Validation of core competencies during residency training in anaesthesiology

Directory of Open Access Journals (Sweden)

Spies, Claudia

2011-01-01

Full Text Available Background and goal: Curriculum development for residency training is increasingly challenging in times of financial restrictions and time limitations. Several countries have adopted the CanMEDS framework for medical education as a model into their curricula of specialty training. The purpose of the present study was to validate the competency goals, as derived from CanMEDS, of the Department of Anaesthesiology and Intensive Care Medicine of the Berlin Charité University Medical Centre, by conducting a staff survey. These goals for the qualification of specialists stipulate demonstrable competencies in seven areas: expert medical action, efficient collaboration in a team, communications with patients and family, management and organisation, lifelong learning, professional behaviour, and advocacy of good health. We had previously developed a catalogue of curriculum items based on these seven core competencies. In order to evaluate the validity of this catalogue, we surveyed anaesthetists at our department in regard to their perception of the importance of each of these items. In addition to the descriptive acquisition of data, it was intended to assess the results of the survey to ascertain whether there were differences in the evaluation of these objectives by specialists and registrars. Methods: The questionnaire with the seven adapted CanMEDS Roles included items describing each of their underlying competencies. Each anaesthetist (registrars and specialists working at our institution in May of 2007 was asked to participate in the survey. Individual perception of relevance was rated for each item on a scale similar to the Likert system, ranging from 1 (highly relevant to 5 (not at all relevant, from which ratings means were calculated. For determination of reliability, we calculated Cronbach’s alpha. To assess differences between subgroups, we performed analysis of variance.Results: All seven roles were rated as relevant. Three of the seven

Mobbing Exposure of Anaesthesiology Residents in Turkey.

Science.gov (United States)

Aykut, Gülnihal; Efe, Esra Mercanoğlu; Bayraktar, Selcan; Şentürk, Sinem; Başeğmez, İrem; Özkumit, Özlem; Kabak, Elmas; Yavaşçaoğlu, Belgin; Bilgin, Hülya

2016-08-01

In recent years, psychological problems that are caused by working conditions, like burn out syndrome, are more commonly observed. In our study, we aimed to evaluate mobbing exposure, factors causing mobbing and precautions for mobbing in residency students who are educated in anaesthesiology and reanimation clinics in Turkey. After obtaining consent from the ethics committee, we sent our questionnaires to the secretariats of the departments by postal mail. Completed questionnaires were collected in our department's secretariat blindly and randomly mixed. One hundred and one participants were returned the questionnaires. Data was statistically analysed in SPSS 21.0 software programme. During residency programme, sated to have experienced mobbing one or more time. Interestingly, 5.9% participants complained of physical mobbing. Mobbing exposure was more common in females. The most serious new onset psychosomatic symptoms stated during residency were committing suicide (2%), addiction (16%), severe depression (18%), panic attack (8%), more accidents (7%) and tendency of violence (15%). In mobbing group there was statistically significant dissatisfaction rate. In professions where mobbing is common, incidences of psychiatric diseases and suicide attempts are high are increased. Who are under risk for experiencing mobbing should be noticed carefully to ensure good judgement and problems should be inspected objectively in a detailed manner. Anesthesiology societies and other medical professional societies should establish mobbing committees. Thus, mobbing problems can be resolved and healthy career oppurtunities can be presented to residents.

[Job rotation in anaesthesiological care: impacts on knowledge and learning].

Science.gov (United States)

Jordan, Silvia; Brauner, Elisabeth

2008-04-01

Job rotation in anaesthesiological care is explored in this article. Based on discussions of 'high reliability organizations', and based on current theory in social and organizational psychology, we empirically investigated the impact of job rotation on knowledge management and learning. The study was conducted at the University Hospital of Innsbruck during the job training period of novice nurse anaesthetists. Qualitative interviews were conducted as well as a questionnaire administered. Data were collected between September 2003 and June 2005. Observational and interview data were combined with a questionnaire study to assess transactive memory and cooperation using a mixed-method design. Qualitative data were analyzed using GABEK, a computer-supported content analysis system; quantitative data were analyzed statistically with SPSS. Results indicate that job rotation had both positive and negative effects on knowledge and learning. On the one hand, job rotation can foster flexibility and awareness of a person's own fallibility and lack of knowledge. On the other hand, trust, group cohesion, and social meta-knowledge can be hampered by constant rotation. Consequently, stabilization and change need equal consideration when designing work in high reliability organizations.

Anaesthesiological strategies in elective craniotomy: randomized, equivalence, open trial – The NeuroMorfeo trial

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Guzzetti Stefano

2009-04-01

Full Text Available Abstract Background Many studies have attempted to determine the "best" anaesthetic technique for neurosurgical procedures in patients without intracranial hypertension. So far, no study comparing intravenous (IA with volatile-based neuroanaesthesia (VA has been able to demonstrate major outcome differences nor a superiority of one of the two strategies in patients undergoing elective supratentorial neurosurgery. Therefore, current practice varies and includes the use of either volatile or intravenous anaesthetics in addition to narcotics. Actually the choice of the anaestesiological strategy depends only on the anaesthetists' preferences or institutional policies. This trial, named NeuroMorfeo, aims to assess the equivalence between volatile and intravenous anaesthetics for neurosurgical procedures. Methods/Design NeuroMorfeo is a multicenter, randomized, open label, controlled trial, based on an equivalence design. Patients aged between 18 and 75 years, scheduled for elective craniotomy for supratentorial lesion without signs of intracranial hypertension, in good physical state (ASA I-III and Glasgow Coma Scale (GCS equal to 15, are randomly assigned to one of three anaesthesiological strategies (two VA arms, sevoflurane + fentanyl or sevoflurane + remifentanil, and one IA, propofol + remifentanil. The equivalence between intravenous and volatile-based neuroanaesthesia will be evaluated by comparing the intervals required to reach, after anaesthesia discontinuation, a modified Aldrete score ≥ 9 (primary end-point. Two statistical comparisons have been planned: 1 sevoflurane + fentanyl vs. propofol + remifentanil; 2 sevoflurane + remifentanil vs. propofol + remifentanil. Secondary end-points include: an assessment of neurovegetative stress based on (a measurement of urinary catecholamines and plasma and urinary cortisol and (b estimate of sympathetic/parasympathetic balance by power spectrum analyses of electrocardiographic tracings recorded

Inadequate cerebral oxygen delivery and central fatigue during strenuous exercise

DEFF Research Database (Denmark)

Nybo, Lars; Rasmussen, Peter

2007-01-01

Under resting conditions, the brain is protected against hypoxia because cerebral blood flow increases when the arterial oxygen tension becomes low. However, during strenuous exercise, hyperventilation lowers the arterial carbon dioxide tension and blunts the increase in cerebral blood flow, which...... can lead to an inadequate oxygen delivery to the brain and contribute to the development of fatigue....

Antarctica’s Protected Areas Are Inadequate, Unrepresentative, and at Risk

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Shaw, Justine D.; Terauds, Aleks; Riddle, Martin J.; Possingham, Hugh P.; Chown, Steven L.

2014-01-01

Antarctica is widely regarded as one of the planet's last true wildernesses, insulated from threat by its remoteness and declaration as a natural reserve dedicated to peace and science. However, rapidly growing human activity is accelerating threats to biodiversity. We determined how well the existing protected-area system represents terrestrial biodiversity and assessed the risk to protected areas from biological invasions, the region's most significant conservation threat. We found that Antarctica is one of the planet's least protected regions, with only 1.5% of its ice-free area formally designated as specially protected areas. Five of the distinct ice-free ecoregions have no specially designated areas for the protection of biodiversity. Every one of the 55 designated areas that protect Antarctica's biodiversity lies closer to sites of high human activity than expected by chance, and seven lie in high-risk areas for biological invasions. By any measure, including Aichi Target 11 under the Convention on Biological Diversity, Antarctic biodiversity is poorly protected by reserves, and those reserves are threatened. PMID:24936869

[Part-time concepts in anaesthesia -example of a department of anaesthesiology at a university hospital in Germany].

Science.gov (United States)

Höltje, Maike; Osthaus, W Alexander; Koppert, Wolfgang

2015-05-01

Part-time work concepts are requested for different reasons from an increasing number of employees. Despite this fact there are no systematic part-time work concepts published in the German literature, especially for physicians working in hospitals. This article describes background and circumstances of a part-time work concept which was established two years ago in a department of anaesthesiology at a university hospital in Germany. This concept considers needs of young families as well as older employees. We are convinced that a transparent part-time work concept is a good argument for job-seeking physicians when deciding for an employer. The benefit for the already employed colleagues has at least the same value. © Georg Thieme Verlag Stuttgart · New York.

The Protection of Animals in Thailand--An Insight into Animal Protection Legislation

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Sulaiman Dorloh

2017-09-01

Full Text Available There are many critics of current Thai law concerning the welfare of animals. They argue that the PACPAWA,2014 is inadequate to protect the welfare of animals. The absence of clear guidelines in the legislation concerning animal welfare has resulted in animal welfare receiving inadequate protection. There are other limitations contributing to the inadequacy of existing laws in protecting animals in Thailand. The possible penalties are very low. For the offence of cruelty against an animal, the PACPAWA,2014 sets a maximum fine of TBH 2000. This is considered inadequate and ineffective in preventing cruelty to animals. The study utilises doctrinal legal research or library-based research approach to provide valuable insights in understanding the law and and ascertaining the principles of legal interpretation and analysis. The study also provides possible suggestions to enhance the protection of the welfare of animals in Thailand. The research suggests that education should play an important role in promoting kindness towards animals.

Inadequate housing in Ghana

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Franklin Obeng-Odoom

2011-01-01

Full Text Available Two themes are evident in housing research in Ghana. One involves the study of how to increase the number of dwellings to correct the overall housing deficit, and the other focuses on how to improve housing for slum dwellers. Between these two extremes, there is relatively little research on why the existing buildings are poorly maintained. This paper is based on a review of existing studies on inadequate housing. It synthesises the evidence on the possible reasons for this neglect, makes a case for better maintenance and analyses possible ways of reversing the problem of inadequate housing.

Radiologists' responses to inadequate referrals

International Nuclear Information System (INIS)

Lysdahl, Kristin Bakke; Hofmann, Bjoern Morten; Espeland, Ansgar

2010-01-01

To investigate radiologists' responses to inadequate imaging referrals. A survey was mailed to Norwegian radiologists; 69% responded. They graded the frequencies of actions related to referrals with ambiguous indications or inappropriate examination choices and the contribution of factors preventing and not preventing an examination of doubtful usefulness from being performed as requested. Ninety-five percent (344/361) reported daily or weekly actions related to inadequate referrals. Actions differed among subspecialties. The most frequent were contacting the referrer to clarify the clinical problem and checking test results/information in the medical records. Both actions were more frequent among registrars than specialists and among hospital radiologists than institute radiologists. Institute radiologists were more likely to ask the patient for additional information and to examine the patient clinically. Factors rated as contributing most to prevent doubtful examinations were high risk of serious complications/side effects, high radiation dose and low patient age. Factors facilitating doubtful examinations included respect for the referrer's judgment, patient/next-of-kin wants the examination, patient has arrived, unreachable referrer, and time pressure. In summary, radiologists facing inadequate referrals considered patient safety and sought more information. Vetting referrals on arrival, easier access to referring clinicians, and time for radiologists to handle inadequate referrals may contribute to improved use of imaging. (orig.)

Bridge Failure Due to Inadequate Design of Bed Protection

Science.gov (United States)

Gupta, Yogita; Kaur, Suneet; Dindorkar, Nitin

2017-12-01

The shallow foundation is generally provided on non-erodible strata or where scour depth is less. It is also preferable for low perennial flow or standing water condition. In the present case study shallow foundation is adopted for box type bridge. The total length of the bridge is 132.98 m, consisting of eight unit of RCC box. Each unit is composed of three cell box. The bottom slab of box unit is acted as raft foundation, founded 500 mm below ground level. River bed protection work is provided on both upstream and downstream side along the whole length of the bridge as it is founded above scour level. The bridge collapsed during the monsoon just after two years of service. The present paper explains the cause of failure. This study on failure of the bridge illustrates the importance of bridge inspection before and after monsoon period and importance of the timely maintenance. Standard specifications of Indian Road Congress for the river bed protection work are also included.

Radiologists' responses to inadequate referrals

Energy Technology Data Exchange (ETDEWEB)

Lysdahl, Kristin Bakke [Oslo University College, Faculty of Health Sciences, Oslo (Norway); University of Oslo, Section for Medical Ethics, Faculty of Medicine, P.O. Box 1130, Blindern, Oslo (Norway); Hofmann, Bjoern Morten [University of Oslo, Section for Medical Ethics, Faculty of Medicine, P.O. Box 1130, Blindern, Oslo (Norway); Gjoevik University College, Faculty of Health Care and Nursing, Gjoevik (Norway); Espeland, Ansgar [Haukeland University Hospital, Department of Radiology, Bergen (Norway); University of Bergen, Section for Radiology, Department of Surgical Sciences, Bergen (Norway)

2010-05-15

To investigate radiologists' responses to inadequate imaging referrals. A survey was mailed to Norwegian radiologists; 69% responded. They graded the frequencies of actions related to referrals with ambiguous indications or inappropriate examination choices and the contribution of factors preventing and not preventing an examination of doubtful usefulness from being performed as requested. Ninety-five percent (344/361) reported daily or weekly actions related to inadequate referrals. Actions differed among subspecialties. The most frequent were contacting the referrer to clarify the clinical problem and checking test results/information in the medical records. Both actions were more frequent among registrars than specialists and among hospital radiologists than institute radiologists. Institute radiologists were more likely to ask the patient for additional information and to examine the patient clinically. Factors rated as contributing most to prevent doubtful examinations were high risk of serious complications/side effects, high radiation dose and low patient age. Factors facilitating doubtful examinations included respect for the referrer's judgment, patient/next-of-kin wants the examination, patient has arrived, unreachable referrer, and time pressure. In summary, radiologists facing inadequate referrals considered patient safety and sought more information. Vetting referrals on arrival, easier access to referring clinicians, and time for radiologists to handle inadequate referrals may contribute to improved use of imaging. (orig.)

9 CFR 417.6 - Inadequate HACCP Systems.

Science.gov (United States)

2010-01-01

... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Inadequate HACCP Systems. 417.6 Section 417.6 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... ANALYSIS AND CRITICAL CONTROL POINT (HACCP) SYSTEMS § 417.6 Inadequate HACCP Systems. A HACCP system may be...

Protective Health Education

Science.gov (United States)

Aydin, Ganime

2016-01-01

Problem Statement: As a result of wars, starvation, traffic accidents, homicide, infectious diseases, insufficient adult protection, migration, and inadequate legal reforms the mortality rate of children has become a serious problem in the world. Protective health education contributes to a child's physical and social health. In this case, the…

Predictors of Inadequate Prenatal Care in Methamphetamine-Using Mothers in New Zealand and the United States

Science.gov (United States)

LaGasse, Linda L.; Wouldes, Trecia A.; Arria, Amelia M.; Wilcox, Tara; Derauf, Chris; Newman, Elana; Shah, Rizwan; Smith, Lynne M.; Neal, Charles R.; Huestis, Marilyn A.; DellaGrotta, Sheri; Lester, Barry M.

2013-01-01

This study compared patterns of prenatal care among mothers who used methamphetamine (MA) during pregnancy and non-using mothers in the US and New Zealand (NZ), and evaluated associations among maternal drug use, child protective services (CPS) referral, and inadequate prenatal care in both countries. The sample consisted of 182 mothers in the MA-Exposed and 196 in the Comparison groups in the US, and 107 mothers in the MA-Exposed and 112 in the Comparison groups in NZ. Positive toxicology results and/or maternal report of MA use during pregnancy were used to identify MA use. Information about sociodemographics, prenatal care and prenatal substance use was collected by maternal interview. MA-use during pregnancy is associated with lower socio-economic status, single marital status, and CPS referral in both NZ and the US. Compared to their non-using counterparts, MA-using mothers in the US had significantly higher rates of inadequate prenatal care. No association was found between inadequate care and MA-use in NZ. In the US, inadequate prenatal care was associated with CPS referral, but not in NZ. Referral to CPS for drug use only composed 40 % of all referrals in the US, but only 15 % of referrals in NZ. In our study population, prenatal MA-use and CPS referral eclipse maternal sociodemographics in explanatory power for inadequate prenatal care. The predominant effect of CPS referral in the US is especially interesting, and should encourage further research on whether the US policy of mandatory reporting discourages drug-using mothers from seeking antenatal care. PMID:22588827

Radiation exposure of an anaesthesiologist in catheterisation and electrophysiological cardiac procedures

International Nuclear Information System (INIS)

Andreoli, Stefano; Moretti, Renzo; Lorini, Ferdinando Luca; Lagrotta, Mariavittoria

2016-01-01

Sometimes, cardiac catheterisation and electrophysiological procedures, diagnostic and interventional, require an anaesthesiological support. The anaesthesiologist receives radiation doses depending on various factors, such as type of procedure and exposure modality, anaesthesiological technique, individual protective devices and operator experience. The aim of this study was to investigate the dose per procedure, the exposure inhomogeneity and the effective dose, E, of a senior anaesthesiologist in the haemodynamic laboratory of Ospedali Riuniti, Bergamo. The dose monitoring was routinely performed with sets of several thermoluminescent dosemeters and an electronic personal dosemeter. The study covered 300 consecutive procedures over 1 y. The anaesthesiologist wore a protective apron, a thyroid collar and glasses (0.5 mm lead-equivalent). (authors)

Clinical significance of inadequate endometrial biopsies prior to hysterectomy.

Science.gov (United States)

Turney, Emily H; Farghaly, Hanan; Eskew, Ashley M; Parker, Lynn P; Milam, Michael R

2012-01-01

To evaluate preoperative clinical risk factors associated with significant uterine histopathologic abnormalities in final hysterectomy specimens in patients with inadequate preoperative endometrial biopsies. This is an institutional review board-approved, retrospective cohort analysis of 469 consecutive patients who underwent preoperative endometrial biopsies with subsequent hysterectomy from January 1, 2005, to December 31, 2009, at the University of Louisville Medical Center. We analyzed risk factors for inadequate biopsy and for final diagnosis of endometrial pathology (defined as endometrial hyperplasia or uterine cancer). Of the 469 preoperative endometrial biopsies reviewed, 26.2% (123/469) were inadequate (IBx) and 73.8% (346/469) were adequate and benign. IBx on endometrial biopsies was associated with a greater risk of having significant uterine histopathologic abnormalities on final hysterectomy specimens (6.5% vs. 2.3%, RR 2.8 [95% CI 1.1-7.3], p = 0.04). Although inadequate endometrial biopsies are a common finding, they can be associated with significant uterine histopathologic abnormalities on final hysterectomy specimens.

7 CFR 765.203 - Protective advances.

Science.gov (United States)

2010-01-01

... following actions will be charged to the borrower's account: (a) Maintain abandoned security property; (b) Preserve inadequately maintained security; (c) Pay real estate taxes and assessments; (d) Pay property... ground rents; (h) Pay expenses for emergency measures to protect the Agency's collateral; and (i) Protect...

Consequences of Inadequate Physical Activity

Centers for Disease Control (CDC) Podcasts

2018-03-27

Listen as CDC Epidemiologist Susan Carlson, PhD, talks about her research, which estimates the percentage of US deaths attributed to inadequate levels of physical activity.  Created: 3/27/2018 by Preventing Chronic Disease (PCD), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 3/27/2018.

Evidence Report: Risk Factor of Inadequate Nutrition

Science.gov (United States)

Smith, Scott M.; Zwart, Sara R.; Heer, Martina

2015-01-01

The importance of nutrition in exploration has been documented repeatedly throughout history, where, for example, in the period between Columbus' voyage in 1492 and the invention of the steam engine, scurvy resulted in more sailor deaths than all other causes of death combined. Because nutrients are required for the structure and function of every cell and every system in the body, defining the nutrient requirements for spaceflight and ensuring provision and intake of those nutrients are primary issues for crew health and mission success. Unique aspects of nutrition during space travel include the overarching physiological adaptation to weightlessness, psychological adaptation to extreme and remote environments, and the ability of nutrition and nutrients to serve as countermeasures to ameliorate the negative effects of spaceflight on the human body. Key areas of clinical concern for long-duration spaceflight include loss of body mass (general inadequate food intake), bone and muscle loss, cardiovascular and immune system decrements, increased radiation exposure and oxidative stress, vision and ophthalmic changes, behavior and performance, nutrient supply during extravehicular activity, and general depletion of body nutrient stores because of inadequate food supply, inadequate food intake, increased metabolism, and/or irreversible loss of nutrients. These topics are reviewed herein, based on the current gap structure.

The Link Between Inadequate Sleep and Obesity in Young Adults.

Science.gov (United States)

Vargas, Perla A

2016-03-01

The prevalence of obesity has increased dramatically over the past decade. Although an imbalance between caloric intake and physical activity is considered a key factor responsible for the increase, there is emerging evidence suggesting that other factors may be important contributors to weight gain, including inadequate sleep. Overall research evidence suggests that inadequate sleep is associated with obesity. Importantly, the strength and trajectory of the association seem to be influenced by multiple factors including age. Although limited, the emerging evidence suggests young adults might be at the center of a "perfect health storm," exposing them to the highest risk for obesity and inadequate sleep. Unfortunately, the methods necessary for elucidating the complex relationship between sleep and obesity are lacking. Uncovering the underlying factors and trajectories between inadequate sleep and weight gain in different populations may help to identify the windows of susceptibility and to design targeted interventions to prevent the negative impact of obesity and related diseases.

Wind energy: Overcoming inadequate wind and modeling uncertainties

Energy Technology Data Exchange (ETDEWEB)

Kane, Vivek

2010-09-15

'Green Energy' is the call of the day, and significance of Wind Energy can never be overemphasized. But the key question here is - What if the wind resources are inadequate? Studies reveal that the probability of finding favorable wind at a given place on land is only 15%. Moreover, there are inherent uncertainties associated with wind business. Can we overcome inadequate wind resources? Can we scientifically quantify uncertainty and model it to make business sense? This paper proposes a solution, by way of break-through Wind Technologies, combined with advanced tools for Financial Modeling, enabling vital business decisions.

Inadequate exercise as a risk factor for sepsis mortality.

Science.gov (United States)

Williams, Paul T

2013-01-01

Test whether inadequate exercise is related to sepsis mortality. Mortality surveillance of an epidemiological cohort of 155,484 National Walkers' and Runners' Health Study participants residing in the United States. Deaths were monitored for an average of 11.6-years using the National Death index through December 31, 2008. Cox proportional hazard analyses were used to compare sepsis mortality (ICD-10 A40-41) to inadequate exercise (<1.07 METh/d run or walked) as measured on their baseline questionnaires. Deaths occurring within one year of the baseline survey were excluded. Sepsis was the underlying cause in 54 deaths (sepsis(underlying)) and a contributing cause in 184 deaths (sepsis(contributing)), or 238 total sepsis-related deaths (sepsis(total)). Inadequate exercise was associated with 2.24-fold increased risk for sepsis(underlying) (95%CI: 1.21 to 4.07-fold, P = 0.01), 2.11-fold increased risk for sepsis(contributing) (95%CI: 1.51- to 2.92-fold, P<10(-4)), and 2.13-fold increased risk for sepsis(total) (95%CI: 1.59- to 2.84-fold, P<10(-6)) when adjusted for age, sex, race, and cohort. The risk increase did not differ significantly between runners and walkers, by sex, or by age. Sepsis(total) risk was greater in diabetics (P = 10(-5)), cancer survivors (P = 0.0001), and heart attack survivors (P = 0.003) and increased with waist circumference (P = 0.0004). The sepsis(total) risk associated with inadequate exercise persisted when further adjusted for diabetes, prior cancer, prior heart attack and waist circumference, and when excluding deaths with cancer, or cardiovascular, respiratory, or genitourinary disease as the underlying cause. Inadequate exercise also increased sepsis(total) risk in 2163 baseline diabetics (4.78-fold, 95%CI: 2.1- to 13.8-fold, P = 0.0001) when adjusted, which was significantly greater (P = 0.03) than the adjusted risk increase in non-diabetics (1.80-fold, 95%CI: 1.30- to 2.46-fold, P = 0

Applications of cathodic protection for the protection of aqueous and soil corrosion of power plant components

International Nuclear Information System (INIS)

Sinha, A.K.; Mitra, A.K.; Bhakta, U.C.; Sanyal, S.K.

2000-01-01

Power plant components exposed to environments such as water and soil are susceptible to severe corrosion. Many times the effect of corrosion in power plant components can be catastrophic. The problem is aggravated for underground pipelines due to additional factors such as large network of pipelines, proximity to earth mat, high voltage transmission lines, corrosive chemicals, inadequate approach etc. Other components such as condenser water boxes, internals of pipelines, clarifier bridge structures, cooling water inlet gates and pipes etc. which are in continuous contact with water, are subjected to severe corrosion. The nature and locations of all such components are at places which are not accessible for routine maintenance and hence they require long term reliable protection against corrosion. Experience has shown that anti-corrosive coatings are inadequate in preventing corrosion and due to their location regular maintenance coatings are also not feasible. Under such circumstances the applications of cathodic protection provides a long term solution the design of cathodic protection, for such applications differs from the commonly employed cathodic protection for cross-country pipelines and submerged structures due to other complexities in the plant region and maintenance of the applied system. The present paper intends to discuss the applications of cathodic protection with suitable anti-corrosive coatings for protection of various power plant components and the specific features of each type of application. (author)

The importance of verifiable fire protection design

Energy Technology Data Exchange (ETDEWEB)

Medonos, Sava [Petrellus Ltd. (United Kingdom)]. E-mail: smm@petrellus.co.uk; Geddes, Paul [Global Solutions UK Ltd. (United Kingdom)]. E-mail: paul@globalsolutionsuk.com

2004-07-01

Simplistic methods based on the Hp/A ratio between the heated surface area and volume or a 2-dimensional analysis may be sufficient for the determination of fire protection coatings for simple components. For the optimization of fire protection of pressure systems and load bearing structures, however, they have proved to be inadequate, as they do not represent the response taking place. This often leads to over-protection or inadequate fire resistance. In the past 10 years there have been claims in petrochemical industry of 'methods' for fire protection 'optimization' based on a walk-down through a topside or plant, or a heat-up calculation of a few cross sections with no regard to stress. These methods are wrong. In the best case these 'methods of optimization' lead to high unnecessary costs and in the worst case in an explosion of a vessel, structural collapse, domino effects and cataclysmic fire throughout the plant. The operator or design contractor should always require a Method Statement including a proof of verification to obtain the adequate quality of fire protection. (author)

The significance of inadequate transcranial Doppler studies in children with sickle cell disease.

Directory of Open Access Journals (Sweden)

Simon Greenwood

Full Text Available Sickle cell disease (SCD is a common cause of cerebrovascular disease in childhood. Primary stroke prevention is effective using transcranial Doppler (TCD scans to measure intracranial blood velocities, and regular blood transfusions or hydroxycarbamide when these are abnormal. Inadequate TCD scans occur when it is not possible to measure velocities in all the main arteries. We have investigated the prevalence and significance of this in a retrospective audit of 3915 TCD scans in 1191 children, performed between 2008 and 2015. 79% scans were normal, 6.4% conditional, 2.8% abnormal and 12% inadequate. 21.6% of 1191 patients had an inadequate scan at least once. The median age of first inadequate scan was 3.3 years (0.7-19.4, with a U-shaped frequency distribution with age: 28% aged 2-3 years, 3.5% age 10 years, 25% age 16 years. In young children reduced compliance was the main reason for inadequate TCDs, whereas in older children it was due to a poor temporal ultrasound window. The prevalence of inadequate TCD was 8% in the main Vascular Laboratory at King's College Hospital and significantly higher at 16% in the outreach clinics (P<0.0001, probably due to the use of a portable ultrasound machine. Inadequate TCD scans were not associated with underlying cerebrovascular disease.

Inadequate humidification of respiratory gases during mechanical ventilation of the newborn.

Science.gov (United States)

Tarnow-Mordi, W O; Sutton, P; Wilkinson, A R

1986-01-01

Proximal airway humidity was measured during mechanical ventilation in 14 infants using an electronic hygrometer. Values below recommended minimum humidity of adult inspired gas were recorded on 251 of 396 occasions. Inadequate humidification, largely due to inadequate proximal airway temperature, is commoner than recognised in infants receiving mechanical ventilation. PMID:3740912

Initial treatment of severe malaria in children is inadequate – a study ...

African Journals Online (AJOL)

-medicated at home. Initial consultations are at primary local health facilities where less effective drugs are prescribed at inadequate dosages. Recommended ACTs were also often prescribed at inadequate dosages. Education in the use of ...

Determinants of inadequate fruit and vegetable consumption amongst Portuguese adults.

Science.gov (United States)

Oliveira, A; Maia, B; Lopes, C

2014-04-01

A low consumption of fruit and vegetables (F&V) represents a high burden on health. The present study evaluates sociodemographic, lifestyle and anthropometric determinants of an inadequate consumption of F&V (Diet was assessed by a validated food frequency questionnaire. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by logistic regression, after sex stratification and controlling for age, education, marital status, smoking, regular physical exercise and total energy intake. Older women and men had 37% and 67%, respectively, lower odds of inadequate F&V consumption (≥65 versus 12 versus excessive alcohol (women: ≥15 g day(-1) ; men: ≥30 g day(-1) ) presented a two- and four-fold higher probability of having inadequate F&V consumption compared to nondrinkers (OR = 1.95, 95% CI = 1.38-2.77 in women; OR = 4.40, 95% CI = 2.70-7.18 in men). In both sexes, an inadequate consumption of F&V was more frequently found in younger, less educated and less physically active subjects with smoking and drinking habits. Strategies aiming to increase F&V consumption should consider these target groups that present a clustering of unhealthy lifestyles. © 2013 The British Dietetic Association Ltd.

Barriers to Mammography among Inadequately Screened Women

Science.gov (United States)

Stoll, Carolyn R. T.; Roberts, Summer; Cheng, Meng-Ru; Crayton, Eloise V.; Jackson, Sherrill; Politi, Mary C.

2015-01-01

Mammography use has increased over the past 20 years, yet more than 30% of women remain inadequately screened. Structural barriers can deter individuals from screening, however, cognitive, emotional, and communication barriers may also prevent mammography use. This study sought to identify the impact of number and type of barriers on mammography…

Relationship between health services, socioeconomic variables and inadequate weight gain among Brazilian children.

Science.gov (United States)

de Souza, A C; Peterson, K E; Cufino, E; Gardner, J; Craveiro, M V; Ascherio, A

1999-01-01

This ecological analysis assessed the relative contribution of behavioural, health services and socioeconomic variables to inadequate weight gain in infants (0-11 months) and children (12-23 months) in 140 municipalities in the State of Ceara, north-east Brazil. To assess the total effect of selected variables, we fitted three unique sets of multivariate linear regression models to the prevalence of inadequate weight gain in infants and in children. The final predictive models included variables from the three sets. Findings showed that participation in growth monitoring and urbanization were inversely and significantly associated with the prevalence of inadequate weight gain in infants, accounting for 38.3% of the variation. Female illiteracy rate, participation in growth monitoring and degree of urbanization were all positively associated with prevalence of inadequate weight gain in children. Together, these factors explained 25.6% of the variation. Our results suggest that efforts to reduce the average municipality-specific female illiteracy rate, in combination with participation in growth monitoring, may be effective in reducing municipality-level prevalence of inadequate weight gain in infants and children in Ceara.

Italian retail gasoline activities: inadequate distribution network

International Nuclear Information System (INIS)

Verde, Stefano

2005-01-01

It is common belief that competition in the Italian retail gasoline activities is hindered by oil companies' collusive behaviour. However, when developing a broader analysis of the sector, low efficiency and scarce competition could results as the consequences coming from an inadequate distribution network and from the recognition of international markets and focal point [it

Patterns of distribution and protection status of the endemic ...

African Journals Online (AJOL)

The majority of these endemics are small mammals and many are listed in the Red Data Book, especially those restricted to the Nama-and Succulent Karoo. This is of concern, as both areas are inadequately protected by the existing protected areas. The coastal forests also contain many Red Data Book species, particularly ...

Pipelines cathodic protection design methodologies for impressed ...

African Journals Online (AJOL)

Several inadequate designs of cathodically polarized offshore and onshore pipelines have been reported in Nigeria owing to design complexity and application of the cathodic protection system. The present study focused on critical and detailed approach in impressed current and sacrificial anode design calculation ...

Behaviorally inadequate

DEFF Research Database (Denmark)

Kasperbauer, Tyler Joshua

2014-01-01

According to situationism in psychology, behavior is primarily influenced by external situational factors rather than internal traits or motivations such as virtues. Environmental ethicists wish to promote pro-environmental behaviors capable of providing adequate protection for the environment...

Cognitive Attributes of Adequate and Inadequate Responders to Reading Intervention in Middle School

Science.gov (United States)

Miciak, Jeremy; Stuebing, Karla K.; Vaughn, Sharon; Roberts, Greg; Barth, Amy E.; Fletcher, Jack M.

2014-01-01

No studies have investigated the cognitive attributes of middle school students who are adequate and inadequate responders to Tier 2 reading intervention. We compared students in Grades 6 and 7 representing groups of adequate responders (n = 77) and inadequate responders who fell below criteria in (a) comprehension (n = 54); (b) fluency (n = 45);…

Factors associated with inadequate work ability among women in the clothing industry.

Science.gov (United States)

Augusto, Viviane Gontijo; Sampaio, Rosana Ferreira; Ferreira, Fabiane Ribeiro; Kirkwood, Renata Noce; César, Cibele Comini

2015-01-01

Work ability depends on a balance between individual resources and work demands. This study evaluated factors that are associated with inadequate work ability among workers in the clothing industry. We conducted a cross-sectional observational study of 306 workers in 40 small and medium-sized enterprises. We assessed work ability, individual resources, physical and psychosocial demands, and aspects of life outside work using a binary logistic regression model with hierarchical data entry. The mean work ability was 42.5 (SD=3.5); when adjusted for age, only 11% of the workers showed inadequate work ability. The final model revealed that smoking, high isometric physical load, and poor physical environmental conditions were the most significant predictors of inadequate work ability. Good working conditions and worker education must be implemented to eliminate factors that can be changed and that have a negative impact on work ability. These initiatives include anti-smoking measures, improved postures at work, and better physical environmental conditions.

Prevalence of Inadequate Immunity to Measles, Mumps, Rubella, and Varicella in MLB and NBA Athletes.

Science.gov (United States)

Conway, Justin J; Toresdahl, Brett G; Ling, Daphne I; Boniquit, Nicole T; Callahan, Lisa R; Kinderknecht, James J

2018-05-01

Multiple outbreaks of vaccine-preventable viral diseases have occurred in professional sports in recent years. Currently, there is no established protocol for vaccination or immunity screening for professional athletes. There are significant differences in the prevalence of inadequate immunity dependent on age, sport, country of birth, and participation in collegiate sports. Cross-sectional cohort study. Level 4. A sample of Major League Baseball (MLB) and National Basketball Association (NBA) players were screened for serologic evidence of immunity to measles, mumps, rubella, and varicella prior to the 2015 and 2016 seasons. The results were designated as adequate (immune) or inadequate (equivocal or nonimmune) based on laboratory criteria. Comparison with an age-matched control group was performed using data from the National Health and Nutrition Examination Survey (NHANES). A total of 98 athletes (62 MLB, 36 NBA) were screened. The prevalence of inadequate immunity for any virus was 35.5% in MLB players and 33.3% in NBA players. There was a significantly greater risk of inadequate immunity to rubella (risk ratio, 6.38; P < 0.01) and varicella (risk ratio, 4.21; P < 0.01) in athletes compared with the age-matched NHANES population. Our analysis did not reveal differences in rates of immunity based on sport, country of birth (US born vs international), or participation in college athletics. There was a lower rate of inadequate immunity to varicella with increasing age (odds ratio, 0.72; P = 0.05). One-third of athletes studied had inadequate immunity to 1 of the 4 viruses tested. Younger players had a significantly greater risk of inadequate immunity to varicella. Birth outside the US and lack of participation in college athletics were not found to influence immunity rates. These results can inform the development of future screening programs to prevent outbreaks of viral infections in professional athletes.

Inadequate pre-season preparation of schoolboy rugby players - a ...

African Journals Online (AJOL)

... in prospective studies at the same schools. The players' knowledge of techniques known to prevent rugby injuries was inadequate and too little attention was paid at the start of the rugby season to training and coaching techniques to reduce injury risk. Coaching errors may therefore have predisposed players to injury.

Cognitive Attributes of Adequate and Inadequate Responders to Reading Intervention in Middle School

OpenAIRE

Miciak, Jeremy; Stuebing, Karla K.; Vaughn, Sharon; Roberts, Greg; Barth, Amy Elizabeth; Fletcher, Jack M.

2014-01-01

No studies have investigated the cognitive attributes of middle school students who are adequate and inadequate responders to Tier 2 reading intervention. We compared students in Grades 6 and 7 representing groups of adequate responders (n = 77) and inadequate responders who fell below criteria in (a) comprehension (n = 54); (b) fluency (n = 45); and (c) decoding, fluency, and comprehension (DFC; n = 45). These students received measures of phonological awareness, listening comprehension, rap...

The association between inadequate prenatal care and future healthcare use among offspring in the Bedouin population.

