical stereo microscopy, measurement of surface profile and hardness of materials. After immersion test, SS 304B4 and SS 304B7 showed slight weight gain which indicate oxide layer formation on the surface of coupons. The SS 430 material showed negligible weight loss which indicates mild general corrosion effect. On visual observation with SEM and Metallography, all material showed pitting corrosion attack. All sample materials were subjected to series of measurements like Open Circuit potential, Cyclic polarization, Pitting potential, protection potential, Critical anodic current and SEM examination. All materials show pitting loop in OC2 operating condition. However, its absence in OC1 operating condition clearly indicates the activity of chloride ion to penetrate oxide layer on the sample surface, at higher temperature. The critical pitting temperature of all samples remains between 100° and 200°C.

  20. Work motivation, task delegation and job satisfaction of general practice staff: a cross-sectional study.

    Science.gov (United States)

    Riisgaard, Helle; Søndergaard, Jens; Munch, Maria; Le, Jette V; Ledderer, Loni; Pedersen, Line B; Nexøe, Jørgen

    2017-04-01

    Recent research has shown that a high degree of task delegation is associated with the practise staff's overall job satisfaction, and this association is important to explore since job satisfaction is related to medical as well as patient-perceived quality of care. This study aimed: (1) to investigate associations between degrees of task delegation in the management of chronic disease in general practice, with chronic obstructive pulmonary disease (COPD) as a case and the staff's work motivation, (2) to investigate associations between the work motivation of the staff and their job satisfaction. The study was based on a questionnaire to which 621 members of the practice staff responded. The questionnaire consisted of a part concerning degree of task delegation in the management of COPD in their respective practice and another part being about their job satisfaction and motivation to work. In the first analysis, we found that 'maximal degree' of task delegation was significantly associated with the staff perceiving themselves to have a large degree of variation in tasks, odds ratio (OR) = 4.26, confidence interval (CI) = 1.09, 16.62. In the second analysis, we found that this perceived large degree of variation in tasks was significantly associated with their overall job satisfaction, OR = 2.81, confidence interval = 1.71, 4.61. The results suggest that general practitioners could delegate highly complex tasks in the management of COPD to their staff without influencing the staff's work motivation, and thereby their job satisfaction, negatively, as long as they ensure sufficient variation in the tasks. © The Author 2017. Published by Oxford University Press.

  1. Respiratory symptoms and occupation: a cross-sectional study of the general population

    Directory of Open Access Journals (Sweden)

    Smit Henriëtte A

    2002-12-01

    Full Text Available Abstract Background This study focused on respiratory symptoms due to occupational exposures in a contemporary general population cohort. Subjects were from the Dutch Monitoring Project on Risk Factors for Chronic Diseases (MORGEN. The composition of this population enabled estimation of respiratory risks due to occupation from the recent past for both men and women. Methods The study subjects (aged 20–59 were all inhabitants of Doetinchem, a small industrial town, and came from a survey of a random sample of 1104 persons conducted in 1993. A total of 274 cases with respiratory symptoms (subdivided in asthma and bronchitis symptoms and 274 controls without symptoms were matched for age and sex. Relations between industry and occupation and respiratory symptoms were explored and adjusted for smoking habits and social economic status. Results Employment in the 'construction' (OR = 3.38; 95%CI 1.02 – 11.27, 'metal' (OR = 3.17; 95%CI 0. 98 – 10.28, 'rubber, plastics and synthetics' (OR = 6.52; 95%CI 1.26 – 53.80, and 'printing' industry (OR = 3.96; 95%CI 0.85 – 18.48 were positively associated with chronic bronchitis symptoms. In addition, the 'metal' industry was found to be weakly associated with asthma symptoms (OR = 2.59; 95%CI 0.87 – 7.69. Duration of employment within these industries was also positively associated with respiratory symptoms. Conclusion Respiratory symptoms in the general population are traceable to employment in particular industries even in a contemporary cohort with relatively young individuals.

  2. Overlap between Headache, Depression, and Anxiety in General Neurological Clinics: A Cross-sectional Study

    Institute of Scientific and Technical Information of China (English)

    Cui-Bai Wei; Jian-Ping Jia; Fen Wang; Ai-Hong Zhou; Xiu-Mei Zuo; Chang-Biao Chu

    2016-01-01

    Background:Many studies have reported that depression and anxiety have bidirectional relationship with headache.However,few researches investigated the roles of depression or anxiety in patients with headache.We surveyed the prevalence of depression and anxiety as a complication or cause of headache among outpatients with a chief complaint of headache at neurology clinics in general hospitals.Additional risk factors for depression and anxiety were also analyzed.Methods:A cross-sectional study was conducted at 11 general neurological clinics.All consecutive patients with a chief complaint of headache were enrolled.Diagnoses of depression and anxiety were made using the Chinese version of the Mini International Neuropsychiatric Interview,and those for headache were made according to the International Classification of Headache Disorders,2nd Edition.The headache impact test and an 11-point verbal rating scale were applied to assess headache severity and intensity.Logistic regression was used to analyze risk factors of patients with headache for depression or anxiety.Results:A total of 749 outpatients with headache were included.Among them,148 (19.7%) were diagnosed with depression and 103 (13.7%) with anxiety.Further analysis showed that 114 (15.2%) patients complaining headache due to somatic symptoms of psychiatric disorders and 82 (10.9%) had a depression or anxiety comorbidity with headache.Most patients with depression or anxiety manifested mild to moderate headaches.Poor sleep and severe headache-related disabilities were predictors for either depression or anxiety.Conclusion:Clinicians must identify the etiology of headache and recognize the effects of depression or anxiety on headache to develop specific treatments.

  3. A cross-cultural study of the structure of comorbidity among common psychopathological syndromes in the general health care setting

    NARCIS (Netherlands)

    Krueger, RF; Chentsova-Dutton, YE; Markon, KE; Goldberg, D; Ormel, J

    This study presents analyses of 7 common psychopathological syndromes in the World Health Organization (WHO) Collaborative Study of Psychological Problems in General Health Care (T. B. Ustun & N. Sartorius, 1995). Data on depression, somatization, hypochondriasis, neurasthenia, anxious worry,

  4. Recent operating experience during startup testing at latest 1100 MWe BWR-5 nuclear power plants

    International Nuclear Information System (INIS)

    Tanabe, Akira; Tateishi, Mizuo; Kajikawa, Makoto; Hayase, Yuichi.

    1986-01-01

    In June and September 1985, the latest two 1100 Mwe BWR-5 nuclear power plants started commercial operation about ten days earlier than initially expected without any unscheduled shutdown. These latest plants, 2F-3 and K-1, are characterized by an improved core with new 8 x 8 fuel assemblies, highly reliable control systems, advanced control room system and turbine steam full bypass system for full load rejection (2F3). This paper describes the following operating experiences gained during their startup testing. 1) Continuous operation at full load rejection. 2) Stable operation at natural circulating flow condition. 3) 31 and 23 hour short time start up operation. 4) 100-75-100 %, 1-8-1-14 hours daily load following operation. (author)

  5. Emergency general surgery in Rwandan district hospitals: a cross-sectional study of spectrum, management, and patient outcomes.

    Science.gov (United States)

    Mpirimbanyi, Christophe; Nyirimodoka, Alexandre; Lin, Yihan; Hedt-Gauthier, Bethany L; Odhiambo, Jackline; Nkurunziza, Theoneste; Havens, Joaquim M; Omondi, Jack; Rwamasirabo, Emile; Ntirenganya, Faustin; Toma, Gabriel; Mubiligi, Joel; Bayitondere, Scheilla; Riviello, Robert

    2017-12-01

    Management of emergency general surgical conditions remains a challenge in rural sub-Saharan Africa due to issues such as insufficient human capacity and infrastructure. This study describes the burden of emergency general surgical conditions and the ability to provide care for these conditions at three rural district hospitals in Rwanda. This retrospective cross-sectional study included all patients presenting to Butaro, Kirehe and Rwinkwavu District Hospitals between January 1st 2015 and December 31st 2015 with emergency general surgical conditions, defined as non-traumatic, non-obstetric acute care surgical conditions. We describe patient demographics, clinical characteristics, management and outcomes. In 2015, 356 patients presented with emergency general surgical conditions. The majority were male (57.2%) and adults aged 15-60 years (54.5%). The most common diagnostic group was soft tissue infections (71.6%), followed by acute abdominal conditions (14.3%). The median length of symptoms prior to diagnosis differed significantly by diagnosis type (p operated on at the district hospital, either by a general surgeon or general practitioner. Patients were more likely to receive surgery if they presented to a hospital with a general surgeon compared to a hospital with only general practitioners (75% vs 43%, p operation in a hospital with a general surgeon as opposed to a general practitioner. This provides evidence to support increasing the surgical workforce in district hospitals in order to increase surgical availability for patients.