Science.gov (United States)

Estis-Deaton, Asia; Sheiner, Eyal; Wainstock, Tamar; Landau, Daniella; Walfisch, Asnat

2017-12-01

To evaluate the impact of inadequate prenatal care on long-term morbidity among the offspring of an ethnic minority population. A retrospective population-based cohort analysis was performed among all Bedouin women with singleton pregnancies who delivered in a tertiary medical center in Israel between January 1, 1991, and January 1, 2014. Morbidity was defined as pediatric hospitalization across six distinct disease categories before 18 years of age. The cumulative morbidity rates were compared for offspring born following pregnancies with either inadequate (prenatal care facility) or adequate prenatal care. Overall, 127 396 neonates were included; 19 173 (15.0%) were born following inadequate prenatal care. Pediatric hospitalizations for all morbidities other than cardiovascular ones were less frequent among the inadequate prenatal care group than the adequate prenatal care group (Pprenatal care group, with the exception of cardiovascular disease. Inadequate prenatal care correlated with reduced pediatric hospitalization rates among offspring, possibly owing to a lack of child healthcare service utilization within the Bedouin population. © 2017 International Federation of Gynecology and Obstetrics.

Predictors of Hearing Protection Use in Construction Workers

OpenAIRE

Edelson, Jane; Neitzel, Richard; Meischke, Hendrika; Daniell, William; Sheppard, Lianne; Stover, Bert; Seixas, Noah

2009-01-01

Objectives: Although noise-induced hearing loss is completely preventable, it remains highly prevalent among construction workers. Hearing protection devices (HPDs) are commonly relied upon for exposure reduction in construction, but their use is complicated by intermittent and highly variable noise, inadequate industry support for hearing conservation, and lax regulatory enforcement.

Self-esteem, social support, and satisfaction differences in women with adequate and inadequate prenatal care.

Science.gov (United States)

Higgins, P; Murray, M L; Williams, E M

1994-03-01

This descriptive, retrospective study examined levels of self-esteem, social support, and satisfaction with prenatal care in 193 low-risk postpartal women who obtained adequate and inadequate care. The participants were drawn from a regional medical center and university teaching hospital in New Mexico. A demographic questionnaire, the Coopersmith self-esteem inventory, the personal resource questionnaire part 2, and the prenatal care satisfaction inventory were used for data collection. Significant differences were found in the level of education, income, insurance, and ethnicity between women who received adequate prenatal care and those who received inadequate care. Women who were likely to seek either adequate or inadequate prenatal care were those whose total family income was $10,000 to $19,999 per year and high school graduates. Statistically significant differences were found in self-esteem, social support, and satisfaction between the two groups of women. Strategies to enhance self-esteem and social support have to be developed to reach women at risk for receiving inadequate prenatal care.

Skull-base Osteomyelitis: a Dreaded Complication after Trivial Fall and Inadequate Management

Directory of Open Access Journals (Sweden)

Kundan Mittal

2015-10-01

Full Text Available Introduction: Skull-based osteomyelitis is bony infection which generally originates from inadequately treated chronic infection, adjoining tissue infection or after trauma.Case: 11 month female child had a trivial fall while standing near a bucket. The child developed fracture of right clavicle and left orbital swelling which was inadequately treated. This resulted in in spread of infection to adjoining tissues, skull bones, sinuses and brain.Conclusion: Cranial base osteomyelitis is rare but dreaded condition which requires early diagnosis and prompt treatment to avoid mortality and morbidity in form of neurological deficits and permanent disability

Do infants with cow's milk protein allergy have inadequate levels of vitamin D?

Science.gov (United States)

Silva, Cristiane M; Silva, Silvia A da; Antunes, Margarida M de C; Silva, Gisélia Alves Pontes da; Sarinho, Emanuel Sávio Cavalcanti; Brandt, Katia G

To verify whether infants with cow's milk protein allergy have inadequate vitamin D levels. This cross-sectional study included 120 children aged 2 years or younger, one group with cow's milk protein allergy and a control group. The children were recruited at the pediatric gastroenterology, allergology, and pediatric outpatient clinics of a university hospital in the Northeast of Brazil. A questionnaire was administered to the caregiver and blood samples were collected for vitamin D quantification. Vitamin D levels <30ng/mL were considered inadequate. Vitamin D level was expressed as mean and standard deviation, and the frequency of the degrees of sufficiency and other variables, as proportions. Infants with cow's milk protein allergy had lower mean vitamin D levels (30.93 vs.35.29ng/mL; p=0.041) and higher deficiency frequency (20.3% vs.8.2; p=0.049) than the healthy controls. Exclusively or predominantly breastfed infants with cow's milk protein allergy had higher frequency of inadequate vitamin D levels (p=0.002). Regardless of sun exposure time, the groups had similar frequencies of inadequate vitamin D levels (p=0.972). Lower vitamin D levels were found in infants with CMPA, especially those who were exclusively or predominantly breastfed, making these infants a possible risk group for vitamin D deficiency. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Do infants with cow's milk protein allergy have inadequate levels of vitamin D?

Directory of Open Access Journals (Sweden)

Cristiane M. Silva

Full Text Available Abstract Objective: To verify whether infants with cow's milk protein allergy have inadequate vitamin D levels. Methods: This cross-sectional study included 120 children aged 2 years or younger, one group with cow's milk protein allergy and a control group. The children were recruited at the pediatric gastroenterology, allergology, and pediatric outpatient clinics of a university hospital in the Northeast of Brazil. A questionnaire was administered to the caregiver and blood samples were collected for vitamin D quantification. Vitamin D levels <30 ng/mL were considered inadequate. Vitamin D level was expressed as mean and standard deviation, and the frequency of the degrees of sufficiency and other variables, as proportions. Results: Infants with cow's milk protein allergy had lower mean vitamin D levels (30.93 vs.35.29 ng/mL; p = 0.041 and higher deficiency frequency (20.3% vs.8.2; p = 0.049 than the healthy controls. Exclusively or predominantly breastfed infants with cow's milk protein allergy had higher frequency of inadequate vitamin D levels (p = 0.002. Regardless of sun exposure time, the groups had similar frequencies of inadequate vitamin D levels (p = 0.972. Conclusions: Lower vitamin D levels were found in infants with CMPA, especially those who were exclusively or predominantly breastfed, making these infants a possible risk group for vitamin D deficiency.

Magnitude and determinants of inadequate third-trimester weight gain in rural Bangladesh

Science.gov (United States)

Hasan, S. M. Tafsir; Rahman, Sabuktagin; Locks, Lindsey Mina; Rahman, Mizanur; Hore, Samar Kumar; Saqeeb, Kazi Nazmus; Khan, Md. Alfazal

2018-01-01

Objectives The objective of this study was to estimate the magnitude and determinants of inadequate weight gain in the third-trimester among rural women in Matlab, Bangladesh. Methods The study analyzed data on weight gain in the third trimester in 1,883 pregnant women in Matlab, Bangladesh. All these women were admitted to Matlab hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) for childbirth during 2012–2014, and they had singleton live births at term. Data were retrieved from the electronic databases of Matlab Health and Demographic Surveillance System and Matlab hospital. A multivariable logistic regression for inadequate weight gain in the third trimester (≤4 kg) was built with sociodemographic, environmental and maternal factors as predictors. Results One thousand and twenty-six (54%) pregnant women had inadequate weight gain in the third trimester. In the multivariable model, short stature turned out to be the most robust risk factor for inadequate weight gain in the third trimester (OR = 2.5; 95% CI 1.8, 3.5 for short compared to tall women). Pre-third-trimester BMI was inversely associated with insufficient weight gain (OR = 0.96; 95% CI 0.93, 0.99 for 1 unit increase in BMI). Other risk factors for inadequate weight gain in the third trimester were advanced age (OR = 1.9; 95% CI 1.2, 3.1 for ≥35 years compared to ≤19 years), parity (OR = 1.5; 95% CI 1.2, 1.9 for multipara compared to nulliparous women), low socioeconomic status (OR = 1.7; 95% CI 1.2, 2.3 for women in the lowest compared to women in the highest wealth quintile), low level of education (OR = 1.6; 95% CI 1.2, 2.1 for ≤5 years compared to ≥10 years of education), belonging to the Hindu religious community (OR = 1.8; 95% CI 1.3, 2.5), consuming arsenic-contaminated water (OR = 1.4; 95% CI 1.1, 1.9), and conceiving during monsoon or dry season compared to summer (OR = 1.4; 95% CI 1.1, 1.8). Conclusions Among rural Bangladeshi women in Matlab

Magnitude and determinants of inadequate third-trimester weight gain in rural Bangladesh.

Science.gov (United States)

Hasan, S M Tafsir; Rahman, Sabuktagin; Locks, Lindsey Mina; Rahman, Mizanur; Hore, Samar Kumar; Saqeeb, Kazi Nazmus; Khan, Md Alfazal; Ahmed, Tahmeed

2018-01-01

The objective of this study was to estimate the magnitude and determinants of inadequate weight gain in the third-trimester among rural women in Matlab, Bangladesh. The study analyzed data on weight gain in the third trimester in 1,883 pregnant women in Matlab, Bangladesh. All these women were admitted to Matlab hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) for childbirth during 2012-2014, and they had singleton live births at term. Data were retrieved from the electronic databases of Matlab Health and Demographic Surveillance System and Matlab hospital. A multivariable logistic regression for inadequate weight gain in the third trimester (≤4 kg) was built with sociodemographic, environmental and maternal factors as predictors. One thousand and twenty-six (54%) pregnant women had inadequate weight gain in the third trimester. In the multivariable model, short stature turned out to be the most robust risk factor for inadequate weight gain in the third trimester (OR = 2.5; 95% CI 1.8, 3.5 for short compared to tall women). Pre-third-trimester BMI was inversely associated with insufficient weight gain (OR = 0.96; 95% CI 0.93, 0.99 for 1 unit increase in BMI). Other risk factors for inadequate weight gain in the third trimester were advanced age (OR = 1.9; 95% CI 1.2, 3.1 for ≥35 years compared to ≤19 years), parity (OR = 1.5; 95% CI 1.2, 1.9 for multipara compared to nulliparous women), low socioeconomic status (OR = 1.7; 95% CI 1.2, 2.3 for women in the lowest compared to women in the highest wealth quintile), low level of education (OR = 1.6; 95% CI 1.2, 2.1 for ≤5 years compared to ≥10 years of education), belonging to the Hindu religious community (OR = 1.8; 95% CI 1.3, 2.5), consuming arsenic-contaminated water (OR = 1.4; 95% CI 1.1, 1.9), and conceiving during monsoon or dry season compared to summer (OR = 1.4; 95% CI 1.1, 1.8). Among rural Bangladeshi women in Matlab, third-trimester weight gain was in

Heat stress and inadequate sanitary facilities at workplaces - an occupational health concern for women?

Science.gov (United States)

Venugopal, Vidhya; Rekha, Shanmugam; Manikandan, Krishnamoorthy; Latha, Perumal Kamalakkannan; Vennila, Viswanathan; Ganesan, Nalini; Kumaravel, Perumal; Chinnadurai, Stephen Jeremiah

2016-01-01

Health concerns unique to women are growing with the large number of women venturing into different trades that expose them to hot working environments and inadequate sanitation facilities, common in many Indian workplaces. The study was carried out to investigate the health implications of exposures to hot work environments and inadequate sanitation facilities at their workplaces for women workers. A cross-sectional study was conducted with 312 women workers in three occupational sectors in 2014-2015. Quantitative data on heat exposures and physiological heat strain indicators such as core body temperature (CBT), sweat rate (SwR), and urine specific gravity (USG) were collected. A structured questionnaire captured workers perceptions about health impacts of heat stress and inadequate sanitary facilities at the workplace. Workplace heat exposures exceeded the threshold limit value for safe manual work for 71% women (Avg. wet bulb globe temperature=30°C±2.3°C) during the study period. Eighty-seven percent of the 200 women who had inadequate/no toilets at their workplaces reported experiencing genitourinary problems periodically. Above normal CBT, SwR, and USG in about 10% women workers indicated heat strain and moderate dehydration that corroborated well with their perceptions. Observed significant associations between high-heat exposures and SwR (t=-2.3879, p=0.0192), inadequate toilet facilities and self-reported adverse heat-related health symptoms (χ (2)=4.03, p=0.0444), and prevalence of genitourinary issues (χ (2)=42.92, p=0.0005×10(-7)) reemphasize that heat is a risk and lack of sanitation facilities is a major health concern for women workers. The preliminary evidence suggests that health of women workers is at risk due to occupational heat exposures and inadequate sanitation facilities at many Indian workplaces. Intervention through strong labor policies with gender sensitivity is the need of the hour to empower women, avert further health risks, and

How many medical requests for US, body CT, and musculoskeletal MR exams in outpatients are inadequate?

International Nuclear Information System (INIS)

Sardanelli, Francesco; Aliprandi, Alberto; Fausto, Alfonso

2005-01-01

Purpose: Our aim was to evaluate how many medical requests for US, CT and MR outpatients exams are inadequate. Materials and methods: We evaluated three series of consecutive requests for outpatients exams, distinguishing firstly the adequate from the inadequate requests. The inadequate requests were classified as: (A) absence of real indication; (B) lacking or vague clinical query; (C) absence of important information on patient's status. US requests concerned 282 patients for 300 body segments, as follows: neck (n=50); upper abdomen (n=95); lower abdomen (n=12); upper and lower abdomen (n=84); musculoskeletal (n=32); other body segments (n=27). CT requests concerned 280 patients for 300 body segments, as follows: chest (n=67); abdomen (n=77); musculoskeletal (n=94); other body segments (n=62). MR musculoskeletal requests concerned 138 patients for 150 body segments, as follows: knee (n=87); ankle (n=13); shoulder (n=28); other body segments (n=22). Results: A total of 228/300 US requests (76%) were inadequate, ranging from 66% (musculoskeletal) to 86% (neck) classified as: A, 21/228 (9%); B, 130/228 (57%); C, 77/228 (34%). A total of 231/300 (77%) body CT request were inadequate, ranging from 72% (chest) to 86% (musculoskeletal), classified as: A, 22/231 (10%); B, 88/231 (38%); C, 121/231 (52%). A total of 124/150 (83%) MR musculoskeletal requests were inadequate, ranging from 69% (ankle) to 89% (knee), classified as: A, 12/124 (10%); B, 50/124 (40%); C, 62/124 (50%). No significant difference was found among the levels of inadequacy for the three techniques and among the body segments for each of the three techniques. Conclusions: The majority of the medical requests for outpatients exams turned out to be inadequate. A large communication gap between referring physicians and radiologists needs to be filled [it

Consequences of Inadequate Staffing Include Missed Care, Potential Failure to Rescue, and Job Stress and Dissatisfaction.

Science.gov (United States)

Simpson, Kathleen Rice; Lyndon, Audrey; Ruhl, Catherine

2016-01-01

To evaluate responses of registered nurse members of the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) to a survey that sought their recommendations for staffing guidelines and their perceptions of the consequences of inadequate nurse staffing. The goal was to use these member data to inform the work of the AWHONN nurse staffing research team. Secondary analysis of responses to the 2010 AWHONN nurse staffing survey. Online. AWHONN members (N = 884). Review of data from an online survey of AWHONN members through the use of thematic analysis for descriptions of the consequences of inadequate nurse staffing during the childbirth process. Three main themes emerged as consequences of inadequate staffing or being short-staffed: Missed Care, Potential for Failure to Rescue, and Job-Related Stress and Dissatisfaction. These themes are consistent with those previously identified in the literature related to inadequate nurse staffing. Based on the responses from participants in the 2010 AWHONN nurse staffing survey, consequences of inadequate staffing can be quite serious and may put patients at risk for preventable harm. Copyright © 2016 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

Fire protection for telecommunications central offices

International Nuclear Information System (INIS)

McKenna, L.A. Jr.

1990-01-01

The provision of continuous, uninterrupted telecommunications service is vital to modern life. In order to provide uninterrupted service to customers, a service continuity program has been in place with AT and T for many years. This program integrates many different protection strategies and plans, each designed to mitigate one of the many threats to service continuity. The fire protection program implemented within AT and T is a part of this service continuity program. In the design of this program, a number of unusual problems had to be addressed due to the service continuity requirements. Typical solutions to fire protection problems (ignition prevention, detection, and suppression) which are embodied in building and fire prevention codes are inadequate to provide service continuity. This presentation outlines the basic arrangement of a telecommunications central office, the specific fire protection problems encountered, the fire protection philosophy developed through the use of a systems approach, and the implementation of the fire protection program. Special emphasis is placed on the strategies employed in lieu of more traditional fire protection schemes and the stimuli for selecting them

Advanced worker protection system

Energy Technology Data Exchange (ETDEWEB)

Caldwell, B.; Duncan, P.; Myers, J. [Oceaneering Space Systems, Houston, TX (United States)

1995-10-01

The Department of Energy (DOE) is in the process of defining the magnitude and diversity of Decontamination and Decommissioning (D&D) obligations at its numerous sites. The DOE believes that existing technologies are inadequate to solve many challenging problems such as how to decontaminate structures and equipment cost effectively, what to do with materials and wastes generated, and how to adequately protect workers and the environment. Preliminary estimates show a tremendous need for effective use of resources over a relatively long period (over 30 years). Several technologies are being investigated which can potentially reduce D&D costs while providing appropriate protection to DOE workers. The DOE recognizes that traditional methods used by the EPA in hazardous waste site clean up activities are insufficient to provide the needed protection and worker productivity demanded by DOE D&D programs. As a consequence, new clothing and equipment which can adequately protect workers while providing increases in worker productivity are being sought for implementation at DOE sites. This project describes the development of an Advanced Worker Protection System (AWPS) which will include a life-support backpack with liquid air for cooling and as a supply of breathing gas, protective clothing, respirators, communications, and support equipment.

Advanced worker protection system

International Nuclear Information System (INIS)

Caldwell, B.; Duncan, P.; Myers, J.

1995-01-01

The Department of Energy (DOE) is in the process of defining the magnitude and diversity of Decontamination and Decommissioning (D ampersand D) obligations at its numerous sites. The DOE believes that existing technologies are inadequate to solve many challenging problems such as how to decontaminate structures and equipment cost effectively, what to do with materials and wastes generated, and how to adequately protect workers and the environment. Preliminary estimates show a tremendous need for effective use of resources over a relatively long period (over 30 years). Several technologies are being investigated which can potentially reduce D ampersand D costs while providing appropriate protection to DOE workers. The DOE recognizes that traditional methods used by the EPA in hazardous waste site clean up activities are insufficient to provide the needed protection and worker productivity demanded by DOE D ampersand D programs. As a consequence, new clothing and equipment which can adequately protect workers while providing increases in worker productivity are being sought for implementation at DOE sites. This project describes the development of an Advanced Worker Protection System (AWPS) which will include a life-support backpack with liquid air for cooling and as a supply of breathing gas, protective clothing, respirators, communications, and support equipment

Factors associated with an inadequate hypoglycemia in the insulin tolerance test in Japanese patients with suspected or proven hypopituitarism.

Science.gov (United States)

Takahashi, Kiyohiko; Nakamura, Akinobu; Miyoshi, Hideaki; Nomoto, Hiroshi; Kameda, Hiraku; Cho, Kyu Yong; Nagai, So; Shimizu, Chikara; Taguri, Masataka; Terauchi, Yasuo; Atsumi, Tatsuya

2017-04-29

We attempted to identify the predictors of an inadequate hypoglycemia in insulin tolerance test (ITT), defined as a blood glucose level higher than 2.8 mmol/L after insulin injection, in Japanese patients with suspected or proven hypopituitarism. A total of 78 patients who had undergone ITT were divided into adequate and inadequate hypoglycemia groups. The relationships between the subjects' clinical parameters and inadequate hypoglycemia in ITT were analyzed. Stepwise logistic regression analysis identified high systolic blood pressure (SBP) and high homeostasis model assessment of insulin resistance (HOMA-IR) as being independent factors associated with inadequate hypoglycemia in ITT. Receiver operating characteristic (ROC) curve analysis revealed the cutoff value for inadequate hypoglycemia was 109 mmHg for SBP and 1.4 for HOMA-IR. The areas under ROC curve for SBP and HOMA-IR were 0.72 and 0.86, respectively. We confirmed that high values of SBP and HOMA-IR were associated with inadequate hypoglycemia in ITT, regardless of the degree of reduction of pituitary hormone levels. Furthermore, the strongest predictor of inadequate hypoglycemia was obtained by using the cutoff value of HOMA-IR. Our results suggest that HOMA-IR is a useful pre-screening tool for ITT in these populations.

Parenting and the workplace: The construction of parenting protections in United States law

OpenAIRE

Eichner Maxine

2008-01-01

Abstract In this paper, I discuss the shortcomings of the legal protections that exist for pregnancy, breastfeeding, and parenting for United States' workers. The two main sources of protection for pregnancy and parenting in United States employment law are the Pregnancy Discrimination Act (PDA) and the Family and Medical Leave Act (FMLA). Both, I argue, contain inadequate protections for the needs of pregnant women and breastfeeding mothers, as well as their infants. I consider what it is ab...

Racial and Social Class Differences in How Parents Respond to Inadequate Achievement: Consequences for Children's Future Achievement.

Science.gov (United States)

Robinson, Keith; Harris, Angel L

2013-12-01

Despite numerous studies on parental involvement in children's academic schooling, there is a dearth of knowledge on how parents respond specifically to inadequate academic performance. This study examines whether 1) racial differences exist in parenting philosophy for addressing inadequate achievement, 2) social class has implications for parenting philosophy, and 3) parents' philosophies are consequential for children's academic achievement. Using data from the Child Development Supplement (N=1041) to the Panel Study of Income Dynamics, we sort parents into two categories-those whose parenting repertoires for addressing poor achievement include punitive responses and those whose repertoires do not. We then determine whether racial differences exist between these categories and how various responses within the aforementioned categories are related to students' academic achievement. The findings show that white and black parents have markedly different philosophies on how to respond to inadequate performance, and these differences appear to impact children's achievement in dramatically different ways. Educators and policy makers should pay particular attention to how parents respond to inadequate achievement as imploring parents of inadequately performing students to be more involved without providing them with some guidance might exacerbate the problem.

Heat stress and inadequate sanitary facilities at workplaces – an occupational health concern for women?

Science.gov (United States)

Venugopal, Vidhya; Rekha, Shanmugam; Manikandan, Krishnamoorthy; Latha, Perumal Kamalakkannan; Vennila, Viswanathan; Ganesan, Nalini; Kumaravel, Perumal; Chinnadurai, Stephen Jeremiah

2016-01-01

Background Health concerns unique to women are growing with the large number of women venturing into different trades that expose them to hot working environments and inadequate sanitation facilities, common in many Indian workplaces. Objective The study was carried out to investigate the health implications of exposures to hot work environments and inadequate sanitation facilities at their workplaces for women workers. Design A cross-sectional study was conducted with 312 women workers in three occupational sectors in 2014–2015. Quantitative data on heat exposures and physiological heat strain indicators such as core body temperature (CBT), sweat rate (SwR), and urine specific gravity (USG) were collected. A structured questionnaire captured workers perceptions about health impacts of heat stress and inadequate sanitary facilities at the workplace. Results Workplace heat exposures exceeded the threshold limit value for safe manual work for 71% women (Avg. wet bulb globe temperature=30°C±2.3°C) during the study period. Eighty-seven percent of the 200 women who had inadequate/no toilets at their workplaces reported experiencing genitourinary problems periodically. Above normal CBT, SwR, and USG in about 10% women workers indicated heat strain and moderate dehydration that corroborated well with their perceptions. Observed significant associations between high-heat exposures and SwR (t=−2.3879, p=0.0192), inadequate toilet facilities and self-reported adverse heat-related health symptoms (χ2=4.03, p=0.0444), and prevalence of genitourinary issues (χ2=42.92, p=0.0005×10−7) reemphasize that heat is a risk and lack of sanitation facilities is a major health concern for women workers. Conclusions The preliminary evidence suggests that health of women workers is at risk due to occupational heat exposures and inadequate sanitation facilities at many Indian workplaces. Intervention through strong labor policies with gender sensitivity is the need of the hour to

Heat stress and inadequate sanitary facilities at workplaces – an occupational health concern for women?

Directory of Open Access Journals (Sweden)

Vidhya Venugopal

2016-09-01

Full Text Available Background: Health concerns unique to women are growing with the large number of women venturing into different trades that expose them to hot working environments and inadequate sanitation facilities, common in many Indian workplaces. Objective: The study was carried out to investigate the health implications of exposures to hot work environments and inadequate sanitation facilities at their workplaces for women workers. Design: A cross-sectional study was conducted with 312 women workers in three occupational sectors in 2014–2015. Quantitative data on heat exposures and physiological heat strain indicators such as core body temperature (CBT, sweat rate (SwR, and urine specific gravity (USG were collected. A structured questionnaire captured workers perceptions about health impacts of heat stress and inadequate sanitary facilities at the workplace. Results: Workplace heat exposures exceeded the threshold limit value for safe manual work for 71% women (Avg. wet bulb globe temperature=30°C±2.3°C during the study period. Eighty-seven percent of the 200 women who had inadequate/no toilets at their workplaces reported experiencing genitourinary problems periodically. Above normal CBT, SwR, and USG in about 10% women workers indicated heat strain and moderate dehydration that corroborated well with their perceptions. Observed significant associations between high-heat exposures and SwR (t=−2.3879, p=0.0192, inadequate toilet facilities and self-reported adverse heat-related health symptoms (χ2=4.03, p=0.0444, and prevalence of genitourinary issues (χ2=42.92, p=0.0005×10−7 reemphasize that heat is a risk and lack of sanitation facilities is a major health concern for women workers. Conclusions: The preliminary evidence suggests that health of women workers is at risk due to occupational heat exposures and inadequate sanitation facilities at many Indian workplaces. Intervention through strong labor policies with gender sensitivity is the

Inadequate control of world's radioactive sources

International Nuclear Information System (INIS)

2002-01-01

The radioactive materials needed to build a 'dirty bomb' can be found in almost any country in the world, and more than 100 countries may have inadequate control and monitoring programs necessary to prevent or even detect the theft of these materials. The IAEA points out that while radioactive sources number in the millions, only a small percentage have enough strength to cause serious radiological harm. It is these powerful sources that need to be focused on as a priority. In a significant recent development, the IAEA, working in collaboration with the United States Department of Energy (DOE) and the Russian Federation's Ministry for Atomic Energy (MINATOM), have established a tripartite working group on 'Securing and Managing Radioactive Sources'. Through its program to help countries improve their national infrastructures for radiation safety and security, the IAEA has found that more than 100 countries may have no minimum infrastructure in place to properly control radiation sources. However, many IAEA Member States - in Africa, Asia, Latin America, and Europe - are making progress through an IAEA project to strengthen their capabilities to control and regulate radioactive sources. The IAEA is also concerned about the over 50 countries that are not IAEA Member States (there are 134), as they do not benefit from IAEA assistance and are likely to have no regulatory infrastructure. The IAEA has been active in lending its expertise to search out and secure orphaned sources in several countries. More than 70 States have joined with the IAEA to collect and share information on trafficking incidents and other unauthorized movements of radioactive sources and other radioactive materials. The IAEA and its Member States are working hard to raise levels of radiation safety and security, especially focusing on countries known to have urgent needs. The IAEA has taken the leading role in the United Nations system in establishing standards of safety, the most significant of

Predicting Patients with Inadequate 24- or 48-Hour Urine Collections at Time of Metabolic Stone Evaluation.

Science.gov (United States)

McGuire, Barry B; Bhanji, Yasin; Sharma, Vidit; Frainey, Brendan T; McClean, Megan; Dong, Caroline; Rimar, Kalen; Perry, Kent T; Nadler, Robert B

2015-06-01

We aimed to understand the characteristics of patients who are less likely to submit adequate urine collections at metabolic stone evaluation. Inadequate urine collection was defined using two definitions: (1) Reference ranges for 24-hour creatinine/kilogram (Cr/24) and (2) discrepancy in total 24-hour urine Cr between 24-hour urine collections. There were 1502 patients with ≥1 kidney stone between 1998 and 2014 who performed a 24- or 48-hour urine collection at Northwestern Memorial Hospital and who were identified retrospectively. Multivariate analysis was performed to analyze predictor variables for adequate urine collection. A total of 2852 urine collections were analyzed. Mean age for males was 54.4 years (range 17-86), and for females was 50.2 years (range 8-90). One patient in the study was younger than 17 years old. (1) Analysis based on the Cr 24/kg definition: There were 50.7% of patients who supplied an inadequate sample. Females were nearly 50% less likely to supply an adequate sample compared with men, Pcollections were achieved in 82.8%, 66.9%, 51.7%, 38.5%, and 26.4% of patients, respectively. Statistical significance was observed based on differences of ≥40%, and this was defined as the threshold for an inadequate sample. Female sex (OR 0.73 [0.54-0.98], P=0.037) predicted supplying inadequate samples. Adequate collections were more likely to be received on a Sunday (OR 1.6 [1.03-2.58], P=0.038) and by sedentary workers (OR 2.3 [1.12-4.72], P=0.023). Urine collections from patients during metabolic evaluation for nephrolithiasis may be considered inadequate based on two commonly used clinical definitions. This may have therapeutic or economic ramifications and the propensity for females to supply inadequate samples should be investigated further.

Inadequate Evidence for Multiple Intelligences, Mozart Effect, and Emotional Intelligence Theories

Science.gov (United States)

Waterhouse, Lynn

2006-01-01

I (Waterhouse, 2006) argued that, because multiple intelligences, the Mozart effect, and emotional intelligence theories have inadequate empirical support and are not consistent with cognitive neuroscience findings, these theories should not be applied in education. Proponents countered that their theories had sufficient empirical support, were…

Eye protection practices and symptoms among welders in the Limpopo Province of South Africa+

Directory of Open Access Journals (Sweden)

H. L. Sithole

2009-12-01

though the majority of the welders wore protective devices while welding, a few did not always use such devices while others used sunglasses for protection.  Moreover, many of the welders were occasionally, and only a few were always, exposed to welding flashes when protective devices were not used. Therefore, we concluded that eye protectionpractices amongst the welders appeared to be inadequate to avoid hazards associated with welding.  It is recommended that an eye protection educational campaign for welders should form part of the SouthAfrican Government’s workplace safety program.

Sun protection counseling by pediatricians has little effect on parent and child sun protection behavior.

Science.gov (United States)

Cohen, Liza; Brown, Judith; Haukness, Heather; Walsh, Lori; Robinson, June K

2013-02-01

To compare counseling concerning sun protection and outdoor exercise with the parent's report of the behavior of a child aged 9-16 years old. Structured interviews of medical personnel in 3 Chicago area practices elicited information about counseling methods and recommendations. In each practice, a convenience sample of parents completed a self-reported survey of their and their child's behavior. Sun protection counseling occurred more frequently than exercise counseling in all practices (P = .014). Sun protection counseling was associated with parental prompting (P = .004), performing a summer camp physical (P = .002), and the child having a sunburn (P = .003). After controlling for the child's age, sex, and skin tone, sun protection counseling was not associated with the child's use of sun protection. In multivariate analysis of the child's sun protection behavior, parental sunburns, indoor tanning in the last 12 months, perception of skin cancer risk, and sun protection self-efficacy were significant (P = .02). Children who pursued outdoor sports were twice as likely to use inadequate sun protection and sustain sunburns (CI 1.3-1.7). The child's sun protection behavior was influenced by parental sun protection, parental perception of skin cancer risk, and parental sun protection self-efficacy; therefore, sun protection for children needs to be aimed at parents as well as children. Communication with parents in a way that incorporates the principles of motivational interviewing may be more effective in promoting behavioral change than admonitions to use sunscreen. Copyright © 2013 Mosby, Inc. All rights reserved.

Inadequate pelvic radiographs: implications of not getting it right the first time.

Science.gov (United States)

Parker, S; Nagra, N S; Kulkarni, K; Pegrum, J; Barry, S; Hughes, R; Ghani, Y

2017-09-01

Introduction Pelvic radiography is a frequent investigation. European guidelines aim to ensure appropriate use and adequate quality. When initial images are inadequate, repeat radiographs are often required, which may have significant patient safety and economic implications. Objectives The study aimed to assess the adequacy of pelvic imaging across three orthopaedic centres, to identify causes for inadequate imaging and to establish the cost of inadequate imaging from financial and patient safety perspectives. Methods Pelvic radiographs were identified on Picture Archiving and Communication System software at three UK hospitals. Radiographs were assessed against European guidelines and indications for repeat imaging were analysed. Results A total of 1,531 sequential pelvic radiographs were reviewed. The mean age of patients was 60 years (range 5 months to 101 years). Of this total, 51.9% of images were suboptimal, with no significant difference across the three hospitals (P > 0.05). Hospital 3 repeated radiographs in 6.3% of cases, compare with 18.1% and 19.7% at hospitals 1 and 2, respectively (P > 0.05). Hospital 3 identified pathology missed on the initial radiograph in 1% of cases, compared with 5.4% and 5.5% at hospitals 1 and 2, respectively (P > 0.05). Out-of-hours imaging is associated with a higher rate of suboptimal quality (69.1%) compared with normal working hours (51.3%; P = 0.006). Adequacy rates vary with age (χ 2 = 43.62, P hours imaging.

Estimating the global prevalence of inadequate zinc intake from national food balance sheets: effects of methodological assumptions.

Directory of Open Access Journals (Sweden)

K Ryan Wessells

Full Text Available The prevalence of inadequate zinc intake in a population can be estimated by comparing the zinc content of the food supply with the population's theoretical requirement for zinc. However, assumptions regarding the nutrient composition of foods, zinc requirements, and zinc absorption may affect prevalence estimates. These analyses were conducted to: (1 evaluate the effect of varying methodological assumptions on country-specific estimates of the prevalence of dietary zinc inadequacy and (2 generate a model considered to provide the best estimates.National food balance data were obtained from the Food and Agriculture Organization of the United Nations. Zinc and phytate contents of these foods were estimated from three nutrient composition databases. Zinc absorption was predicted using a mathematical model (Miller equation. Theoretical mean daily per capita physiological and dietary requirements for zinc were calculated using recommendations from the Food and Nutrition Board of the Institute of Medicine and the International Zinc Nutrition Consultative Group. The estimated global prevalence of inadequate zinc intake varied between 12-66%, depending on which methodological assumptions were applied. However, country-specific rank order of the estimated prevalence of inadequate intake was conserved across all models (r = 0.57-0.99, P<0.01. A "best-estimate" model, comprised of zinc and phytate data from a composite nutrient database and IZiNCG physiological requirements for absorbed zinc, estimated the global prevalence of inadequate zinc intake to be 17.3%.Given the multiple sources of uncertainty in this method, caution must be taken in the interpretation of the estimated prevalence figures. However, the results of all models indicate that inadequate zinc intake may be fairly common globally. Inferences regarding the relative likelihood of zinc deficiency as a public health problem in different countries can be drawn based on the country

Evidence Report: Risk of Inadequate Human-Computer Interaction

Science.gov (United States)

Holden, Kritina; Ezer, Neta; Vos, Gordon

2013-01-01

Human-computer interaction (HCI) encompasses all the methods by which humans and computer-based systems communicate, share information, and accomplish tasks. When HCI is poorly designed, crews have difficulty entering, navigating, accessing, and understanding information. HCI has rarely been studied in an operational spaceflight context, and detailed performance data that would support evaluation of HCI have not been collected; thus, we draw much of our evidence from post-spaceflight crew comments, and from other safety-critical domains like ground-based power plants, and aviation. Additionally, there is a concern that any potential or real issues to date may have been masked by the fact that crews have near constant access to ground controllers, who monitor for errors, correct mistakes, and provide additional information needed to complete tasks. We do not know what types of HCI issues might arise without this "safety net". Exploration missions will test this concern, as crews may be operating autonomously due to communication delays and blackouts. Crew survival will be heavily dependent on available electronic information for just-in-time training, procedure execution, and vehicle or system maintenance; hence, the criticality of the Risk of Inadequate HCI. Future work must focus on identifying the most important contributing risk factors, evaluating their contribution to the overall risk, and developing appropriate mitigations. The Risk of Inadequate HCI includes eight core contributing factors based on the Human Factors Analysis and Classification System (HFACS): (1) Requirements, policies, and design processes, (2) Information resources and support, (3) Allocation of attention, (4) Cognitive overload, (5) Environmentally induced perceptual changes, (6) Misperception and misinterpretation of displayed information, (7) Spatial disorientation, and (8) Displays and controls.

The inadequate liability and compensation regime for damage caused by nuclear activities

International Nuclear Information System (INIS)

Dyke, Jon M. Van

2010-09-01

The specific obligation to provide restitution and compensation when nuclear activities cause injuries has been recognized repeatedly and is now certainly part of customary international law. But problems remain regarding how to measure damages, how to implement the duty to repair the injuries, and what specific obligations exist to protect neighboring states from transboundary pollution. Although some treaties exist governing liability for harm resulting from nuclear accidents, they are not adequate to protect victims and have not been widely ratified. The failure to require nuclear operators to prepare for damage that may result from accidents constitutes a subsidy to the nuclear industry and makes it difficult to compare the real costs of nuclear energy with the costs of other energy sources. This survey of settled norms and unresolved issues demonstrates that further work is needed to develop a comprehensive and authoritative regime to govern harm from nuclear activities. Although it is clear that both the operators of nuclear facilities and the states that have jurisdiction over them would be responsible to provide restitution and compensation for such harm under a strict liability regime, the types of injuries that must be compensated and the range of damages that must be covered remain subjects of controversy. Although the underlying customary international law principles (the no-harm principle and the polluter-pays principle) are clear, the actual treaties that have been drafted are inadequate and they have not been widely ratified. Victims of damage from nuclear activities would have difficulty finding a neutral tribunal in which to bring their claims and would face procedural obstacles including caps on liabilities and inappropriately short statutes of limitations as well as difficulties regarding proof of damages. The failure to develop a proper regime that would ensure full restitution and compensation for harm resulting from nuclear facilities

High Prevalence of Inadequate Calcium and Iron Intakes by Mexican Population Groups as Assessed by 24-Hour Recalls.

Science.gov (United States)

Sánchez-Pimienta, Tania G; López-Olmedo, Nancy; Rodríguez-Ramírez, Sonia; García-Guerra, Armando; Rivera, Juan A; Carriquiry, Alicia L; Villalpando, Salvador

2016-09-01

A National Health and Nutrition Survey (ENSANUT) conducted in Mexico in 1999 identified a high prevalence of inadequate mineral intakes in the population by using 24-h recall questionnaires. However, the 1999 survey did not adjust for within-person variance. The 2012 ENSANUT implemented a more up-to-date 24-h recall methodology to estimate usual intake distributions and prevalence of inadequate intakes. We examined the distribution of usual intakes and prevalences of inadequate intakes of calcium, iron, magnesium, and zinc in the Mexican population in groups defined according to sex, rural or urban area, geographic region of residence, and socioeconomic status (SES). We used dietary intake data obtained through the 24-h recall automated multiple-pass method for 10,886 subjects as part of ENSANUT 2012. A second measurement on a nonconsecutive day was obtained for 9% of the sample. Distributions of usual intakes of the 4 minerals were obtained by using the Iowa State University method, and the prevalence of inadequacy was estimated by using the Institute of Medicine's Estimated Average Requirement cutoff. Calcium inadequacy was 25.6% in children aged 1-4 y and 54.5-88.1% in subjects >5 y old. More than 45% of subjects >5 y old had an inadequate intake of iron. Less than 5% of children aged 12 y had inadequate intakes of magnesium, whereas zinc inadequacy ranged from <10% in children aged <12 y to 21.6% in men aged ≥20 y. Few differences were found between rural and urban areas, regions, and tertiles of SES. Intakes of calcium, iron, magnesium, and zinc are inadequate in the Mexican population, especially among adolescents and adults. These results suggest a public health concern that must be addressed. © 2016 American Society for Nutrition.

Inadequate Gestational Weight Gain Predicts Adverse Pregnancy Outcomes in Mothers with Inflammatory Bowel Disease: Results from a Prospective US Pregnancy Cohort.

Science.gov (United States)

Bengtson, May-Bente; Martin, Christopher F; Aamodt, Geir; Vatn, Morten H; Mahadevan, Uma

2017-08-01

Malnutrition and weight loss are common features of patients with inflammatory bowel disease (IBD). To explore the impact of inadequate gestational weight gain (GWG) on adverse outcomes among IBD mothers in the prospective US pregnancy in Inflammatory Bowel Disease and Neonatal Outcomes (PIANO) cohort. The PIANO cohort comprises 559 and 363 pregnant mothers with Crohn's disease (CD) and ulcerative colitis (UC), respectively, enrolled between 2006 and 2014. The mothers were followed during and after pregnancy to ascertain medication, measurement of disease activity and complications during pregnancy and at delivery. Inadequate GWG was based on US Institute of Medicine recommendations. The associations between inadequate GWG and adverse pregnancy outcomes in maternal IBD were analyzed, adjusted for diabetes, hypertension, smoking, maternal age, education, and disease activity. Maternal CD and UC with inadequate GWG had a 2.5-fold increased risk of preterm birth (OR 2.5, CI 1.3, 4.9 and OR 2.5, CI 1.2, 5.6). Furthermore, an increased risk of intrauterine growth restriction and a trend for small for gestational age were demonstrated in CD but not in UC (OR 3.3, CI 1.1, 10.0, OR 4.5, CI 0.8, 24.3, p = 0.08). Flares increased risk of inadequate GWG (OR 1.6, CI 1.2, 2.3, p = 0.002) but did not change the associations between inadequate GWG and adverse pregnancy outcomes in our models. The US PIANO cohort demonstrated that inadequate GWG was a strong independent predictor of adverse pregnancy outcomes in IBD mothers.

Factors associated with inadequate receipt of components and use of antenatal care services in Nigeria: a population-based study.

Science.gov (United States)

Agho, Kingsley E; Ezeh, Osita K; Ogbo, Felix A; Enoma, Anthony I; Raynes-Greenow, Camille

2018-05-01

Antenatal care (ANC) is an essential intervention to improve maternal and child health. In Nigeria, no population-based studies have investigated predictors of poor receipt of components and uptake of ANC at the national level to inform targeted maternal health initiatives. This study aimed to examine factors associated with inadequate receipt of components and use of ANC in Nigeria. The study used information on 20 405 singleton live-born infants of the mothers from the 2013 Nigeria Demographic and Health Survey. Multivariable logistic regression analyses that adjusted for cluster and survey weights were used to determine potential factors associated with inadequate receipt of components and use of ANC. The prevalence of underutilization and inadequate components of ANC were 47.5% (95% CI: 45.2 to 49.9) and 92.6% (95% CI: 91.8 to 93.2), respectively. Common risk factors for underutilization and inadequate components of ANC in Nigeria included residence in rural areas, no maternal education, maternal unemployment, long distance to health facilities and less maternal exposure to the media. Other risk factors for underutilization of ANC were home births and low household wealth. The study suggests that underutilization and inadequate receipt of the components of ANC were associated with amenable factors in Nigeria. Subsidized maternal services and well-guided health educational messages or financial support from the government will help to improve uptake of ANC services.

Advanced worker protection system

International Nuclear Information System (INIS)

Caldwell, B.; Duncan, P.; Myers, J.

1995-01-01

The Department of Energy (DOE) is in the process of defining the magnitude and diversity of Decontamination and Decommissioning (D ampersand D) obligations at its numerous sites. The DOE believes that existing technologies are inadequate to solve many challenging problems such as how to decontaminate structures and equipment cost effectively, what to do with materials and wastes generated, and how to adequately protect workers and the environment. Preliminary estimates show a tremendous need for effective use of resources over a relatively long period (over 30 years). Several technologies are being investigated which can potentially reduce D ampersand D costs while providing appropriate protection to DOE workers. The DOE recognizes that traditional methods used by the EPA in hazardous waste site clean up activities are insufficient to provide the needed protection and worker productivity demanded by DOE D ampersand D programs. As a consequence, new clothing and equipment which can adequately protect workers while providing increases in worker productivity are being sought for implementation at DOE sites. This project will result in the development of an Advanced Worker Protection System (AWPS). The AWPS will be built around a life support backpack that uses liquid air to provide cooling as well as breathing gas to the worker. The backpack will be combined with advanced protective garments, advanced liquid cooling garment, respirator, communications, and support equipment to provide improved worker protection, simplified system maintenance, and dramatically improve worker productivity through longer duration work cycles. Phase I of the project has resulted in a full scale prototype Advanced Worker Protection Ensemble (AWPE, everything the worker will wear), with sub-scale support equipment, suitable for integrated testing and preliminary evaluation. Phase II will culminate in a full scale, certified, pre-production AWPS and a site demonstration

Advanced worker protection system

Energy Technology Data Exchange (ETDEWEB)

Caldwell, B.; Duncan, P.; Myers, J.

1995-12-01

The Department of Energy (DOE) is in the process of defining the magnitude and diversity of Decontamination and Decommissioning (D&D) obligations at its numerous sites. The DOE believes that existing technologies are inadequate to solve many challenging problems such as how to decontaminate structures and equipment cost effectively, what to do with materials and wastes generated, and how to adequately protect workers and the environment. Preliminary estimates show a tremendous need for effective use of resources over a relatively long period (over 30 years). Several technologies are being investigated which can potentially reduce D&D costs while providing appropriate protection to DOE workers. The DOE recognizes that traditional methods used by the EPA in hazardous waste site clean up activities are insufficient to provide the needed protection and worker productivity demanded by DOE D&D programs. As a consequence, new clothing and equipment which can adequately protect workers while providing increases in worker productivity are being sought for implementation at DOE sites. This project will result in the development of an Advanced Worker Protection System (AWPS). The AWPS will be built around a life support backpack that uses liquid air to provide cooling as well as breathing gas to the worker. The backpack will be combined with advanced protective garments, advanced liquid cooling garment, respirator, communications, and support equipment to provide improved worker protection, simplified system maintenance, and dramatically improve worker productivity through longer duration work cycles. Phase I of the project has resulted in a full scale prototype Advanced Worker Protection Ensemble (AWPE, everything the worker will wear), with sub-scale support equipment, suitable for integrated testing and preliminary evaluation. Phase II will culminate in a full scale, certified, pre-production AWPS and a site demonstration.

Inadequate management of pregnancy-associated listeriosis: lessons from four case reports.

Science.gov (United States)

Charlier, C; Goffinet, F; Azria, E; Leclercq, A; Lecuit, M

2014-03-01

Listeria monocytogenes infection during pregnancy can lead to dramatic fetal or neonatal outcomes. No clinical trial has evaluated treatment options, and retrospective studies of cases are therefore important to define optimal regimens. We report four cases of materno-neonatal listeriosis illustrating inadequate antimicrobial therapy management and discuss recommended treatment options. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

Parenting and the workplace: the construction of parenting protections in United States law.

Science.gov (United States)

Eichner, Maxine

2008-08-04

In this paper, I discuss the shortcomings of the legal protections that exist for pregnancy, breastfeeding, and parenting for United States' workers. The two main sources of protection for pregnancy and parenting in United States employment law are the Pregnancy Discrimination Act (PDA) and the Family and Medical Leave Act (FMLA). Both, I argue, contain inadequate protections for the needs of pregnant women and breastfeeding mothers, as well as their infants. I consider what it is about the way these statutes conceptualize the needs of pregnant women, mothers, and their babies, that prevents more robust protection of their needs. I then compare the minimal protection afforded American women and families with more progressive policies in other countries to highlight the possibilities that arise when the state affirmatively supports working parents and their children.

Human resources of local governments as motivators of participation of businesses and citizens in protecting of environment

OpenAIRE

NIKOLIĆ N.; GAJOVIĆ A.; PAUNOVIĆ V.

2015-01-01

This paper discusses the importance of human resources of local governments in the motivation of businesses and citizens in protecting the environment. The inability to absorb current problems caused by inadequate and incomplete arrangement of utilization of human resources of the local government of Lučani caused the redefining of strategic priorities of environmental protection. The motivational power of human resources of local governments expressed through interaction with the population ...

OCCUPATIONAL ACCIDENTS AS INDICATORS OF INADEQUATE WORK CONDITIONS AND WORK ENVIRONMENT

OpenAIRE

Petar Babović

2009-01-01

Occupational accidents due to inadequate working conditions and work environment present a major problem in highly industrialised countries, as well as in developing ones. Occupational accidents are a regular and accompanying phenomenon in all human activities and one of the main health related and economic problems in modern societies.The aim of this study is the analysis of the connections of unfavourable working conditions and working environment on occupational accidents. Occurrence of oc...

Managing inadequate responses to frontline treatment of chronic myeloid leukemia: a case-based review.

Science.gov (United States)

Bixby, Dale L

2013-05-01

The tyrosine kinase inhibitors (TKIs) imatinib, nilotinib, and dasatinib are the standard of care for treating patients with newly diagnosed chronic-phase chronic myeloid leukemia (CML). Compared with interferon-based treatment, the previous standard of care, imatinib is associated with significantly higher cytogenetic response rates and prolonged overall survival. Nilotinib and dasatinib, both newer and more potent TKIs, significantly improve cytogenetic and molecular response rates compared with imatinib. Despite significant advances in CML treatment enabled by the TKIs, a fraction of patients who receive frontline treatment with a TKI demonstrate inadequate response. The reasons for this vary, but in many cases, inadequate response can be attributed to non-adherence to the treatment regimen, intolerance to the drug, intrinsic or acquired resistance to the drug, or a combination of reasons. More often than not, strategies to improve response necessitate a change in treatment plan, either a dose adjustment or a switch to an alternate drug, particularly in the case of drug intolerance or drug resistance. Improved physician-patient communication and patient education are effective strategies to address issues relating to adherence and intolerance. Because inadequate response to TKI treatment correlates with poor long-term outcomes, it is imperative that patients who experience intolerance or who fail to achieve appropriate responses are carefully evaluated so that appropriate treatment modifications can be made to maximize the likelihood of positive long-term outcome. Copyright © 2012. Published by Elsevier Ltd.

[Small pox--infection, therapy and anaesthesiological management (part 1)].

Science.gov (United States)

Langefeld, T W; Engel, J; Menges, T; Hempelmann, G

2003-07-01

Smallpox is an acute contagious and sometimes fatal infectious disease. It is caused by the variola-virus. Smallpox is characterized by a typical disease form with a progressive distinctive skin rash, especially at face, arms and legs. Smallpox has a fatality rate of about 30 % and the therapy of infected patients is only symptomatically. As prevention the WHO initiated worldwide vaccination programs in the year 1967. The last naturally occurring case of smallpox in the world was in Somalia in 1977. Since then the only known cases of smallpox happened from an outbreak in Birmingham, England caused by a laboratory accident in the year of 1979. On May the 8 th 1980 the disease was declared as eliminated from the world by the WHO (WHO-Resolution 33.33). A natural occurrence of the variola-virus seems to be not given. Nevertheless the virus exists for research in two laboratories, the American Centers of Disease Control and Prevention in Atlanta, Georgia and in the Russian Research Center for Virology and Biotechnics in Kolzowo, Sibiria. Threatening infections with smallpox or other microorganisms, used as bioweapons, get a new dimension through global terrorism. The variola-virus represents an optimal candidate for bioweapons. It is easy to replicate, it is highly contagious and the transmission over aerosol or direct contact from man to man is easy to handle. After the disease was eliminated from the world, routine vaccination among general public was stopped. Therefore younger people don't possess any vaccination protection. Older formerly vaccinated people probably have only a non-sufficient protection. Because of the smallpox elimination a lot of physicians have no experience with this disease. An outbreak of this smallpox isn't only controlled by new vaccination. In our times we need adapted prevention-standards, pox-alarm plans and quarantine standards.

Randomized Trial of Once-Daily Fluticasone Furoate in Children with Inadequately Controlled Asthma

DEFF Research Database (Denmark)

Oliver, Amanda J.; Covar, Ronina A.; Goldfrad, Caroline H.

2016-01-01

Objective To evaluate the dose-response, efficacy, and safety of fluticasone furoate (FF; 25 µg, 50 µg, and 100 µg), administered once daily in the evening during a 12-week treatment period to children with inadequately controlled asthma. Study design This was a Phase IIb, multicenter, stratified...

Parenting and the workplace: The construction of parenting protections in United States law

Directory of Open Access Journals (Sweden)

Eichner Maxine

2008-08-01

Full Text Available Abstract In this paper, I discuss the shortcomings of the legal protections that exist for pregnancy, breastfeeding, and parenting for United States' workers. The two main sources of protection for pregnancy and parenting in United States employment law are the Pregnancy Discrimination Act (PDA and the Family and Medical Leave Act (FMLA. Both, I argue, contain inadequate protections for the needs of pregnant women and breastfeeding mothers, as well as their infants. I consider what it is about the way these statutes conceptualize the needs of pregnant women, mothers, and their babies, that prevents more robust protection of their needs. I then compare the minimal protection afforded American women and families with more progressive policies in other countries to highlight the possibilities that arise when the state affirmatively supports working parents and their children.

Inadequate ventilation for nosocomial tuberculosis prevention in public hospitals in Central Thailand.

Science.gov (United States)

Jiamjarasrangsi, W; Bualert, S; Chongthaleong, A; Chaindamporn, A; Udomsantisuk, N; Euasamarnjit, W

2009-04-01

Forty-two community and general hospitals in central Thailand. To examine the adequacy of indoor ventilation for nosocomial tuberculosis (TB) prevention in public hospitals in central Thailand. A cross-sectional survey was conducted among 323 patient care and ancillary areas in the target hospitals. Data on indoor ventilation rate were collected by the tracer gas method and reported as air changes per hour (ACH). The adequacy of the measured ventilation rates were then determined by comparison with the international recommended standard values. Indoor ventilation rates were inadequate in almost half of the studied areas (144/323, 44.6%). The inadequacy was particularly serious in the emergency rooms (ERs) and radiological areas, where 73.8% (31/42 each) of the rooms had ACH below the recommended standards. Detailed analysis showed that most of the rooms with natural ventilation had air exchange rates that exceeded the recommended standards, while the opposite was the case for rooms with air-conditioning, particularly the window or wall-mount type. Indoor ventilation in high-risk nosocomial TB areas in public hospitals in Thailand was inadequate due to the installation of air-conditioning systems in modern buildings.

Household Response to Inadequate Sewerage and Garbage Collection Services in Abuja, Nigeria.

Science.gov (United States)

Abubakar, Ismaila Rimi

2017-01-01

Provision of sanitation and garbage collection services is an important and yet challenging issue in the rapidly growing cities of developing countries, with significant human health and environmental sustainability implications. Although a growing number of studies have investigated the consequences of inadequate delivery of basic urban services in developing countries, few studies have examined how households cope with the problems. Using the Exit, Voice, Loyalty, and Neglect (EVLN) model, this article explores how households respond to inadequate sewerage and garbage collection services in Abuja, Nigeria. Based on a qualitative study, data were gathered from in-depth interviews with sixty households, complemented with personal observation. The findings from grounded analysis indicated that majority (62%) and about half (55%) of the respondents have utilized the informal sector for sewerage services and garbage collection, respectively, to supplement the services provided by the city. While 68% of the respondents reported investing their personal resources to improve the delivery of existing sewerage services, half (53%) have collectively complained to the utility agency and few (22%) have neglected the problems. The paper concludes by discussing the public health and environmental sustainability implications of the findings.

The Impact of Child, Family, and Child Protective Services Factors on Reports of Child Sexual Abuse Recurrence

Science.gov (United States)

Sinanan, Allison N.

2011-01-01

This study identified selected child factors (e.g., age, gender, race/ethnicity, disabilities, prior victimization, and relationship to perpetrator of abuse), family risk factors (e.g., substance abuse, domestic violence, inadequate housing, and financial problems), and services provided by child protective services that likely increased reports…

Effect of inadequate ferrule segment location on fracture resistance of endodontically treated teeth

Directory of Open Access Journals (Sweden)

Satheesh B Haralur

2018-01-01

Full Text Available Introduction: The circumferential 2 mm ferrule during the fabrication of the crown is strongly advocated for the long-term clinical success. During the routine clinical practice, the dentist encounters the endodontically treated tooth (ETT with inadequacy of the ferrule in some segment due to caries, abrasion, and erosions. The aim of this in vitro study was to investigate the consequence of inadequate segmental ferrule location on fracture strength of the root canal-treated anterior and posterior teeth. Materials and Methods: Fifty each maxillary canine and mandibular premolar intact human teeth were root canal treated and sectioned at 2 mm above the cementum-enamel junction. The teeth samples were divided into 5 groups of 10 each. The G-I and G-V samples had the 360° ferrule and complete absence of the ferrule, respectively. The G-II had the inadequate ferrule on the palatal surface, while G-III and G-IV had inadequate ferrule at buccal and proximal area. Teeth samples were subsequently restored with glass-reinforced fiber post, composite core, and full veneer metal crown. The samples were tested with universal testing machine under static load to record the fracture resistance. The acquired data were subjected to ANOVA and Tukey's post hoc statistical analysis. Results: The G-I with circumferential ferrule showed the higher fracture resistance. The teeth samples with lack of the ferrule had the least fracture resistance. Among the segmental absence of ferrule, teeth samples with lack of the proximal ferrule were least affected. Deficiency of a ferrule on the lingual wall significantly affected the fracture strength in both anterior and posterior ETT. Conclusions: The ETT with sectional inadequacy of the ferrule is significantly more effective in resisting the fracture in comparison to the complete absence of the ferrule.

Protected area networks and savannah bird biodiversity in the face of climate change and land degradation.

Science.gov (United States)

Beale, Colin M; Baker, Neil E; Brewer, Mark J; Lennon, Jack J

2013-08-01

The extent to which climate change might diminish the efficacy of protected areas is one of the most pressing conservation questions. Many projections suggest that climate-driven species distribution shifts will leave protected areas impoverished and species inadequately protected while other evidence suggests that intact ecosystems within protected areas will be resilient to change. Here, we tackle this problem empirically. We show how recent changes in distribution of 139 Tanzanian savannah bird species are linked to climate change, protected area status and land degradation. We provide the first evidence of climate-driven range shifts for an African bird community. Our results suggest that the continued maintenance of existing protected areas is an appropriate conservation response to the challenge of climate and environmental change. © 2013 John Wiley & Sons Ltd/CNRS.

Risk factors for and consequences of inadequate surgical margins in oral squamous cell carcinoma

DEFF Research Database (Denmark)

Lawaetz, Mads; Homøe, Preben

2014-01-01

OBJECTIVE: The purpose of this study was to examine which factors are associated with inadequate surgical margins and to assess the postoperative consequences. STUDY DESIGN: A retrospective cohort of 110 patients with oral squamous cell carcinoma treated with surgery during a 2-year period...

76 FR 33780 - Assessments for Mismatched Payments or Inadequate Payment Information for Geothermal, Solid...

Science.gov (United States)

2011-06-09

...] Assessments for Mismatched Payments or Inadequate Payment Information for Geothermal, Solid Minerals, and...: Regulations for geothermal, solid minerals, and Indian oil and gas leases authorize the Office of Natural..., Office of Natural Resources Revenue, P.O. Box 25165, MS 61211B, Denver, Colorado 80225-0165...

Performance of the lot quality assurance sampling method compared to surveillance for identifying inadequately-performing areas in Matlab, Bangladesh.

Science.gov (United States)

Bhuiya, Abbas; Hanifi, S M A; Roy, Nikhil; Streatfield, P Kim

2007-03-01

This paper compared the performance of the lot quality assurance sampling (LQAS) method in identifying inadequately-performing health work-areas with that of using health and demographic surveillance system (HDSS) data and examined the feasibility of applying the method by field-level programme supervisors. The study was carried out in Matlab, the field site of ICDDR,B, where a HDSS has been in place for over 30 years. The LQAS method was applied in 57 work-areas of community health workers in ICDDR,B-served areas in Matlab during July-September 2002. The performance of the LQAS method in identifying work-areas with adequate and inadequate coverage of various health services was compared with those of the HDSS. The health service-coverage indicators included coverage of DPT, measles, BCG vaccination, and contraceptive use. It was observed that the difference in the proportion of work-areas identified to be inadequately performing using the LQAS method with less than 30 respondents, and the HDSS was not statistically significant. The consistency between the LQAS method and the HDSS in identifying work-areas was greater for adequately-performing areas than inadequately-performing areas. It was also observed that the field managers could be trained to apply the LQAS method in monitoring their performance in reaching the target population.

A new methodology for the assessment of hand protection from ultraviolet exposure.

Science.gov (United States)

Khazova, M; O'Hagan, J B; Grainger, K J-L

2006-01-01

A number of industrial applications and public services involve occupational exposure to ultraviolet radiation (UVR) from a variety of lamps and lasers. The aim of this study was to develop a methodology for the assessment of the UV protection level for disposable gloves. Glove UV protection factor is defined as a time-scale increase in exposure permitted for the hand protected by a glove with respect to an unprotected hand. Our study showed that for all tested gloves a change in UVR attenuation with stretching is characteristic for the type of glove material and can be included as a scaling factor in the definition of UVR protection. Glove material has a bigger effect on UVR protection level than variations in the glove thickness or its colour. Examples of assessment of the 'worst case scenario' are compared with the protection level against a number of sources, together with the guidance on a simplified evaluation protocol. An application-specific assessment, illustrated for 'SmartWater' forensic examinations and biological trans-illuminators, demonstrates that some gloves provide inadequate protection against occupational UV exposure.

Cognitive Dissonance, Confirmatory Bias and Inadequate Information Processing: Evidence from Experimental Auctions

OpenAIRE

Cao, Ying; Just, David R.; Wansink, Brian

2014-01-01

Using psychological terms such as cognitive dissonance and confirmation bias, this study reveals how individual consumers inadequately process (food safety) information, pay limited attention to signals, and make purchase decisions that are bias towards their initial choices. While it is expected that reading extra information about potential risk associated with the food decreases consumers' willingness to pay (WTP), the magnitude of the impact varies across individuals. In general, consumer...

Role of Sex and the Environment in Moderating Weight Gain Due to Inadequate Sleep.

Science.gov (United States)

Coborn, Jamie E; Houser, Monica M; Perez-Leighton, Claudio E; Teske, Jennifer A

2017-12-01

The growing prevalence of obesity, inadequate sleep and sleep disorders together with the negative impact of lack of sleep on overall health highlights the need for therapies targeted towards weight gain due to sleep loss. Sex disparities in obesity and sleep disorders are present; yet, the role of sex is inadequately addressed and thus it is unclear whether sensitivity to sleep disruption differs between men and women. Like sex, environmental factors contribute to the development of obesity and poor sleep. The obesogenic environment is characterized by easy access to palatable foods and a low demand for energy expenditure in daily activities. These and other environmental factors are discussed, as they drive altered sleep or their interaction with food choice and intake can promote obesity. We discuss data that suggest differences in sleep patterns and responses to sleep disruption influence sex disparities in weight gain, and that enviromental disturbances alter sleep and interact with features of the obesogenic environment that together promote obesity.

Inadequate Sleep and Exercise Associated with Burnout and Depression Among Medical Students.

Science.gov (United States)

Wolf, Megan R; Rosenstock, Jason B

2017-04-01

The authors studied whether low levels of exercise or inadequate sleep correlated with higher levels of burnout and depression in medical students. Medical students of all years at the University of Pittsburgh School of Medicine, Pittsburgh, PA, USA, were invited to participate in an anonymous online survey in Fall 2012 and Winter 2013. Validated measures were used to assess exercise, sleep, burnout, and depression. Response rates were 28.7 % at the beginning of the school year and 22.6 % at the middle of the school year. Burnout rates overall were 22.4 % at the beginning of the year and 19.2 % in the middle of the year. Eight percent of students screened positive for depression at the beginning of the year and 9.3 % in the middle of the year. Decreased exercise frequency was significantly correlated with lower professional efficacy. Pathological sleepiness was significantly associated with a higher prevalence of burnout. Inadequate sleep correlated with significantly lower professional efficacy and higher exhaustion scores. Burnout was associated with a positive depression screen. Positive depression screening, pathological sleepiness, and sleeping less than 7 h a night were independent predictors of burnout. Sleep habits, exercise, and a positive depression screen were associated with burnout risk within the medical student population.

IE Information Notice No. 85-75: Improperly installed instrumentation, inadequate quality control and inadequate postmodification testing

International Nuclear Information System (INIS)

Jordan, E.L.

1992-01-01

On June 10, 1985, the licensee informed the NRC Resident Inspector that for approximately 5 days LaSalle Unit 2 had been without the capability of automatic actuation of emergency core cooling (ECCS) and that for approximately 3 days during this period the plant had been without secondary containment integrity. The major cause of this condition was improper installation (the variable and reference legs were reversed) of the two reactor vessel level actuation switches which control Division 1 automatic depressurization system (ADS), low pressure core spray (LPCS), and reactor core isolation cooling (RCIC). On July 20, 1985, the Trojan Nuclear Power Plant tripped from 100% power because of a turbine trip that was caused by the loss of the unit auxiliary transformer. All systems functioned normally except that low suction pressure caused one auxiliary feedwater pump to trip and then the other auxiliary feedwater pump to trip after restart of the first auxiliary feedwater pump. The cause of the trips of the auxiliary feedwater pumps can be traced back to improper postmodification adjustment and inadequate postmodification testing following retrofit of environmentally qualified controllers for the auxiliary feedwater system. The auxiliary feedwater pump trips on low suction pressure were caused by excessive combined flow from the two auxiliary feedwater pumps that draw from a single header from the condensate storage tank. The flow control valves were open farther than required after new environmentally qualified controllers had been installed during a recent refueling outage

Healthcare professionals' perceptions on the emotional impact of having an inadequate response to antidepressant medications: survey and prospective patient audit.

Science.gov (United States)

Mago, Rajnish; Fagiolini, Andrea; Weiller, Emmanuelle; Weiss, Catherine

2018-01-01

Despite the availability of effective antidepressants, about half of patients with major depressive disorder (MDD) display an inadequate response to their initial treatment. A large patient survey recently reported that 29.8% of MDD patients experiencing an inadequate treatment response felt frustrated about their medication and 19.2% were frustrated with their healthcare provider. This survey and chart audit evaluated healthcare professionals' (HCP) views on the emotional impact of having an inadequate response to antidepressant medication. HCPs who frequently treat patients with MDD completed a survey and chart audit of their MDD patients currently experiencing an inadequate response to antidepressant treatment. 287 HCPs completed 1336 chart audits. HCPs reported that 38% of their patients were trusting/accepting of their MDD medications and 41% of their patients trusted/felt confident with their healthcare provision. Conversely, HCPs reported that 11% of their patients were frustrated with their medication and 5% with their healthcare benefits. HCPs cited impact on daily life (53%) and treatment issues (lack of efficacy and side effects; 50%) as the main drivers for their patients' feelings of frustration. When HCPs recognized patients' feelings of frustration, the top concerns of the HCPs were worsening of symptoms (43%) and non-compliance (41%). This survey and chart audit highlights the emotional burden associated with inadequate responses to MDD treatment in addition to persistent symptoms. Differences between the views of the HCPs and patients are highlighted and suggest that HCPs may underestimate the full impact that having to try numerous medications has on their patients.

25 CFR 170.811 - What happens if lack of funds results in inadequate maintenance?

Science.gov (United States)

2010-04-01

... maintenance? 170.811 Section 170.811 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM BIA Road Maintenance § 170.811 What happens if lack of funds results in inadequate maintenance? If BIA determines that an IRR transportation facility is not being...

Examining the Relationship Between Children's ADHD Symptomatology and Inadequate Parenting: The Role of Household Chaos.

Science.gov (United States)

Wirth, Andrea; Reinelt, Tilman; Gawrilow, Caterina; Schwenck, Christina; Freitag, Christine M; Rauch, Wolfgang A

2017-02-01

This study examines the interrelations of parenting practices, emotional climate, and household chaos in families with children with and without ADHD. In particular, indirect pathways from children's ADHD symptomatology to inadequate parenting and negative emotional climate via household chaos were investigated. Parenting, emotional climate, and household chaos were assessed using questionnaires and a speech sample of parents of 31 children with and 53 without ADHD, aged 7 to 13 years. Group differences were found for certain parenting dimensions, the parent-child relationship, critical comments, and household chaos. While we found significant indirect effects between children's ADHD and certain parenting dimensions through household chaos, no effects were found for any aspect of emotional climate. Children's ADHD symptoms translate into inadequate parenting through household chaos, which underlines the need for interventions to improve household organization skills in parents of children with ADHD.

Inadequate emergence after anesthesia: emergence delirium and hypoactive emergence in the Postanesthesia Care Unit.

Science.gov (United States)

Xará, Daniela; Silva, Acácio; Mendonça, Júlia; Abelha, Fernando

2013-09-01

To evaluate the frequency, determinants, and outcome of inadequate emergence after elective surgery in the Postanesthesia Care Unit (PACU). Prospective observational study. 12-bed PACU of a tertiary-care hospital in a major metropolitan area. 266 adult patients admitted to the PACU. To evaluate inadequate emergence, the Richmond Agitation and Sedation Scale (RASS) was administered to patients 10 minutes after their admission to the PACU. Demographic data, perioperative variables, and postoperative length of stay (LOS) in the PACU and the hospital were recorded. 40 (15%) patients showed symptoms of inadequate emergence: 17 patients (6.4%) screened positive for emergence delirium and 23 patients (8.6%) showed hypoactive emergence. Determinants of emergence delirium were longer duration of preoperative fasting (P = 0.001), higher visual analog scale (VAS) scores for pain (P = 0.002), and major surgical risk (P = 0.001); these patients had a higher frequency of postoperative delirium (P = 0.017) and had higher nausea VAS score 6 hours after surgery (P = 0.001). Determinants of hypoactive emergence were duration of surgery (P = 0.003), amount of crystalloids administered during surgery (P = 0.002), residual neuromuscular block (P < 0.001), high-risk surgery (P = 0.002), and lower core temperature on PACU admission (P = 0.028); these patients also had more frequent residual neuromuscular block (P < 0.001) postoperative delirium (P < 0.001), and more frequent adverse respiratory events (P = 0.02). Patients with hypoactive emergence had longer PACU and hospital LOS. Preventable determinants for emergence delirium were higher postoperative pain scores and longer fasting times. Hypoactive emergence was associated with longer postoperative PACU and hospital LOSs. © 2013 Elsevier Inc. All rights reserved.

Internet addiction: reappraisal of an increasingly inadequate concept.

Science.gov (United States)

Starcevic, Vladan; Aboujaoude, Elias

2017-02-01

This article re-examines the popular concept of Internet addiction, discusses the key problems associated with it, and proposes possible alternatives. The concept of Internet addiction is inadequate for several reasons. Addiction may be a correct designation only for the minority of individuals who meet the general criteria for addiction, and it needs to be better demarcated from various patterns of excessive or abnormal use. Addiction to the Internet as a medium does not exist, although the Internet as a medium may play an important role in making some behaviors addictive. The Internet can no longer be separated from other potentially overused media, such as text messaging and gaming platforms. Internet addiction is conceptually too heterogeneous because it pertains to a variety of very different behaviors. Internet addiction should be replaced by terms that refer to the specific behaviors (eg, gaming, gambling, or sexual activity), regardless of whether these are performed online or offline.

Post-implementation review of inadequate core cooling instrumentation

International Nuclear Information System (INIS)

Anderson, J.L.; Anderson, R.L.; Hagen, E.W.; Morelock, T.C.; Huang, T.L.; Phillips, L.E.

1988-01-01

Studies of Three Mile Island (TMI) accident identified the need for additional instrumentation to detect inadequate core cooling (ICC) in nuclear power plants. Industry studies by plant owners and reactor vendors supported the conclusion that improvements were needed to help operators diagnose the approach to or existence of ICC and to provide more complete information for operator control of safety injection, flow to minimize the consequences of such an accident. In 1980, the US Nuclear Regulatory Commission (NRC) required further studies by the industry and described ICC instrumentation design requirements that included human factors and environmental considerations. On December 10, 1982, NRC issued to Babcock and Wilcox (BandW) licensees' orders for Modification of License and transmitted to all pressurized water reactor (PWR) licensees Generic Letter 82-28 to inform them of the revised NRC requirements. The instrumentation requirements for detection of ICC include upgraded subcooling margin monitors (SMMs), upgraded core exit thermocouples (CETs), and installation of a reactor coolant inventory tracking system (RCITS)

Permeation of Telone EC through protective gloves.

Science.gov (United States)

Zainal, Hanaa; Que Hee, Shane S

2005-09-30

Telone is a potent fumigant that is based on the chlorinated unsaturated hydrocarbon, 1,3-dichloropropene (1,3-DCP). It is often applied without dilution and so poses severe inhalation and air pollution threats. Urinary metabolites of 1,3-DCP have been detected after Telone skin exposure, so that preventing dermal exposure is also important. The objective of the study was to assess if nitrile and multi-layer ("laminated") gloves provide adequate protection against Telone EC formulation. To accomplish this, disposable (Safeskin) and chemically resistant (Sol-Vex) nitrile and laminated (Barrier mark and Silver Shield) glove materials were challenged by Telone EC with hexane liquid collection in an ASTM-type I-PTC-600 permeation cell. Analyses of cis- and trans-1,3-DCP in the collection fluid at specified times were performed on a moderately polar capillary column by gas chromatography-electron capture detection. Telone EC caused microholes in both nitrile materials, though the chemically protective material was degraded slower than the disposable nitrile. The laminated gloves offered limited protection. Silver Shield protected best because 1.5-2.3 mg 1,3-DCP permeated by 8 h relative to 2.5-7.6 mg for Barrier, implying about 2.5 times more protection for 8 h. Even for Silver Shield, the extent of protection was inadequate as illustrated by a risk assessment of the skin exposure situation. The normalized breakthrough times for both types of laminated gloves varied between 27 and 60 min. It is recommended that Viton gloves still be worn for protection.

Advanced worker protection system. Topical report, Phase I

Energy Technology Data Exchange (ETDEWEB)

Myers, J.

1995-07-01

The Department of Energy (DOE) is in the process of defining the magnitude and diversity of Decontamination and Decommissioning (D&D) obligations at its numerous sites. The DOE believes that existing technologies are inadequate to solve many challenging problems such as how to decontaminate structures and equipment cost effectively, what to do with materials and wastes generated, and how to adequately protect workers and the environment. Preliminary estimates show a tremendous need for effective use of resources over a relatively long period (over 30 years). Several technologies are being investigated which can potentially reduce D&D costs while providing appropriate protection to DOE workers. The DOE recognizes that traditional methods used by the EPA in hazardous waste site clean up activities are insufficient to provide the needed protection and worker productivity demanded by DOE D&D programs. As a consequence, new clothing and equipment which can adequately protect workers while providing increases in worker productivity are being sought for implementation at DOE sites. This project will result in the development of an Advanced Worker Protection System (AWPS). The AWPS will be built around a life support backpack that uses liquid air to provide cooling as well as breathing gas to the worker. The backpack will be combined with advanced protective garments, advanced liquid cooling garment, respirator, communications, and support equipment to provide improved worker protection, simplified system, maintenance, and dramatically improve worker productivity through longer duration work cycles.