  6. Generalized Superconductivity. Generalized Levitation

    International Nuclear Information System (INIS)

    Ciobanu, B.; Agop, M.

    2004-01-01

    In the recent papers, the gravitational superconductivity is described. We introduce the concept of generalized superconductivity observing that any nongeodesic motion and, in particular, the motion in an electromagnetic field, can be transformed in a geodesic motion by a suitable choice of the connection. In the present paper, the gravitoelectromagnetic London equations have been obtained from the generalized Helmholtz vortex theorem using the generalized local equivalence principle. In this context, the gravitoelectromagnetic Meissner effect and, implicitly, the gravitoelectromagnetic levitation are given. (authors)

  7. Latest Progress in Research on the SpaceLiner High-Speed Passenger Transportation Concept

    OpenAIRE

    Sippel, Martin; van Foreest, Arnold

    2007-01-01

    A vision aimed at revolutionizing ultra-long distance travel between different points on earth could be realized by a high-speed intercontinental passenger transport using rocket based, suborbital launchers. The paper gives an overview on the latest progress in conceptual design of the DLR SpaceLiner presenting geometrical size and mass data and describing results of trajectory simulations. The rockets are based on an advanced but technically conservative approach not relying on e...

  8. Elastic-plastic fracture analysis of carbon steel piping using the latest CEGB R6 approach

    International Nuclear Information System (INIS)

    Kanno, S.; Hasegawa, K.; Shimizu, T.; Kobayashi, H.

    1991-01-01

    The elastic-plastic fracture of carbon steel piping having various pipe diameters and circumferential crack angles and subjected to a bending moment is analyzed using the latest United Kingdom Central Electricity Generating Board R6 approach. The elastic-plastic fracture criterion must be applied instead of the plastic collapse criterion with increase of the pipe diameter and the crack angle. A simplified elastic-plastic fracture analysis procedure based on the R6 approach is proposed. (author)

  9. Use a renewable energy sources and latest power-saving technologies in the the Republic Kazakstan

    International Nuclear Information System (INIS)

    Gulevich, N.V.

    1996-01-01

    The subject of alternative power in Kazakstan is brought up. Wind-, hydro-, solar power, biogas installation can improve the Republic power base. The main directions of activity of A. Einstein International Power engineering Academy on involving renewable energy sources and latest power-saving technologies to Republic of Kazakstan's fuel-power balance is given. It should be noted that renewable power engineering usually handles reversible energy sources and reserved power cycles. (author)

  10. Latest results on b-physics from the ATLAS and CMS experiments

    CERN Document Server

    Pasqualucci, E; The ATLAS collaboration

    2013-01-01

    This paper briefly reviews some of the latest measurements of the ATLAS and CMS experiments at LHC in the b-physics sector, namely the ones on rare and semi-rare B0(s) decays, the parity violation in the b decay and the CP violation parameters in the Bs --> J/psi (μ+μ−)phi(K+K−) process, some of the measurements on heavy quarkonia systems.

  11. Design process and philosophy of TVA's latest advance control room complex

    International Nuclear Information System (INIS)

    Owens, G.R.; Masters, D.W.

    1979-01-01

    TVA's latest nuclear power plant control room design includes a greater emphasis on human factors as compared to their earlier plant designs. This emphasis has resulted in changes in the overall design philosophy and design process. This paper discusses some of the prominent design features of both the control room and the surrounding control room complex. In addition, it also presents some of the important activities involved in the process of developing the advanced control room design

  12. Latest LHCf results and preparation to the LHC run for 13 TeV proton–proton interactions

    Directory of Open Access Journals (Sweden)

    Bonechi L.

    2015-01-01

    Full Text Available The LHCf experiment is a CERN experiment dedicated to forward physics which is optimized to measure the neutral particle flow at extreme pseudo-rapidity values, ranging from 8.4 up to infinity. LHCf results are extremely important for the calibration of the hadronic interaction models used for the study of the development of atmospheric showers in the Earth atmosphere. Starting from the recent run of proton-Lead nucleus interactions at LHC, the LHCf and ATLAS collaborations have performed a common data taking which allows a combined study of the central and forward regions of the interaction. The latest results of LHCf, the upgrade of the detectors for the next 6.5 TeV + 6.5 TeV proton–proton run and the status of the LHCf-ATLAS common activities are summarized in this paper.

  13. THE LATEST ADVANCEMENTS IN THE ACYLATION REACTIONS VIA CROSS-DEHYDROGENATIVE COUPLING AND/OR METAL CATALYSTS

    Directory of Open Access Journals (Sweden)

    Soykan Ağar

    2017-12-01

    Full Text Available There are quite many examples in the scientific literature regarding the acylation reactions, especially the metal-catalyzed acylation reactions, metal-free acylation reactions, metal-catalyzed acylation via cross-dehydrogenative coupling (CDC reactions and metal-free acylation via cross-dehydrogenative coupling (CDC reactions. In this review paper, the most important examples of these domains were brought together and their mechanisms were exhibited in a clear, chronological format. Following these, the best example study towards green chemistry with a metal-free and high-yielding route was mentioned and discussed to demonstrate what has achieved in this field regarding the new acylation reaction mechanisms using the advantages of cross-dehydrogenative coupling (CDC reactions. The most prominent studies regarding these domains have been examined thoroughly and the latest progress in this field was explained in detail.

  14. Explaining the social gradient in sickness absence: a study of a general working population in Sweden.

    Science.gov (United States)

    Löve, Jesper; Hensing, Gunnel; Holmgren, Kristina; Torén, Kjell

    2013-06-05

    Some previous studies have proposed potential explanatory factors for the social gradient in sickness absence. Yet, this research area is still in its infancy and in order to comprise the full range of socioeconomic positions there is a need for studies conducted on random population samples. The main aim of the present study was to investigate if somatic and mental symptoms, mental wellbeing, job strain, and physical work environment could explain the association between low socioeconomic position and belonging to a sample of new cases of sick-listed employees. This study was conducted on one random working population sample (n = 2763) and one sample of newly sick-listed cases of employees (n = 3044), drawn from the same random general population in western Sweden. Explanatory factors were self-rated 'Somatic and mental symptoms', 'Mental well-being', 'job strain', and 'physical work conditions' (i.e. heavy lifting and awkward work postures). Multiple logistic regression analyses were used. Somatic and mental symptoms, mental well-being, and job strain, could not explain the association between socioeconomic position and sickness absence in both women and men. However, physical work conditions explained the total association in women and much of this association in men. In men the gradient between Non-skilled manual OR 1.76 (1.24;2.48) and Skilled manual OR 1.59 (1.10;2.20), both in relation to Higher non-manual, remained unexplained. The present study strengthens the scientific evidence that social differences in physical work conditions seem to comprise a key element of the social gradient in sickness absence, particularly in women. Future studies should try to identify further predictors for this gradient in men.

  15. Associations between self-esteem, general self-efficacy and approaches to studying in occupational therapy students: A cross-sectional study

    OpenAIRE

    Bonsaksen, Tore; Sadeghi, Talieh; Thørrisen, Mikkel Magnus

    2017-01-01

    The aim of this study was to explore associations between self-esteem, general self-efficacy, and the deep, strategic, and surface approaches to studying. Norwegian occupational therapy students (n = 125) completed questionnaires measuring study approaches, self-esteem, and general self-efficacy. Regression analyses were used to explore the direct relationships between self-esteem, general self-efficacy and the approaches to studying, after controlling for age, gender, prior higher education,...

  16. Impaired Fertility Associated with Subclinical Hypothyroidism and Thyroid Autoimmunity: The Danish General Suburban Population Study

    Directory of Open Access Journals (Sweden)

    Anne-Dorthe Feldthusen

    2015-01-01

    Full Text Available Introduction. The aim of this study was to estimate the significance of TSH, thyroid peroxidase antibody (TPOAb, and mild (subclinical hypothyroidism in women from The Danish General Suburban Population Study (GESUS on the number of children born, the number of pregnancies, and the number of spontaneous abortions. Methods. Retrospective cross sectional study of 11254 women participating in GESUS. Data included biochemical measurements and a self-administrated questionnaire. Results. 6.7% had mild (subclinical hypothyroidism and 9.4% prevalent hypothyroidism. In women with mild hypothyroidism TPOAb was significantly elevated and age at first child was older compared to controls. TSH and TPOAb were negatively linearly associated with the number of children born and the number of pregnancies in the full cohort in age-adjusted and multiadjusted models. TSH or TPOAb was not associated with spontaneous abortions. Mild (subclinical hypothyroidism was associated with a risk of not having children and a risk of not getting pregnant in age-adjusted and multiadjusted models. Prevalent hypothyroidism was not associated with the number of children born, the number of pregnancies, or spontaneous abortions. Conclusion. Impaired fertility is associated with TSH, TPOAb, and mild (subclinical hypothyroidism in a Danish population of women.

  17. The 12-item General Health Questionnaire (GHQ-12: translation and validation study of the Iranian version

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    Garmaroudi Gholamreza

    2003-11-01

    Full Text Available Abstract Background The objective of this study was to translate and to test the reliability and validity of the 12-item General Health Questionnaire (GHQ-12 in Iran. Methods Using a standard 'forward-backward' translation procedure, the English language version of the questionnaire was translated into Persian (Iranian language. Then a sample of young people aged 18 to 25 years old completed the questionnaire. In addition, a short questionnaire containing demographic questions and a single measure of global quality of life was administered. To test reliability the internal consistency was assessed by Cronbach's alpha coefficient. Validity was performed using convergent validity. Finally, the factor structure of the questionnaire was extracted by performing principal component analysis using oblique factor solution. Results In all 748 young people entered into the study. The mean age of respondents was 21.1 (SD = 2.1 years. Employing the recommended method of scoring (ranging from 0 to 12, the mean GHQ score was 3.7 (SD = 3.5. Reliability analysis showed satisfactory result (Cronbach's alpha coefficient = 0.87. Convergent validity indicated a significant negative correlation between the GHQ-12 and global quality of life scores as expected (r = -0.56, P Conclusion The study findings showed that the Iranian version of the GHQ-12 has a good structural characteristic and is a reliable and valid instrument that can be used for measuring psychological well being in Iran.

  18. NRC [Nuclear Regulatory Commission] staff evaluation of the General Electric Company Nuclear Reactor Study (''Reed Report'')

    International Nuclear Information System (INIS)

    1987-07-01

    In 1975, the General Electric Company (GE) published a Nuclear Reactor Study, also referred to as ''the Reed Report,'' an internal product-improvement study. GE considered the document ''proprietary'' and thus, under the regulations of the Nuclear Regulatory Commission (NRC), exempt from mandatory public disclosure. Nonetheless, members of the NRC staff reviewed the document in 1976 and determined that it did not raise any significant new safety issues. The staff also reached the same conclusion in subsequent reviews. However, in response to recent inquiries about the report, the staff reevaluated the Reed Report from a 1987 perspective. This re-evaluation, documented in this staff report, concluded that: (1) there are no issues raised in the Reed Report that support a need to curtail the operation of any GE boiling water reactor (BWR); (2) there are no new safety issues raised in the Reed Report of which the staff was unaware; and (3) although certain issues addressed by the Reed Report are still being studied by the NRC and the industry, there is no basis for suspending licensing and operation of GE BWR plants while these issues are being resolved

  19. BILE DUCT INJURIES FOLLOWING LAPAROSCOPIC CHOLECYSTECTOMY- A RETROSPECTIVE STUDY AT GOVERNMENT GENERAL HOSPITAL, KAKINADA

    Directory of Open Access Journals (Sweden)

    Ravichandra Matcha

    2017-11-01

    Full Text Available BACKGROUND This study aimed at assessing the outcome of laparoscopic cholecystectomy (LC by determining the frequency of complications, especially of bile duct injuries. MATERIALS AND METHODS The case files of all patients undergoing laparoscopic cholecystectomy between January 2008 and December 2016 at Government General Hospital, Kakinada were retrospectively analysed. We evaluated the data according to outcome measures, such as bile duct injury, morbidity, mortality and numbers of patients whose resections had to be converted from laparoscopic to open. RESULTS During the eight years (January 2008 and December 2016, 336 patients underwent LC for chronic cholecystitis (CC, of whom 22 (6.5% developed complications. Among those who developed complications, two patients had major bile duct injuries (0.4%; 43 other patients (12.8% had planned laparoscopic operations converted to open cholecystectomy intra-operatively. None of the patients in this study died as a result of LC. CONCLUSION Bile duct injury is a major complication of LC. Anatomical anomalies, local pathology, and poor surgical techniques are the main factors responsible. The two patients who had severe common bile duct injury in this study had major anatomical anomalies that were only recognized during surgery.

  20. The fungal and acritarch events as time markers for the latest Permian mass extinction: An update

    Directory of Open Access Journals (Sweden)

    Michael R. Rampino

    2018-01-01

    Full Text Available The latest Permian extinction (252 Myr ago was the most severe in the geologic record. On land, widespread Late Permian gymnosperm/seed-fern dominated forests appear to have suffered rapid and almost complete destruction, as evidenced by increased soil erosion and changes in fluvial style in deforested areas, signs of wildfires, replacement of trees by lower plants, and almost complete loss of peat-forming and fire-susceptible vegetation. Permian–Triassic boundary strata at many sites show two widespread palynological events in the wake of the forest destruction: The fungal event, evidenced by a thin zone with >95% fungal cells (Reduviasporonites and woody debris, found in terrestrial and marine sediments, and the acritarch event, marked by the sudden flood of unusual phytoplankton in the marine realm. These two events represent the global temporary explosive spread of stress-tolerant and opportunistic organisms on land and in the sea just after the latest Permian disaster. They represent unique events, and thus they can provide a time marker in correlating latest Permian marine and terrestrial sequences.

  1. General Practitioners' Perspective on eHealth and Lifestyle Change: Qualitative Interview Study.

    Science.gov (United States)

    Brandt, Carl Joakim; Søgaard, Gabrielle Isidora; Clemensen, Jane; Sndergaard, Jens; Nielsen, Jesper Bo

    2018-04-17

    Wearables, fitness apps, and patient home monitoring devices are used increasingly by patients and other individuals with lifestyle challenges. All Danish general practitioners (GPs) use digital health records and electronic health (eHealth) consultations on a daily basis, but how they perceive the increasing demand for lifestyle advice and whether they see eHealth as part of their lifestyle support should be explored further. This study aimed to explore GPs' perspectives on eHealth devices and apps and the use of eHealth in supporting healthy lifestyle behavior for their patients and themselves. A total of 10 (5 female and 5 male) GPs were recruited by purposive sampling, aged 38 to 69 years (mean 51 years), of which 4 had an urban uptake of patients and 6 a rural uptake. All of them worked in the region of Southern Denmark where GPs typically work alone or in partnership with 1 to 4 colleagues and all use electronic patient health records for prescription, referral, and asynchronous electronic consultations. We performed qualitative, semistructured, individual in-depth interviews with the GPs in their own office about how they used eHealth and mHealth devices to help patients challenged with lifestyle issues and themselves. We also interviewed how they treated lifestyle-challenged patients in general and how they imagined eHealth could be used in the future. All GPs had smartphones or tablets, and everyone communicated on a daily basis with patients about disease and medicine via their electronic health record and the internet. We identified 3 themes concerning the use of eHealth: (1) how eHealth is used for patients; (2) general practitioners' own experience with improving lifestyle and eHealth support; and (3) relevant coaching techniques for transformation into eHealth. GPs used eHealth frequently for themselves but only infrequently for their patients. GPs are familiar with behavioral change techniques and are ready to use them in eHealth if they are used to

  2. Frequent attenders in general practice and immigrant status in Norway: a nationwide cross-sectional study.

    Science.gov (United States)

    Diaz, Esperanza; Gimeno-Feliu, Luis-Andrés; Calderón-Larrañaga, Amaia; Prados-Torres, Alexandra

    2014-12-01

    To compare the likelihood of being a frequent attender (FA) to general practice among native Norwegians and immigrants, and to study socioeconomic and morbidity factors associated with being a FA for natives and immigrants. Linked register data for all inhabitants in Norway with at least one visit to the general practitioner (GP) in 2008 (2 967 933 persons). Immigrants were grouped according to their country of origin into low- (LIC), middle- (MIC), and high-income countries (HIC). FAs were defined as patients whose attendance rate ranked in the top 10% (cut-off point > 7 visits). FAs were compared with other GP users by means of multivariate binary logistic analyses adjusting for socioeconomic and morbidity factors. Among GP users during the daytime, immigrants had a higher likelihood of being a FA compared with natives (OR (95% CI): 1.13 (1.09-1.17) and 1.15 (1.12-1.18) for HIC, 1.84 (1.78-1.89) and 1.66 (1.63-1.70) for MIC, and 1.77 (1.67-1.89) and 1.65 (1.57-1.74) for LIC for men and women respectively). Pregnancy, middle income earned in Norway, and having cardiologic and psychiatric problems were the main factors associated with being a FA. Among immigrants, labour immigrants and the elderly used GPs less often, while refugees were overrepresented among FAs. Psychiatric, gastroenterological, endocrine, and non-specific drug morbidity were relatively more prevalent among immigrant FA compared with natives. Although immigrants account for a small percentage of all FAs, GPs and policy-makers should be aware of differences in socioeconomic and morbidity profiles to provide equality of health care.