Cathodic protection for the bottoms of above ground storage tanks

Energy Technology Data Exchange (ETDEWEB)

Mohr, John P. [Tyco Adhesives, Norwood, MA (United States)

2004-07-01

Impressed Current Cathodic Protection has been used for many years to protect the external bottoms of above ground storage tanks. The use of a vertical deep ground bed often treated several bare steel tank bottoms by broadcasting current over a wide area. Environmental concerns and, in some countries, government regulations, have introduced the use of dielectric secondary containment liners. The dielectric liner does not allow the protective cathodic protection current to pass and causes corrosion to continue on the newly placed tank bottom. In existing tank bottoms where inadequate protection has been provided, leaks can develop. In one method of remediation, an old bottom is covered with sand and a double bottom is welded above the leaking bottom. The new bottom is welded very close to the old bottom, thus shielding the traditional cathodic protection from protecting the new bottom. These double bottoms often employ the use of dielectric liner as well. Both the liner and the double bottom often minimize the distance from the external tank bottom. The minimized space between the liner, or double bottom, and the bottom to be protected places a challenge in providing current distribution in cathodic protection systems. This study examines the practical concerns for application of impressed current cathodic protection and the types of anode materials used in these specific applications. One unique approach for an economical treatment using a conductive polymer cathodic protection method is presented. (author)

Overview of radiation protection programme in nuclear medicine facility for diagnostic procedures

International Nuclear Information System (INIS)

Ahmed, Ezzeldein Mohammed Nour Mohammed

2015-02-01

This project was conducted to review Radiation Protection Program in Nuclear Medicine facility for diagnostic procedures which will provide guide for meeting the standard and regulatory requirements in diagnostic nuclear medicine. The main objective of this project is to keep dose to staff, patient and public as low as reasonably achievable (ALARA). The specific objectives were to review the Radiation Protection Program (RPP) in diagnostic nuclear medicine and to make some recommendation for improving the level of radiation protection in diagnostic nuclear medicine that will help to control normal exposure and prevent or mitigate potential exposure. The methodology used is review of various documents. The review showed that if the Radiation Protection Program is inadequate it leads to unjustified exposure to radiation. Finally, this study stated some recommendations that if implemented could improve the level of radiation protection in nuclear medicine department. One of the most important recommendations is that a qualified Radiation Protection Officer (RPO) should be appointed to lay down and oversee a radiation protection in the nuclear medicine department. The RPO must be given the full authority and the adequate time to enable him to perform his duties effectively. (au)

The sun protection factor (SPF) inadequately defines broad spectrum photoprotection: demonstration using skin reconstructed in vitro exposed to UVA, UVBor UV-solar simulated radiation.

Science.gov (United States)

Bernerd, Françoise; Vioux, Corinne; Lejeune, François; Asselineau, Daniel

2003-01-01

Wavelength specific biological damage has been previously identified in human skin reconstructed in vitro. Sunburn cell and pyrimidine dimers were found after UVB exposure, and alterations of dermal fibroblasts after UVA exposure. These damages permitted us to discriminate UVB and UVA single absorbers. The present study shows that these biological effects can be obtained simultaneously by a combined UVB + UVA exposure using ultraviolet solar simulated light (UV-SSR), which represents a relevant UV source. In addition, the protection afforded by two broad spectrum sunscreen complex formulations was assessed after topical application. These two formulations displayed the same sun protection factor but different UVA protection factors determined by the persistent pigment darkening (PPD) method. Dose response experiments of UVA or UV-SSR showed that the preparation with the highest PF-UVA provided a better protection with regard to dermal damage compared to the other formulation. Using an original UVB source to obtain the UVB portion of SSR spectrum, the preparations provided the same protection. This study strikingly illustrates the fact that the photoprotection afforded by two sunscreen formulations having similar SPF values is not equal with regard to dermal damage related to photoaging.

Evaluation of protection measurements for rural environments

International Nuclear Information System (INIS)

Silva, Diogo N.G.; Silva, Fernanda L.; Conti, Luiz F.; Wasserman, Maria Angelica V.; Rochedo, Elaine R.R.

2011-01-01

Among the planning activities of actuation in nuclear/radiological emergences, it is included the efficiency evaluation of protection and remediation measurements. From the development of a data base on such measurements for the agricultural areas, the program SIEM was used for effectuation the simulations involving the 137 Cs, 131 I and 90 Sr radionuclides, in scenery previously established for simulation those areas of a 50 km surrounding the Admiral Alvaro Alberto nuclear power plant. The obtained results indicate that the scenery is determinant of efficiency measurements involving various specific factors of each place, such as: agricultural and cattle breeding products, consumption habits of population and the grade of subsistence by the diet items, making not practical the elaboration of predefined generic sceneries. The great dependence on seasoning related to the moment of accident makes inadequate any previous evaluation what soever for evaluation of efficiency of protection and remediation measurements. Therefore, previous decisions are not recommended about the relevance of protection measurements for rural areas. Two classification criteria were defined: (i) the efficiency in reduction the doses in the firs year; and, (i i) efficiency in reduction the dose at long term

Inadequate calcium intake is highly prevalent in Korean children and adolescents: the Korea National Health and Nutrition Examination Survey (KNHANES) 2007-2010.

Science.gov (United States)

Im, Jong Geun; Kim, Shin Hye; Lee, Gyeong-Yoon; Joung, Hyojee; Park, Mi-Jung

2014-11-01

The present study aimed to assess the adequacy of Ca intake and major food sources of Ca in Korean children and adolescents. A cross-sectional study. Data from the Korean National Health and Nutrition Examination Survey (KNHANES) 2007-2010. We analysed the daily Ca intake, major food sources of Ca and the prevalence of inadequate Ca intake in the study population. Ca intake was categorized as inadequate when the participant's daily Ca intake was less than the Estimated Average Requirement. Subject The study population consisted of 7233 children and adolescents (3973 boys, 3260 girls; aged 1-18 years). Mean Ca intake was 510·2 mg/d in boys and 431·7 mg/d in girls. Overall, 75·0 % of adolescents (boys 71·6 %, girls 79·1 %) had inadequate Ca intake. The prevalence of inadequate Ca intake increased significantly from toddlers (45-55 %) to adolescents (78-86 %) in both genders. The highest ranked food sources for Ca were dairy products (35·0 %), followed by vegetables (17·3 %), grains (11·3 %) and seafood (9·9 %). Ca intake from dairy products decreased significantly from 57 % in toddlers to 30 % in adolescents, while Ca intakes from other foods increased with age. Inadequate Ca intake is highly prevalent and increased with age in Korean children and adolescents. It should be emphasized to encourage children and adolescents to eat more Ca-rich products to meet their Ca needs.

Preparing for budget-based payment methodologies: global payment and episode-based payment.

Science.gov (United States)

Hudson, Mark E

2015-10-01

Use of budget-based payment methodologies (capitation and episode-based bundled payment) has been demonstrated to drive value in healthcare delivery. With a focus on high-volume, high-cost surgical procedures, inclusion of anaesthesiology services in these methodologies is likely. This review provides a summary of budget-based payment methodologies and practical information necessary for anaesthesiologists to prepare for participation in these programmes. Although few examples of anaesthesiologists' participation in these models exist, an understanding of the structure of these programmes and opportunities for participation are available. Prospective preparation in developing anaesthesiology-specific bundled payment profiles and early participation in pathway development associated with selected episodes of care are essential for successful participation as a gainsharing partner. With significant opportunity to contribute to care coordination and cost management, anaesthesiology can play an important role in budget-based payment programmes and should expect to participate as full gainsharing partners. Precise costing methodologies and accurate economic modelling, along with identification of quality management and cost control opportunities, will help identify participation opportunities and appropriate payment and gainsharing agreements. Anaesthesiology-specific examples with budget-based payment models are needed to help guide increased participation in these programmes.

Delayed ultraviolet light-induced cessation of respiration by inadequate aeration of Escherichia coli

International Nuclear Information System (INIS)

Joshi, J.G.; Swenson, P.A.; Schenley, R.L.

1977-01-01

Inadequately aerated Escherichia coli B/r cultures did not shut their respiration off 60 min after ultraviolet light (52 J/m 2 at 254 nm) as they did when well supplied with oxygen. Since cessation of respiration is associated with cell death, the result suggested that oxygen toxicity by superoxide radicals generated by cell metabolism might be responsible for cell death. The specific activity of superoxide dismutase, which scavenges O 2 - radicals, increased twofold after 90 min of adequate aeration, but the specific activity of catalase remained constant. Respiration and viability of irradiated cells were affected not at all by the presence of superoxide dismutase and only slightly by the presence of catalase. Metal ions such as Mn 2+ and Fe 2+ , inducers of superoxide dismutase, had no effect on respiration and viability. When irradiated cells were incubated under N 2 for 90 min, the respiration, growth, and viability time-course responses were the same as for cells not exposed to anaerobiosis. We conclude that superoxide anions generated at the time of irradiation play no part in cessation of respiration and cell death and that inadequate aeration or anaerobiosis delays the ultraviolet light-induced synthesis of proteins responsible for the irreversible cessation of respiration

The relations between inadequate parent-child boundaries and borderline personality disorder in adolescence.

Science.gov (United States)

Vanwoerden, Salome; Kalpakci, Allison; Sharp, Carla

2017-11-01

Borderline Personality Disorder (BPD) is a severe mental illness that onsets in adolescence. Research has demonstrated the central role of parent-child relationships for the development and maintenance of BPD although more research is necessary to clarify the specific dynamics that relate to BPD during adolescence. Based on preliminary research establishing the importance of parent-child boundaries for adolescent BPD, this study sought to evaluate the relations between different forms of inadequate boundaries and BPD in adolescence using a multi-method approach. To that end, 301 adolescents (65.1% female; ages 12-17) inpatients were recruited; parents and adolescents completed questionnaire- and interview-based measures of BPD features in adolescent children and a questionnaire-based measure of parent-child boundaries. Relations were found between parental guilt induction and psychological control with children's BPD features above and beyond relations with psychiatric severity and gender. Relations between parent reports of triangulation (when children are recruited to mediate parental marital conflict) and children's BPD were contingent on the level of children's perceptions of triangulation. Findings confirm previous research suggesting the relevance of inadequate parent-child boundaries to children's BPD features and have important implications for understanding the dynamics in families with adolescents with BPD, representing a relevant treatment target. Copyright © 2017 Elsevier B.V. All rights reserved.

The Influence of Inadequate Teacher-to-Student Social Support on Amotivation of Physical Education Students

Science.gov (United States)

Shen, Bo; Li, Weidong; Sun, Haichun; Rukavina, Paul Bernard

2010-01-01

Guided by Green-Demers, Leagult, Pelletier, and Pelletier's (2008) assumption that amotivation (absence of motivation) is a multidimensional construct, we designed this study to investigate the influence of inadequate teacher-to-student social support on amotivation of high-school physical education students. Five hundred and sixty-six ninth…

‘Tied Visas’ and Inadequate Labour Protections: A formula for abuse and exploitation of migrant domestic workers in the United Kingdom

Directory of Open Access Journals (Sweden)

Daphne Demetriou

2015-09-01

Full Text Available This article examines the link between restrictive immigration schemes, specifically ‘tied visas’ and the selective application of labour laws, with exploitation of workers. It focuses on the situation of migrant domestic workers, who accompany their employers to the United Kingdom (UK and are exposed to both an excessively restrictive visa regime, introduced in April 2012, and limited labour protections. The immigration status of these workers is currently tied to a named employer, a restriction that traps workers into exploitative conditions, often amounting to forced labour, servitude or slavery. Additionally, current UK labour laws are either not enforced or not applicable to domestic workers. The article concludes that unless the current immigration regime is abolished and comprehensive labour law protections are extended to migrant domestic workers, exploitation will continue.

Hand protection from ultraviolet exposure

International Nuclear Information System (INIS)

Khazova, M.; O'Hagan, J.B.

2006-01-01

specific UV protection factor - Lamp-type specific protection factor, for group of U.V.R. sources with similar spectral characteristics. Examples of assessment of the 'worst case scenario' are compared with the protection level against a number of the sources, together with guidance on a simplified evaluation protocol. An application specific assessment, illustrated for 'Smart Water' forensic examinations and biological trans-illuminators, demonstrates that some gloves provide inadequate protection against occupational ultraviolet exposure. (authors)

Hand protection from ultraviolet exposure

Energy Technology Data Exchange (ETDEWEB)

Khazova, M.; O' Hagan, J.B. [Health Protection Agency, Radiation Protection Division, Chilton, Did cot (United Kingdom)

2006-07-01

specific UV protection factor - Lamp-type specific protection factor, for group of U.V.R. sources with similar spectral characteristics. Examples of assessment of the 'worst case scenario' are compared with the protection level against a number of the sources, together with guidance on a simplified evaluation protocol. An application specific assessment, illustrated for 'Smart Water' forensic examinations and biological trans-illuminators, demonstrates that some gloves provide inadequate protection against occupational ultraviolet exposure. (authors)

Adverse outcomes after percutaneous dilatational tracheostomy versus surgical tracheostomy in intensive care patients: case series and literature review

OpenAIRE

Jarosz, Konrad; Kubisa, Bartosz; Andrzejewska, Agata; Mr?wczy?ska, Katarzyna; Hamerlak, Zbigniew; Bartkowska-?niatkowska, Alicja

2017-01-01

Konrad Jarosz,1 Bartosz Kubisa,2 Agata Andrzejewska,3 Katarzyna Mrówczyńska,3 Zbigniew Hamerlak,4 Alicja Bartkowska-Śniatkowska5 1Department of Clinical Nursing, Pomeranian Medical University, 2Thoracic Surgery and Transplantation Department, Pomeranian Medical University, 3Anaesthesiology and Intensive Care Department, Pomeranian Medical University, 4Stomatology Department, Pomeranian Medical University, 5Anaesthesiology and Pediatric Intensive Care Department, Poznan Universit...

Inadequate Gestational Weight Gain, the Hidden Link Between Maternal IBD and Adverse Pregnancy Outcomes: Results from the Norwegian Mother and Child Cohort Study.

Science.gov (United States)

Bengtson, May-Bente; Aamodt, Geir; Mahadevan, Uma; Vatn, Morten H

2017-07-01

Patients with inflammatory bowel disease (IBD) are in general prone to weight loss. We explored the risk of inadequate gestational weight gain (GWG), and the impact of GWG on adverse pregnancy outcomes, among mothers with IBD in the Norwegian Mother and Child Cohort Study (MoBa). The MoBa with 95,200 mothers enrolled from 1999 to 2008, comprised 217 mothers with ulcerative colitis and 166 with Crohn's disease. Demographics were ascertained through a basic questionnaire before the first ultrasound visit and an IBD history and disease activity during pregnancy through a questionnaire mailed out in 2013. Inadequate GWG was based on the US Institute of Medicine recommendations. The associations between IBD and inadequate GWG or adverse pregnancy outcomes were explored, adjusted for diabetes, hypertension, smoking, maternal age, education, and disease activity. Mothers with Crohn's disease (34.3%) and ulcerative colitis (26.7%) were more frequently exposed to inadequate GWG compared with non-IBD mothers (19.4%) (adjusted odds ratio [aOR] = 2.02, 95% confidence interval [CI], 1.42-2.86 and aOR = 1.46, 95% CI, 1.04-2.05, respectively). Mothers with IBD with inadequate GWG (exposed) had a 2-fold risk of small for gestational age infants compared with exposed non-IBD mothers (aOR = 1.93, 95% CI, 1.13-3.29). Exposed mothers with Crohn's disease and ulcerative colitis had a several-fold increased risk of small for gestational age compared with nonexposed IBD mothers (aOR = 4.5, 95% CI, 1.3-16.2, aOR = 5.5, 95% CI, 1.6-18.5). Disease activity was associated with reduced GWG (17.5 kg) (aOR = 3.34, 95% CI, 1.33-8.38). Inadequate GWG should be considered as a risk factor for adverse pregnancy outcomes or as a marker of disease activity.

Psychological distress is associated with inadequate dietary intake in Vietnamese marriage immigrant women in Korea.

Science.gov (United States)

Hwang, Ji-Yun; Lee, Sang Eun; Kim, Sun Hye; Chung, Hye Won; Kim, Wha Young

2010-05-01

Previous studies have reported that the nutritional status of Vietnamese female marriage immigrants in Korea is inadequate. And the mediation of acculturation stress can contribute to problems in their eating practices and dietary intakes. This study examines an association between psychological distress and inadequate dietary intake in Vietnamese female marriage immigrants living in Korea. A cross-sectional study analyzed baseline data (n=570) from the Cohort of Intermarried Women in Korea. Daily nutrient intakes were compared according to the quartiles of distress scores assessed by the Psychological Well-Being Index-Short Form. One-way analysis of variance and chi(2) tests were used to compare eating practices and nutrient intake across quartiles of psychological distress. Subjects in the highest stress scores were more likely to skip breakfast and to change their dietary habits after living in Korea than those in groups with low stress scores. Analyses of the subjects' Mini Dietary Assessments revealed that those with the highest stress scores were less likely to consume milk or dairy products, eat regular meals, or have balanced diets than those with the lowest stress scores. Nutrient intakes were found to be inadequate in the subjects, and those with the highest stress scores showed lower consumptions of energy, carbohydrate, protein, fat, calcium, zinc, thiamin, riboflavin, and folate compared to those with the lowest scores. The prevalence of underweight (body mass index [calculated as kg/m(2)] Korea was negatively associated with dietary intake. These findings can assist dietetics practitioners working with minority immigrants because such information is important in designing appropriate strategies for dietary counseling. A follow-up study should address the underlying mechanisms of the observed diet-distress association in Vietnamese marriage immigrant women in Korea, as well as other various ethnic minority immigrants in Korea. Copyright 2010 American

Evaluation of the ocular protection for low intensity therapeutic lasers

International Nuclear Information System (INIS)

Cordon, Rosely

2003-01-01

The low intensity laser therapy (LILT) has been extensively used in medicine and dentistry presenting positive effects. However, the laser radiation can also cause adverse effects. Due to the ocular focalization property, in the wavelength from 400 to 1400 nm, the retina is more susceptible to damage by radiation than any other part of the human body. Then, the ocular protection is frequently emphasized. This protection must attenuate the radiation to a safe level. The International Electrotechnical Commission (IEC) standard IEC 60825-1 suggests safety requirements for medical laser equipment, including the ocular protection, based on maximum permissible exposure levels. The Brazilian legislation adopts a corresponding IEC standard, the NBR IEC 601.2.22, for safety requirements. The aim of this study was to analyze the adequacy of the ocular protectors furnished by four laser equipment manufacturers, commercially available in Brazil, commonly used for LILT. For this purpose, the laser equipment and the respective ocular protectors were characterized. The adequacy was verified according to the IEC standards. It was found, among other results, ocular protectors attenuating to safe levels the radiation emitted by the respective laser equipment, however, presenting inadequate visual transmission. Inefficient protection and protection indicated in cases where they were not necessary were also observed. (author)

Lack of adequate sun protection for children with oculocutaneous albinism in South Africa

Science.gov (United States)

Lund, Patricia M; Taylor, Julie S

2008-01-01

Background Childhood is a high risk time for ultraviolet induced skin damage as this age group has more time and opportunity to be outdoors in the sun. Children in Africa with the inherited condition oculocutaneous albinism (OCA) are especially vulnerable due to their lack of protective melanin. They are highly susceptible to developing skin lesions that have both cosmetic and health complications, with a high risk of developing skin cancers. The study aimed to explore the adequacy of sun protection strategies of children with albinism in order to inform future provision. Methods Community based participatory research methods were employed to investigate sun protection strategies in 90 pupils with OCA (40 female and 50 male) boarding at a special school educating pupils with visual impairment in a rural area of northern South Africa. Hats worn and sunscreen preparations used were examined during semi-structured face to face interviews conducted in small peer groups. The resident nurse interpreted if necessary and provided additional information on monitoring and treatment of skin lesions. Results Participants with albinism in this study were exposed to high levels of ultraviolet radiation throughout the year and showed skin damage despite wearing protective head gear. All except one pupil possessed at least one hat, with a mean brim width of 5.4 cm. Gender differences in sun avoidance behaviour were documented, with females seeking shade during recreational periods and males playing soccer outside. Although 38% of pupils were using a sunscreen with a sun protection factor (SPF) rating, only 12% had government sponsored tubes of SPF15 cream. Government sponsored sunscreen preparations were only provided if actively sought, involving time consuming trips to regional hospitals, with inadequate availability and insufficient supply. Conclusion Children with albinism living away from home in rural areas appear to have inadequate sun protection strategies. Changes in

Lack of adequate sun protection for children with oculocutaneous albinism in South Africa

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Taylor Julie S

2008-06-01

Full Text Available Abstract Background Childhood is a high risk time for ultraviolet induced skin damage as this age group has more time and opportunity to be outdoors in the sun. Children in Africa with the inherited condition oculocutaneous albinism (OCA are especially vulnerable due to their lack of protective melanin. They are highly susceptible to developing skin lesions that have both cosmetic and health complications, with a high risk of developing skin cancers. The study aimed to explore the adequacy of sun protection strategies of children with albinism in order to inform future provision. Methods Community based participatory research methods were employed to investigate sun protection strategies in 90 pupils with OCA (40 female and 50 male boarding at a special school educating pupils with visual impairment in a rural area of northern South Africa. Hats worn and sunscreen preparations used were examined during semi-structured face to face interviews conducted in small peer groups. The resident nurse interpreted if necessary and provided additional information on monitoring and treatment of skin lesions. Results Participants with albinism in this study were exposed to high levels of ultraviolet radiation throughout the year and showed skin damage despite wearing protective head gear. All except one pupil possessed at least one hat, with a mean brim width of 5.4 cm. Gender differences in sun avoidance behaviour were documented, with females seeking shade during recreational periods and males playing soccer outside. Although 38% of pupils were using a sunscreen with a sun protection factor (SPF rating, only 12% had government sponsored tubes of SPF15 cream. Government sponsored sunscreen preparations were only provided if actively sought, involving time consuming trips to regional hospitals, with inadequate availability and insufficient supply. Conclusion Children with albinism living away from home in rural areas appear to have inadequate sun protection

Inadequate-1D and dynamic NMR of mesoion 3-phenyl-1-thio-2,3,4-triazole-5-methylides; INADEQUATE-1D i dynamiczny NMR mezojonowych 3-fenylo-1-tio-2,3,4-triazolo-5-metylidow

Energy Technology Data Exchange (ETDEWEB)

Bocian, W.; Stefaniak, L. [Inst. Chemii Organicznej, Polska Akademia Nauk, Warsaw (Poland)

1994-12-31

The chemical shifts and coupling constants have been measured in series of mesoionic triazoles by means of inadequate atoms and dynamic NMR techniques. The electronic structure and other parameters of C5-C6 chemical bond in different derivatives of mesoionic 3-phenyl-1-thio-2,3,4-triazole-5 methyls have been determined. 14 refs, 3 figs, 2 tabs.

Associations between Inadequate Parenting Practices and Behavioral Problems in Children and Adolescents with Attention Deficit Hyperactivity Disorder

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Maria Cristina Triguero Veloz Teixeira

2015-01-01

Full Text Available Children and adolescents with ADHD present behaviors such as impulsiveness, inattention, and difficulties with personal organization that represent an overload for parents. Moreover, it also increases their level of stress and leads them to resort to inadequate educational strategies. The present study verifies associations between inadequate parenting practices and behavioral profiles of children and adolescents with ADHD. The sample was composed of 22 children with ADHD (age range 6–16 years and their mothers. Spearman correlation analyses were made with the scores of Parenting Style Inventory (PSI and Child Behavior Checklist for ages 6–18 (CBCL/6–18. Results indicate statistically significant associations between behavioral problems and the use of punishment practices and negligence. When assessing a child with ADHD, it is important to verify the predominant types of parenting practices that can influence both immediate interventions and the prognosis of the disorder.

Comparison of Dynamic Contrast-Enhanced MRI and PET/CT in the Evaluation of Laryngeal Cancer After Inadequate CT Results

International Nuclear Information System (INIS)

Citil, Serdal; Dogan, Serap; Atilgan, Hasan Ikbal; Menzilcioglu, Mehmet Sait; Sahin, Tuna; Abdulrezzak, Ummuhan; Duymus, Mahmut; Ozturk, Mustafa

2015-01-01

To investigate the diagnostic value of dynamic magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) for laryngeal cancers after inadequate CT results. The study comprised 45 patients investigated for primary laryngeal cancer or recurrence-residue in which CT was considered inadequate. A mass was found in 20 patients. Dynamic MRI and PET/CT were compared for diagnosis of mass, lymph node involvement, recurrence and residue. The dynamic curves formed in dynamic MRI were investigated for diagnostic contributions. The sensitivity and specificity of the dynamic MRI, for supraglottic, glottic and subglottic location, was 100%, 80%, and 92%; 100%, 85%, and 100%, respectively. In PET/CT the sensitivity and specificity were 100% for all of those localizations. For lymph node involvement, the sensitivity of dynamic MRI and PET/CT was 100%, the specificity was 100% and 93%, respectively. For recurrence-residue, the sensitivity and specificity of dynamic MRI were 86% and 67%, respectively, with 100% sensitivity and specificity in PET/CT. The sensitivity of type A curve for detection of malignancy was 40%, and specificity was 100%. When type A and B curves were included, the sensitivity was 100%. For patients investigated for laryngeal cancer in which CT is considered inadequate, dynamic MRI or PET/CT is useful

Comparison of Dynamic Contrast-Enhanced MRI and PET/CT in the Evaluation of Laryngeal Cancer After Inadequate CT Results.

Science.gov (United States)

Citil, Serdal; Dogan, Serap; Atilgan, Hasan Ikbal; Menzilcioglu, Mehmet Sait; Sahin, Tuna; Abdulrezzak, Ummuhan; Duymus, Mahmut; Ozturk, Mustafa

2015-01-01

To investigate the diagnostic value of dynamic magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) for laryngeal cancers after inadequate CT results. The study comprised 45 patients investigated for primary laryngeal cancer or recurrence-residue in which CT was considered inadequate. A mass was found in 20 patients. Dynamic MRI and PET/CT were compared for diagnosis of mass, lymph node involvement, recurrence and residue. The dynamic curves formed in dynamic MRI were investigated for diagnostic contributions. The sensitivity and specificity of the dynamic MRI, for supraglottic, glottic and subglottic location, was 100%, 80%, and 92%; 100%, 85%, and 100%, respectively. In PET/CT the sensitivity and specificity were 100% for all of those localizations. For lymph node involvement, the sensitivity of dynamic MRI and PET/CT was 100%, the specificity was 100% and 93%, respectively. For recurrence-residue, the sensitivity and specificity of dynamic MRI were 86% and 67%, respectively, with 100% sensitivity and specificity in PET/CT. The sensitivity of type A curve for detection of malignancy was 40%, and specificity was 100%. When type A and B curves were included, the sensitivity was 100%. For patients investigated for laryngeal cancer in which CT is considered inadequate, dynamic MRI or PET/CT is useful.

PROTECTION FROM COSMIC RADIATION IN LONG-TERM MANNED SPACEFLIGHTS

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Marco Durante

2012-06-01

Full Text Available Current space programs are shifting toward planetary exploration, and in particular towards human missions to the moon and Mars. Space radiation, comprised of energetic protons and heavy nuclei, has been shown to produce distinct biological damage compared to radiation on Earth, leading to large uncertainties in the projection of health risks. Even if uncertainties in risk assessment will be reduced in the next few years, there is little doubt that appropriate countermeasures have to be taken to reduce the exposure or the biological damage produced by cosmic radiation. In addition, it is necessary to provide effective countermeasures against solar particle events, which can produce acute effects, even life threatening, for inadequately protected crews. Unfortunately, passive (bulk shielding is currently unable to provide adequate protection, because cosmic rays have very high energy and nuclear fragmentation in the absorbers produce light fragments. Material science could provide new materials with better shielding properties for space radiation. Active (magnetic shielding could be an interesting alternative, pending technical improvements.

Evaluation of inadequate, indeterminate, false-negative and false-positive cases in cytological examination for breast cancer according to histological type

Science.gov (United States)

2012-01-01

Background We previously investigated the current status of breast cytology cancer screening at seven institutes in our area of southern Fukuoka Prefecture, and found some differences in diagnostic accuracy among the institutions. In the present study, we evaluated the cases involved and noted possible reasons for their original cytological classification as inadequate, indeterminate, false-negative and false-positive according to histological type. Methods We evaluated the histological findings in 5693 individuals who underwent cytological examination for breast cancer (including inadequate, indeterminate, false-negative and false-positive cases), to determine the most common histological types and/or features in these settings and the usefulness/limitations of cytological examination for the diagnosis of breast cancer. Results Among 1152 cytologically inadequate cases, histology revealed that 75/173 (43.6%) cases were benign, including mastopathy (fibrocystic disease) in 38.6%, fibroadenoma in 24.0% and papilloma in 5.3%. Ninety-five of 173 (54.9%) cases were histologically malignant, with scirrhous growing type, invasive ductal carcinoma (SIDC) being significantly more frequent (49.5%) than papillotubular growing type (Papi-tub) (P breast disease. In particular, several inadequate, indeterminate and false-negative cases with samples collected by aspiration were diagnosed as SIDC. These findings should encourage the use of needle biopsy rather than aspiration when this histological type is identified on imaging. Namely, good communication between clinicians and pathological staff, and triple assessment (i.e., clinical, pathological and radiological assessment), are important for accurate diagnosis of aspiration samples. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/7349809170055423 PMID:22607447

Factors explaining inadequate prenatal care utilization by first and second generation non-western women in The Netherlands.

NARCIS (Netherlands)

Boerleider, A.W.; Manniën, J.; Wiegers, T.A.; Francke, A.L.; Devillé, W.L.J.M.

2013-01-01

Background: In many industrialized western countries non-western women constitute a substantial part of the prenatal care client population. In The Netherlands, these women have also been shown to be more likely to make inadequate use of prenatal care. Explanatory factors for this include, among

Safety and efficacy of twice-daily exenatide in Taiwanese patients with inadequately controlled type 2 diabetes mellitus

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Chieh-Hsiang Lu

2013-03-01

Conclusion: This subgroup analysis of Taiwanese patients was consistent with the overall study results, which showed that exenatide BID is superior to placebo for improving glycemic control in Asian patients with type 2 diabetes who experienced inadequate glycemic control when using oral antidiabetic therapy.

Use of basal stimulation at anesthesiology department

OpenAIRE

MARKOVÁ, Alena

2012-01-01

The theme ?The Use of Basal Stimulation at the Anaesthesiology and Resuscitation Department? was chosen in order to map out the use of this nursing method by the nurses and the staff who I cooperate with. The theoretical part deals with the environment at the Anaesthesiology and Resuscitation Department where the basal stimulation is used and also with special characteristics of the nursing care. Further, it deals with monitoring patients, causes of consciousness defects occurrence and kinds ...

Evaluation on the implementation of respiratory protection measures in old age homes

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Lee DT

2017-09-01

Full Text Available Diana TF Lee,1 Doris Yu,1 Margaret Ip,2 Jennifer YM Tang3 1The Nethersole School of Nursing, The Chinese University of Hong Kong, 2Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, 3Sau Po Centre on Ageing, The University of Hong Kong, Pok Fu Lam, Hong Kong Purpose: Old age homes (OAHs represent a vulnerable community for influenza outbreaks. Effective implementation of respiratory protection measures has been identified as an effective prevention measure to reduce mortality and morbidity caused by such outbreaks. Yet, relatively little is known about this aspect in these homes. This study evaluated the implementation of respiratory protection measures among infection control officers (ICOs and health care workers (HCWs in these homes in Hong Kong.Patients and methods: A territory-wide, cross-sectional survey was conducted in 87 OAHs. A total of 87 ICOs and 1,763 HCWs (including nurses, health workers, care workers, allied HCWs and assistants completed the questionnaires that evaluated the implementation at the organizational level and individual level, respectively. Generalized estimating equations with unstructured working correlation matrix were used to analyze the simultaneous influence of organizational and individual factors on the implementation.Results: At the organizational level, all homes had a policy on respiratory protection and implementation of such measures was generally adequate. Basic resources such as paper towels/hand dryers and equipment disinfectants, however, were rated as most inadequate by HCWs. Training opportunities were also identified as grossly inadequate. Only less than half of the ICOs and HCWs participated in training on infection control either at the initiation of employment or on a regular basis. Twenty-five percent of HCWs even indicated that they had never participated in any infection control training. At the individual level, hand hygiene, among other

Filtration of nanoparticles - Application to respiratory protecting devices

International Nuclear Information System (INIS)

Brochot, C.

2012-01-01

This study aims to determine how the respiratory protective devices (RPD), whose performances are qualified for particles above 100 nm, are effective for nanoparticles. Indeed, if the use of a collective filtration is inadequate, wearing a RPD is the last protection recommended. A literature review showed that no research concerned the effectiveness of half-masks for nanoparticles. The test bench ETNA has been sized and built to overcome these lacks. Two half masks were tested according to different configurations: constant flow rate and cyclic flow rate (average flow of 84 L /min), particle size (from 5 to 100 nm), positions of the mask (sealed, usual, or with calibrated leaks). The results show that, since the RPD contain high efficiency filter media (without charged fibers) for the most penetrating particle size (100 nm - 300 nm), the RPD is more efficient for nanoparticles. Furthermore, the results obtained in the presence of actual and calibrated leaks, highlighted the importance of face seal leakages in determining the performance of RPD. A model for calculating the protection factor was established based on the balance between the airflow through the filter and the leak. This model was validated using measurements obtained in the presence of calibrated leaks, and applied for the analysis of our results in usual position. (author)

Survey of Radiation Protection Education and Training in Finland in 2003

International Nuclear Information System (INIS)

Havukainen, R.; Korpela, H.; Vaisala, S.; Piri, A.; Kettunen, E.

2004-01-01

The current state and need for radiation protection training in Finland have been surveyed by the Radiation and Nuclear Safety Authority STUK. The survey sought to determine whether the current requirements for radiation protection training had been met, and to promote radiation protection training. Details of the scope and quality of present radiation protection training were requested from all educational institutes and organizations providing radiation protection training. The survey covered both basic and further training, special training of radiation safety officers, and supplementary training. The questionnaire was sent to 77 educational organization units, 66 per cent of which responded. Radiation workers and radiation safety officers were asked about radiation protection knowledge and needs for additional training. The questionnaire was sent to 880 radiation users and 170 radiation safety officers, 70 per cent of whom responded. The survey covered all professional groups and fields of the use of ionizing radiation except nuclear energy. The amount of radiation protection training in basic and further (specialization) training in the same vocational or academic degree varied remarkably by educational organization. The average amounts of radiation protection included in most professional degrees met the requirements. 32 per cent of workers considered their radiation protection training inadequate for their duties, and 48 per cent had completed no supplementary training in radiation protection over the last five years. Nurses working in public sector hospitals and physicians working in health centres had the greatest need for radiation protection training. 78 per cent of radiation workers in industry felt that they had sufficient radiation protection training. Co-operation between educational organizations is necessary to harmonize radiation protection training. Guidance of the Ministry of Education (the competent authority for education) is needed in this

[Is there an Association between Prevention Campaign Knowledge and Sun Protection Behaviour of Parents for their Children? Results of a Parent Survey].

Science.gov (United States)

Klostermann, S; Fromme, H; Bolte, G

2015-06-01

The aims of this study are to assess prevalence of awareness of sun protection campaigns among parents in Bavaria, Germany, to analyse the impact of sociodemographic factors on campaign knowledge and the association between parental campaign knowledge and sun protection behaviour in their children. A cross-sectional survey was undertaken in 2010-2011 in Bavaria, Germany, with parents of 4,579 children aged 5-6 years (response rate 61%). Prevalence of knowledge of sun protection campaigns is 13% among parents in Germany and independent of sociodemographic factors. Ignorance of sun protection campaigns is associated with inadequate sun protection behaviour in children independent of sociodemographic and exposure characteristics. Awareness of sun protection campaigns is low among parents. Knowledge of adequate sun protection behaviour should be further increased at the population level in Germany independently of sociodemographic status. © Georg Thieme Verlag KG Stuttgart · New York.

Inadequate Nutritional Status of Hospitalized Cancer Patients

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Ali Alkan

2017-03-01

Full Text Available Objective: In oncology practice, nutrition and also metabolic activity are essential to support the nutritional status and prevent malignant cachexia. It is important to evaluate the patients and plan the maneuvers at the start of the therapy. The primary objective of the study is to define the nutritional status of hospitalized patients and the factors affecting it in order to define the most susceptible patients and maneuvers for better nutritional support. Methods: Patients hospitalized in oncology clinic for therapy were evaluated for food intake and nutritional status through structured interviews. The clinical properties, medical therapies, elements of nutritional support were noted and predictors of inadequate nutritional status (INS were analyzed. Results: Four hundred twenty three patients, between 16-82 years old (median: 52 were evaluated. Nearly half of the patients (185, 43% reported a better appetite at home than in hospital and declared that hospitalization is an important cause of loss of appetite (140/185, 75.6%. Presence of nausea/vomiting (N/V, depression, age less than 65 and use of non-steroidal anti-inflammatory drugs (NSAIDs were associated with increased risk of INS in hospitalized cancer patients. On the contrary, steroid medication showed a positive impact on nutritional status of cancer patients. Conclusion: N/V, younger age, presence of depression and NSAIDs medication were associated with INS in hospitalized cancer patients. Clinicians should pay more attention to this group of patients. In addition, unnecessary hospitalizations and medications that may disturb oral intake must be avoided. Corticosteroids are important tools for managing anorexia and INS.

Dialysis Hypotension : A Role for Inadequate Increase in Arginine Vasopressin Levels? A Systematic Literature Review and Meta-Analysis

NARCIS (Netherlands)

Ettema, Esmee M.; Zittema, Debbie; Kuipers, Johanna; Gansevoort, Ron T.; Vart, Priya; de Jong, Paul E.; Westerhuis, Ralf; Franssen, Casper F. M.