  3. Dealing with requests for euthanasia: a qualitative study investigating the experience of general practitioners.

    Science.gov (United States)

    Georges, J-J; The, A M; Onwuteaka-Philipsen, B D; van der Wal, G

    2008-03-01

    Caring for terminally ill patients is a meaningful task, however the patient's suffering can be a considerable burden and cause of frustration. The aim of this study is to describe the experiences of general practitioners (GPs) in The Netherlands in dealing with a request for euthanasia from a terminally ill patient. The data, collected through in-depth interviews, were analysed according to the constant comparative method. Having to face a request for euthanasia when attempting to relieve a patient's suffering was described as a very demanding experience that GPs generally would like to avoid. Nearly half of the GPs (14/30) strive to avoid euthanasia or physician assisted suicide because it was against their own personal values or because it was emotional burdening to be confronted with this issue. They explained that by being directed on promoting a peaceful dying process, or the quality of end-of-life of a patient by caring and supporting the patient and the relatives it was mainly possible to shorten patient's suffering without "intentionally hastening a patient's death on his request". The other GPs (16/30) explained that as sometimes the suffering of a patient could not be lessened they were open to consider a patient's request for euthanasia or physician assisted suicide. They underlined the importance of a careful decision-making process, based on finding a balance between the necessity to shorten the patient's suffering through euthanasia and their personal values. Dealing with requests for euthanasia is very challenging for GPs, although they feel committed to alleviate a patient's suffering and to promote a peaceful death.

  4. Perioperative management of patients for osteo-odonto-kreatoprosthesis under general anaesthesia: A retrospective study

    Directory of Open Access Journals (Sweden)

    Rakesh Garg

    2011-01-01

    Full Text Available An osteo-odonto-keratoprosthesis (OOKP procedure is indicated in patients with failed corneal transplant but having intact retina for visual improvement. We studied perioperative concerns of patients who underwent the staged OOKP procedure. This was a retrospective analysis of patients who underwent OOKP. The information regarding symptoms, associated comorbidities, perioperative events including anaesthetic management were collected. Eight patients (five females and three males underwent the staged OOKP procedure. The median age was 18 years. The median weight was 45 kg. The median duration of loss of vision was 4 years. The aetiology of blindness included Stevens-Johnson′s syndrome (SJS (7 and chemical burn (1. Four patients had generalized skin problem due to SJS. All cases were managed under general anaesthesia, and airway management included nasotracheal intubation for stage I and orotracheal intubation for stage II. The median mallampati classification was I prior to OOKP stage I procedure while it changed to II at stage II procedure. Two patients required fibreoptic nasotracheal intubation. One patient had excessive oozing from the mucosal harvest site and was managed conservatively. In one patient, tooth harvesting was done twice as the first tooth was damaged during creating a hole in it. We conclude that OOKP requires multidisciplinary care. Anaesthesiologist should evaluate the airway carefully and disease-associated systemic involvements. The use of various drugs requires caution and steroid supplementation should be done. Airway difficulty should be anticipated, mandating thorough evaluation. Re-evaluation of airway is prudent as it may become difficult during the staged OOKP procedure.

  5. The unclosing premature mortality gap in gout: a general population-based study.

    Science.gov (United States)

    Fisher, Mark C; Rai, Sharan K; Lu, Na; Zhang, Yuqing; Choi, Hyon K

    2017-07-01

    Gout, the most common inflammatory arthritis, is associated with premature mortality. Whether this mortality gap has improved over time, as observed in rheumatoid arthritis (RA), is unknown. Using an electronic medical record database representative of the UK general population, we identified incident gout cases and controls between 1999 and 2014. The gout cohort was divided based on year of diagnosis into early (1999-2006) and late (2007-2014) cohorts. We compared the mortality rates and HRs, adjusting for potential confounders between the cohorts. We conducted sensitivity analyses among patients with gout who received at least one prescription for urate-lowering therapy, which has been found to have a validity of 90%. In both cohorts, patients with gout showed similar levels of excess mortality compared with their corresponding comparison cohort (ie, 29.1 vs 23.5 deaths/1000 person-years and 23.0 vs 18.8 deaths/1000 person-years in the early and late cohorts, respectively). The corresponding mortality HRs were 1.25 (95% CI 1.21 to 1.30) and 1.24 (95% CI 1.20 to 1.29), and the multivariable HRs were 1.10 (95% CI 1.06 to 1.15) and 1.09 (95% CI 1.05 to 1.13), respectively (both p values for interaction >0.72). Our sensitivity analyses showed similar findings (both p values for interaction >0.88). This general population-based cohort study indicates that the level of premature mortality among patients with gout remains unimproved over the past 16 years, unlike RA during the same period. This unclosing premature mortality gap calls for improved management of gout and its comorbidities. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  6. Retaining the general practitioner workforce in England: what matters to GPs? A cross-sectional study.

    Science.gov (United States)

    Dale, Jeremy; Potter, Rachel; Owen, Katherine; Parsons, Nicholas; Realpe, Alba; Leach, Jonathan

    2015-10-16

    The general practice (GP) workforce in England is in crisis, reflected in increasing rates of early retirement and intentions to reduce hours of working. This study aimed to investigate underlying factors and how these might be mitigated. GPs in central England were invited to participate in an on-line survey exploring career plans and views and experiences of work-related pressures. Quantitative data were analysed using logistic regression analysis and principal components analysis. Qualitative data were analysed using a thematic framework approach. Of 1,192 GPs who participated, 978 (82.0 %) stated that they intend to leave general practice, take a career break and/or reduce clinical hours of work within the next five years. This included 488 (41.9 %) who intend to leave practice, and almost a quarter (279; 23.2 %) intending to take a career break. Only 67 (5.6 %) planned to increase their hours of clinical work. For participants planning to leave practice, the issues that most influenced intentions were volume and intensity of workload, time spent on "unimportant tasks", introduction of seven-day working and lack of job satisfaction. Four hundred fifty five participants responded to open questions (39128 words in total). The main themes were the cumulative impact of work-related pressures, the changing and growing nature of the workload, and the consequent stress. Reducing workload intensity, workload volume, administrative activities, with increased time for patient care, no out-of-hour commitments, more flexible working conditions and greater clinical autonomy were identified as the most important requirements to address the workforce crisis. In addition, incentive payments, increased pay and protected time for education and training were also rated as important. New models of professionalism and organisational arrangements may be needed to address the issues described here. Without urgent action, the GP workforce crisis in England seems set to worsen.

  7. Collaboration between general practitioners and mental health care professionals: a qualitative study.

    Science.gov (United States)

    Fredheim, Terje; Danbolt, Lars J; Haavet, Ole R; Kjønsberg, Kari; Lien, Lars

    2011-05-23

    Collaboration between general practice and mental health care has been recognised as necessary to provide good quality healthcare services to people with mental health problems. Several studies indicate that collaboration often is poor, with the result that patient' needs for coordinated services are not sufficiently met, and that resources are inefficiently used. An increasing number of mental health care workers should improve mental health services, but may complicate collaboration and coordination between mental health workers and other professionals in the treatment chain. The aim of this qualitative study is to investigate strengths and weaknesses in today's collaboration, and to suggest improvements in the interaction between General Practitioners (GPs) and specialised mental health service. This paper presents a qualitative focus group study with data drawn from six groups and eight group sessions with 28 health professionals (10 GPs, 12 nurses, and 6 physicians doing post-doctoral training in psychiatry), all working in the same region and assumed to make professional contact with each other. GPs and mental health professionals shared each others expressions of strengths, weaknesses and suggestions for improvement in today's collaboration. Strengths in today's collaboration were related to common consultations between GPs and mental health professionals, and when GPs were able to receive advice about diagnostic treatment dilemmas. Weaknesses were related to the GPs' possibility to meet mental health professionals, and lack of mutual knowledge in mental health services. The results describe experiences and importance of interpersonal knowledge, mutual accessibility and familiarity with existing systems and resources. There is an agreement between GPs and mental health professionals that services will improve with shared knowledge about patients through systematic collaborative services, direct cell-phone lines to mental health professionals and allocated

  8. Collaboration between general practitioners and mental health care professionals: a qualitative study

    Directory of Open Access Journals (Sweden)