2014-01-01

Background: Intradialytic hypotension is a common complication of hemodialysis (HD). Some studies have suggested that inadequate arginine vasopressin (AVP) increase could play a role in the pathogenesis of intradialytic hypotension. However, AVP levels during HD and its relation to hypotension has

Burden of disease from inadequate water, sanitation and hygiene in low- and middle-income settings: a retrospective analysis of data from 145 countries

Science.gov (United States)

Prüss-Ustün, Annette; Bartram, Jamie; Clasen, Thomas; Colford, John M; Cumming, Oliver; Curtis, Valerie; Bonjour, Sophie; Dangour, Alan D; De France, Jennifer; Fewtrell, Lorna; Freeman, Matthew C; Gordon, Bruce; Hunter, Paul R; Johnston, Richard B; Mathers, Colin; Mäusezahl, Daniel; Medlicott, Kate; Neira, Maria; Stocks, Meredith; Wolf, Jennyfer; Cairncross, Sandy

2014-01-01

Objective To estimate the burden of diarrhoeal diseases from exposure to inadequate water, sanitation and hand hygiene in low- and middle-income settings and provide an overview of the impact on other diseases. Methods For estimating the impact of water, sanitation and hygiene on diarrhoea, we selected exposure levels with both sufficient global exposure data and a matching exposure-risk relationship. Global exposure data were estimated for the year 2012, and risk estimates were taken from the most recent systematic analyses. We estimated attributable deaths and disability-adjusted life years (DALYs) by country, age and sex for inadequate water, sanitation and hand hygiene separately, and as a cluster of risk factors. Uncertainty estimates were computed on the basis of uncertainty surrounding exposure estimates and relative risks. Results In 2012, 502 000 diarrhoea deaths were estimated to be caused by inadequate drinking water and 280 000 deaths by inadequate sanitation. The most likely estimate of disease burden from inadequate hand hygiene amounts to 297 000 deaths. In total, 842 000 diarrhoea deaths are estimated to be caused by this cluster of risk factors, which amounts to 1.5% of the total disease burden and 58% of diarrhoeal diseases. In children under 5 years old, 361 000 deaths could be prevented, representing 5.5% of deaths in that age group. Conclusions This estimate confirms the importance of improving water and sanitation in low- and middle-income settings for the prevention of diarrhoeal disease burden. It also underscores the need for better data on exposure and risk reductions that can be achieved with provision of reliable piped water, community sewage with treatment and hand hygiene. PMID:24779548

Burden of disease from inadequate water, sanitation and hygiene in low- and middle-income settings: a retrospective analysis of data from 145 countries.

Science.gov (United States)

Prüss-Ustün, Annette; Bartram, Jamie; Clasen, Thomas; Colford, John M; Cumming, Oliver; Curtis, Valerie; Bonjour, Sophie; Dangour, Alan D; De France, Jennifer; Fewtrell, Lorna; Freeman, Matthew C; Gordon, Bruce; Hunter, Paul R; Johnston, Richard B; Mathers, Colin; Mäusezahl, Daniel; Medlicott, Kate; Neira, Maria; Stocks, Meredith; Wolf, Jennyfer; Cairncross, Sandy

2014-08-01

To estimate the burden of diarrhoeal diseases from exposure to inadequate water, sanitation and hand hygiene in low- and middle-income settings and provide an overview of the impact on other diseases. For estimating the impact of water, sanitation and hygiene on diarrhoea, we selected exposure levels with both sufficient global exposure data and a matching exposure-risk relationship. Global exposure data were estimated for the year 2012, and risk estimates were taken from the most recent systematic analyses. We estimated attributable deaths and disability-adjusted life years (DALYs) by country, age and sex for inadequate water, sanitation and hand hygiene separately, and as a cluster of risk factors. Uncertainty estimates were computed on the basis of uncertainty surrounding exposure estimates and relative risks. In 2012, 502,000 diarrhoea deaths were estimated to be caused by inadequate drinking water and 280,000 deaths by inadequate sanitation. The most likely estimate of disease burden from inadequate hand hygiene amounts to 297,000 deaths. In total, 842,000 diarrhoea deaths are estimated to be caused by this cluster of risk factors, which amounts to 1.5% of the total disease burden and 58% of diarrhoeal diseases. In children under 5 years old, 361,000 deaths could be prevented, representing 5.5% of deaths in that age group. This estimate confirms the importance of improving water and sanitation in low- and middle-income settings for the prevention of diarrhoeal disease burden. It also underscores the need for better data on exposure and risk reductions that can be achieved with provision of reliable piped water, community sewage with treatment and hand hygiene. © 2014 The Authors. Tropical Medicine and International Health published by John Wiley & Sons Ltd.

Microbiological changes after periodontal therapy in diabetic patients with inadequate metabolic control

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Carina Maciel Silva-Boghossian

2014-05-01

Full Text Available The present study investigated the effect of non-surgical periodontal treatment (SRP on the composition of the subgingival microbiota of chronic periodontitis (CP in individuals with type 2 diabetes (DM2 with inadequate metabolic control and in systemically healthy (SH individuals. Forty individuals (20 DM2 and 20 SH with CP underwent full-mouth periodontal examination. Subgingival plaque was sampled from 4 deep sites of each individual and tested for mean prevalence and counts of 45 bacterial taxa by the checkerboard method. Clinical and microbiological assessments were performed before and 3 months after SRP. At baseline, those in the DM2 group presented a significantly higher percentage of sites with visible plaque and bleeding on probing compared with those in the SH group (p < 0.01. Those in the DM2 group presented significantly higher levels of C. rectus and P. gingivalis, and lower prevalence of P. micra and S. anginosus, compared with those in the SH group (p ≤ 0.001. At the 3-month visit, both groups showed a significant improvement in all clinical parameters (p < 0.01. Those in the DM2 group showed significantly higher prevalence and/or levels of A. gerencseriae, A. naeslundii I, A. oris, A. odontolyticus, C. sputigena, F. periodonticum, and G. morbillorum compared with those in the SH group (p ≤ 0.001. However, those in the DM2 group showed a significant reduction in the levels of P. intermedia, P. gingivalis, T. forsythia, and T. denticola (p ≤ 0.001 over time. Those in the SRP group showed improved periodontal status and reduced levels of putative periodontal pathogens at 3 months’ evaluation compared with those in the DM2 group with inadequate metabolic control.

Poison politics: a contentious history of consumer protection against dangerous household chemicals in the United States.

Science.gov (United States)

Jones, Marian Moser; Benrubi, Isidore Daniel

2013-05-01

The history of consumer protection against household poisons presents a key case study of the uniquely American struggle to balance public health and safety with the interests of business. By the late 19th century, package designs, warning labels, and state statutes had formed an uneven patchwork of protective mechanisms against accidental poisonings. As household chemicals proliferated in the early 20th century, physicians concerned with childhood poisonings pressured the federal government to enact legislation mandating warning labels on packaging for these substances. Manufacturers of household chemicals agreed to labeling requirements for caustic poisons but resisted broader regulation. Accidental poisonings of children continued to increase until the enactment of broad labeling and packaging legislation in the 1960s and 1970s. This history suggests that voluntary agreements between government agencies and manufacturers are inadequate to protect consumers against household poisonings and that, in the United States, protective household chemical regulation proceeds in a reactive rather than a precautionary manner.

Lack of access to chemotherapy for colon cancer: multiplicative disadvantage of being extremely poor, inadequately insured and African American.

Science.gov (United States)

Gorey, Kevin M; Haji-Jama, Sundus; Bartfay, Emma; Luginaah, Isaac N; Wright, Frances C; Kanjeekal, Sindu M

2014-03-22

Despite evidence of chemotherapy's ability to cure or comfort those with colon cancer, nearly half of such Americans do not receive it. African Americans (AA) seem particularly disadvantaged. An ethnicity by poverty by health insurance interaction was hypothesized such that the multiplicative disadvantage of being extremely poor and inadequately insured is worse for AAs than for non-Hispanic white Americans (NHWA). California registry data were analyzed for 459 AAs and 3,001 NHWAs diagnosed with stage II to IV colon cancer between 1996 and 2000 and followed until 2011. Socioeconomic data from the 2000 census categorized neighborhoods: extremely poor (≥ 30% of households poor), middle (5-29% poor) and low poverty (Primary health insurers were Medicaid, Medicare, private or none. Chemotherapy rates were age and stage-adjusted and comparisons used standardized rate ratios (RR). Logistic and Cox regressions, respectively, modeled chemotherapy receipt and long term survival. A significant 3-way ethnicity by poverty by health insurance interaction effect on chemotherapy receipt was observed. Among those who did not live in extremely poor neighborhoods and were adequately insured privately or by Medicare, chemotherapy rates did not differ significantly between AAs (37.7%) and NHWAs (39.5%). Among those who lived in extremely poor neighborhoods and were inadequately insured by Medicaid or uninsured, AAs (14.6%) were nearly 60% less likely to receive chemotherapy than were NHWAs (25.5%, RR = 0.41). When the 3-way interaction effect as well as the main effects of poverty, health insurance and chemotherapy was accounted for, survival rates of AAs and NHWAs were the same. The multiplicative barrier to colon cancer care that results from being extremely poor and inadequately insured is worse for AAs than it is for NHWAs. AAs are more prevalently poor, inadequately insured, and have fewer assets so they are probably less able to absorb the indirect and direct, but uncovered

Improving the Effectiveness of Speaker Verification Domain Adaptation With Inadequate In-Domain Data

Science.gov (United States)

2017-08-20

M speakers. We seek a probabilistic solution to domain adap- tation, and so we encode knowledge of the out-of-domain data in prior distributions...the VB solution from (16)-(21) becomes: µ =αȳ + (1− α)µout, (24) Σa =α ( 1 NT NT∑ n=1 〈ynyTn 〉 − ȳȳT ) + (1− α) Σouta (25) + α (1− α) ( ȳ − µout...non- English languages and from unseen channels. An inadequate in-domain set was provided, which consisted of 2272 samples from 1164 speakers, and

Influences of Inadequate Instructional Materials and Facilities in Teaching and Learning of Electrical/Electronics Technology Education Courses

Science.gov (United States)

Ogbu, James E.

2015-01-01

This study investigated the influences of inadequate instructional materials and facilities in the teaching and learning of electrical/electronics (E/E) technology education courses. The study was guided by two research questions and two null hypotheses which were tested at 0.05 level of significance. The design employed was descriptive survey…

Loss of integrity of thyroid morphology and function in children born to mothers with inadequately treated Graves' disease

NARCIS (Netherlands)

Kempers, Marlies J. E.; van Trotsenburg, A. S. Paul; van Rijn, Rick R.; Smets, Anne M. J. B.; Smit, Bert J.; de Vijlder, Jan J. M.; Vulsma, Thomas

2007-01-01

Context: Central congenital hypothyroidism (CH-C) in neonates born to mothers with inadequately treated Graves' disease usually needs T-4 supplementation. The thyroid and its regulatory system have not yet been extensively studied after T-4 withdrawal, until we observed disintegrated thyroid glands

Evaluation of inadequate, indeterminate, false-negative and false-positive cases in cytological examination for breast cancer according to histological type

Directory of Open Access Journals (Sweden)

Yamaguchi Rin

2012-05-01

Full Text Available Abstract Background We previously investigated the current status of breast cytology cancer screening at seven institutes in our area of southern Fukuoka Prefecture, and found some differences in diagnostic accuracy among the institutions. In the present study, we evaluated the cases involved and noted possible reasons for their original cytological classification as inadequate, indeterminate, false-negative and false-positive according to histological type. Methods We evaluated the histological findings in 5693 individuals who underwent cytological examination for breast cancer (including inadequate, indeterminate, false-negative and false-positive cases, to determine the most common histological types and/or features in these settings and the usefulness/limitations of cytological examination for the diagnosis of breast cancer. Results Among 1152 cytologically inadequate cases, histology revealed that 75/173 (43.6% cases were benign, including mastopathy (fibrocystic disease in 38.6%, fibroadenoma in 24.0% and papilloma in 5.3%. Ninety-five of 173 (54.9% cases were histologically malignant, with scirrhous growing type, invasive ductal carcinoma (SIDC being significantly more frequent (49.5% than papillotubular growing type (Papi-tub (P P = 0.0001 and ductal carcinoma in situ (DCIS (P = 0.0001. Among 458 indeterminate cases, 54/139 (38.8% were histologically benign (mastopathy, 30.0%; fibroadenoma, 27.8%; papilloma, 26.0% and 73/139 (52.5% were malignant, with SIDC being the most frequent malignant tumor (37.0%. Among 52 false-negative cases, SIDC was significantly more frequent (42.3% than DCIS (P = 0.0049 and Papi-tub (P = 0.001. There were three false-positive cases, with one each of fibroadenoma, epidermal cyst and papilloma. Conclusions The inadequate, indeterminate, false-negative and false-positive cases showed similar histological types, notably SIDC for malignant tumors, and mastopathy, fibroadenoma and papilloma for

Mangroves protected villages and reduced death toll during Indian super cyclone.

Science.gov (United States)

Das, Saudamini; Vincent, Jeffrey R

2009-05-05

Protection against coastal disasters has been identified as an important service of mangrove ecosystems. Empirical studies on this service have been criticized, however, for using small samples and inadequately controlling for confounding factors. We used data on several hundred villages to test the impact of mangroves on human deaths during a 1999 super cyclone that struck Orissa, India. We found that villages with wider mangroves between them and the coast experienced significantly fewer deaths than ones with narrower or no mangroves. This finding was robust to the inclusion of a wide range of other variables to our statistical model, including controls for the historical extent of mangroves. Although mangroves evidently saved fewer lives than an early warning issued by the government, the retention of remaining mangroves in Orissa is economically justified even without considering the many benefits they provide to human society besides storm-protection services.

[Helsinki declaration on patient safety in anaesthesiology -part 10: infection control/hygiene].

Science.gov (United States)

Kerwat, Klaus; Wulf, Hinnerk

2013-11-01

There is a plethora of laws, regulations, guidelines and recommendations relating to infection control and hygiene. Major issues are the prevention of nosocomial infections, staff protection and environmental protection. Of the highest relevance are the infection control law [Infektionsschutzgesetz (IfSG)], the hygiene regulations of the German federal states [Hygieneverordnungen der Bundesländer], the German technical rules for biological materials [Technische Regel Biologische Arbeitsstoffe 250 (TRBA 250)] - biological materials in health-care and welfare work [Biologische Arbeitsstoffe im Gesundheitswesen und in der Wohlfahrtspflege], the guidelines for hospital hygiene and prevention of infection of the commission for hospital hygiene and prevention of infection of the Robert-Koch Institute [Richtlinie für Krankenhaushygiene und Infektionsprävention von der Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert Koch-Institut], the recommendations of the commission on anti-infectives, resistance and therapy of the Robert-Koch Institute [Empfehlungen der Kommission Antiinfektiva, Resistenz und Therapie (ART) beim Robert Koch-Institut]. Of subordinate importance are, e.g., the recommendations of the German Society for Anesthesiology and Intensive Medicine (DGAI). It is practically impossible for an anesthesiologist working in a hospital to have knowledge of all laws, regulations, guidelines and recommendations. And this is also not reasonable. Thus it is necessary to distinguish the relevant from the irrelevant. Checklists can be useful here. The most important and effective individual action in hospital hygiene is and remains hand hygiene as is propagated in the action "clean hands", irrespective of all laws, regulations, guidelines and recommendations. © Georg Thieme Verlag Stuttgart · New York.

Risk Factors and Protective Factors for Lower-Extremity Running Injuries A Systematic Review.

Science.gov (United States)

Gijon-Nogueron, Gabriel; Fernandez-Villarejo, Marina

2015-11-01

A review of the scientific literature was performed 1) to identify studies describing the most common running injuries and their relation to the risk factors that produce them and 2) to search for potential and specific protective factors. Spanish and English biomedical search engines and databases (MEDLINE/PubMed, Database Enfermería Fisioterapia Podología [ENFISPO], Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature) were queried (February 1 to November 30, 2013). A critical reading and assessment was then performed by the Critical Appraisal Skills Programme Spanish tool. In total, 276 abstracts that contained the selected key words were found. Of those, 25 identified and analyzed articles were included in the results. Injuries result from inadequate interaction between the runner's biomechanics and external factors. This leads to an excessive accumulation of impact peak forces in certain structures that tends to cause overuse injuries. The main reasons are inadequate muscle stabilization and pronation. These vary depending on the runner's foot strike pattern, foot arch morphology, and sex. Specific measures of modification and control through running footwear are proposed.

Contemporary social network sites: Relevance in anesthesiology teaching, training, and research.

Science.gov (United States)

Haldar, Rudrashish; Kaushal, Ashutosh; Samanta, Sukhen; Ambesh, Paurush; Srivastava, Shashi; Singh, Prabhat K

2016-01-01

The phenomenal popularity of social networking sites has been used globally by medical professionals to boost professional associations and scientific developments. They have tremendous potential to forge professional liaisons, generate employment,upgrading skills and publicizing scientific achievements. We highlight the role of social networking mediums in influencing teaching, training and research in anaesthesiology. The growth of social networking sites have been prompted by the limitations of previous facilities in terms of ease of data and interface sharing and the amalgamation of audio visual aids on common platforms in the newer facilities. Contemporary social networking sites like Facebook, Twitter, Tumblr,Linkedn etc and their respective features based on anaesthesiology training or practice have been discussed. A host of advantages which these sites confer are also discussed. Likewise the potential pitfalls and drawbacks of these facilities have also been addressed. Social networking sites have immense potential for development of training and research in Anaesthesiology. However responsible and cautious utilization is advocated.

A test of the cerebellar hypothesis of dyslexia in adequate and inadequate responders to reading intervention.

Science.gov (United States)

Barth, Amy E; Denton, Carolyn A; Stuebing, Karla K; Fletcher, Jack M; Cirino, Paul T; Francis, David J; Vaughn, Sharon

2010-05-01

The cerebellar hypothesis of dyslexia posits that cerebellar deficits are associated with reading disabilities and may explain why some individuals with reading disabilities fail to respond to reading interventions. We tested these hypotheses in a sample of children who participated in a grade 1 reading intervention study (n = 174) and a group of typically achieving children (n = 62). At posttest, children were classified as adequately responding to the intervention (n = 82), inadequately responding with decoding and fluency deficits (n = 36), or inadequately responding with only fluency deficits (n = 56). Based on the Bead Threading and Postural Stability subtests from the Dyslexia Screening Test-Junior, we found little evidence that assessments of cerebellar functions were associated with academic performance or responder status. In addition, we did not find evidence supporting the hypothesis that cerebellar deficits are more prominent for poor readers with "specific" reading disabilities (i.e., with discrepancies relative to IQ) than for poor readers with reading scores consistent with IQ. In contrast, measures of phonological awareness, rapid naming, and vocabulary were strongly associated with responder status and academic outcomes. These results add to accumulating evidence that fails to associate cerebellar functions with reading difficulties.

Protection of hydrological heritage sites of Serbia: Problems and perspectives

Directory of Open Access Journals (Sweden)

Simić Sava

2012-01-01

Full Text Available Protection of hydrological heritage sites, water protection segment, is an integral part of nature conservation. Today it is the basic theme of the hydrological heritage, the new field of hydrology and geo-heritage, which, by exploring and evaluating hydrological diversity of a particular area and identifying representative water phenomena, sets their preservation and protection as one of the utmost objectives. Two main problems in the protection of water phenomena in Serbia are: inadequate attitude of the individual and society, as a result of poor knowledge of the characteristics and values of waters, and the ever-present need for men to use them (as resources. Lack of understanding, in the professional sphere, the value and importance of water phenomena in the natural system - as a result of a firmly based biocentrism in nature conservation, lack of hydrologic group within the geo-heritage and a small number of interested professionals are some of the associated problems that limit the activities in this field. Specific problems - from the lack of organized and synchronized scientific research to the lack of a database on the hydrological heritage sites, are somewhat common to other segments of the nature conservation of Serbia. There are three possible directions of the future actions on the protection of hydrological heritage sites of Serbia: complete protection, protection with utilization for the needs of tourism and protection with utilization for the needs of water management. The most complex task of hydrological heritage will just be to combine the preservation and protection with tourism and water management, because it is diverse and often conflicting industries about. A possible solution to this problem is illustrated through the idea of water reserves.

Response to baricitinib therapy in patients with rheumatoid arthritis with inadequate response to csDMARDs as a function of baseline characteristics.

Science.gov (United States)

Kremer, Joel M; Schiff, Michael; Muram, David; Zhong, Jinglin; Alam, Jahangir; Genovese, Mark C

2018-01-01

We analysed the effects of baseline characteristics on the safety and efficacy of baricitinib in patients with rheumatoid arthritis (RA) with inadequate response to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) from two phase III trials. In RA-BEAM (NCT01710358), patients with inadequate response to methotrexate were randomised to placebo, baricitinib 4 mg or adalimumab 40 mg. RA-BUILD (NCT01721057) patients had inadequate response to ≥1 csDMARDs and were randomised to either placebo or once-daily baricitinib (2 or 4 mg). Both study populations were naïve to biologic DMARDs (bDMARDs). Primary end point for both studies was American College of Rheumatology 20% improvement (ACR20) response at week 12. Pooled data from the two trials were analysed post hoc based on select subgroups defined by age, previous csDMARD use, baseline RA disease activity, etc, with assessment of clinical and safety outcomes at week 12 and radiographic outcomes at week 24 for the baricitinib 4 mg and placebo-treated patients. Efficacy was observed with baricitinib 4 mg treatment irrespective of patient demographics and baseline disease characteristics. ORs primarily favoured baricitinib over placebo in the ACR20 response. In other outcomes such as Disease Activity Score for 28 joints based on high-sensitivity C reactive protein levels, Simplified Disease Activity Index score ≤11 and radiographic progression, baricitinib 4 mg showed better responses than placebo regardless of baseline characteristics. Safety events were more common in patients over 65 years, but similar between baricitinib 4 mg and placebo patients. Baseline characteristics did not substantially affect clinical response to baricitinib 4 mg in patients with RA with inadequate response to csDMARDs.

The challenge of inadequate achievement in mathematics: Focus on a meta-approach

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Kobus Maree

2009-09-01

Full Text Available As is the case elsewhere in the world, all stakeholders in South Africa are deeply concerned about the level and scope of underachievement in mathematics, not only at Grade 12 level, but, indeed, at University, University of Technology and Further Education and Training levels. These concerns assume a deeper dimension in light of the fact that inadequate achievement in mathematics inevitably will have a ripple effect on the academic situation in any country: inadequate achievement in mathematics precludes learners from applying for admission to sought-after fi elds of study, which, in turn, prevents numerous learners from realising their true potential and, eventually, from being happy and successful in careers that they might otherwise have been able to execute successfully. It goes without saying that inadequate achievement in mathematics will impact negatively on the overall economic situation in any country (even more so in a developing country such as South Africa. Truth being, achievement in mathematics amounts to equipping oneself with survival skills. In this article, the spotlight shifts from a narrow and outdated focus on problems that are associated with inadequate achievement in mathematics to possible solutions for this disconcerting situation and the implied challenge it raises. The focus is thus on three levels that collectively underpin and impact on achievement in mathematics, viz. the macro level, the meso level and the micro level. The macro level refers mainly to the input by the national government (and, by default, the National Department of Education. In the fi rst instance, it is the responsibility of the state to provide adequate schooling facilities for all learners, irrespective of where they fi nd themselves. Furthermore, it is the duty of the state to ensure that every learner has access to basic facilities, including food, water, sanitation and housing. The state (via the National Department of Education is also

Review of the radiation protection calculations for the encapsulation plant

International Nuclear Information System (INIS)

Ranta-aho, A.

2008-09-01

The radiation protection calculations of the encapsulation plant have been carried out with the MCNP5 Monte Carlo code. The focus of the study has been in the parts of the encapsulation plant where the spent fuel is handled after discharge from the transportation casks i.e. the fuel handling cell, the fuel drying station, the canister transfer corridor, the welding chamber, the weld inspection room, the canister buffer storage and the canister lift. The protection against radiation hazard has been mainly designed with thick concrete walls. Additionally, the entrances to the rooms with shielding requirements have been equipped with mazes. The present design excludes doors with shielding properties. The aim of this work was to verify and evaluate the necessary wall thicknesses and the functioning of the mazes in the current design. The calculations verified that for the most parts of the facility, the currently designed walls thicknesses provide adequate protection against radiation from the different spent fuel assembly configurations. Some corrective actions however seem necessary in order to stay clearly below desired radiation limits. For the most parts the functioning of the mazes was inadequate. In some of the cases a different design of the maze will be sufficient action but in some cases the radiation protection can only be secured by heavy doors for practical reasons. (orig.)

Nonoclusive thrombosis of mechanical mitral valve prosthesis caused by inadequate treatment of anticoagulant therapy resistance

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Ivanović Branislava

2008-01-01

Full Text Available Background. Oral anticoagulants have been used in the prevention of thromboembolic complications for over six decades. A rare, but possible problem in the application of these medications could be resistance to them. Case report. We presented a patient with nonocclusive thrombosis of the mechanical mitral prosthesis due to inadequately treated resistance to peroral anticoagulant therapy. Resistance to oral anticoagulant medications was proven by an increased dosage of warfarin up to 20 mg and, after that, acenokumarol to 15 mg over ten days which did not lead to an increase in the international normalized ratio (INR value over 1.2. On the basis of information that she did not take food rich in vitamin K or medications which could reduce effects of oral anticoagulants, and that she did not have additional illnesses and conditions that could cause an inadequate response to anticoagulant therapy, it was circumstantially concluded that this was a hereditary form of resistance. Because of the existing mechanical prosthetics on the mitral position, low molecular heparin has been introduced into the therapy. The patient reduced it on her own initiative, leading to nonocclusive valvular thrombosis. Conclusion. When associated complications like absolute arrhithmia does not exist, the finding of resistance to oral anticoagulant agents is an indication for the replacement of a mechanical prosthetic with a biological one which has been done in this patients.

Explanatory factors for first and second-generation non-western women's inadequate prenatal care utilisation: a prospective cohort study.

Science.gov (United States)

Boerleider, Agatha W; Manniën, Judith; van Stenus, Cherelle M V; Wiegers, Therese A; Feijen-de Jong, Esther I; Spelten, Evelien R; Devillé, Walter L J M

2015-04-21

Little research into non-western women's prenatal care utilisation in industrialised western countries has taken generational differences into account. In this study we examined non-western women's prenatal care utilisation and its explanatory factors according to generational status. Data from 3300 women participating in a prospective cohort of primary midwifery care clients (i.e. women with no complications or no increased risk for complications during pregnancy, childbirth and the puerperium who receive maternity care by autonomous midwives) in the Netherlands (the DELIVER study) was used. Gestational age at entry and the total number of prenatal visits were aggregated into an index. The extent to which potential factors explained non-western women's prenatal care utilisation was assessed by means of blockwise logistic regression analyses and percentage changes in odds ratios. The unadjusted odds of first and second-generation non-western women making inadequate use of prenatal care were 3.26 and 1.96 times greater than for native Dutch women. For the first generation, sociocultural factors explained 43% of inadequate prenatal care utilisation, socioeconomic factors explained 33% and demographic and pregnancy factors explained 29%. For the second generation, sociocultural factors explained 66% of inadequate prenatal care utilisation. Irrespective of generation, strategies to improve utilisation should focus on those with the following sociocultural characteristics (not speaking Dutch at home, no partner or a first-generation non-Dutch partner). For the first generation, strategies should also focus on those with the following demographic, pregnancy and socioeconomic characteristics (aged ≤ 19 or ≥ 36, unplanned pregnancies, poor obstetric histories (extra-uterine pregnancy, molar pregnancy or abortion), a low educational level, below average net household income and no supplementary insurance.

Overload protection: avoidance response to heavy plantar surface loading.

Science.gov (United States)

Robbins, S E; Hanna, A M; Gouw, G J

1988-02-01

Current footwear which are designed for use in running are examples of intentional biomechanical model integration into device design. The inadequacy of this footwear in protecting against injury is postulated to be due to fixation on inadequate models of locomotory biomechanics that do not provide for feedback control; in particular, an hypothesized plantar surface sensory-mediated feedback control system, which imparts overload protection during locomotion. A heuristic approach was used to identify the hypothesized system. A random series of loads (0 to 164 kg) was applied to the knee flexed at 90 degrees. In this testing system, plantar surface avoidance behavior was the difference between the sum of the leg weight and the load applied to the knee, and the load measured at the plantar surface; this was produced by activation of hip flexors. Significant avoidance behavior was found in all of the subjects (P less than 0.001). On all surfaces tested, including modern athletic footwear (P less than 0.001), its magnitude increased directly in relation to the load applied to the knee (P less than 0.001). There were significant differences in avoidance behavior in relation to the weight-bearing surfaces tested (P less than 0.05). With the identification of a feedback control system which would serve to moderate loading during locomotion, an explanation is provided as to why current athletic footwear do not protect and may be injurious; thus allowing the design of footwear which may be truly protective.

Infection prevention during anaesthesia ventilation by the use of breathing system filters (BSF): Joint recommendation by German Society of Hospital Hygiene (DGKH) and German Society for Anaesthesiology and Intensive Care (DGAI).

Science.gov (United States)

Kramer, Axel; Kranabetter, Rainer; Rathgeber, Jörg; Züchner, Klaus; Assadian, Ojan; Daeschlein, Georg; Hübner, Nils-Olaf; Dietlein, Edeltrut; Exner, Martin; Gründling, Matthias; Lehmann, Christian; Wendt, Michael; Graf, Bernhard Martin; Holst, Dietmar; Jatzwauk, Lutz; Puhlmann, Birgit; Welte, Thomas; Wilkes, Antony R

2010-09-21

An interdisciplinary working group from the German Society of Hospital Hygiene (DGKH) and the German Society for Anaesthesiology and Intensive Care (DGAI) worked out the following recommendations for infection prevention during anaesthesia by using breathing system filters (BSF). The BSF shall be changed after each patient. The filter retention efficiency for airborne particles is recommended to be >99% (II). The retention performance of BSF for liquids is recommended to be at pressures of at least 60 hPa (=60 mbar) or 20 hPa above the selected maximum ventilation pressure in the anaesthetic system. The anaesthesia breathing system may be used for a period of up to 7 days provided that the functional requirements of the system remain unchanged and the manufacturer states this in the instructions for use.THE BREATHING SYSTEM AND THE MANUAL VENTILATION BAG ARE CHANGED IMMEDIATELY AFTER THE RESPECTIVE ANAESTHESIA IF THE FOLLOWING SITUATION HAS OCCURRED OR IT IS SUSPECTED TO HAVE OCCURRED: Notifiable infectious disease involving the risk of transmission via the breathing system and the manual bag, e.g. tuberculosis, acute viral hepatitis, measles, influenza virus, infection and/or colonisation with a multi-resistant pathogen or upper or lower respiratory tract infections. In case of visible contamination e.g. by blood or in case of defect, it is required that the BSF and also the anaesthesia breathing system is changed and the breathing gas conducting parts of the anaesthesia ventilator are hygienically reprocessed.Observing of the appropriate hand disinfection is very important. All surfaces of the anaesthesia equipment exposed to hand contact must be disinfected after each case.

Gaps in governance: protective mechanisms used by nurse leaders when policy and practice are misaligned.

Science.gov (United States)

Knight, Kaye M; Kenny, Amanda; Endacott, Ruth

2015-04-09

Due to large geographical distances, the telephone is central to enabling rural Australian communities to access care from their local health service. While there is a history of rural nurses providing care via the telephone, it has been a highly controversial practice that is not routinely documented and little is known about how the practice is governed. The lack of knowledge regarding governance extends to the role of Directors of Nursing as clinical leaders charged with the responsibility of ensuring practice safety, quality, regulation and risk management. The purpose of this study was to identify clinical governance processes related to managing telephone presentations, and to explore Directors of Nursing perceptions of processes and clinical practices related to the management of telephone presentations to health services in rural Victoria, Australia. Qualitative documentary analysis and semi structured interviews were used in the study to examine the content of health service policies and explore the perceptions of Directors of Nursing in eight rural health services regarding policy content and enactment when people telephone rural health services for care. Participants were purposively selected for their knowledge and leadership role in governance processes and clinical practice. Data from the interviews were analysed using framework analysis. The process of analysis resulted in the identification of five themes. The majority of policies reviewed provided little guidance for managing telephone presentations. The Directors of Nursing perceived policy content and enactment to be largely inadequate. When organisational structures failed to provide appropriate governance for the context, the Directors of Nursing engaged in protective mechanisms to support rural nurses who manage telephone presentations. Rural Directors of Nursing employed intuitive behaviours to protect rural nurses practicing within a clinical governance context that is inadequate for the

Intravenous glutathione for skin lightening: Inadequate safety data ...

African Journals Online (AJOL)

protein thiol that protects mammalian cells from oxidative stress. Intravenous (IV) GSH for skin lightening is advertised by clinics in South Africa and internationally online, yet to date no published review on the subject exists. Methods.

Sustainable Land Use, Soil Protection and Phosphorus Management from a Cross-National Perspective

Directory of Open Access Journals (Sweden)

Jessica Stubenrauch

2018-06-01

Full Text Available The scarcity of phosphorus (P is a global concern that is not restricted to western industrialized nations. Until now, most countries in the world are highly dependent on importing mineral P fertilizers for agriculture. The industrialized nation of Germany, the emerging economy of Costa Rica, and the developing country of Nicaragua are examined with regard to their legislation in the field of environmental protection and agriculture, in particular with regard to soil protection and fertilizer law. Based on the structure of agriculture in each country, control weaknesses in legislation in the individual countries, which is largely determined by command-and-control law, are identified and compared. It becomes clear that soil protection in all three countries has not yet been adequately standardised in law and at the same time the efficient use of organic or recycled P fertilizers instead of (finite mineral P fertilizers is inadequately regulated. In particular, frugality, i.e., the strategy of lower (and not only more efficient consumption of P fertilizers, has so far played no regulatory role in land-use governance.

Description of a method of control for glass lenses used as a protection medium against radiation

International Nuclear Information System (INIS)

Alonso, J.V.S.; Torio, P.P.

1977-01-01

The control of ocular protection medium which is normally used by workers, finds itself confronted by unsurmountable difficulties. Transmission determination needs fine glass lenses, extrapolating the values obtained to the real value of the medium used. The degree of protection required of the glass used by workers has been determined using successive approximations. The work method is quick and simple, and the apparatus used is within the reach of any medium sized laboratory. A theoretical justification has been made of the fundamental principles of the method; for example, the protective power of various filter lenses used by workers in this country has been determined. The method has been centred on the possibility of its practical application. The results obtained are interpreted taking into consideration a possible emissing source, and their discussion is based on prevailing standards which exist in most European countries. The control carried out has allowed to state that in most cases the protection medium used is not adequate, owing to a poor selection or an inadequate maintenance

Predictors of sun protection behaviors and severe sunburn in an international online study.

Science.gov (United States)

Bränström, Richard; Kasparian, Nadine A; Chang, Yu-mei; Affleck, Paul; Tibben, Aad; Aspinwall, Lisa G; Azizi, Esther; Baron-Epel, Orna; Battistuzzi, Linda; Bergman, Wilma; Bruno, William; Chan, May; Cuellar, Francisco; Debniak, Tadeusz; Pjanova, Dace; Ertmanski, Slawomir; Figl, Adina; Gonzalez, Melinda; Hayward, Nicholas K; Hocevar, Marko; Kanetsky, Peter A; Leachman, Sancy A; Heisele, Olita; Palmer, Jane; Peric, Barbara; Puig, Susana; Schadendorf, Dirk; Gruis, Nelleke A; Newton-Bishop, Julia; Brandberg, Yvonne

2010-09-01

The incidence of melanoma continues to increase in many countries, and primary prevention of melanoma includes avoidance of sunburn as well as adequate sun protection behavior. The aim of this study was to examine the prevalence of self-reported sun protection behaviors and sunburn in users of the Internet, and to identify the demographic, clinical, and attitudinal/motivational correlates of sun protection behaviors. Self-report data were gathered on behalf of the GenoMEL consortium using an online survey available in 10 different languages, and 8,178 individuals successfully completed at least 80% of survey items, with 73% of respondents from Europe, 12% from Australia, 7% from the United States, 2% from Israel, and 6% from other countries. Half of all respondents and 27% of those with a previous melanoma reported at least one severe sunburn during the previous 12 months. The strongest factors associated with sun protection behavior were perceived barriers to protection (beta = -0.44/beta = -0.37), and respondents who reported a positive attitude toward suntans were less likely to protect (beta = -0.16/beta = -0.14). Reported use of protective clothing and shade, as well as avoidance of midday sun exposure, were more strongly related to reduced risk of sunburn than sunscreen use. Despite widespread dissemination of public health messages about the importance of sun protection, a substantial proportion of this international sample, including respondents with a previous melanoma, reported inadequate sun protection behaviors resulting in severe sunburn. Future strategies to decrease sunburn should target the practical, social, and psychological barriers associated with nonuptake of sun protection. (c)2010 AACR.

Predictors of Sun Protection Behaviours and Severe Sunburn inan International on-line study

Science.gov (United States)

Bränström, Richard; Kasparian, Nadine A.; Chang, Yu-mei; Affleck, Paul; Tibben, Aad; Aspinwall, Lisa G.; Azizi, Esther; Baron-Epel, Orna; Battistuzzi, Linda; Bergman, Wilma; Bruno, William; Chan, May; Cuellar, Francisco; Dębniak, Tadeusz; Pjanova, Dace; Ertmański, Sƚawomir; Figl, Adina; Gonzalez, Melinda; Hayward, Nicholas K.; Hocevar, Marko; Kanetsky, Peter A.; Leachman, Sancy A.; Heisele, Olita; Palmer, Jane; Peric, Barbara; Puig, Susana; Schadendorf, Dirk; Gruis, Nelleke A.; Newton-Bishop, Julia; Brandberg, Yvonne

2013-01-01

Background The incidence of melanoma continues to increase in many countries, and primary prevention of melanoma includes avoidance of sunburn as well as adequate sun protection behaviour. The aim of this study was to examine the prevalence of self-reported sun protection behaviours and sunburn in users of the Internet, and to identify the demographic, clinical and attitudinal/motivational correlates of sun protection behaviours. Methods Self-report data were gathered on behalf of GenoMEL (www.genomel.org) using an online survey available in 10 different languages, and 8,178 individuals successfully completed at least 80% of survey items, with 73% of respondents from Europe, 12% from Australia, 7% from the USA, 2% from Israel, and 6% from other countries. Results Half of all respondents and 27% of those with a previous melanoma reported at least one severe sunburn during the previous 12 months. The strongest factors associated with sun protection behaviour were perceived barriers to protection (β=−0.44/β=−0.37), and respondents who reported a positive attitude towards suntans were less likely to protect (β=−0.16/β=−0.14). Reported use of protective clothing and shade, as well as avoidance of midday sun exposure, were more strongly related to reduced risk of sunburn than sunscreen use. Conclusions Despite widespread dissemination of public health messages about the importance of sun protection, a substantial proportion of this international sample, including respondents with a previous melanoma, reported inadequate sun protection behaviours resulting in severe sunburn. Impact Future strategies to decrease sunburn should target the practical, social and psychological barriers associated with non-uptake of sun protection. PMID:20643826

Ground and surface water in New Mexico: are they protected against uranium mining and milling

International Nuclear Information System (INIS)

Townsend, K.K.