    Haavet Ole R

    2011-05-01

    Full Text Available Abstract Background Collaboration between general practice and mental health care has been recognised as necessary to provide good quality healthcare services to people with mental health problems. Several studies indicate that collaboration often is poor, with the result that patient' needs for coordinated services are not sufficiently met, and that resources are inefficiently used. An increasing number of mental health care workers should improve mental health services, but may complicate collaboration and coordination between mental health workers and other professionals in the treatment chain. The aim of this qualitative study is to investigate strengths and weaknesses in today's collaboration, and to suggest improvements in the interaction between General Practitioners (GPs and specialised mental health service. Methods This paper presents a qualitative focus group study with data drawn from six groups and eight group sessions with 28 health professionals (10 GPs, 12 nurses, and 6 physicians doing post-doctoral training in psychiatry, all working in the same region and assumed to make professional contact with each other. Results GPs and mental health professionals shared each others expressions of strengths, weaknesses and suggestions for improvement in today's collaboration. Strengths in today's collaboration were related to common consultations between GPs and mental health professionals, and when GPs were able to receive advice about diagnostic treatment dilemmas. Weaknesses were related to the GPs' possibility to meet mental health professionals, and lack of mutual knowledge in mental health services. The results describe experiences and importance of interpersonal knowledge, mutual accessibility and familiarity with existing systems and resources. There is an agreement between GPs and mental health professionals that services will improve with shared knowledge about patients through systematic collaborative services, direct cell

  9. Considerations on requests for euthanasia or assisted suicide; a qualitative study with Dutch general practitioners.

    Science.gov (United States)

    Ten Cate, Katja; van Tol, Donald G; van de Vathorst, Suzanne

    2017-11-16

    In the Netherlands, euthanasia or assisted suicide (EAS) is neither a right of the patient nor a duty of the physician. Beside the legal requirements, physicians can weigh their own considerations when they decide on a request for EAS. We aim at a better understanding of the considerations that play a role when physicians decide on a request for EAS. This was a qualitative study. We analysed 33 interviews held with general practitioners (GPs) from various regions in the Netherlands. The considerations found can be divided in three main types. (i) Perceived legal criteria, (ii) individual interpretations of the legal criteria and (iii) considerations unrelated to the legal criteria. Considerations of this 3rd type have not been mentioned so far in the literature and the debate on EAS. Examples are: the family should agree to EAS, the patient's attitude must reflect resignation, or conflicts must be resolved. Our study feeds the ethical discussion on the tension that can arise between a physician's own views on death and dying, and the views and preferences of his patients. When considerations like 'no unresolved conflicts' or 'enough resignation' influence the decision to grant a request for EAS this poses questions from an ethical and professional point of view. We hypothesise that these considerations reflect GPs' views on what 'good dying' entails and we advocate further research on this topic. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. GLOBAL GENERAL RELATIVISTIC MAGNETOHYDRODYNAMIC SIMULATIONS OF BLACK HOLE ACCRETION FLOWS: A CONVERGENCE STUDY

    International Nuclear Information System (INIS)

    Shiokawa, Hotaka; Dolence, Joshua C.; Gammie, Charles F.; Noble, Scott C.

    2012-01-01

    Global, general relativistic magnetohydrodynamic (GRMHD) simulations of non-radiative, magnetized disks are widely used to model accreting black holes. We have performed a convergence study of GRMHD models computed with HARM3D. The models span a factor of four in linear resolution, from 96 × 96 × 64 to 384 × 384 × 256. We consider three diagnostics of convergence: (1) dimensionless shell-averaged quantities such as plasma β; (2) the azimuthal correlation length of fluid variables; and (3) synthetic spectra of the source including synchrotron emission, absorption, and Compton scattering. Shell-averaged temperature is, except for the lowest resolution run, nearly independent of resolution; shell-averaged plasma β decreases steadily with resolution but shows signs of convergence. The azimuthal correlation lengths of density, internal energy, and temperature decrease steadily with resolution but show signs of convergence. In contrast, the azimuthal correlation length of magnetic field decreases nearly linearly with grid size. We argue by analogy with local models, however, that convergence should be achieved with another factor of two in resolution. Synthetic spectra are, except for the lowest resolution run, nearly independent of resolution. The convergence behavior is consistent with that of higher physical resolution local model ( s hearing box ) calculations and with the recent non-relativistic global convergence studies of Hawley et al.

  11. Descriptive study of perioperative analgesic medications associated with general anesthesia for dental rehabilitation of children.

    Science.gov (United States)

    Carter, Laura; Wilson, Stephen; Tumer, Erwin G

    2010-01-01

    The purpose of this retrospective chart review was to document sedation and analgesic medications administered preoperotively, intraoperatively, and during postanesthesia care for children undergoing dental rehabilitation using general anesthesia (GA). Patient gender, age, procedure type performed, and ASA status were recorded from the medical charts of children undergoing GA for dental rehabilitation. The sedative and analgesic drugs administered pre-, intra-, and postoperatively were recorded. Statistical analysis included descriptive statistics and cross-tabulation. A sample of 115 patients with a mean age of 64 (+/-30) months was studied; 47% were females, and 71% were healthy. Over 80% of the patients were administered medications primarily during pre- and intraoperative phases, with fewer than 25% receiving medications postoperatively. Morphine and fentanyl were the most frequently administered agents intraoperatively. The procedure type, gender, and health status were not statistically associated with the number of agents administered. Younger patients, however, were statistically more likely to receive additional analgesic medications. Our study suggests that a minority of patients have postoperative discomfort in the postanesthesia care unit; mild to moderate analgesics were administered during intraoperative phases of dental rehabilitation.

  12. Ethnographic study of ICT-supported collaborative work routines in general practice

    Science.gov (United States)

    2010-01-01

    Background Health informatics research has traditionally been dominated by experimental and quasi-experimental designs. An emerging area of study in organisational sociology is routinisation (how collaborative work practices become business-as-usual). There is growing interest in the use of ethnography and other in-depth qualitative approaches to explore how collaborative work routines are enacted and develop over time, and how electronic patient records (EPRs) are used to support collaborative work practices within organisations. Methods/design Following Feldman and Pentland, we will use 'the organisational routine' as our unit of analysis. In a sample of four UK general practices, we will collect narratives, ethnographic observations, multi-modal (video and screen capture) data, documents and other artefacts, and analyse these to map and compare the different understandings and enactments of three common routines (repeat prescribing, coding and summarising, and chronic disease surveillance) which span clinical and administrative spaces and which, though 'mundane', have an important bearing on quality and safety of care. In a detailed qualitative analysis informed by sociological theory, we aim to generate insights about how complex collaborative work is achieved through the process of routinisation in healthcare organisations. Discussion Our study offers the potential not only to identify potential quality failures (poor performance, errors, failures of coordination) in collaborative work routines but also to reveal the hidden work and workarounds by front-line staff which bridge the model-reality gap in EPR technologies and via which "automated" safety features have an impact in practice. PMID:21190583

  13. Ecstasy use and depression: a 4-year longitudinal study among an Australian general community sample.

    Science.gov (United States)

    George, Amanda M; Olesen, Sarah; Tait, Robert J

    2013-10-01

    Longitudinal, population-based studies can better assess the relationship of ecstasy use with depression. We examined whether change in ecstasy use was associated with change in depressive symptoms/probable depression over a 4-year period, among a large Australian sample. The Personality and Total Health project is a longitudinal general community study of Australians from Canberra and Queanbeyan. Data from the youngest cohort when aged 24-30 (N = 2, 128) and 4 years later (N = 1, 977) was included. The Goldberg depression scale and the Brief Patient Health Questionnaire measured depressive symptoms and probable depression, respectively. Multilevel growth models also considered demographics, psychosocial characteristics, and other drug use. Ecstasy use was not associated with long-term depressive symptoms or greater odds of depression in multivariate analyses. Users had more self-reported depressive symptoms when using ecstasy compared to not using. However, differences between people who had and had not ever used ecstasy largely accounted for this. Other factors were more important in the prediction of depression. It would be premature to conclude that ecstasy use is not related to the development of long-term depressive symptoms, given the relatively low level of ecstasy and other drug use in this community sample. Results showed that other factors need to be considered when investigating ecstasy use and depression.

  14. Metabolic syndrome in Mexican women survivors of breast cancer: a pilot study at a general hospital.

    Science.gov (United States)

    Ortiz-Mendoza, Carlos Manuel; de-la-Fuente-Vera, Tania Angélica; Pérez-Chávez, Ernesto

    2014-01-01

    According to developed countries' studies, in breast cancer survivors there is a high prevalence of metabolic syndrome; however, in Mexico data is lacking about this issue. To explore if metabolic syndrome occurs in Mexican women survivors of breast cancer. At a second-level general hospital, women with breast cancer with a surviving > 2 years were studied. The analysis involved their demographic and anthropometric features, blood pressure measurement, time of surviving, besides fasting blood levels of lipids and glucose. The sample consisted of 100 women; 42% were obese (body mass index > or = 30 kg/m2). The sample's mean age was 60 years with a mean surviving time of 6.5 years. Their mean glucose level was 122 mg/dL and triglycerides 202 mg/dL. There were 33% with blood pressure > or = 130/85mm Hg or diagnosis of hypertension. Fifty-seven percent had glucose > 99 mg/dL or diagnosis of diabetes mellitus, and 58% had triglycerides > 149 mg/dL. Metabolic syndrome occurred in 57% of obese women. Our results suggest that metabolic syndrome occurs in more than 50% of obese Mexican women survivors of breast cancer.

  15. Ethnographic study of ICT-supported collaborative work routines in general practice.

    Science.gov (United States)

    Swinglehurst, Deborah; Greenhalgh, Trisha; Myall, Michelle; Russell, Jill

    2010-12-29

    Health informatics research has traditionally been dominated by experimental and quasi-experimental designs. An emerging area of study in organisational sociology is routinisation (how collaborative work practices become business-as-usual). There is growing interest in the use of ethnography and other in-depth qualitative approaches to explore how collaborative work routines are enacted and develop over time, and how electronic patient records (EPRs) are used to support collaborative work practices within organisations. Following Feldman and Pentland, we will use 'the organisational routine' as our unit of analysis. In a sample of four UK general practices, we will collect narratives, ethnographic observations, multi-modal (video and screen capture) data, documents and other artefacts, and analyse these to map and compare the different understandings and enactments of three common routines (repeat prescribing, coding and summarising, and chronic disease surveillance) which span clinical and administrative spaces and which, though 'mundane', have an important bearing on quality and safety of care. In a detailed qualitative analysis informed by sociological theory, we aim to generate insights about how complex collaborative work is achieved through the process of routinisation in healthcare organisations. Our study offers the potential not only to identify potential quality failures (poor performance, errors, failures of coordination) in collaborative work routines but also to reveal the hidden work and workarounds by front-line staff which bridge the model-reality gap in EPR technologies and via which "automated" safety features have an impact in practice.

  16. A clinimetric analysis of the Hopkins Symptom Checklist (SCL-90-R) in general population studies (Denmark, Norway, and Italy)

    DEFF Research Database (Denmark)

    Carrozzino, Danilo; Vassend, Olav; Bjørndal, Flemming

    2016-01-01

    the factor structure. The scalability of the traditional SCL-90-R subscales (somatization, hostility, and interpersonal sensitivity) as well as the affective subscales (depression and anxiety and ADHD) were tested by Mokken’s item response theory model. Results: Across the three general population studies...... the traditional scaled SCL-90-R factor including 83 items was identified by PCA. The Mokken analysis accepted the scalability of both the general factor and the clinical SCL-90-R subscales under examination. Conclusion: The traditional, scaled, general 83 item SCL-90-R scale is a valid measure of general...

  17. Routine general practice care for panic disorder within the lifestyle approach to managing panic study

    Directory of Open Access Journals (Sweden)

    Rodney A. Lambert

    2012-07-01

    Full Text Available Routine general practice (GP care is rarely comprehensively described in clinical trials. This paper examines routine GP care within the lifestyle approach to managing panic (LAMP study. The aim of this paper is to describe/discuss routine GP care for panic disorder (PD patients within both study arms in the LAMP study. An unblinded pragmatic randomised controlled trial in 15 East of England GP practices (2 primary care trusts. Participants met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for PD with/without agoraphobia. Follow-up measures recorded at 20 weeks/10 months following randomisation. Control arm, unrestricted routine GP care (practice appointments, referrals and prescriptions. Trial arm, occupational therapyled lifestyle treatment comprising lifestyle review of fluid intake, diet pattern, exercise, caffeine, alcohol and nicotine. Primary outcome measure: beck anxiety inventory. At baseline, participants attended 2-3 times more GP appointments than population average, reducing at 10 months to 1.6 times population average for routine GP care and 0.97 population average for lifestyle arm. At 10 months, 33% fewer referrals (6 referrals; 0 mental health than at baseline (9 referrals; 2 mental health were made for lifestyle arm patients compared with 42% increase (from 12 referrals; 8 mental health at baseline to 17 referrals; 7 mental health in GP care arm. Selective serotonin reuptake inhibitors were prescribed most often. Benzodiazepines and beta-blockers were prescribed more often than tricyclic against current clinical guidelines. In conclusion, we found that PD patients at baseline were high healthcare resource users. Treatment in both study arms reduced resource use. Routine GP care requires further review for this patient group.

  18. Method for mapping population-based case-control studies: an application using generalized additive models

    Directory of Open Access Journals (Sweden)

    Aschengrau Ann

    2006-06-01

    Full Text Available Abstract Background Mapping spatial distributions of disease occurrence and risk can serve as a useful tool for identifying exposures of public health concern. Disease registry data are often mapped by town or county of diagnosis and contain limited data on covariates. These maps often possess poor spatial resolution, the potential for spatial confounding, and the inability to consider latency. Population-based case-control studies can provide detailed information on residential history and covariates. Results Generalized additive models (GAMs provide a useful framework for mapping point-based epidemiologic data. Smoothing on location while controlling for covariates produces adjusted maps. We generate maps of odds ratios using the entire study area as a reference. We smooth using a locally weighted regression smoother (loess, a method that combines the advantages of nearest neighbor and kernel methods. We choose an optimal degree of smoothing by minimizing Akaike's Information Criterion. We use a deviance-based test to assess the overall importance of location in the model and pointwise permutation tests to locate regions of significantly increased or decreased risk. The method is illustrated with synthetic data and data from a population-based case-control study, using S-Plus and ArcView software. Conclusion Our goal is to develop practical methods for mapping population-based case-control and cohort studies. The method described here performs well for our synthetic data, reproducing important features of the data and adequately controlling the covariate. When applied to the population-based case-control data set, the method suggests spatial confounding and identifies statistically significant areas of increased and decreased odds ratios.

  19. Palliative sedation in Dutch general practice from 2005 to 2011: a dynamic cohort study of trends and reasons.

    NARCIS (Netherlands)

    Donker, G.A.; Slotman, F.G.; Spreeuwenberg, P.; Francke, A.L.

    2013-01-01

    Background: Little is known about the quantity and reasons for use of palliative sedation in general practice. Aim: To gain more insight into the trends of and reasons for palliative sedation in Dutch general practice. Design and setting: Dynamic cohort study using registrations and questionnaire

  20. Palliative sedation in Dutch general practice from 2005 to 2011: a dynamic cohort study of trends and reasons

    NARCIS (Netherlands)

    Donker, G.A.; Slotman, F.G.; Spreeuwenberg, P.; Francke, A.L.

    2013-01-01

    Background: Little is known about the quantity and reasons for use of palliative sedation in general practice. Aim: To gain more insight into the trends of and reasons for palliative sedation in Dutch general practice. Design and setting: Dynamic cohort study using registrations and questionnaire

  1. Sexual, marital, and general life functioning in couples coping with colorectal cancer : A dyadic study across time

    NARCIS (Netherlands)

    Traa, M.J.; Braeken, J.; de Vries, J.; Roukema, J.A.; Slooter, G.D.; Crolla, R.M.P.H.; Borremans, M.P.M.; den Oudsten, B.L.

    2015-01-01

    Objectives This study evaluated the following: (a) levels of sexual, marital, and general life functioning for both patients and partners; (b) interdependence between both members of the couple; and (c) longitudinal change in sexual, marital, and general life functioning and longitudinal

  2. Incidence rates and risk factors of bipolar disorder in the general population: a population-based cohort study

    NARCIS (Netherlands)

    Kroon, Jojanneke S.; Wohlfarth, Tamar D.; Dieleman, Jeanne; Sutterland, Arjen L.; Storosum, Jitschak G.; Denys, Damiaan; de Haan, Lieuwe; Sturkenboom, Mirjam C. J. M.

    2013-01-01

    To estimate the incidence rates (IRs) of bipolar I and bipolar II disorders in the general population according to sociodemographic population characteristics. A cohort study (during the years 1996-2007) was conducted in a general practitioners research database with a longitudinal electronic record

  3. A Study of General Education Astronomy Students' Understandings of Cosmology. Part I. Development and Validation of Four Conceptual Cosmology Surveys

    Science.gov (United States)

    Wallace, Colin S.; Prather, Edward E.; Duncan, Douglas K.