1978-01-01

Inadequate funds to allow New Mexico to collect data on the effects of uranium mining and milling on ground and surface water resources and vigorous opposition by the uranium companies have made the Environmental Protection Agency reluctant to adopt the state's request for control of discharges. The state is unable to monitor for the presence of toxic materials and questions have been raised over EPA's jurisdiction over groundwater. Federal and state water pollution regulations are reviewed and weaknesses noted, particularly the effect of terrain and the limitations on regulation of navigable waters

Assessing the effectiveness of specially protected areas for conservation of Antarctica's botanical diversity.

Science.gov (United States)

Hughes, Kevin A; Ireland, Louise C; Convey, Peter; Fleming, Andrew H

2016-02-01

Vegetation is sparsely distributed over Antarctica's ice-free ground, and distinct plant communities are present in each of the continent's 15 recently identified Antarctic Conservation Biogeographic Regions (ACBRs). With rapidly increasing human activity in Antarctica, terrestrial plant communities are at risk of damage or destruction by trampling, overland transport, and infrastructure construction and from the impacts of anthropogenically introduced species, as well as uncontrollable pressures such as fur seal (Arctocephalus gazella) activity and climate change. Under the Protocol on Environmental Protection to the Antarctic Treaty, the conservation of plant communities can be enacted and facilitated through the designation of Antarctic Specially Protected Areas (ASPAs). We examined the distribution within the 15 ACBRs of the 33 ASPAs whose explicit purpose includes protecting macroscopic terrestrial flora. We completed the first survey using normalized difference vegetation index (NDVI) satellite remote sensing to provide baseline data on the extent of vegetation cover in all ASPAs designated for plant protection in Antarctica. Large omissions in the protection of Antarctic botanical diversity were found. There was no protection of plant communities in 6 ACBRs, and in another 6, area was included in an ASPA that protected vegetation. Protected vegetation cover within the 33 ASPAs totaled 16.1 km(2) for the entire Antarctic continent; over half was within a single protected area. Over 96% of the protected vegetation was contained in 2 ACBRs, which together contributed only 7.8% of the continent's ice-free ground. We conclude that Antarctic botanical diversity is clearly inadequately protected and call for systematic designation of ASPAs protecting plant communities by the Antarctic Treaty Consultative Parties, the members of the governing body of the continent. © 2015 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society

An influenza viral vector Brucella abortus vaccine induces good cross-protection against Brucella melitensis infection in pregnant heifers.

Science.gov (United States)

Tabynov, Kaissar; Ryskeldinova, Sholpan; Sansyzbay, Abylai

2015-07-17

Brucella melitensis can be transmitted and cause disease in cattle herds as a result of inadequate management of mixed livestock farms. Ideally, vaccines against Brucella abortus for cattle should also provide cross-protection against B. melitensis. Previously we created a novel influenza viral vector B. abortus (Flu-BA) vaccine expressing the Brucella ribosomal proteins L7/L12 or Omp16. This study demonstrated Flu-BA vaccine with adjuvant Montanide Gel01 provided 100% protection against abortion in vaccinated pregnant heifers and good cross-protection of the heifers and their calves or fetuses (90-100%) after challenge with B. melitensis 16M; the level of protection provided by Flu-BA was comparable to the commercial vaccine B. abortus S19. In terms of the index of infection and colonization of Brucella in tissues, both vaccines demonstrated significant (P=0.02 to P<0.0001) protection against B. melitensis 16M infection compared to the negative control group (PBS+Montanide Gel01). Thus, we conclude the Flu-BA vaccine provides cross-protection against B. melitensis infection in pregnant heifers. Copyright © 2015 Elsevier Ltd. All rights reserved.

Pre-operative fasting: a nationwide survey of German anaesthesia departments.

Science.gov (United States)

Breuer, J-P; Bosse, G; Seifert, S; Prochnow, L; Martin, J; Schleppers, A; Geldner, G; Soreide, E; Spies, C

2010-03-01

Shorter pre-operative fasting improves clinical outcome without an increased risk. Since October 2004, German Anaesthesiology Societies have officially recommended a fast of 2 h for clear fluids and 6 h for solid food before elective surgery. We conducted a nationwide survey to evaluate the current clinical practice in Germany. Between July 2006 and January 2007, standardized questionnaires were mailed to 3751 Anaesthesiology Society members in leading positions requesting anonymous response. The overall response rate was 66% (n=2418). Of those, 2148 (92%) claimed familiarity with the new guidelines. About a third (n=806, 34%) reported full adherence to the new recommendations, whereas 1043 (45%) reported an eased fasting practice. Traditional Nil per os after midnight was still recommended by 157 (7%). Commonest reasons reported for adopting the new guidelines were: 'improved pre-operative comfort' (84%), and 'increased patient satisfaction' (83%); reasons against were: 'low flexibility in operation room management' (19%), and 'increased risk of aspiration' (13%). Despite the apparent understanding of the benefits from reduced pre-operative fasting, full implementation of the guidelines remains poor in German anaesthesiology departments.

Local environmental conditions and the stability of protective layers on steel surfaces

Energy Technology Data Exchange (ETDEWEB)

Jensen, J P [Technical Univ. of Denmark, Lyngby (Denmark); Bursik, A

1996-12-01

Local environmental conditions determine whether the protective layers on steel surfaces are stable. With unfavorable local environmental conditions, the protective layers may be subject to damage. Taking the cation conductivity of all plant cycle streams <0.2 {mu}S/cm for granted, an adequate feed-water and - if applicable - boiler water conditioning is required to prevent such damage. Even if the mentioned conditions are met in a bulk, the local environmental conditions may be inadequate. The reasons for this may be the disregarding of interactions among material, design, and chemistry. The paper presents many possible mechanisms of protective layer damage that are directly influenced or exacerbated by plant cycle chemistry. Two items are discussed in more detail: First, the application of all volatile treatment for boiler water conditioning of drum boiler systems operating at low pressures and, second, the chemistry in the transition zone water/steam in the low pressure turbine. The latter is of major interest for the understanding and prevention of corrosion due to high concentration of impurities in the aqueous liquid phases. This is a typical example showing that local environmental conditions may fundamentally differ from the overall bulk chemistry. (au) 19 refs.

Medical students' knowledge of ionizing radiation and radiation protection.

Science.gov (United States)

Hagi, Sarah K; Khafaji, Mawya A

2011-05-01

To assess the knowledge of fourth-year medical students in ionizing radiation, and to study the effect of a 3-hour lecture in correcting their misconceptions. A cohort study was conducted on fourth-year medical students at King Abdul-Aziz University, Jeddah, Kingdom of Saudi Arabia during the academic year 2009-2010. A 7-question multiple choice test-type questionnaire administered before, and after a 3-hour didactic lecture was used to assess their knowledge. The data was collected from December 2009 to February 2010. The lecture was given to 333 (72%) participants, out of the total of 459 fourth-year medical students. It covered topics in ionizing radiation and radiation protection. The questionnaire was validated and analyzed by 6 content experts. Of the 333 who attended the lecture, only 253 (76%) students completed the pre- and post questionnaire, and were included in this study. The average student score improved from 47-78% representing a gain of 31% in knowledge (p=0.01). The results indicated that the fourth-year medical students' knowledge regarding ionizing radiation and radiation protection is inadequate. Additional lectures in radiation protection significantly improved their knowledge of the topic, and correct their current misunderstanding. This study has shown that even with one dedicated lecture, students can learn, and absorb general principles regarding ionizing radiation.

Compliance with technical standards for radiological protection at radiation therapy services in Sao Paulo State, Brazil

International Nuclear Information System (INIS)

Eduardo, Maria Bernadete de Paula; Novaes, Hillegonda Maria Dutilh

2004-01-01

Radiation therapy services provide essential therapeutic procedures for cancer, one of the main causes of population morbidity and mortality. Despite their importance in the health system and their potential risks due to the use of ionizing radiation, there are few studies on such services. We evaluated compliance with technical standards for radiological protection in radiation therapy services in Sao Paulo State, Brazil. Forty-nine services were studied in 2000 through interviews with technical staff. Typologies of performance profiles focusing on structure and process variables were constructed and services compared. Important differences were observed in the services' positions in the health care system, level of complexity, and geographic distribution, with better average performance in structural conditions but very inadequate performance in patient protection, indicating the need for more effective health surveillance. (author)

Predicting inadequate bowel preparation for colonoscopy in participants receiving split-dose bowel preparation: development and validation of a prediction score

NARCIS (Netherlands)

Dik, V.K.; Moons, L.M.; Huyuk, M.; Schaar, P. van der; Cappel, W.H. de Vos Tot Nede; Borg, P.C. ter; Meijssen, M.A.; Ouwendijk, R.J.; Fevre, D.M. Le; Stouten, M.; Galien, O. van der; Hiemstra, T.J.; Monkelbaan, J.F.; Oijen, M.G. van; Siersema, P.D.

2015-01-01

BACKGROUND: Adequate bowel preparation is important for optimal colonoscopy. It is important to identify patients at risk for inadequate bowel preparation because this allows taking precautions in this specific group. OBJECTIVE: To develop a prediction score to identify patients at risk for

Predicting inadequate bowel preparation for colonoscopy in participants receiving split-dose bowel preparation : Development and validation of a prediction score

NARCIS (Netherlands)

Dik, Vincent K.; Moons, Leon M G; Hüyük, Melek; Van Der Schaar, Peter; De Vos Tot Nederveen Cappel, Wouter H.; Ter Borg, Pieter C J; Meijssen, Maarten A C; Ouwendijk, Rob J T H; Le Fèvre, Doris M.; Stouten, Merijn; Van Der Galiën, Onno; Hiemstra, Theo J.; Monkelbaan, Jan F.; van Oijen, Martijn G. H.; Siersema, Peter D.; Tang, Thjon J.; Ter Borg, Frank; Kuipers, Ernst J.

2015-01-01

Background: Adequate bowel preparation is important for optimal colonoscopy. It is important to identify patients at risk for inadequate bowel preparation because this allows taking precautions in this specific group. Objective: To develop a prediction score to identify patients at risk for

Ethical considerations in internet use of electronic protected health information.

Science.gov (United States)

Polito, Jacquelyn M

2012-03-01

Caregivers, patients, and their family members are increasingly reliant on social network websites for storing, communicating, and referencing medical information. The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule seeks balance by protecting the privacy of patients' health information and assuring that this information is available to those who need it to provide health care. Though federal and state governments have created laws and policies to safeguard patient privacy and confidentiality, the laws are inadequate against the rapid and innovative use of electronic health websites. As Internet use broadens access to information, health professionals must be aware that this information is not always secure. We must identify and reflect on medical ethics issues and be accountable for maintaining privacy for the patient.

Gonad protection in young orthopaedic patients.

Science.gov (United States)

Kenny, N; Hill, J

1992-05-30

To determine whether gonad shields are correctly positioned on the pelvic radiographs of children with slipped capital femoral epiphysis. Retrospective study of radiographs taken of children treated by in situ pinning of slipped capital femoral epiphysis between 1 January 1983 and 31 December 1988. Three teaching hospitals in north west England. 32 patients with complete set of radiographs. An average of 10.8 anteroposterior pelvic radiographs plus 8.9 lateral hip radiographs had been performed per patient. Gonad shields had been completely omitted in 137 (40%) anteroposterior pelvic radiographs performed on the 32 patients at the time of completion of the study. In 100 (29%) the gonad shields were adequately protecting the gonads, but in 109 (31%) the gonad shields were not protecting the gonads due to incorrect positioning of the shield. The incorrect positioning of the gonad shields was more commonly found in girls than boys (64 vs 45; p less than 0.012), presumably because of the difficulty in determining gonadal position in relation to surface landmarks. Absence of gonad shields was also more commonly seen in girls (82 v 55; p less than 0.005), but this is not easily explained. Gonad shields are not protecting the gonads in a large percentage of anteroposterior pelvic radiographs (71%) because they have been omitted or inadequately placed. This avoidable excess radiation exposure to the gonads, combined with the inability to shield the gonads in lateral hip radiographs and the large number of radiographs performed, results in the gonads receiving a higher dose of radiation than may otherwise be the case, and may increase the potential for disease in the future offspring of these patients.

Assessment of the Academic Staff’s Knowledge, Attitudes and Habits Related to Sun Protection and Sunscreen Use

Directory of Open Access Journals (Sweden)

Emine Tuğba Alataş

2018-03-01

Full Text Available Objective: In recent years, the risk of cutaneous melanoma, skin cancers and photo sensitive skin diseases is increasing with the rise in unconscious sunbathe. The aim of our study is to investigate the knowledge, attitudes and habits of academic staff related to sun protection. Methods: A cross-sectional study was conducted in which 438 academic staff participated (a response rate 30.4%. The academic staff was asked to fill out our survey of 26 questions. Results: One hundred ninety-six women (44.7% and 242 men (55.3% participated in the study. Among the sun protection methods applied by the academic staff were applying sun protection cream, using sun glasses and avoiding sunlight as the first three methods, respectively. When the academic staff’s knowledge levels of sunscreen creams, sun protection factor (SPF, ultraviolet A (UVA and ultraviolet B (UVB assessed, it was determined that 11.2% of the participants knew the definition of SPF 30. In the question about UVA and UVB, 27.9% answered correctly. Conclusion: The use of sun protective cream among the sun protection methods by the academic staff is the first place. However, it has been determined that this method of protection is not conscious and regularly. Academic staff’s knowledge of sun protective creams, SPF, UVB and UVA was found to be inadequate.

Intubation af førstegangsfødende med Klippel-Feils syndrom

DEFF Research Database (Denmark)

Münter, Kristine; Johansen, Jakob; Atke, Anders

2014-01-01

We describe a case of a first time parturient with Klippel-Feil syndrome (KFS). KFS is defined by fusion of cervical vertebrae and the clinical triad of low posterior hairline, short wide neck and limited neck movement. KFS represents a complex challenging anaesthesiologic condition due to limite...... spine disorder that might need airway management....... movement of the neck and the risk of irreversible neurologic sequelae if manipulated, as well as unpredictable effect of neuroaxial anaesthesia. We recommend awake fiberoptic intubation for airway management in this rare disorder and stress the necessity of early anaesthesiologic assessment in any cervical...

Results of salvage radiotherapy after inadequate surgery in invasive cervical carcinoma patients: A retrospective analysis

International Nuclear Information System (INIS)

Saibishkumar, Elantholi P.; Patel, Firuza D.; Ghoshal, Sushmita; Kumar, Vinay; Karunanidhi, Gunaseelan; Sharma, Suresh C.

2005-01-01

Purpose: To evaluate the results of salvage radiotherapy (RT) after inadequate surgery in patients with invasive carcinoma of the cervix. Methods and Materials: Between 1996 and 2001, 105 invasive cervical carcinoma patients were treated at our center with external beam RT with or without intracavitary RT after having undergone total/subtotal hysterectomy at outside institutions. Results: The median follow-up was 34 months. The gap between surgery and RT was 23-198 days (median, 80). Clinically visible residual disease was present in 81 patients (77.1%). Total hysterectomy had been done in 82 patients (78%) and subtotal hysterectomy in 23 patients (22%). The 5-year overall survival, disease-free survival, and pelvic control rates of all patients were 55.2%, 53.3%, and 72.4%, respectively. On univariate analysis, older age, total hysterectomy, hemoglobin level >10 g% before RT, nonsquamous histologic type, use of intracavitary RT, a shorter gap between surgery and RT, and the absence of, or a small volume of, residual disease favorably affected the outcome. The 5-year actuarial rate of late toxicity (Radiation Therapy Oncology Group Criteria) was 19% in the rectum, 4.8% in the bladder, 24.8% in the skin, and 14.3% in the small intestine. Conclusions: Inadequate and inappropriate surgery in invasive cervical cancer with resulting gross residual disease is common in India. Factors such as the use of intracavitary RT, the correction of anemia, and a shorter gap between surgery and RT will enable postoperative RT to achieve acceptable results with minimal morbidity

Inadequate Riboflavin Intake and Anemia Risk in a Chinese Population: Five-Year Follow Up of the Jiangsu Nutrition Study

Science.gov (United States)

Shi, Zumin; Zhen, Shiqi; Wittert, Gary A.; Yuan, Baojun; Zuo, Hui; Taylor, Anne W.

2014-01-01

Objectives Riboflavin (vitamin B2) has been shown in animal studies to affect the absorption and metabolism of iron. Cross-sectional population studies show a relationship between riboflavin intake and anemia but prospective population studies are limited. The aim of the study was to determine the relationship between riboflavin intake and the risk of anemia in a Chinese cohort. Method The study used data from 1253 Chinese men and women who participated in two waves of the Jiangsu Nutrition Study (JIN), five years apart, in 2002 and 2007. Riboflavin intake and hemoglobin (Hb) were quantitatively assessed together with dietary patterns, lifestyle, socio-demographic and health-related factors. Results At baseline, 97.2% of participants had inadequate riboflavin intake (below the estimate average requirement). Riboflavin intake was positively associated with anemia at baseline, but low riboflavin intake was associated with an increased risk of anemia at follow-up among those anemic at baseline. In the multivariate model, adjusting for demographic and lifestyle factors and dietary patterns, the relative risk and 95% confidence interval for anemia at follow-up, across quartiles of riboflavin intake were: 1, 0.82(0.54–1.23), 0.56(0.34–0.93), 0.52(0.28–0.98) (p for trend 0.021). There was a significant interaction between riboflavin and iron intake; when riboflavin intake was low, a high iron intake was associated with a lower probability of anemia at follow-up. This association disappeared when riboflavin intake was high. Conclusion Inadequate riboflavin intake is common and increases the risk of anemia in Chinese adults. Given the interaction with iron intake correcting inadequate riboflavin intake may be a priority in the prevention of anemia, and population based measurement and intervention trials are required. PMID:24533156

[The current situation of occupational protection against skin/mucosa contamination among obstetrician and gynecologist].

Science.gov (United States)

Zhang, Yujuan; Li, Peng; Wang, Jianmei; Huo, Yan; Yang, Jing

2015-03-01

To investigate the occurrence and protection of skin/mucosa contamination among obstetrician and gynecologist. By random, stratified, and clustered sampling, 219 obstetrician and gynecologist were selected. 210 valid questionnaires were collected, efficiency is 95.89%. 110 obstetrician and gynecologist come from tertiary hospitals, 100 come from secondary hospitals. A self-administered questionnaire on skin/mucosa contamination was employed to gauge the implementation of protection, types and working links of skin/mucosa contamination. Of the respondents, only 14.76% (31/210) and 5.24% (11/210) adhered to proper hand washing and wearing protective glasses within nearly 1 year in practical work. Of the respondents, 73.81% (155/210) had experienced the skin/mucosa contamination during their vocation, 50.95% (107/210) occurred sharps injuries, 45.71% (96/210) occurred damaged skin contamination, and 43.33% (91/210) occurred mucosa contamination. Sharps injuries mainly occurred when abdominal operation (45.71%, 96/120), damaged skin contamination mainly occurred when gynecological examination (21.43%, 45/210), and mucosa contamination mainly occurred when midwifery (37.14%, 78/210). The implementation of protective measures is inadequate and incidence of skin/mucosa contamination is higher among obstetrician and gynecologist. Therefore, occupational protection education should focus on different types and working links of skin/mucosa contamination. At the same time, strict supervision and management system should be established.

Personal protective equipment and improving compliance among healthcare workers in high-risk settings.

Science.gov (United States)

Honda, Hitoshi; Iwata, Kentaro

2016-08-01

Personal protective equipment (PPE) protects healthcare workers (HCWs) from infection by highly virulent pathogens via exposure to body fluids and respiratory droplets. Given the recent outbreaks of contagious infectious diseases worldwide, including Ebola virus and Middle Eastern respiratory syndrome, there is urgent need for further research to determine optimal PPE use in high-risk settings. This review intends to provide a general understanding of PPE and to provide guidelines for appropriate use based on current evidence. Although previous studies have focused on the efficacy of PPE in preventing transmission of pathogens, recent studies have examined the dangers to HCWs during removal of PPE when risk of contamination is highest. Access to adequate PPE supplies is crucial to preventing transmission of pathogens, especially in resource-limited settings. Adherence to appropriate PPE use is a challenge due to inadequate education on its usage, technical difficulties, and tolerability of PPE in the workplace. Future projects aim at ameliorating this situation, including redesigning PPE which is crucial to improving the safety of HCWs. PPE remains the most important strategy for protecting HCW from potentially fatal pathogens. Further research into optimal PPE design and use to improve the safety of HCWs is urgently needed.

Experimental Study on the Influence of AC Stray Current on the Cathodic Protection of Buried Pipe

Directory of Open Access Journals (Sweden)

Qingmiao Ding

2016-01-01

Full Text Available The size of the damaged area of the coating and its position on the pipeline impacted the cathodic protection potential, and there was a damaged area of the greatest impact value. When damaged area was 300 mm2, the IR drop was the largest, and this situation could easily lead to inadequate protection; when the parallel spacing between pipeline and interference source was unchanged, the measured value curves of cathodic protection potential presented “U” shaped trend with the increasing stray current interference intensity. Under certain parallel spacing between pipeline and interference source, high alternating stray current intensity would cause serious negative offsets, so that the overprotection of the pipeline occurred, and make the coating crack; there was a parallel threshold length. When less than the threshold, the pipe-ground potential increases rapidly with the parallel length increasing. In order to judge whether a pipeline was interference by AC stray current and the risk of stray current corrosion, we should make a comprehensive analysis of the cathodic protection energizing potential, the switch-off potential, AC pipe-soil potential, IR drops, and so on.

NPP physical protection and information security as necessary conditions for reducing nuclear and radiation accident risks

International Nuclear Information System (INIS)

Pogosov, O.Yu.; Derevyanko, O.V.

2017-01-01

The paper focuses on the fact that nuclear failures and incidents can lead to radioactive contamination of NPP premises. Nuclear and radiation hazard may be caused by malefactors in technological processes when applying computers or inadequate control in case of insufficient level of information security.The researchers performed analysis of factors for reducing risks of nuclear and radiation accidents at NPPs considering specific conditions related to information security of NPP physical protection systems. The paper considers connection of heterogeneous factors that may increase the risk of NPP accidents, possibilities and ways to improve adequate modelling of security of information with limited access directly related to the functioning of automated set of engineering and technical means for NPP physical protection. Within the overall Hutchinson formalization, it is proposed to include additional functional dependencies on indicators specific for NPPs into analysis algorithms.

MODERNIZATION OF RUSSIAN HEALT PROTECTION SYSTEM SOLVES THE PROBLEM OF RENDERING QUALITY MEDICAL AID TO POPULATION

Directory of Open Access Journals (Sweden)

V. A. Alexeev

2011-01-01

Full Text Available Last two dozen years, permanent growth of death rate and decrease birth rate take place in Russia. To great extent, this is owing to inadequate health protection system. The practice of personal payments for medical services in amounts unattainable for overwhelming majority of thepopulation grows. RF President’s Administration sets an example: cardiologist’s advice in their clinics costs 40 times more that according to obligatory medical insurance rates. 84% of the country citizens do not approve this approach and consider it socially unjust. An important national project aimed at modernization of the health protection system started in 2011. Non-private medical establishments are to be equipped with up-to-date equipment, modern information systems and medical service standards based on CRM system adopted in developed countries; salaries of health personnel are to be increased.

Non-western women in maternity care in the Netherlands: Exploring 'inadequate' use of prenatal care and the experiences of care professionals

NARCIS (Netherlands)

Boerleider, A.W.

2015-01-01

Non-western women in the Netherlands are more likely to make inadequate use of prenatal care than native Dutch women. Furthermore, non-western women are diverse in origin which implies diversity in their needs and expectations for maternity care. This thesis examines the factors and reasons

Evaluation of the integrity of radiological protection clothing used in veterinary radiology

Energy Technology Data Exchange (ETDEWEB)

Rosa, Paola da Costa; Barros, Frieda Saicla; Costa, Douglas Siqueira da, E-mail: paah_dacosta@hotmail.com [Universidade Tecnologica Federal do Parana (UTFPR), Curitiba, PR (Brazil). Curso Superior de Tecnologia em Radiologia e Programa de Pos-Graduacao em Engenharia Biomedica

2017-11-01

This study aimed to evaluate the integrity of radiological protection clothing used by veterinarians in veterinary radiology facilities, and whether they are available in an adequate quantity for the team. Inspection was performed by palpation, followed by X-ray scanning in 189 clothing from 29 veterinary facilities. The results indicate that 5% of the clothes evaluated in this study were considered inadequate due to the failure of the integrity of the lead, being most lead aprons. All facilities have at least two lead aprons and one Thyroid protectors. 24% of the facilities have lead glasses, pointing to a risk to veterinarians by radiosensitivity of the eyes. Also, 24% of the facilities do not have lead gloves, which also presents a risk due to the hand's exposure to the primary beam. Most lead clothing has shield equivalence of 0.5mmPb. The method used in the study was effective in attesting the adequacy of lead clothing. It is recommended to periodically evaluate clothing to ensure that users are always protected. (author)

Evaluation of the integrity of radiological protection clothing used in veterinary radiology

International Nuclear Information System (INIS)

Rosa, Paola da Costa; Barros, Frieda Saicla; Costa, Douglas Siqueira da

2017-01-01

This study aimed to evaluate the integrity of radiological protection clothing used by veterinarians in veterinary radiology facilities, and whether they are available in an adequate quantity for the team. Inspection was performed by palpation, followed by X-ray scanning in 189 clothing from 29 veterinary facilities. The results indicate that 5% of the clothes evaluated in this study were considered inadequate due to the failure of the integrity of the lead, being most lead aprons. All facilities have at least two lead aprons and one Thyroid protectors. 24% of the facilities have lead glasses, pointing to a risk to veterinarians by radiosensitivity of the eyes. Also, 24% of the facilities do not have lead gloves, which also presents a risk due to the hand's exposure to the primary beam. Most lead clothing has shield equivalence of 0.5mmPb. The method used in the study was effective in attesting the adequacy of lead clothing. It is recommended to periodically evaluate clothing to ensure that users are always protected. (author)

Rethinking clinical trials of transcranial direct current stimulation: participant and assessor blinding is inadequate at intensities of 2mA.

Directory of Open Access Journals (Sweden)

Neil E O'Connell

Full Text Available BACKGROUND: Many double-blind clinical trials of transcranial direct current stimulation (tDCS use stimulus intensities of 2 mA despite the fact that blinding has not been formally validated under these conditions. The aim of this study was to test the assumption that sham 2 mA tDCS achieves effective blinding. METHODS: A randomised double blind crossover trial. 100 tDCS-naïve healthy volunteers were incorrectly advised that they there were taking part in a trial of tDCS on word memory. Participants attended for two separate sessions. In each session, they completed a word memory task, then received active or sham tDCS (order randomised at 2 mA stimulation intensity for 20 minutes and then repeated the word memory task. They then judged whether they believed they had received active stimulation and rated their confidence in that judgement. The blinded assessor noted when red marks were observed at the electrode sites post-stimulation. RESULTS: tDCS at 2 mA was not effectively blinded. That is, participants correctly judged the stimulation condition greater than would be expected to by chance at both the first session (kappa level of agreement (κ 0.28, 95% confidence interval (CI 0.09 to 0.47 p=0.005 and the second session (κ=0.77, 95%CI 0.64 to 0.90, p=<0.001 indicating inadequate participant blinding. Redness at the reference electrode site was noticeable following active stimulation more than sham stimulation (session one, κ=0.512, 95%CI 0.363 to 0.66, p<0.001; session two, κ=0.677, 95%CI 0.534 to 0.82 indicating inadequate assessor blinding. CONCLUSIONS: Our results suggest that blinding in studies using tDCS at intensities of 2 mA is inadequate. Positive results from such studies should be interpreted with caution.

Inadequate functional health literacy in Spanish as a barrier to cervical cancer screening among immigrant Latinas in New York City.

Science.gov (United States)

Garbers, Samantha; Chiasson, Mary Ann

2004-10-01

The objective of this study was to examine the association between inadequate functional health literacy in Spanish among low-income Latinas aged 40 and older and cervical cancer screening knowledge and behavior. Spanish-speaking Latinas aged 40-78 of various nationalities (n = 205) participated in a study that included a survey on cervical cancer knowledge and behavior administered in Spanish and the Spanish version of the Test of Functional Health Literacy in Adults. Compared to those with adequate and marginal health literacy, women with inadequate functional health literacy in Spanish were significantly less likely to have ever had a Papanicolaou (Pap) test (odds ratio, 0.12; 95% confidence interval [CI], 0.04-0.37) or in the last three years (odds ratio, 0.35; 95% CI, 0.18-0.68) and were significantly more likely to have had their last Pap test at a local public hospital (odds ratio, 2.43; 95% CI, 1.18-4.97). Even when controlling for other factors, women with inadequate health literacy were 16.7 times less likely (adjusted odds ratio, 0.06; 95% CI, 0.01-0.55) to have ever had a Pap test. Almost half of the population we studied will have difficulty interpreting written medical materials, even in Spanish. When developing efforts to reach women who have not been screened, programs and service providers need to be aware that the women most in need of information about screening may be more likely to be unable to read any written materials provided to them, regardless of the language or level of simplicity of the materials. Programs and strategies need to be implemented to increase screening prevalence and to minimize the identified gaps in regular screening for Latinas who have low health literacy.

Protection of human research participants: accreditation of programmes in the Indian context.

Science.gov (United States)

Bhosale, Neelambari; Nigar, Shagoofa; Das, Soma; Divate, Uma; Divate, Pathik

2014-01-01

The recent negative media reports on the status of participants in clinical trials in India, together with the concerns expressed by the regulatory bodies, have raised questions regarding India's credibility in the conduct of clinical research. Even though the regulations require the registration of trials with the Clinical Trial Registry-India and despite the recently mandated registration of ethics committees (ECs) with the Drugs Controller General of India, the lack of governmental audit and accreditation procedures and bodies has resulted in inadequate protection of human participants in clinical research. Institutions and research sites would benefit by implementing a human research protection programme, which would safeguard the rights, safety and wellbeing of participants in clinical trials, in addition to improving the processes and procedures for the conduct of the trial. The Jehangir Clinical Development Centre, Pune has received accreditation from the Association for the Accreditation of Human Research Protection Programme (AAHRPP). A unique feature of the AAHRPP is the integrative nature of the programme, wherein the sponsors of the trial, investigators, EC members and institution work towards the common goal of protecting research participants. Here, we discuss the improvement needed in the quality standards of institutions for them to be able to meet the requirements of the AAHRPP. We also suggest the need for a governmental accreditation body, which will be required for the future promotion of and improvement in the standards for clinical practice in India.

The technical workforce: education, training, and manpower needs in radiation protection

International Nuclear Information System (INIS)

Ziemer, P.L.

1984-01-01

In considering our technical workforce with respect to radiation protection, three main questions face us today and will continue to face us in the future: 1. What are the present and future personnel needs in health physics and related disciplines. 2. What kinds of education and training programs are required to meet these needs. 3. What is being done and what needs to be done to provide the required education and training programs. To address these three questions, this paper summarizes recent projections on the manpower needs for professional health physicists over the next two decades. The current status of education and training programs, both for health physicists and for other personnel requiring radiation protection training, is reviewed. Attention is directed toward present enrollment and degree trends which indicate inadequate supplies of personnel to fill present and projected positions, particularly at the BS and the graduate degree levels. Information on the job market, including numbers and types of positions and salary levels, is also summarized. The question of what needs to be done in the future to provide adequate education and training programs is discussed with respect to federal policies, regulations, and industrial responsibilities. Although the federal government will continue to have responsbilities to support education and training in radiation protection, an increasingly important and critical role is seen for the private sector

Triage of means: options for conserving tiger corridors beyond designated protected lands in India

Directory of Open Access Journals (Sweden)

Indranil Mondal

2016-11-01

Full Text Available The latest tiger census conducted in India during the year 2014 shows that it harbours 57% of the global tiger population in 7% of their historic global range. At the same time, India has 1.25 billion people growing at a rate of 1.7% per year. Protected tiger habitats in India are geographically isolated and collectively holds this tiger population under tremendous anthropogenic pressure. These protected lands are in itself not enough to sustain the growing tiger population, intensifying human-tiger conflict as dispersing individuals enter human occupied areas. These factors – isolation and inadequate size of the protected lands harbouring tiger meta-populations, highlight the need to connect tiger habitats and the importance of corridors beyond protected lands. It is imperative to conserve such corridors passing through private lands to safeguard the long-term survival of the tigers in India. The goal of long-term tiger conservation in India lies in smartly integrating tiger conservation concerns in various sectors where tiger conservation is not the priority. To effectively tap into all these resources, we propose a Triage of Means strategy. Here we do not prioritize species, populations or sites due to the non-availability of conservation resources. Instead, we aim to prioritize from available resources (means to achieve conservation from other sectors where tiger conservation is not the focus. We outline how to prioritise resources available from various sectors into conservation by prioritizing issues hampering tiger conservation beyond protected habitats.

Tofacitinib for Psoriatic Arthritis in Patients with an Inadequate Response to TNF Inhibitors.

Science.gov (United States)

Gladman, Dafna; Rigby, William; Azevedo, Valderilio F; Behrens, Frank; Blanco, Ricardo; Kaszuba, Andrzej; Kudlacz, Elizabeth; Wang, Cunshan; Menon, Sujatha; Hendrikx, Thijs; Kanik, Keith S

2017-10-19

Tofacitinib is an oral Janus kinase inhibitor that is under investigation for the treatment of psoriatic arthritis. We evaluated tofacitinib in patients with active psoriatic arthritis who had previously had an inadequate response to tumor necrosis factor (TNF) inhibitors. In this 6-month randomized, placebo-controlled, double-blind, phase 3 trial, we randomly assigned 395 patients, in a 2:2:1:1 ratio, to four regimens: 5 mg of tofacitinib administered orally twice daily (132 patients); 10 mg of tofacitinib twice daily (132 patients); placebo, with a switch to 5 mg of tofacitinib twice daily at 3 months (66 patients); or placebo, with a switch to 10 mg of tofacitinib twice daily at 3 months (65 patients). Data from the patients who received placebo during the first 3 months of the trial were pooled. The primary end points were the percentage of patients who had at least 20% improvement according to the criteria of the American College of Rheumatology (ACR20 response) and the change from baseline score on the Health Assessment Questionnaire-Disability Index (HAQ-DI; scores range from 0 to 3, with higher scores indicating greater disability) at the month 3 analysis. At 3 months, the rates of ACR20 response were 50% with the 5-mg dose of tofacitinib and 47% with the 10-mg dose, as compared with 24% with placebo (Ptofacitinib continuously and in 6% who received the 10-mg dose continuously. Over the course of 6 months, there were four serious infections, three herpes zoster infections, one myocardial infarction, and one ischemic stroke among the patients who received tofacitinib continuously. Elevations of aspartate and alanine aminotransferase concentrations of three or more times the upper limit of the normal range occurred in more patients who received tofacitinib continuously than in patients who received placebo followed by tofacitinib. In this trial involving patients with active psoriatic arthritis who had had an inadequate response to TNF inhibitors, tofacitinib

Patient information regarding medical radiation exposure is inadequate: Patients' experience in a university hospital

International Nuclear Information System (INIS)

Ukkola, L.; Oikarinen, H.; Henner, A.; Haapea, M.; Tervonen, O.

2017-01-01

Introduction: It is suspected that little or no information is provided to patients regarding radiological examinations. The purpose was to evaluate the coverage, content and source of this information in a university hospital. Methods: Altogether 147 patients (18–85 years) were interviewed after different examinations using a questionnaire. The patients had undergone 35 low (<1 mSv), 66 medium (1–10), and 46 high (>10) dose examinations. They were asked if they were informed about radiation use, the course or indication of the examination, the consequences of not having the examination, other options, the dose and risks of radiation, the source for the information and if any consent was enquired. Results: 52 (35%) patients did not receive any information while 95 (65%) obtained some information. Fifty-six (38%) patients received an information letter, and 75 (51%) obtained oral information, mainly from the referrer or the radiographer. The information was mostly about indication, course or radiation use, very seldom about radiation risks and the other areas. Those with a nuclear medicine examination received information more often than those with other medium- or high-dose examinations (p = 0.004). The patients scored the received information as 2.2 (mean, SD 1.3) on a Likert scale from 1 (poor) to 5 (good). Conclusion: Patients obtained inadequate information regarding radiological examinations in a university hospital. The information was provided non-systematically from various sources. The results help to set up practical guidelines for systematic information and to follow up their efficiency. The mode of operation might be helpful elsewhere in the future. - Highlights: • Patients obtained inadequate information regarding medical radiation exposure. • The information was provided non-systematically from various sources. • Patients with nuclear examinations were informed better than with other modalities. • In addition to general guidelines

HIPAA-protecting patient confidentiality or covering something else?