    2011-01-01

    This is the first in a series of five articles describing a national study of general education astronomy students' conceptual and reasoning difficulties with cosmology. In this paper, we describe the process by which we designed four new surveys to assess general education astronomy students' conceptual cosmology knowledge. These surveys focused…

  4. Identifying asthma and chronic obstructive pulmonary disease in patients with persistent cough presenting to general practitioners : descriptive study

    NARCIS (Netherlands)

    Thiadens, HA; de Bock, GH; Deker, FW; Huysman, JAN; Springer, MP; Postma, DS

    1998-01-01

    Objective: To determine the prevalence of asthma and chronic obstructive pulmonary disease in patients not known to have these disorders, who present in general practice with persistent cough, and to ascertain criteria to help general practitioners in diagnosis. Design: Descriptive study. Setting:

  5. Prevalence of fragrance contact allergy in the general population of five European countries : A cross-sectional study

    NARCIS (Netherlands)

    Diepgen, T. L.; Ofenloch, R.; Bruze, M.; Cazzaniga, S.; Coenraads, P. J.; Elsner, P.; Goncalo, M.; Svensson, A.; Naldi, L.

    2015-01-01

    Background Contact allergy to fragrances is assessed mostly in clinical populations of patients. Studies in the general population are scarce and vary in their methodology across countries. Objectives To determine the prevalence of fragrance contact allergy in the European general population and to

  6. Generalized equations for estimating DXA percent fat of diverse young women and men: The Tiger Study

    Science.gov (United States)

    Popular generalized equations for estimating percent body fat (BF%) developed with cross-sectional data are biased when applied to racially/ethnically diverse populations. We developed accurate anthropometric models to estimate dual-energy x-ray absorptiometry BF% (DXA-BF%) that can be generalized t...

  7. Balancing Generalization and Lexical Conservatism: An Artificial Language Study with Child Learners

    Science.gov (United States)

    Wonnacott, Elizabeth

    2011-01-01

    Successful language acquisition involves generalization, but learners must balance this against the acquisition of lexical constraints. Such learning has been considered problematic for theories of acquisition: if learners generalize abstract patterns to new words, how do they learn lexically-based exceptions? One approach claims that learners use…

  8. MR imaging in patients with knee injury: an observational study in general practice

    NARCIS (Netherlands)

    S.S. Boks (Simone)

    2007-01-01

    textabstractKnee trauma is often seen in general practice. The availability of magnetic resonance (MR) imaging has improved the diagnostic possibilities after knee trauma. Nevertheless, little is known about the findings on MR imaging after knee trauma in general practice. Especially, there is

  9. Organisational determinants of production and efficiency in general practice: a population-based study

    DEFF Research Database (Denmark)

    Rose Olsen, Kim; Gyrd-Hansen, Dorte; Sørensen, Torben Højmark

    2013-01-01

    Shortage of general practitioners (GPs) and an increased political focus on primary care have enforced the interest in efficiency analysis in the Danish primary care sector. This paper assesses the association between organisational factors of general practices and production and efficiency. We a...

  10. A Computer-Based Laboratory Project for the Study of Stimulus Generalization and Peak Shift

    Science.gov (United States)

    Derenne, Adam; Loshek, Eevett

    2009-01-01

    This paper describes materials designed for classroom projects on stimulus generalization and peak shift. A computer program (originally written in QuickBASIC) is used for data collection and a Microsoft Excel file with macros organizes the raw data on a spreadsheet and creates generalization gradients. The program is designed for use with human…

  11. Xanthelasmata, arcus corneae, and ischaemic vascular disease and death in general population: prospective cohort study

    DEFF Research Database (Denmark)

    Christoffersen, Mette; Frikke-Schmidt, Ruth; Schnohr, Peter

    2011-01-01

    To test the hypothesis that xanthelasmata and arcus corneae, individually and combined, predict risk of ischaemic vascular disease and death in the general population.......To test the hypothesis that xanthelasmata and arcus corneae, individually and combined, predict risk of ischaemic vascular disease and death in the general population....

  12. General Personality Disorder: A study into the core components of personality pathology

    NARCIS (Netherlands)

    Berghuis, H.

    2014-01-01

    This thesis explores the structure of various models of General Personality Disorder (PD) and severity levels of PD. In the first part of this thesis, a model of functional impairment, i.e. Livesley's adaptive failure model, as a definition of General PD, and a model of structural impairment, i.e.

  13. Generalized Trust Through Civic Engagement? Evidence from Five National Panel Studies

    NARCIS (Netherlands)

    van Ingen, Erik; Bekkers, René

    2015-01-01

    According to a popular version of social capital theory, civic engagement should produce generalized trust among citizens. We put this theory to the test by examining the causal connection between civic engagement and generalized trust using multiple methods and multiple (prospective) panel

  14. Natural carcinogenic fiber and pleural plaques assessment in a general population: A cross-sectional study

    Energy Technology Data Exchange (ETDEWEB)

    Ledda, Caterina, E-mail: cledda@unict.it [Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania (Italy); Hygiene and Public Health, Department Medical Sciences, Surgical and Advanced Technologies “GF Ingrassia”, University of Catania, Catania (Italy); Pomara, Cristoforo [Legal Medicine, Department of Clinical and Experimental Medicine, University of Foggia, Foggia (Italy); Department of Anatomy, School of Medicine, University of Malta, Msida (Malta); Bracci, Massimo [Occupational Medicine, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona (Italy); Mangano, Dario [Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania (Italy); Ricceri, Vincenzo [Division of Radiology - Hospital of Biancavilla “Maria SS. Addolorata”, ASP Catania, Biancavilla (Italy); Musumeci, Andrea [Division of Radiology – University Hospital “Policlinico – Vittorio Emanuele”, University of Catania, Catania (Italy); Ferrante, Margherita [Hygiene and Public Health, Department Medical Sciences, Surgical and Advanced Technologies “GF Ingrassia”, University of Catania, Catania (Italy); Musumeci, Giuseppe; Loreto, Carla [Human Anatomy and Histology, Department of Biomedical and Biotechnology Sciences, University of Catania, Catania (Italy); Fenga, Concettina [Occupational Medicine, Department of the Environment, Safety, Territory, Food and Health Sciences, University of Messina, Messina (Italy); Santarelli, Lory [Occupational Medicine, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona (Italy); Rapisarda, Venerando [Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania (Italy)

    2016-10-15

    Natural carcinogenic fibers are asbestos and asbestiform fibers present as a natural component of soils or rocks. These fibers are released into the environment resulting in exposure of the general population. Environmental contamination by fibers are those cases occurred in: rural regions of Turkey, in Mediterranean countries and in other sites of the world, including northern Europe, USA and China. Fluoro-edenite(FE) is a natural mineral species first isolated in Biancavilla, Sicily. The fibers are similar in size and morphology to some amphibolic asbestos fibers, whose inhalation can cause chronic inflammation and cancer. The aim of the current study is to assess the presence and features of pleural plaques (PPs) in Biancavilla's general population exposed to FE through a retrospective cross-sectional study. All High-Resolution Computed Tomography (HRCT) chest scans carried out between June 2009 and June 2015 in Biancavilla municipality hospital site (exposed subjects) were reviewed. The exposed groups were 1:1 subjects, matched according to age and sex distributions, with unexposed subjects (n.1.240) randomly selected among HRCT chest scans carried out in a Hospital 30 km away from Biancavilla. Subjects from Biancavilla with PPs were significantly more numerous than the control group ones (218 vs 38). Average age of either group was >60 years; the age of exposed subjects was significantly (p=0.0312) lesser than the unexposed group. In exposed subjects, in most PPs thickness ranged between 2 and 4.9 cm(38%, n=83); while in unexposed ones PPs thickness was less than 2 cm (55%, n=21). As to the size of PPs in exposed subjects, in most cases it ranged between 1 cm and 24% of chest wall (53%, n=116); while in unexposed ones the size of PPs was lesser than 1 cm (23%, n=58). Among exposed subjects, 36 cases (17%) PPs were detected with calcification, whereas in unexposed ones only three (8%) presented calcification. 137 lung parenchymal abnormalities were

  15. Structural Behavioral Study on the General Aviation Network Based on Complex Network

    Science.gov (United States)

    Zhang, Liang; Lu, Na

    2017-12-01

    The general aviation system is an open and dissipative system with complex structures and behavioral features. This paper has established the system model and network model for general aviation. We have analyzed integral attributes and individual attributes by applying the complex network theory and concluded that the general aviation network has influential enterprise factors and node relations. We have checked whether the network has small world effect, scale-free property and network centrality property which a complex network should have by applying degree distribution of functions and proved that the general aviation network system is a complex network. Therefore, we propose to achieve the evolution process of the general aviation industrial chain to collaborative innovation cluster of advanced-form industries by strengthening network multiplication effect, stimulating innovation performance and spanning the structural hole path.