Directory of Open Access Journals (Sweden)

Robbins RA

2013-10-01

Full Text Available No abstract available. Article truncated at 150 words. A case of a physician fired from the Veterans Administration (VA for violation of the Health Care Portability and Accountability Act of 1996 (HIPAA illustrates a problem with both the law and the VA. Anil Parikh, a VA physician at the Jesse Brown VA in Chicago, was dismissed on a charge of making unauthorized disclosures of confidential patient information on October 19, 2007. On January 3, 2011 the Merit Systems Protection Board (MSPB reversed Dr. Parikh’s removal. Dr. Parikh's initially made disclosures to the VA Office of Inspector General and to Senator Barack Obama and Congressman Luis Gutierrez, in whose district the Jesse Brown VA lies. Dr. Parikh alleged that there were systematic problems within the Jesse Brown VA that resulted in untimely and inadequate patient care. The confidential patient information Parikh disclosed included examples of the misdiagnoses and misdirection of patients within the hospital. Specifically, Dr. Parikh alleged that …

Evaluation of protection measurements for rural environments; Avaliacao de medidas de protecao para ambientes rurais

Energy Technology Data Exchange (ETDEWEB)

Silva, Diogo N.G.; Silva, Fernanda L.; Conti, Luiz F., E-mail: dneves@ird.gov.b, E-mail: lfcconti@ird.gov.b, E-mail: fleite@ird.gov.b [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Wasserman, Maria Angelica V., E-mail: maria.wasserman@pq.cnpq.b [Instituto de Engenharia Nuclear (IEN/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Rochedo, Elaine R.R., E-mail: erochedo@cnen.gov.b [Comissao Nacional de Energia Nuclear (CODIN/CNEN), Rio de Janeiro, RJ (Brazil). Coord. de Instalacoes Nucleares

2011-10-26

Among the planning activities of actuation in nuclear/radiological emergences, it is included the efficiency evaluation of protection and remediation measurements. From the development of a data base on such measurements for the agricultural areas, the program SIEM was used for effectuation the simulations involving the {sup 137}Cs, {sup 131}I and {sup 90}Sr radionuclides, in scenery previously established for simulation those areas of a 50 km surrounding the Admiral Alvaro Alberto nuclear power plant. The obtained results indicate that the scenery is determinant of efficiency measurements involving various specific factors of each place, such as: agricultural and cattle breeding products, consumption habits of population and the grade of subsistence by the diet items, making not practical the elaboration of predefined generic sceneries. The great dependence on seasoning related to the moment of accident makes inadequate any previous evaluation what soever for evaluation of efficiency of protection and remediation measurements. Therefore, previous decisions are not recommended about the relevance of protection measurements for rural areas. Two classification criteria were defined: (i) the efficiency in reduction the doses in the firs year; and, (i i) efficiency in reduction the dose at long term

Radiation protection aspects of the incident recovery

International Nuclear Information System (INIS)

Tibor, Bujtas; Arpad, Nenyei

2006-01-01

On the 10. April 2003 a serious accident occurred at PAKS nuclear power plant. The cleaning of fuel assemblies unloaded from the reactor of unit 2 was commencing under water in the fuel-cleaning equipment in the maintenance shaft number 1. There was no chain reaction in the cleaning tank but the fission products, accumulated in the previous operational time still produced a significant heat. Due to the inadequate cooling of the cleaning tank the assemblies overheated within a few hours. After opening the lid of the tank the entering cold water caused thermal shock and significant damage to the fuel assemblies. cladding of the fuel elements opened up and the uranium dioxide pellets got also damaged. The removal of the damaged fuel assemblies and the released debris must be managed. There are technical difficulties and radiation protection problems to reduce the radiation exposure of the workers as well as the minimization of the radioactive materials released into the environment. The description of the situation and the different actions are detailed. (N.C.)

2013 Nutrition Risk Evidence Review Panel. Evidence Review for: The Risk Factor of Inadequate Nutrition

Science.gov (United States)

2014-01-01

The 2013 Nutrition Risk Standing Review Panel (from here on referred to as the SRP) met for a site visit in Houston, TX on November 20 - 21, 2013. The SRP reviewed the new Evidence Report for the Risk Factor of Inadequate Nutrition (from here on referred to as the 2013 Nutrition Evidence Report), as well as the Research Plan for this Risk. Overall, the SRP thinks the well-qualified research team has compiled an excellent summary of background information in the 2013 Nutrition Evidence Report. The SRP would like to commend the authors in general and particularly note that while the 2013 Nutrition Evidence Report has been written using a single nutrient approach, the research plan takes a much more integrated and physiologically based approach.

Distinguishing the Impacts of Inadequate Prey and Vessel Traffic on an Endangered Killer Whale (Orcinus orca) Population

Science.gov (United States)

Ayres, Katherine L.; Booth, Rebecca K.; Hempelmann, Jennifer A.; Koski, Kari L.; Emmons, Candice K.; Baird, Robin W.; Balcomb-Bartok, Kelley; Hanson, M. Bradley; Ford, Michael J.; Wasser, Samuel K.

2012-01-01

Managing endangered species often involves evaluating the relative impacts of multiple anthropogenic and ecological pressures. This challenge is particularly formidable for cetaceans, which spend the majority of their time underwater. Noninvasive physiological approaches can be especially informative in this regard. We used a combination of fecal thyroid (T3) and glucocorticoid (GC) hormone measures to assess two threats influencing the endangered southern resident killer whales (SRKW; Orcinus orca) that frequent the inland waters of British Columbia, Canada and Washington, U.S.A. Glucocorticoids increase in response to nutritional and psychological stress, whereas thyroid hormone declines in response to nutritional stress but is unaffected by psychological stress. The inadequate prey hypothesis argues that the killer whales have become prey limited due to reductions of their dominant prey, Chinook salmon (Oncorhynchus tshawytscha). The vessel impact hypothesis argues that high numbers of vessels in close proximity to the whales cause disturbance via psychological stress and/or impaired foraging ability. The GC and T3 measures supported the inadequate prey hypothesis. In particular, GC concentrations were negatively correlated with short-term changes in prey availability. Whereas, T3 concentrations varied by date and year in a manner that corresponded with more long-term prey availability. Physiological correlations with prey overshadowed any impacts of vessels since GCs were lowest during the peak in vessel abundance, which also coincided with the peak in salmon availability. Our results suggest that identification and recovery of strategic salmon populations in the SRKW diet are important to effectively promote SRKW recovery. PMID:22701560

The provision of Technical Co-operation: The model project for upgrading radiation protection infrastructure

International Nuclear Information System (INIS)

Barretto, P.M.C.

2001-01-01

The paper describes the IAEA's systematic effort to address the inadequate situation in many of its Member States with regard to radiation protection and safety. For this effort a special project was created and implemented in the past five years to create or strengthen existing radiation protection infrastructure in 52 countries where such infrastructure was non-existent or not appropriate for the type of practice involved. The implementation of this project focused on the development of qualified human resources, assistance for introduction of appropriate legislation and equipment for inspection and analysis. Workplans were tailored to the individual needs of each participating country and the elements of these workplans were grouped into five milestones -- regulatory framework, occupational exposure control, medical exposure control, public exposure control, and emergency preparedness and response capabilities. By the end of 2000 more than 70% of the participating countries had radiation protection laws promulgated and a regulatory authority established; 46% had regulations adopted and 42% had a system of notification, authorization and control of radiation sources operational. During the five years of implementation, 555 fellows received individual training, another 2278 participated in training courses, over 1000 expert missions were fielded and equipment worth about US $6 million was provided. The total cost was over US $17 million. (author)

China's endemic vertebrates sheltering under the protective umbrella of the giant panda.

Science.gov (United States)

Li, Binbin V; Pimm, Stuart L

2016-04-01

The giant panda attracts disproportionate conservation resources. How well does this emphasis protect other endemic species? Detailed data on geographical ranges are not available for plants or invertebrates, so we restrict our analyses to 3 vertebrate taxa: birds, mammals, and amphibians. There are gaps in their protection, and we recommend practical actions to fill them. We identified patterns of species richness, then identified which species are endemic to China, and then which, like the panda, live in forests. After refining each species' range by its known elevational range and remaining forest habitats as determined from remote sensing, we identified the top 5% richest areas as the centers of endemism. Southern mountains, especially the eastern Hengduan Mountains, were centers for all 3 taxa. Over 96% of the panda habitat overlapped the endemic centers. Thus, investing in almost any panda habitat will benefit many other endemics. Existing panda national nature reserves cover all but one of the endemic species that overlap with the panda's distribution. Of particular interest are 14 mammal, 20 bird, and 82 amphibian species that are inadequately protected. Most of these species the International Union for Conservation of Nature currently deems threatened. But 7 mammal, 3 bird, and 20 amphibian species are currently nonthreatened, yet their geographical ranges are pandas are absent and where there are no national nature reserves. The others concentrate in Yunnan, Nan Mountains, and Hainan. Here, 10 prefectures might establish new protected areas or upgrade local nature reserves to national status. © 2015 Society for Conservation Biology.

The Use of Speech Technology to Protect the Document Turnover

Directory of Open Access Journals (Sweden)

Alexandr M. Alyushin

2017-06-01

. The developed software is oriented on the mobile applications on the basis of android operating system. The software has a friendly interface, which allows one to create, correct and check audiomarkers. The performed software tests shows its high efficiency, including the possibility of audiomarkers recognition in various lighting conditions. The possibility of document protection level improvement by logging in voice signature the current level of mental and emotional stress of the document author, which can be used to detect its inadequate state is shown. This makes it possible to identify cases of document preparation under the application of physical or mental violence.

Risk of Performance Decrement and Crew Illness Due to an Inadequate Food System

Science.gov (United States)

Douglas, Grace L.; Cooper, Maya; Bermudez-Aguirre, Daniela; Sirmons, Takiyah

2016-01-01

NASA is preparing for long duration manned missions beyond low-Earth orbit that will be challenged in several ways, including long-term exposure to the space environment, impacts to crew physiological and psychological health, limited resources, and no resupply. The food system is one of the most significant daily factors that can be altered to improve human health, and performance during space exploration. Therefore, the paramount importance of determining the methods, technologies, and requirements to provide a safe, nutritious, and acceptable food system that promotes crew health and performance cannot be underestimated. The processed and prepackaged food system is the main source of nutrition to the crew, therefore significant losses in nutrition, either through degradation of nutrients during processing and storage or inadequate food intake due to low acceptability, variety, or usability, may significantly compromise the crew's health and performance. Shelf life studies indicate that key nutrients and quality factors in many space foods degrade to concerning levels within three years, suggesting that food system will not meet the nutrition and acceptability requirements of a long duration mission beyond low-Earth orbit. Likewise, mass and volume evaluations indicate that the current food system is a significant resource burden. Alternative provisioning strategies, such as inclusion of bioregenerative foods, are challenged with resource requirements, and food safety and scarcity concerns. Ensuring provisioning of an adequate food system relies not only upon determining technologies, and requirements for nutrition, quality, and safety, but upon establishing a food system that will support nutritional adequacy, even with individual crew preference and self-selection. In short, the space food system is challenged to maintain safety, nutrition, and acceptability for all phases of an exploration mission within resource constraints. This document presents the

[Clinic management of public social protection policy in primary health care].

Science.gov (United States)

Arcos-Griffiths, Estela; Muñoz-González, Luz Angélica; Vollrath-Ramírez, Antonia; Sánchez-Segura, Ximena

2016-01-01

Knowing the effectiveness of clinical management of primary care health in the field of Integral Protection System for Children "Chile Crece Contigo" and "Red Protege". Observational, descriptive, with information available from secondary sources of Chile Crece Contigo system in the district of Pudahuel, Santiago de Chile. The population was 1,656 pregnant women assigned to Chile Crece Contigo system in 2009. Social vulnerability was measured with the Social Protection Record. Sociodemographic and Chile Crece Contigo system performance variables were selected. It featured a raw and refined database. Processing and analysis of data was performed using the statistical program Statistical Package for Social Sciences and Excel. Descriptive statistics for frequency, position and dispersion were calculated. Certification of Scientific Ethics Committee of the School of Nursing was granted. A 91.4% of institutional social vulnerability detected by screening social protection record was observed. Psychosocial risk was higher in women with social vulnerability (42.0 vs. 28.2%) more often recognized as inadequate family support, depressive symptoms, domestic violence, substance abuse and conflicts with motherhood. In the universal, specific and integrated performance it was not met with 100% access to benefits. The invisibility of the social vulnerability and low effectiveness of the transfer of benefits to socially vulnerable women/children deserves skills development of contextualized and integrated clinical management professionals in primary health care. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

The creation of the Chagos marine protected area: a fisheries perspective(☆).

Science.gov (United States)

Dunne, Richard P; Polunin, Nicholas V C; Sand, Peter H; Johnson, Magnus L

2014-01-01

From a fisheries perspective, the declaration of a 640,000 km² "no-take" Marine Protected Area (MPA) in the Chagos Archipelago in 2010 was preceded by inadequate consideration of the scientific rationale for protection. The entire area was already a highly regulated zone which had been subject to a well-managed fisheries licensing system. The island of Diego Garcia, the only area where there is evidence of overfishing has, because of its military base, been excluded from the MPA. The no-take mandate removes the primary source of sustenance and economic sustainability of any inhabitants, thus effectively preventing the return of the original residents who were removed for political reasons in the 1960s and 1970s. The principles of natural resource conservation and use have been further distorted by forcing offshore fishing effort to other less well-managed areas where it will have a greater negative impact on the well-being of the species that were claimed to be one of the primary beneficiaries of the declaration. A failure to engage stakeholders has resulted in challenges in both the English courts and before an international tribunal.

Evaluation of the ocular protection for low intensity therapeutic lasers; Avaliacao da protecao ocular para lasers terapeuticos em baixa intensidade

Energy Technology Data Exchange (ETDEWEB)

Cordon, Rosely

2003-07-01

The low intensity laser therapy (LILT) has been extensively used in medicine and dentistry presenting positive effects. However, the laser radiation can also cause adverse effects. Due to the ocular focalization property, in the wavelength from 400 to 1400 nm, the retina is more susceptible to damage by radiation than any other part of the human body. Then, the ocular protection is frequently emphasized. This protection must attenuate the radiation to a safe level. The International Electrotechnical Commission (IEC) standard IEC 60825-1 suggests safety requirements for medical laser equipment, including the ocular protection, based on maximum permissible exposure levels. The Brazilian legislation adopts a corresponding IEC standard, the NBR IEC 601.2.22, for safety requirements. The aim of this study was to analyze the adequacy of the ocular protectors furnished by four laser equipment manufacturers, commercially available in Brazil, commonly used for LILT. For this purpose, the laser equipment and the respective ocular protectors were characterized. The adequacy was verified according to the IEC standards. It was found, among other results, ocular protectors attenuating to safe levels the radiation emitted by the respective laser equipment, however, presenting inadequate visual transmission. Inefficient protection and protection indicated in cases where they were not necessary were also observed. (author)

Fossil fuel subsidy removal and inadequate public power supply: Implications for businesses

International Nuclear Information System (INIS)

Bazilian, Morgan; Onyeji, Ijeoma

2012-01-01

We briefly consider the impact of fossil fuel subsidy removal policies in the context of inadequate power supply, with a focus on the implications for businesses. In doing so, we utilize the case of the early 2012 fuel subsidy removal in Nigeria. The rationale for such subsidy-removal policies is typically informed by analysis showing that they lead to an economically inefficient allocation of resources and market distortions, while often failing to meet intended objectives. However, often the realities of infrastructural and institutional deficiencies are not appropriately factored into the decision-making process. Businesses in many developing countries, already impaired by the high cost of power supply deficiencies, become even less competitive on an unsubsidized basis. We find that justifications for removal often do not adequately reflect the specific environments of developing country economies, resulting in poor recommendations – or ineffective policy. - Highlights: ► We consider the impact of fuel subsidy removal in the context of energy poverty. ► Calls for subsidy removal often do not reflect the developing country realities. ► Businesses impaired by power supply deficiencies, become even less competitive.

WILLINGNESS TO PAY FOR HEALTH PROTECTION: INADEQUATE SENSITIVITY TO PROBABILITY? (R825312)

Science.gov (United States)

The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

Individualised perioperative open-lung approach versus standard protective ventilation in abdominal surgery (iPROVE): a randomised controlled trial.

Science.gov (United States)

Ferrando, Carlos; Soro, Marina; Unzueta, Carmen; Suarez-Sipmann, Fernando; Canet, Jaume; Librero, Julián; Pozo, Natividad; Peiró, Salvador; Llombart, Alicia; León, Irene; India, Inmaculada; Aldecoa, Cesar; Díaz-Cambronero, Oscar; Pestaña, David; Redondo, Francisco J; Garutti, Ignacio; Balust, Jaume; García, Jose I; Ibáñez, Maite; Granell, Manuel; Rodríguez, Aurelio; Gallego, Lucía; de la Matta, Manuel; Gonzalez, Rafael; Brunelli, Andrea; García, Javier; Rovira, Lucas; Barrios, Francisco; Torres, Vicente; Hernández, Samuel; Gracia, Estefanía; Giné, Marta; García, María; García, Nuria; Miguel, Lisset; Sánchez, Sergio; Piñeiro, Patricia; Pujol, Roger; García-Del-Valle, Santiago; Valdivia, José; Hernández, María J; Padrón, Oto; Colás, Ana; Puig, Jaume; Azparren, Gonzalo; Tusman, Gerardo; Villar, Jesús; Belda, Javier

2018-03-01

complications did not differ for patients in OLA-iCPAP (110 [46%] of 241, relative risk 0·89 [95% CI 0·74-1·07; p=0·25]), OLA-CPAP (111 [47%] of 238, 0·91 [0·76-1·09; p=0·35]), or STD-CPAP groups (118 [48%] of 244, 0·95 [0·80-1·14; p=0·65]) when compared with patients in the STD-O 2 group (125 [51%] of 244). Intraoperatively, PEEP was increased in 69 (14%) of patients in the standard perioperative ventilation groups because of hypoxaemia, and no patients from either of the OLA groups required rescue manoeuvres. In patients who have major abdominal surgery, the different perioperative open lung approaches tested in this study did not reduce the risk of postoperative complications when compared with standard lung-protective mechanical ventilation. Instituto de Salud Carlos III of the Spanish Ministry of Economy and Competitiveness, and Grants Programme of the European Society of Anaesthesiology. Copyright © 2018 Elsevier Ltd. All rights reserved.

Is general anesthesia a risk for myocardium? Effect of anesthesia on myocardial function as assessed by cardiac troponin-i in two different groups (isofluran+N2O inhalation and propofol+fentanyl iv anesthesia

Directory of Open Access Journals (Sweden)

Demet Dogan Erol

2007-11-01

Full Text Available Demet Dogan Erol1, Ibrahim Ozen21Department of Anaesthesiology and Reanimation, School of Medicine, Kocatepe University, Afyonkarahisar, Turkey; 2Department of Anaesthesiology and Reanimation, Karadeniz Technical University Faculty of Medicine, Trabzon, TurkeyBackground and objectives: Peroperative myocardial infarction (MI is the most common cause of morbidity and mortality. What is the role of general anesthesia in this process? Is general anesthesia a risk for myocardial infarction? The present study was designed to determine whether the measurement of serum levels of cardiac troponin I (cTnI, a highly sensitive and specific marker for cardiac injury, would help establish the diagnosis of myocardial infarction in two different types of anesthesia.Method: Elective abdominal hysterectomy was planned with the permission of the ethic committee in 40 patients who were 20–45 years range, in ASA-I group, and have a Goldman Cardiac Risk Index-0. The patients were divided into two groups. Isoflurane + N2O was administrated to first group, and Propofol + Fentanyl to second group. cTnI levels were determined before anesthesia, after induction before surgery and 9 hours after the second period respectively.Results: There was no significant difference between the groups by the means of demographic properties, hemodynamic parameters and cTnI levels, and the cTnI levels were determined under the basal levels in all samples.Conclusion: General anesthesia is not a risk for myocardial infarction to state eliminating risk factors and protection hemodynamia cardiac.Keywords: cardiac troponin-I, myocardial infarction, isofluran + N2O inhalation anesthesia, propofol + fentanyl intravenous anesthesia.

Evolution of poor reporting and inadequate methods over time in 20 920 randomised controlled trials included in Cochrane reviews: research on research study.

Science.gov (United States)

Dechartres, Agnes; Trinquart, Ludovic; Atal, Ignacio; Moher, David; Dickersin, Kay; Boutron, Isabelle; Perrodeau, Elodie; Altman, Douglas G; Ravaud, Philippe

2017-06-08

Objective  To examine how poor reporting and inadequate methods for key methodological features in randomised controlled trials (RCTs) have changed over the past three decades. Design  Mapping of trials included in Cochrane reviews. Data sources  Data from RCTs included in all Cochrane reviews published between March 2011 and September 2014 reporting an evaluation of the Cochrane risk of bias items: sequence generation, allocation concealment, blinding, and incomplete outcome data. Data extraction  For each RCT, we extracted consensus on risk of bias made by the review authors and identified the primary reference to extract publication year and journal. We matched journal names with Journal Citation Reports to get 2014 impact factors. Main outcomes measures  We considered the proportions of trials rated by review authors at unclear and high risk of bias as surrogates for poor reporting and inadequate methods, respectively. Results  We analysed 20 920 RCTs (from 2001 reviews) published in 3136 journals. The proportion of trials with unclear risk of bias was 48.7% for sequence generation and 57.5% for allocation concealment; the proportion of those with high risk of bias was 4.0% and 7.2%, respectively. For blinding and incomplete outcome data, 30.6% and 24.7% of trials were at unclear risk and 33.1% and 17.1% were at high risk, respectively. Higher journal impact factor was associated with a lower proportion of trials at unclear or high risk of bias. The proportion of trials at unclear risk of bias decreased over time, especially for sequence generation, which fell from 69.1% in 1986-1990 to 31.2% in 2011-14 and for allocation concealment (70.1% to 44.6%). After excluding trials at unclear risk of bias, use of inadequate methods also decreased over time: from 14.8% to 4.6% for sequence generation and from 32.7% to 11.6% for allocation concealment. Conclusions  Poor reporting and inadequate methods have decreased over time, especially for sequence generation

Performance of the Lot Quality Assurance Sampling Method Compared to Surveillance for Identifying Inadequately-performing Areas in Matlab, Bangladesh

OpenAIRE

Bhuiya, Abbas; Hanifi, S.M.A.; Roy, Nikhil; Streatfield, P. Kim

2007-01-01

This paper compared the performance of the lot quality assurance sampling (LQAS) method in identifying inadequately-performing health work-areas with that of using health and demographic surveillance system (HDSS) data and examined the feasibility of applying the method by field-level programme supervisors. The study was carried out in Matlab, the field site of ICDDR,B, where a HDSS has been in place for over 30 years. The LQAS method was applied in 57 work-areas of community health workers i...

Management of protected areas in Sahel savannah ecoregion of Nigeria under the threat of desertification

Directory of Open Access Journals (Sweden)

BOROKINI Temitope Israel

2013-12-01

Full Text Available This study was conducted to assess the challenges facing 8 selected protected areas in the Sahel Savannah ecoregion and proffer solutions to these challenges in order to ensure conservation and sustainability of Nigeria’s biodiversity. Primary data were collected from randomly-selected 120 staffs using questionnaire administration from 8 Forest Reserves within Borno and Yobe states of Nigeria. A high level of encroachment of all the studied protected areas was observed, which ranged from deforestation, overgrazing, poaching to converting protected areas into farmlands. Other notable challenges include poor staffing, inadequate equipment and funding. The respondents further reported that majority of the defaulters were farmers and local people in the area, involved in such practices for their survival in the wake of harsher climate and desert encroachment in the region. This paper calls for a revision of the Government Policy on Forestry in Nigeria to allow the people own and plant forests, implementation of community based forest resources management, provision of environment and user-friendly solar powered cooking stoves and sustainable farming systems such as crop rotation, intercropping, sustainable irrigation, organic farming and agroforestry. In addition, sources of income for the locals need to be diversified, such as honey bee production.

Optisk og videoassisteret laryngoskopi ved vanskelige luftveje

DEFF Research Database (Denmark)

Johansen, Mathias; Afshari, Arash; Kristensen, Billy B

2009-01-01

Airway management is one of the greatest anaesthesiologic challenges. Direct laryngoscopy using a standard McIntosh laryngoscope has been the predominant intubation choice for many years. Videolaryngoscopy is becoming a widely accepted airway management technique owing to its potential advantages...... over direct laryngoscopy including a better view of the larynx, reduced tracheal intubation time and educational value. We present an overview of the currently most used optical and video-assisted laryngoscopes with a special focus on the McGrath Series 5 videolaryngoscope.......Airway management is one of the greatest anaesthesiologic challenges. Direct laryngoscopy using a standard McIntosh laryngoscope has been the predominant intubation choice for many years. Videolaryngoscopy is becoming a widely accepted airway management technique owing to its potential advantages...

40 ANAESTHETIC MANAGEMENT OF SURGICAL EMERGENCIES ...

African Journals Online (AJOL)

drclement

2009-12-01

Dec 1, 2009 ... *Department of Anaesthesiology, University of Benin Teaching Hospital, Benin City,. Nigeria ... anaesthesia for emergency surgery. This expose seeks .... and the hospital's capacity for ... planning and clinical prudence in the.

Capacity shortfalls hinder the performance of marine protected areas globally

Science.gov (United States)

Gill, David A.; Mascia, Michael B.; Ahmadia, Gabby N.; Glew, Louise; Lester, Sarah E.; Barnes, Megan; Craigie, Ian; Darling, Emily S.; Free, Christopher M.; Geldmann, Jonas; Holst, Susie; Jensen, Olaf P.; White, Alan T.; Basurto, Xavier; Coad, Lauren; Gates, Ruth D.; Guannel, Greg; Mumby, Peter J.; Thomas, Hannah; Whitmee, Sarah; Woodley, Stephen; Fox, Helen E.

2017-03-01

Marine protected areas (MPAs) are increasingly being used globally to conserve marine resources. However, whether many MPAs are being effectively and equitably managed, and how MPA management influences substantive outcomes remain unknown. We developed a global database of management and fish population data (433 and 218 MPAs, respectively) to assess: MPA management processes; the effects of MPAs on fish populations; and relationships between management processes and ecological effects. Here we report that many MPAs failed to meet thresholds for effective and equitable management processes, with widespread shortfalls in staff and financial resources. Although 71% of MPAs positively influenced fish populations, these conservation impacts were highly variable. Staff and budget capacity were the strongest predictors of conservation impact: MPAs with adequate staff capacity had ecological effects 2.9 times greater than MPAs with inadequate capacity. Thus, continued global expansion of MPAs without adequate investment in human and financial capacity is likely to lead to sub-optimal conservation outcomes.

Metabolic regulation during sport events: factual interpretations and inadequate allegations

Directory of Open Access Journals (Sweden)

Jacques Remy Poortmans

2013-09-01

Full Text Available Different fuels are available to generate ATP for muscle activities during sport events. Glycogen from striated muscles and liver stores may be converted to lactic acid or almost completely oxidized to carbon dioxide (CO2, triacylglycerol within the muscle itself and fatty acids from adipose tissue could be converted to CO2 in acting muscles, some free amino acids can be released within the muscle itself and from intestinal stores to sustain the amount of ATP generation indispensable for muscle contraction. All single biochemical reactions, but one, need one or several enzymes to activate the conversion of a substrate into a product. The energy transformation in biochemical reactions is led by application of so-called free energy. Reversible and non-reversible reactions within a metabolic pathway are dependent on specific enzymes near or far from equilibrium. Allosteric enzymes are regulatory enzymes that provide the direction in the pathway. A regulatory enzyme is either activated or inhibited by small regulators (ligands. A reversible substrate cycle between A and B is catalyzed by two enzymes with different fluxes. The need of ATP production for muscle contraction is under the leadership of regulatory enzymes and available substrate stores. The improvement of adapted metabolic reactions under sport training depends on the appropriate increase of regulatory enzymes within the glycolytic and oxidative pathways. The amount of some specific enzymes is increased by training in order to improve the maximum activity of the metabolic pathway. Unfortunately, several publications do not precisely implicate the appropriate enzyme(s to explain or reject the adaptation induced by the training schedule. A few examples will illustrate the factual interpretation and the inadequate allegation.

Inadequate environmental monitoring around offshore oil and gas platforms on the Grand Bank of Eastern Canada: are risks to marine birds known?

Science.gov (United States)

Burke, C M; Montevecchi, W A; Wiese, F K

2012-08-15

Petroleum exploration and production on the Grand Bank of eastern Canada overlaps with productive marine habitat that supports over 40 million marine birds annually. Environmental assessments for oil and gas projects in the region predict insignificant adverse effects on marine birds from oil spills, incineration in platform flares and collisions. Limited baseline data on seasonal occupancies and a failure to quantify the nature and extent of marine bird attraction to platforms and related mortality undermines these assessments. We conducted 22 surveys to offshore platforms on the Grand Bank during 1999-2003 to measure avian associations with platforms and to determine the level of monitoring needed to assess the risks to marine birds. We document seasonal shifts in marine bird occurrences and higher densities of auks (fall) and shearwaters (summer) around platforms relative to surrounding areas. The limited temporal and spatial coverage of our surveys is more robust than existing industry monitoring efforts, yet it is still inadequate to quantify the scale of marine bird associations with platforms or their associated mortality risks. Systematic observations by independent biologists on vessels and platforms are needed to generate reliable assessments of risks to marine birds. Instead, the regulatory body for offshore oil and gas in eastern Canada (Canada - Newfoundland and Labrador Offshore Petroleum Board; C-NLOPB) supports industry self-reporting as the accepted form of environmental monitoring. Conflicting responsibilities of oil and gas regulatory agencies for both energy development and environmental monitoring are major barriers to transparency, unbiased scientific inquiry and adequate environmental protection. Similar conflicts with the oil and gas regulatory body in the United States, the former Minerals and Management Service (MMS) were identified by the U.S. President as a major contributor to the Deepwater Horizon disaster in the Gulf of Mexico. The

Noise Producing Toys and the Efficacy of Product Standard Criteria to Protect Health and Education Outcomes

Directory of Open Access Journals (Sweden)

Stuart J. McLaren

2013-12-01

Full Text Available An evaluation of 28 commercially available toys imported into New Zealand revealed that 21% of these toys do not meet the acoustic criteria in the ISO standard, ISO 8124-1:2009 Safety of Toys, adopted by Australia and New Zealand as AS/NZS ISO 8124.1:2010. While overall the 2010 standard provided a greater level of protection than the earlier 2002 standard, there was one high risk toy category where the 2002 standard provided greater protection. A secondary set of toys from the personal collections of children known to display atypical methods of play with toys, such as those with autism spectrum disorders (ASD, was part of the evaluation. Only one of these toys cleanly passed the 2010 standard, with the remainder failing or showing a marginal-pass. As there is no tolerance level stated in the standards to account for interpretation of data and experimental error, a value of +2 dB was used. The findings of the study indicate that the current standard is inadequate in providing protection against excessive noise exposure. Amendments to the criteria have been recommended that apply to the recently adopted 2013 standard. These include the integration of the new approaches published in the recently amended European standard (EN 71 on safety of toys.

Noise producing toys and the efficacy of product standard criteria to protect health and education outcomes.

Science.gov (United States)

McLaren, Stuart J; Page, Wyatt H; Parker, Lou; Rushton, Martin

2013-12-19

An evaluation of 28 commercially available toys imported into New Zealand revealed that 21% of these toys do not meet the acoustic criteria in the ISO standard, ISO 8124-1:2009 Safety of Toys, adopted by Australia and New Zealand as AS/NZS ISO 8124.1:2010. While overall the 2010 standard provided a greater level of protection than the earlier 2002 standard, there was one high risk toy category where the 2002 standard provided greater protection. A secondary set of toys from the personal collections of children known to display atypical methods of play with toys, such as those with autism spectrum disorders (ASD), was part of the evaluation. Only one of these toys cleanly passed the 2010 standard, with the remainder failing or showing a marginal-pass. As there is no tolerance level stated in the standards to account for interpretation of data and experimental error, a value of +2 dB was used. The findings of the study indicate that the current standard is inadequate in providing protection against excessive noise exposure. Amendments to the criteria have been recommended that apply to the recently adopted 2013 standard. These include the integration of the new approaches published in the recently amended European standard (EN 71) on safety of toys.

Evaluation of inadequate anti-retroviral treatment in patients with HIV/AIDS

Directory of Open Access Journals (Sweden)

Leonardo Carvalho da Fonseca

2012-04-01

Full Text Available INTRODUCTION: Since the emergence of antiretroviral therapy, the survival of patients infected with human immunodeficiency virus has increased. Non-adherence to this therapy is directly related to treatment failure, which allows the emergence of resistant viral strains. METHODS: A retrospective descriptive study of the antiretroviral dispensing records of 229 patients from the Center for Health Care, University Hospital, Federal University of Juiz de Fora, Brazil, was conducted between January and December 2009. RESULTS: The study aimed to evaluate patient compliance and determine if there was an association between non-adherence and the therapy. Among these patients, 63.8% were men with an average age of 44.0 ± 9.9 years. The most used treatment was a combination of 2 nucleoside reverse transcriptase inhibitors with 1 non-nucleoside reverse transcriptase inhibitor (55.5% or with 2 protease inhibitors (28.8%. It was found that patients taking lopinavir/ritonavir with zidovudine and lamivudine had a greater frequency of inadequate treatment than those taking atazanavir with zidovudine and lamivudine (85% and 83.3%, respectively. Moreover, when the combination of zidovudine/ lamivudine was used, the patients were less compliant (χ2 = 4.468, 1 degree of freedom, p = 0.035. CONCLUSIONS: The majority of patients failed to correctly adhere to their treatment; therefore, it is necessary to implement strategies that lead to improved compliance, thus ensuring therapeutic efficacy and increased patient survival.

Survey on Inadequate and Omitted Citations in Manuscripts: A Precursory Study in Identification of Tasks for a Literature Review and Manuscript Writing Assistive System

Science.gov (United States)

Raamkumar, Aravind Sesagiri; Foo, Schubert; Pang, Natalie

2016-01-01

Introduction: This paper looks at the issue of inadequate and omitted citations in manuscripts by collecting the experiential opinions of researchers from the dual perspectives of manuscript reviewers and authors. Method: An online survey was conducted with participation from 207 respondents who had experience of reviewing and authoring research…

Inadequate Iodine Intake in Population Groups Defined by Age, Life Stage and Vegetarian Dietary Practice in a Norwegian Convenience Sample.

Science.gov (United States)

Brantsæter, Anne Lise; Knutsen, Helle Katrine; Johansen, Nina Cathrine; Nyheim, Kristine Aastad; Erlund, Iris; Meltzer, Helle Margrete; Henjum, Sigrun

2018-02-17

Inadequate iodine intake has been identified in populations considered iodine replete for decades. The objective of the current study is to evaluate urinary iodine concentration (UIC) and the probability of adequate iodine intake in subgroups of the Norwegian population defined by age, life stage and vegetarian dietary practice. In a cross-sectional survey, we assessed the probability of adequate iodine intake by two 24-h food diaries and UIC from two fasting morning spot urine samples in 276 participants. The participants included children ( n = 47), adolescents ( n = 46), adults ( n = 71), the elderly ( n = 23), pregnant women ( n = 45), ovo-lacto vegetarians ( n = 25), and vegans ( n = 19). In all participants combined, the median (95% CI) UIC was 101 (90, 110) µg/L, median (25th, 75th percentile) calculated iodine intake was 112 (77, 175) µg/day and median (25th, 75th percentile) estimated usual iodine intake was 101 (75, 150) µg/day. According to WHOs criteria for evaluation of median UIC, iodine intake was inadequate in the elderly, pregnant women, vegans and non-pregnant women of childbearing age. Children had the highest (82%) and vegans the lowest (14%) probability of adequate iodine intake according to reported food and supplement intakes. This study confirms the need for monitoring iodine intake and status in nationally representative study samples in Norway.

Deficits in Response Inhibition in Patients with Attention-Deficit/Hyperactivity Disorder: The Impaired Self-Protection System Hypothesis

Directory of Open Access Journals (Sweden)

Thales Vianna Coutinho

2018-01-01

Full Text Available Problems in inhibitory control are regarded in Psychology as a key problem associated with attention-deficit/hyperactivity disorder (ADHD. They, however, might not be primary deficits, but instead a consequence of inattention. At least two components have been identified and dissociated in studies in regards to inhibitory control: interference suppression, responsible for controlling interference by resisting irrelevant or misleading information, and response inhibition, referring to withholding a response or overriding an ongoing behavior. Poor error awareness and self-monitoring undermine an individual’s ability to inhibit inadequate responses and change course of action. In non-social contexts, an individual depends on his own cognition to regulate his mistakes. In social contexts, however, there are many social cues that should help that individual to perceive his mistakes and inhibit inadequate responses. The processes involved in perceiving and interpreting those social cues are arguably part of a self-protection system (SPS. Individuals with ADHD not only present impulsive behaviors in social contexts, but also have difficulty perceiving their inadequate responses and overriding ongoing actions toward more appropriate ones. In this paper, we discuss that those difficulties are arguably a consequence of an impaired SPS, due to visual attention deficits and subsequent failure in perceiving and recognizing accurately negative emotions in facial expressions, especially anger. We discuss evidence that children with ADHD exhibit problems in a series of components involved in the activation of that system and advocate that the inability to identify the anger expressed by others, and thus, not experiencing the fear response that should follow, is, ultimately, what prevents them from inhibiting the ongoing inappropriate behavior, since a potential threat is not registered. Getting involved in high-risk situations, such as reckless driving, could

Inadequate recording of alcohol-drinking, tobacco-smoking and discharge diagnosis in medical in-patients: failure to recognize risks including drug interactions.