  16. The Titan Haze Simulation Experiment: Latest Laboratory Results and Dedicated Plasma Chemistry Model

    Science.gov (United States)

    Sciamma-O'Brien, Ella; Raymond, Alexander; Mazur, Eric; Salama, Farid

    2018-06-01

    Here, we present the latest results on the gas and solid phase analyses in the Titan Haze Simulation (THS) experiment. The THS experiment, developed at NASA Ames’ COSmIC facility is a unique experimental platform that allows us to simulate Titan’s complex atmospheric chemistry at Titan-like temperature (200 K) by cooling down N2-CH4-based mixtures in a supersonic expansion before inducing the chemistry by plasma.Gas phase: The residence time of the jet-accelerated gas in the active plasma region is less than 4 µs, which results in a truncated chemistry enabling us to control how far in the chain of reactions the chemistry is processing. By adding heavier molecules in the initial gas mixture, it is then possible to study the first and intermediate steps of Titan’s atmospheric chemistry as well as specific chemical pathways, as demonstrated by mass spectrometry and comparison to Cassini CAPS data [1]. A new model was recently developed to simulate the plasma chemistry in the THS. Calculated mass spectra produced by this model are in good agreement with the experimental THS mass spectra, confirming that the short residence time in the plasma cavity limits the growth of larger species [2].Solid phase: Scanning electron microscopy and infrared spectroscopy have been used to investigate the effect of the initial gas mixture on the morphology of the THS Titan aerosol analogs as well as on the level and nature of the nitrogen incorporation into these aerosols. A comparison to Cassini VIMS observational data has shown that the THS aerosols produced in simpler mixtures, i.e., that contain more nitrogen and where the N-incorporation is in isocyanide-type molecules instead of nitriles, are more representative of Titan’s aerosols [3]. In addition, a new optical constant facility has been developed at NASA Ames that allows us to determine the complex refractive indices of THS Titan aerosol analogs from NIR to FIR (0.76-222 cm-1). The facility and preliminary results

  17. Economic system as the basic object of study in the general educational institutions

    Directory of Open Access Journals (Sweden)

    Михаил Бурла

    2017-09-01

    Full Text Available This article analyzes the prevailing practice of studying the economies at different levels in schools of Moldova, Russia and Ukraine. The main attention is paid to the development of methods of studying modern conceptual device that describes the nature, composition, structure and parameters of economic systems in educational institutions. In modern textbooks that are currently used in general education institutions there are some basic concepts and indicators, which allow to fully understand the world economy, economy of states and regions. There are such categories as “economic system”, “model of the economy”, “structure of the economy”, “the branch of the economy”, “sphere of economy”, “sector of economy”. The analysis of school textbooks on geography and other subjects indicates the need for detailed assimilation of information concerning systems, their types, composition, structure and functions. The study of economic and social geography should be paid main attention to the economic system. This article presents the author’s version of the “economic system” concept’s interpretation with all its constituent elements, reveals the functions of economic systems, the types of economic products and services produced by them, examines the levels from global to local ones with specific examples. Various types of economic structures are shown: 1 sectoral, reflecting the relationship between industries; 2 interbranch, reflecting the relationship between interindustry complexes; 3 territorial, reflecting the share of individual regions in national indicators or the share of countries in global indicators, as well as the spatial location of production and non-production facilities; 4 tiered, reflecting the relationship between the primary, secondary and tertiary sectors of the economy; 5 two-sphere, reflecting the relationship between the production and non-production spheres; 6 organizational and legal, reflecting the

  18. Looking beyond general metrics for model comparison - lessons from an international model intercomparison study

    Science.gov (United States)

    de Boer-Euser, Tanja; Bouaziz, Laurène; De Niel, Jan; Brauer, Claudia; Dewals, Benjamin; Drogue, Gilles; Fenicia, Fabrizio; Grelier, Benjamin; Nossent, Jiri; Pereira, Fernando; Savenije, Hubert; Thirel, Guillaume; Willems, Patrick

    2017-01-01

    International collaboration between research institutes and universities is a promising way to reach consensus on hydrological model development. Although model comparison studies are very valuable for international cooperation, they do often not lead to very clear new insights regarding the relevance of the modelled processes. We hypothesise that this is partly caused by model complexity and the comparison methods used, which focus too much on a good overall performance instead of focusing on a variety of specific events. In this study, we use an approach that focuses on the evaluation of specific events and characteristics. Eight international research groups calibrated their hourly model on the Ourthe catchment in Belgium and carried out a validation in time for the Ourthe catchment and a validation in space for nested and neighbouring catchments. The same protocol was followed for each model and an ensemble of best-performing parameter sets was selected. Although the models showed similar performances based on general metrics (i.e. the Nash-Sutcliffe efficiency), clear differences could be observed for specific events. We analysed the hydrographs of these specific events and conducted three types of statistical analyses on the entire time series: cumulative discharges, empirical extreme value distribution of the peak flows and flow duration curves for low flows. The results illustrate the relevance of including a very quick flow reservoir preceding the root zone storage to model peaks during low flows and including a slow reservoir in parallel with the fast reservoir to model the recession for the studied catchments. This intercomparison enhanced the understanding of the hydrological functioning of the catchment, in particular for low flows, and enabled to identify present knowledge gaps for other parts of the hydrograph. Above all, it helped to evaluate each model against a set of alternative models.

  19. Barriers, facilitators and attitudes influencing health promotion activities in general practice: an explorative pilot study

    Directory of Open Access Journals (Sweden)

    Geense Wytske W

    2013-02-01

    Full Text Available Abstract Background The number of chronically ill patients increases every year. This is partly due to an unhealthy lifestyle. However, the frequency and quality of (evidence-based health promotion activities conducted by Dutch general practitioners (GPs and practice nurses (PNs are limited. The aim of this pilot study was to explore which lifestyle interventions Dutch GPs and PNs carry out in primary care, which barriers and facilitators can be identified and what main topics are with respect to attitudes towards health promoting activities. These topic areas will be identified for a future, larger scale study. Method This qualitative study consisted of 25 semi-structured interviews with sixteen GPs and nine PNs. ATLAS.ti was used to analyse the transcripts of the interviews. Results All GPs and PNs said they discuss lifestyle with their patients. Next to this, GPs and PNs counsel patients, and/or refer them to other disciplines. Only few said they refer patients to specific lifestyle programs or interventions in their own practice or in the neighbourhood. Several barriers and facilitators were identified. The main topics as barriers are: a lack of patients’ motivation to make lifestyle changes, insufficient reimbursement, a lack of proven effectiveness of interventions and a lack of overview of health promoting programs in their neighbourhood. The most cited facilitators are availability of a PN, collaboration with other disciplines and availability of interventions in their own practice. With respect to attitudes, six different types of GPs were identified reflecting the main topics that relate to attitudes, varying from ‘ignorer’ to ‘nurturer’. The topics relating to PNs attitudes towards health promotion activities, were almost unanimously positive. Conclusion GPs and PNs all say they discuss lifestyle issues with their patients, but the health promotion activities that are organized in their practice vary. Main topics that hinder

  20. Evaluation of job satisfaction of practice staff and general practitioners: an exploratory study

    Directory of Open Access Journals (Sweden)

    Goetz Katja

    2011-12-01

    Full Text Available Abstract Background Primary care teams' job satisfaction is an important issue in quality of care. The purpose of our study was to evaluate the job satisfaction of general practitioners (GPs and non-physician staff and to explore the elements that may impact on overall job satisfaction for GPs and non-physician staff separately. Methods The study was based on data from the European Practice Assessment and used an observational design. Job satisfaction was measured with the 10-items Warr-Cook-Wall questionnaire with 7-point-Likert scales. Job satisfaction of GPs and non-physician staff was compared and impact on overall job satisfaction was analysed with stepwise linear regression analyses for both samples separately. Results The study population consisted of 2878 non-physician staff (mean age: 38 years and 676 GPs (mean age: 50 years. The actual mean working time per week of GPs was 50.0 hours and of practice staff 26.0 hours. Both were satisfied with colleagues and fellow workers (mean = 5.99 and mean = 6.18 respectively and mostly dissatisfied with their income (mean = 4.40 and mean = 4.79 respectively. For GPs the opportunity to use their abilities (β = 0.638 and for non-physician staff recognition for their work (β = 0.691 showed the highest scores of explained variance (R2 = 0.406 and R2 = 0.477 respectively regarding overall job satisfaction. Conclusions Non-physician staff evaluate their job satisfaction higher than GPs except recognition for work. Job satisfaction of members of primary care teams is important because poor satisfaction is associated with suboptimal healthcare delivery, poor clinical outcomes and higher turnover of staff.