Science.gov (United States)

Bairstow, B M; Burke, V; Beilin, L J; Deutscher, C

1993-11-01

The records of 62 men and 43 women, 14-88 years old, admitted to general medical wards in a public teaching hospital during 1991 were examined for discharge medications and for the recording of alcohol-drinking, tobacco-smoking and discharge diagnosis. Drinking and smoking status was unrecorded in 22.9% and 21.9% of patients respectively. Twenty-four patients had 31 potential drug interactions which were related to the number of drugs prescribed and to drinking alcohol; 10.5% of the patients had interactions involving alcohol and 2.9% tobacco. Six patients received relatively or absolutely contraindicated drugs, including one asthmatic given two beta-blockers. The drugs prescribed indicated that some patients had conditions such as gastro-oesophageal disorders, diabetes and obstructive airways disease which had not been recorded. Inadequate recording of diagnoses, alcohol and smoking status creates risks to patients and may cause opportunities for preventive care to be missed. This study provides the basis for the development of undergraduate and postgraduate education programmes to address these issues and so decrease risks to patients which arise from inadequate recording practices. Incomplete diagnoses also adversely affect hospital funding where this depends on case-mix diagnostic groups. Quality assurance programmes and other strategies are being implemented to improve medical recording and prescribing habits.

Formalisation for decision support in anaesthesiology

NARCIS (Netherlands)

Renardel de Lavalette, G R; Groenboom, R.; Rotterdam, E; van Harmelen, F; ten Teije, A; de Geus, F.

1997-01-01

This paper reports on research for decision support for anaesthesiologists at the University Hospital in Groningen, the Netherlands. Based on CAROLA, an existing automated operation documentation system, we designed a support environment that will assist in real-time diagnosis. The core of the work

Follow-up of abnormal or inadequate test results in the Danish Cervical Cancer Screening Program

DEFF Research Database (Denmark)

Kristiansen, Bettina Kjær

2014-01-01

Denmark has a higher incidence of cervical cancer than other Nordic countries, although all Danish women (aged 23–65) are screened regularly to identify possible cervical dysplasia or asymptomatic invasive cancer. Annually 40 000 women receives an abnormal or inadequate test result and a follow......-up recommendation. However problems with delayed follow-up may threaten the effectiveness of the Danish Cervical Cancer Screening Program, as 20% of women are delayed and dysplasia potentially can progress into cancer. Delayed follow-up is found in situations where women either consciously or unconsciously postpone...... up will be sent to the women (RCT). The intention is to ensure that all women will be notified about the test result, quickly, homogenously and in layman’s written language, still with the opportunity to contact or be contacted by the GP, if there is special needs. Furthermore, it is assumed that GP...

Praehospitale laegebaserede behandlinger i Danmark

DEFF Research Database (Denmark)

Kindberg, Karsten; Nielsen, Søren Loumann; Møller, Ann M

2009-01-01

INTRODUCTION: With the reduction of administrative Regions in Denmark to a total of five, more focus has been given to prehospital services. Since access to and quality of prehospital treatment is not standardized, it may very well vary between regions. MATERIAL AND METHODS: Information was colle......INTRODUCTION: With the reduction of administrative Regions in Denmark to a total of five, more focus has been given to prehospital services. Since access to and quality of prehospital treatment is not standardized, it may very well vary between regions. MATERIAL AND METHODS: Information......-based prehospital units are staffed with a specialist in anaesthesiology. CONCLUSION: There is considerable variation in the coverage of the physician-based prehospital units in Denmark. There are sound medical arguments for having a specialist in anaesthesiology staffing physician-based prehospital units. All...

The issue of legal protection of the intensive care unit physician within the context of patient consent to treatment. Part I: conscious patient, refusing treatment.

Science.gov (United States)

Siewiera, Jacek; Trnka, Jakub; Kübler, Andrzej

2014-01-01

In daily clinical practice, physicians working in intensive care units (ICUs) face situations when their professional duty to protect the patient's life is in conflict with the obligation to respect the will of the patient and to assess his or her chances of treatment. Although the mere fact of conflict between these fundamental values for the ICU physician is a natural and obvious element in the chosen specialisation, many 'non-medical' circumstances make the given conflict not only very difficult but also dangerous for the physician. So far, the ethical and legal aspects of dying have been commented upon by a large group of lawyers and experts involved in the interpretation of the Polish regulations. The authors believe that a detailed analysis of the regulations should be carried out by persons of legal education, possessing a genuine medical experience associated with the specificity of end of life care in ICUs. In this paper, the authors have compared the current regulations of legislative acts of the common law relating to medical activities at anaesthesiology and intensive care units as well as based on the judgements of the common court of law over the past ten years. In the act of dissuading an ICU doctor from a medical procedure, all factors influencing the doctor's responsibility should be taken into account in accordance with the criminal law. In the case of a patient's death due to a refusal of treatment with the patient's full awareness, and given proper notification as to the consequences of refusing treatment, the doctor's responsibility lies under article 150 of the Polish penal code.

European Society of Anaesthesiology and European Board of Anaesthesiology guidelines for procedural sedation and analgesia in adults

NARCIS (Netherlands)

Hinkelbein, Jochen; Lamperti, Massimo; Akeson, Jonas; Santos, Joao; Costa, Joao; De Robertis, Edoardo; Longrois, Dan; Novak-Jankovic, Vesna; Petrini, Flavia; Struys, Michel M. R. F.; Veyckemans, Francis; Fuchs-Buder, Thomas; Fitzgerald, Robert

2018-01-01

Procedural sedation and analgesia (PSA) has become a widespread practice given the increasing demand to relieve anxiety, discomfort and pain during invasive diagnostic and therapeutic procedures. The role of, and credentialing required by, anaesthesiologists and practitioners performing PSA has been

Iron deficiency is uncommon among lactating women in urban Nepal, despite a high risk of inadequate dietary iron intake.

Science.gov (United States)

Henjum, Sigrun; Manger, Mari; Skeie, Eli; Ulak, Manjeswori; Thorne-Lyman, Andrew L; Chandyo, Ram; Shrestha, Prakash S; Locks, Lindsey; Ulvik, Rune J; Fawzi, Wafaie W; Strand, Tor A

2014-07-14

The main objective of the present study was to examine the association between dietary Fe intake and dietary predictors of Fe status and Hb concentration among lactating women in Bhaktapur, Nepal. We included 500 randomly selected lactating women in a cross-sectional survey. Dietary information was obtained through three interactive 24 h recall interviews including personal recipes. Concentrations of Hb and plasma ferritin and soluble transferrin receptors were measured. The daily median Fe intake from food was 17·5 mg, and 70% of the women were found to be at the risk of inadequate dietary Fe intake. Approximately 90% of the women had taken Fe supplements in pregnancy. The prevalence of anaemia was 20% (Hb levels < 123 g/l) and that of Fe deficiency was 5% (plasma ferritin levels < 15 μg/l). In multiple regression analyses, there was a weak positive association between dietary Fe intake and body Fe (β 0·03, 95% CI 0·014, 0·045). Among the women with children aged < 6 months, but not those with older infants, intake of Fe supplements in pregnancy for at least 6 months was positively associated with body Fe (P for interaction < 0·01). Due to a relatively high dietary intake of non-haem Fe combined with low bioavailability, a high proportion of the women in the present study were at the risk of inadequate intake of Fe. The low prevalence of anaemia and Fe deficiency may be explained by the majority of the women consuming Fe supplements in pregnancy.

67. Anniversary festival of the VSE 23 May 1981, at Interlaken. [Attitude of VSE to the legal requirements concerning the use of nuclear energy and protection of the public from radiation

Energy Technology Data Exchange (ETDEWEB)

1981-10-17

The meeting report contains six statements relating to the attitude of the Swiss Engineers to the legal requirements concerning the use of nuclear energy and the protection of the public from radiation. These imply that the present laws make it almost impossible to proceed with nuclear energy development. Although a proposed article has been introduced into the constitution accepting nuclear power development in parallel with conventional sources, the legal framework is inadequate to support this in practice.

Views of School Counselors and Social Service Workers on the Role of School in the Protection of Children in Care

Directory of Open Access Journals (Sweden)

Davut ELMACI

2017-12-01

Full Text Available The purpose of this research is to determine the views of the school counselors and social service workers about the role of the school in the protection of children in care. The participants of the research, designed as qualitative research, composed of the school counselors working at primary schools where children in care attend in the TR83 region (Amasya, Çorum, Samsun, and Tokat and the social service workers in the same region. In this scope, interviews were conducted with 11 school counselors and 12 social service workers. Research findings show that the role of school is beneficial for socializing children in care. The main problems encountered in fulfilling the current role of the school in the protection of children in care are; behavioral problems of children in care, inadequate communication between the school and the social service institution, the past problems that the children in care experienced, the school staff’s lack of knowledge about children in care and labeling. According to the research results, it is beneficial to raise awareness of school administrators and teachers about child protection and to establish an effective cooperation between school and social service institution.

The impact of an inadequate municipal water system on the residents of Chinhoyi town, Zimbabwe.

Science.gov (United States)

Schwartz, U; Siziya, S; Tshimanga, M; Barduagni, P; Chauke, T L

1999-06-01

To assess the use and impact of the water reticulation system in Chinhoyi on its residents. Cross sectional and case series studies. Chinhoyi town. 600 Chinhoyi residents. Practices and perceptions of Chinhoyi residents on the water system, and distribution of water-related diseases per area of residence. Out of 600 respondents, 565 (99.3%) had access to piped water and 558 (98.0%) to flush toilets. Breakdowns of water supply and functioning of toilet facility were reported by 308 (77.0%) and 110 (28.0%) respondents in the previous six months, respectively. Main complaints of Chinhoyi residents were about low water quality (36.2%), inadequate sewage system (31.3%) and environmental pollution (26.5%). Cases of water-related diseases were not associated with natural water bodies. Chinhoyi residents have good access to the municipal water and an adequate sanitation system. However, low quality of the water, frequent system breakdowns and the degradation and loss of amenity of the environment impair their quality of life.

State Law Challenges to School Discipline: An Outline of Claims and Case Summaries.

Science.gov (United States)

Pressman, Robert

This publication presents topic headings that may be used as a checklist of state law grounds for challenging a disciplinary action. Topics include: (1) illegality in rule adoption; (2) inadequate notice that conduct is subject to discipline; (3) existence of a protected interest; (4) inadequate notice of hearing; (5) inadequate hearing…

Glimepiride versus pioglitazone combination therapy in subjects with type 2 diabetes inadequately controlled on metformin monotherapy: results of a randomized clinical trial.

Science.gov (United States)

Umpierrez, Guillermo; Issa, Maher; Vlajnic, Aleksandra

2006-04-01

To compare the effect of add-on glimepiride or pioglitazone in subjects with type 2 diabetes inadequately controlled on metformin monotherapy. Multicenter, randomized, parallel-group, open-label, forcedtitration study involving 203 adults with poorly controlled type 2 diabetes (A1C 7.5-10%) on metformin monotherapy. Subjects were randomized to receive glimepiride or pioglitazone, titrated to the maximum dose for 26 weeks. Subjects were evaluated for A1C changes, fasting plasma glucose (FPG), insulin, C-peptide, and lipid levels. Safety outcomes and diabetes-related healthcare resource utilization were also evaluated. Both treatment groups achieved similar and significant mean decreases from baseline to endpoint (week 26) in A1C (p = 0.0001) and FPG (p use of fasting C-peptide concentration > or = 0.27 nmol/L in the inclusion criteria was a potential limitation as it may have included those patients with an improved probability for glimepiride or pioglitazone response. In addition, a larger patient population would have provided a greater degree of data applicability. In patients with type 2 diabetes inadequately controlled on metformin monotherapy, add-on glimepiride or pioglitazone results in similar overall improvements in glycemic control. Compared with pioglitazone, glimepiride is associated with faster glycemic control, lower total and LDL cholesterol levels and reduced short-term healthcare costs.

General anaesthesia with multimodal principles versus intrathecal analgesia with conventional principles in total knee arthroplasty

DEFF Research Database (Denmark)

Harsten, Andreas; Hjartarson, Hjortur; Werner, Mads Utke

2013-01-01

Postoperative outcomes following major surgery are influenced by surgical and anaesthesiological factors. While techniques of minimal invasive surgery have been associated with improved outcome, the techniques of minimal invasive, multimodal anaesthesia have not been adequately investigated. The ...

Terrorism, distress, and drinking: vulnerability and protective factors.

Science.gov (United States)

Richman, Judith A; Rospenda, Kathleen M; Cloninger, Lea

2009-12-01

Research has demonstrated effects of 9/11 on distress and drinking outcomes in individuals directly affected and indirectly affected across the United States. Fewer studies have addressed vulnerability and protective factors shown to moderate the effects of stress exposure. We report findings from a Midwestern workplace cohort study. Respondents to a 6 wave longitudinal mail survey completed questionnaires prior to September 11, 2001 and again in 2003 and 2005. Regression analyses encompassed measures of terrorism-related beliefs and fears, workplace stressors (sexual harassment, generalized abuse and low decision latitude), marital and parental status, and perceived social support in 2003, and distress and deleterious drinking outcomes in 2005. Analyses showed that terrorism-related fears significantly interacted with workplace stressors and interpersonal social relationships in predicting distress, drinking or both, controlling for pre-9/11 distress and drinking. Gender differences were also found. This article suggests that certain individuals may be at heightened risk for distressful reactions to and/or deleterious drinking resulting from terrorism-related issues and fears due to additional risk factors involving workplace stressors and inadequate interpersonal bonds. However, limitations of the study were noted and future research was recommended.

Environmental Assessment for the Health Protection Instrument Calibration Facility at the Savannah River Site

Energy Technology Data Exchange (ETDEWEB)

1993-08-01

The purpose of this Environmental Assessment (EA) is to review the possible environmental consequences associated with the construction and operation of a Health Protection Instrument Calibration Facility on the Savannah River Site (SRS). The proposed replacement calibration facility would be located in B Area of SRS and would replace an inadequate existing facility currently located within A Area of SRS (Building 736-A). The new facility would provide laboratories, offices, test equipment and the support space necessary for the SRS Radiation Monitoring Instrument Calibration Program to comply with DOE Orders 5480.4 (Environmental Protection, Safety and Health Protection Standards) and 5480.11 (Radiation Protection for Occupational Workers). The proposed facility would serve as the central site source for the evaluation, selection, inspection, testing, calibration, and maintenance of all SRS radiation monitoring instrumentation. The proposed facility would be constructed on a currently undeveloped portion in B Area of SRS. The exact plot associated with the proposed action is a 1.2 hectare (3 acre) tract of land located on the west side of SRS Road No. 2. The proposed facility would lie approximately 4.4 km (2.75 mi) from the nearest SRS site boundary. The proposed facility would also lie within the confines of the existing B Area, and SRS safeguards and security systems. Archaeological, ecological, and land use reviews have been conducted in connection with the use of this proposed plot of land, and a detailed discussion of these reviews is contained herein. Socioeconomic, operational, and accident analyses were also examined in relation to the proposed project and the findings from these reviews are also contained in this EA.

Environmental Assessment for the Health Protection Instrument Calibration Facility at the Savannah River Site

International Nuclear Information System (INIS)

1993-08-01

The purpose of this Environmental Assessment (EA) is to review the possible environmental consequences associated with the construction and operation of a Health Protection Instrument Calibration Facility on the Savannah River Site (SRS). The proposed replacement calibration facility would be located in B Area of SRS and would replace an inadequate existing facility currently located within A Area of SRS (Building 736-A). The new facility would provide laboratories, offices, test equipment and the support space necessary for the SRS Radiation Monitoring Instrument Calibration Program to comply with DOE Orders 5480.4 (Environmental Protection, Safety and Health Protection Standards) and 5480.11 (Radiation Protection for Occupational Workers). The proposed facility would serve as the central site source for the evaluation, selection, inspection, testing, calibration, and maintenance of all SRS radiation monitoring instrumentation. The proposed facility would be constructed on a currently undeveloped portion in B Area of SRS. The exact plot associated with the proposed action is a 1.2 hectare (3 acre) tract of land located on the west side of SRS Road No. 2. The proposed facility would lie approximately 4.4 km (2.75 mi) from the nearest SRS site boundary. The proposed facility would also lie within the confines of the existing B Area, and SRS safeguards and security systems. Archaeological, ecological, and land use reviews have been conducted in connection with the use of this proposed plot of land, and a detailed discussion of these reviews is contained herein. Socioeconomic, operational, and accident analyses were also examined in relation to the proposed project and the findings from these reviews are also contained in this EA

Assessment of skin exposure to N,N-dimethylformamide and methyl ethylketone through chemical protective gloves and decontamination of gloves for reuse purposes.

Science.gov (United States)

Chao, Keh-Ping; Wang, Ping; Chen, Chen-Peng; Tang, Ping-Yu

2011-02-15

N,N-dimethylformamide (DMF) and methyl ethylketone (MEK) are the hazardous chemicals commonly used in the synthetic leather industries. Although chemical protective gloves provide adequate skin exposure protection to workers in these industries, there is currently no clear guideline or understanding with regard to the use duration of these gloves. In this study, the permeation of DMF/MEK mixture through neoprene gloves and the desorption of chemicals from contaminated gloves were conducted using the ASTM F739 cell. The acceptable use duration time of the gloves against DMF/MEK permeation was estimated by assuming a critical body burden of chemical exposure as a result of dermal absorption. In a re-exposure cycle of 5 days, decontamination of the gloves by aeration at 25°C was found to be inadequate in a reduction of breakthrough time as compared to a new unexposed glove. However, decontamination of the gloves by heating at 70 or 100°C showed that the protective coefficient of the exposed gloves had similar levels of resistance to DMF/MEK as that of new gloves. Implications of this study include an understanding of the use duration of neoprene gloves and proper decontamination of chemical protective gloves for reuse. Copyright © 2010 Elsevier B.V. All rights reserved.

Intent at day case laparoscopic cholecystectomy in Owerri, Nigeria: Initial experiences

Directory of Open Access Journals (Sweden)

Christopher Nonso Ekwunife

2013-01-01

Full Text Available Background and Objective: Laparoscopic cholecystectomy has been the default operation for cholelithiasis at Federal Medical Centre, Owerri for the past 2 years and the outcomes have been good. The duration of post operative stay has been decreasing. We therefore initiated a preliminary 2-year prospective study in May 2010 to determine the feasibility of carrying out day case laparoscopic cholecystectomy in our hospital. Materials and Methods: Patients undergoing laparoscopic cholecystectomy were included in the study if they satisfied the following criteria: Age < 65 years, body mass index < 35 kg/m 2 , American Society of Anaesthesiology physical status class I and II, patient residence within 20 km radius of the hospital, patient acceptance of the procedure and absence of previous complicated upper abdominal surgery. Results: Twelve patients (10 females, 2 males were worked up with the intent of achieving same-day discharge of the patients. Five of the patients (41.7% were discharged on the day of operation. The reasons for overnight stay included inadequate pain control, insertion of drain and patient wishes. There was no conversion to open surgery, no major complications and no case of readmission to the hospital. Conclusions: Day case laparoscopic cholecystectomy in our environment could be safely promoted but will depend on improved facilities and patient enlightenment.

Association of apneic oxygenation with decreased desaturation rates during rapid sequence intubation by a Chinese emergency medicine service.

Science.gov (United States)

Mao, Yong; Qin, Zong-He

2015-01-01

Rapid and safe airway management has always been of paramount importance in successful management of critically ill and injured patients in the emergency department. The achievement rate of emergency medicine inhabitants in airway management improved enhanced essentially subsequent to finishing anaesthesiology turn. There was a slightly higher rate of quick sequence intubation in the postapneic oxygenation groups (preapneic oxygenation 6.4%; postapneic oxygenation 9.1%). The majority of patients intubated in both groups were men (preapneic oxygenation 72.3%; postapneic oxygenation 63.5%). A higher percentage of patients in the preapneic oxygenation group had a Cormack-Lehane grade III or worse view (23.2% versus 11.8%). Anaesthesiology turns should be considered as an essential component of emergency medicine training programs. A collateral curriculum of this nature should also focus on the acquisition of skills in airway management.

Evaluations of emamectin benzoate and propiconazole for protecting individual Pinus contorta from mortality attributed to colonization by Dendroctonus ponderosae and associated fungi.

Science.gov (United States)

Fettig, Christopher J; Munson, A Steven; Grosman, Donald M; Bush, Parshall B

2014-05-01

Protection of conifers from bark beetle colonization typically involves applications of liquid formulations of contact insecticides to the tree bole. An evaluation was made of the efficacy of bole injections of emamectin benzoate alone and combined with the fungicide propiconazole for protecting individual lodgepole pine, Pinus contorta Dougl. ex Loud., from mortality attributed to colonization by mountain pine beetle, Dendroctonus ponderosae Hopkins, and progression of associated blue stain fungi. Injections of emamectin benzoate applied in mid-June did not provide adequate levels of tree protection; however, injections of emamectin benzoate + propiconazole applied at the same time were effective for two field seasons. Injections of emamectin benzoate and emamectin benzoate + propiconazole in mid-September provided tree protection the following field season, but unfortunately efficacy could not be determined during a second field season owing to insufficient levels of tree mortality observed in the untreated control, indicative of low D. ponderosae populations. Previous evaluations of emamectin benzoate for protecting P. contorta from mortality attributed to D. ponderosae have failed to demonstrate efficacy, which was later attributed to inadequate distribution of emamectin benzoate following injections applied several weeks before D. ponderosae colonization. The present data indicate that injections of emamectin benzoate applied in late summer or early fall will provide adequate levels of tree protection the following summer, and that, when emamectin benzoate is combined with propiconazole, tree protection is afforded the year that injections are implemented. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

Industrial radiography in the State of Bahia, Brazil: The health protection of workers

International Nuclear Information System (INIS)

Andrade, Ana Emilia Oliveira de

1997-01-01

This study aimed to identify the Regulatory and Inspection Authority for actions developed by industrial radiography enterprises in the State of Bahia, Brazil, concerning health protection of workers exposed to ionizing radiation in industry. Institutions which legislate about this matter at international, national and State level were identified. These legislations were analysed according to recommendations by the Basic Safety Standards from the Atomic Energy International Agency. Medical Supervision is proposed as a factor to warrant protection to worker's health. This is a service evaluation study, encompassing results, processes and structural components. Emphasis is given to the process component which investigated the adequacy of which is performed by employees and workers. Five enterprises which provide industrial radiography services in the State of Bahia were identified, employing forty workers on a temporary basis. This study also observed: intense workforce, a complete process of contracting out in the sector; inadequate conditions of work organization (long work journey, night work, lack of days-off schedule); inefficiency of medical services responsible by worker's protection concerning radiation specific risks as well as other occupational risks, unrelated to main activity. There is a legal basis for Authorities actions, although it has not been completely implemented. These findings embased the elaboration of a proposal of a Surveillance Program for the Worker Exposed to Industrial Radiation, which includes the setting of safety standards and monitoring of workers exposed to ionization radiation in the occupational environment, accident prevention in this activity and the specialized health care to those affected by radio accidents. (author)

[Light protection: principles of UV protection].

Science.gov (United States)

Stege, H; Mang, R

2006-05-01

UV radiation is responsible for the induction of epithelial and melanocytic skin cancer, photoaging, and photodermatoses. UV protection is necessary to prevent damage caused by non-physiologic exposure. UV protection includes not only reduction of sun exposure but also use of sun protective filters, UV protective clothes, DNA repair enzymes, and antioxidant supplementation. Consumers are uncertain about the possibilities and limitations of commercial sun protection measures. Dermatologists must explain protective measures to the general public which continues to believe that UV-tanned skin is healthy. The sunscreen market is a highly competitive but lucrative market. The range of products with different designations and promises makes difficult for both consumers and dermatologists to determine what is sensible UV protection.

Promoting the Recognition and Protection of the Rights of All Migrants Using a Soft-Law International Migrants Bill of Rights

Directory of Open Access Journals (Sweden)

Ian M. Kysel

2016-06-01

Full Text Available The rights and movement of people crossing international borders remain inadequately governed and incompletely protected by a fragmented patchwork of institutions and norms. In recent years, debates regarding migration law and practice globally have been focused on subcategories of migrants, such as refugees, or on particular migration contexts, such as migration as a result of crisis or climate change. In response, a transnational initiative housed at the Georgetown University Law Center has drafted a soft-law bill of rights — the International Migrants Bill of Rights (IMBR — that seeks to elaborate the law protecting all migrants, regardless of the cause of their movement across an international border. The bill draws its content from human rights, refugee, and labor law, among other areas, and is drafted to be a comprehensive and declarative tool that articulates a core set of rights to protect migrants and to apply in the migration context.This article articulates how such a tool could be used to promote the recognition and protection of the rights of all migrants, in law and in practice. It argues that a soft-law bill of rights could be leveraged to fill significant gaps and promote an improved normative and institutional infrastructure that better protects all migrants worldwide. Section I provides a brief overview of the gap that a soft-law bill of rights can address. Section II provides a brief overview of the history and content of the bill of rights and IMBR Initiative. Section III describes, specifically, how making use of a soft-law bill of rights stands to improve the recognition and protection of fundamental rights that protect all migrants — and how soft law can help fill specific protection gaps.

Protection Coordination in Electrical Substation Part-2 Unit Protections (Differential and Distance Protection)

OpenAIRE

TÜR, Mehmet Rida; Shobole, Abdulfetah; Baysal, Mustafa; Wadi, Mohammed

2018-01-01

Power systemsmust be protected against faults to ensure quality and reliable generation,transmission and distribution of power systems. Power system protection is providedby the protection relays. This paper is the second part of the ProtectionCoordination study for the Siddik Kardesler Substation. The protection fortransmission lines, transformer, bus bars and customer feeders is provided byovercurrent protection, differential and distance protection schemes. In thispaper, issues related wit...

Exploring Social Resilience in Madagascar's Marine Protected Areas

Directory of Open Access Journals (Sweden)

Joshua Cinner

2009-06-01

Full Text Available We examined and compared aspects of local-level resilience in 13 coastal communities within and adjacent to all of Madagascar's national marine protected areas. Our examination of social resilience focused on indicators of the flexibility of household livelihood portfolios and both formal and informal governance institutions, the capacity of communities to organize, their capacity to learn, and access to household assets and community infrastructure. In general, we found high levels of flexibility in formal institutions and livelihood portfolios and high levels of participation in decision-making and community groups. Together, these indicators suggest some latent capacity to adaptively manage resources, but this capacity may be offset by poor levels of trust between communities and resource managers, a poor understanding of the ways in which humans affect marine resources, inadequate feedback of ecological monitoring to communities, inflexibility in informal governance institutions, and a lack of assets to draw upon. We suggest that building desirable resilience in Madagascar's marine protected areas will require the following: investments in community-level infrastructure, projects to generate household income, and enhanced agricultural production to improve the well-being of communities; improvements in the capacity to learn through investments in formal and informal education; enhanced trust between park staff and local communities; empowerment of communities to govern and enforce natural resources; the increased accountability of leaders and transparency of governance processes; adequate cross-scale interaction with local, provincial, and national institutions; and the pursuit of these activities in ways that capitalize on community-specific strengths, such as high flexibility and the presence of sociocultural institutions such as taboos that regulate resource use.

Suboptimal Iodine Concentration in Breastmilk and Inadequate Iodine Intake among Lactating Women in Norway.

Science.gov (United States)

Henjum, Sigrun; Lilleengen, Anne Marie; Aakre, Inger; Dudareva, Anna; Gjengedal, Elin Lovise Folven; Meltzer, Helle Margrete; Brantsæter, Anne Lise

2017-06-22

Breastfed infants depend on sufficient maternal iodine intake for optimal growth and neurological development. Despite this, few studies have assessed iodine concentrations in human milk and there is currently no published data on iodine status among lactating women in Norway. The aim of this study was to assess iodine concentrations in breast milk (BMIC) in lactating women and estimate iodine intake. Five Mother and Child Health Centres in Oslo were randomly selected during 2016, and 175 lactating women between 2nd and 28th weeks postpartum participated. Each of the women provided four breastmilk samples which were pooled and analysed for iodine concentrations. Participants also provided information on iodine intake from food and supplements covering the last 24 h and the habitual iodine intake (food frequency questionnaire). The median (p25, p75 percentiles) BMIC was 68 (45, 98) µg/L and 76% had BMIC food (p25, p75) was 121 (82, 162) µg/day and the total intake (food and supplements) was 134 (95, 222) µg/day. The majority of lactating women had suboptimal BMIC and inadequate intake of iodine from food and supplements.

How many training modalities are needed to obtain procedural confidence in intraosseous access?

DEFF Research Database (Denmark)

Hallas, Peter; Folkestad, Lars; Brabrand, Mikkel

2011-01-01

Participants in advanced resuscitation courses are often expected to learn to perform intraosseous access (IO). But how many learning modalities are needed to achieve procedural confidence in IO? We distributed an online questionnaire to members of emergency medicine, paediatric and anaesthesiology...

Experience of collaboration between a Dutch surgical team in a ...

African Journals Online (AJOL)

University Medical Center Utrecht, Department of Anaesthesiology. 3. University ... also spent on education/ teaching operation techniques/ regional anaesthesia techniques/ scrubbing techniques/ and principles ... ing the quality of care through education, management advice ..... Kingham TP, Kamara TB, Cherian MN, et al.

Assessment of radiological protection systems among diagnostic radiology facilities in North East India.

Science.gov (United States)

Singh, Thokchom Dewan; Jayaraman, T; Arunkumar Sharma, B

2017-03-01

This study aims to assess the adequacy level of radiological protection systems available in the diagnostic radiology facilities located in three capital cities of North East (NE) India. It further attempts to understand, using a multi-disciplinary approach, how the safety codes/standards in diagnostic radiology framed by the Atomic Energy Regulatory Board (AERB) and the International Atomic Energy Agency (IAEA) to achieve adequate radiological protection in facilities, have been perceived, conceptualized, and applied accordingly in these facilities. About 30 diagnostic radiology facilities were randomly selected from three capitals of states in NE India; namely Imphal (Manipur), Shillong (Meghalaya) and Guwahati (Assam). A semi-structured questionnaire developed based on a multi-disciplinary approach was used for this study. It was observed that radiological practices undertaken in these facilities were not exactly in line with safety codes/standards in diagnostic radiology of the AERB and the IAEA. About 50% of the facilities had registered/licensed x-ray equipment with the AERB. More than 80% of the workers did not use radiation protective devices, although these devices were available in the facilities. About 85% of facilities had no institutional risk management system. About 70% of the facilities did not carry out periodic quality assurance testing of their x-ray equipment or surveys of radiation leakage around the x-ray room, and did not display radiation safety indicators in the x-ray rooms. Workers in these facilities exhibited low risk perception about the risks associated with these practices. The majority of diagnostic radiology facilities in NE India did not comply with the radiological safety codes/standards framed by the AERB and IAEA. The study found inadequate levels of radiological protection systems in the majority of facilities. This study suggests a need to establish firm measures that comply with the radiological safety codes/standards of the

Knowledge, attitudes and practices of the general public toward sun exposure and protection: A national survey in Saudi Arabia.

Science.gov (United States)

AlGhamdi, Khalid M; AlAklabi, Aeed S; AlQahtani, Abdulla Z

2016-11-01

Background: Many international studies have been conducted to assess the knowledge, attitudes and practices (KAP) of the public toward sun exposure and sun-protection measures. However, there are scarce data on these factors from the Middle East. Objectives: This study aimed to explore the KAP of the public toward sun exposure and sun-protection measures among Saudis. Methods: A cross-sectional survey using a specially designed questionnaire was conducted on a stratified random sample of the general population in the five geographical regions of Saudi Arabia (central, eastern, northern, southern, and western). Data were collected between October 2010 and March 2011. Multiple logistic regressions were applied to relate the use of sunscreen and skin cancer awareness with various socio-demographic variables. Results: The questionnaire was distributed to 2900 Saudis. A total of 2622 questionnaires were completed, returned, and included in the data analysis, corresponding to a response rate of 90.4%. The mean (SD) age of respondents was 27.8 ± 9.7 years. Fifty percent (1301/1601) of the respondents were males. Fifty-five percent (1406/2544) were aware of the association between sun exposure and skin cancer. Female, young and student respondents were more likely to be aware of the connection between sun exposure and skin cancer ( p  Protective clothes were the most commonly used sun protection measure as reported by more than 90% of our participants. Conclusion: This study has shown that sun awareness and protection are generally inadequate in the Saudi population and suggests the need for health education programs.

Chronic arthritis of the hip joint: an unusual complication of an inadequately treated fistula-in-ano

Science.gov (United States)

Raghunath, Rajat; Varghese, Gigi; Simon, Betty

2014-01-01

We report a case of chronic arthritis of the right hip joint in an otherwise healthy young male athlete as a complication of inadequately treated anal fistula. A young male athlete presented with symptoms of right hip pain and difficulty in walking and intermittent fever for 2 months. He had a history of perianal abscess drainage. On examination he was found to have a tender right hip joint with severe restriction of movements. He was also found to have a partially drained right ischiorectal abscess. X-ray and MRI of the hip joint revealed chronic arthritis of the right hip joint, which was communicating with a complex fistula-in-ano. He underwent a diversion sigmoid colostomy and right ischiorectal abscess drainage along with appropriate antibiotics with a plan for definitive hip joint procedure later. He was lost to follow-up and succumbed to severe perianal sepsis within a few months. PMID:25414226

Inadequately marketing our brand: Medical student awareness of acute care surgery.

Science.gov (United States)

Montgomery, Stephanie C; Privette, Alicia R; Ferguson, Pamela L; Mirdamadi, Meena; Fakhry, Samir M

2015-11-01

Despite focused national efforts to promote acute care surgery (ACS), little is known about medical student awareness of ACS as a career choice. The impending shortage of general surgeons emphasizes the need to increase interest in this comprehensive surgical specialty. The goal of this study was to determine whether students would be more likely to consider choosing ACS if they were aware of the specialty and its benefits. A survey was distributed electronically to medical students at our institution, a Level I trauma center with an active ACS service. The survey asked questions regarding specialty choice and factors that were used in making that decision. Also included were questions regarding their familiarity and affinity for ACS. The survey was returned by 518 students. Each medical school year was proportionately represented. Twenty-one percent of the students reported surgery as their career choice; however, women were half as likely to choose surgery as men. When asked to define ACS, 23% of all students gave the correct response. Only 8.9% of the students in the preclinical years correctly defined ACS. Even in the clinical years, 54% were unaware of ACS as a specialty. Students reported that the top factors that influenced their choice were controllable lifestyle, predictable schedule, and a positive medical school role model. When asked to identify what would make ACS appealing, a 50-hour work week was deemed most influential. When given the definition of ACS with approximate pay and on-call hours, 41.5% of the students and 75% of those interested in surgery would be likely to choose ACS as a career. This study highlights that awareness of ACS as a specialty is lacking. This may reflect inadequate marketing of our "brand" both locally and nationally. Focused efforts at familiarizing students with ACS and increased role modeling may increase interest in ACS.

Recovery at the post anaesthetic care unit after breast cancer surgery

DEFF Research Database (Denmark)

Gärtner, Rune; Callesen, Torben; Kroman, Niels Thorndahl

2010-01-01

Extant literature shows that women having undergone breast cancer surgery have substantial problems at the post-anaesthesia care unit (PACU). Based on nursing reports and elements of the discharge scoring system recommended by The Danish Society of Anaesthesiology and Intensive Care Medicine...

Development of an anaesthesia resident curriculum at the European level

DEFF Research Database (Denmark)

Ostergaard, Helle Thy

2013-01-01

The European Section and Board of Anaesthesiology has recently published new guidelines for specialist education. These guidelines have undergone a major revision towards a competence-based approach. Basically, apart from having to take into account the development of the specialty, with enlarged...

anaesthetic registrars' experiences of perioperative death

African Journals Online (AJOL)

Death on the table: anaesthetic registrars' experiences of perioperative ... aDepartment of Anaesthesiology and Critical Care, University of KwaZulu-Natal, Durban, South Africa ... Results: Themes expressed by participants fell into three broad categories: ... number (up to 70%) of anaesthetists report experiencing adverse.

Protective environment for hematopoietic cell transplant (HSCT) recipients: The Infectious Diseases Working Party EBMT analysis of global recommendations on health-care facilities.

Science.gov (United States)

Styczynski, Jan; Tridello, Gloria; Donnelly, J Peter; Iacobelli, Simona; Hoek, Jennifer; Mikulska, Malgorzata; Aljurf, Mahmoud; Gil, Lidia; Cesaro, Simone

2018-03-13

International guidelines on protective environment for HSCT recipients proposed a set of 10 global recommendations in 2009 on protective environment (GRPE) concerning hospital room design and ventilation. The EBMT Infectious Diseases Working Party undertook a survey on the status on protective environment for HSCT recipients with the aim of surveying current practices and their agreement with GRPE recommendations. The questionnaire consisted of 37 questions divided into 5 sections about filtration, air changes, maintenance, and the protective environment in rooms and the surrounding unit. Overall, 177 centres (response rate 33%) from 36 countries responded, indicating that 99.4% of patient rooms were equipped with HEPA filters, but only 48.6% of the centre's staff were aware of, and could confirm, regular replacement of filters based on manufacturers' recommendations. Well-sealed rooms were used in terms of windows (70.6%), ceilings (35%), and plumbing pipes (51.4%). The sensor monitors in the patient room used to determine when the HEPA filters require changing were installed only in 18.1% of centres. Only 1 centre fulfilled all 10 GRPE recommendations, while 62 centres fulfilled the 3 level "A" recommendations. In conclusion, HEPA-filtered rooms are available in almost all centres, while fewer centres fulfilled other requirements. Knowledge on the details and maintenance of protective environments in the HSCT setting was inadequate, reflecting a lack of communication between the health personnel involved, hospital infection control and the hospital maintenance services.

PROTECTING CRITICAL DATABASES – TOWARDS A RISK-BASED ASSESSMENT OF CRITICAL INFORMATION INFRASTRUCTURES (CIIS IN SOUTH AFRICA

Directory of Open Access Journals (Sweden)

Mzukisi N Njotini

2013-04-01

Full Text Available South Africa has made great strides towards protecting critical information infrastructures (CIIs. For example, South Africa recognises the significance of safeguarding places or areas that are essential to the national security of South Africa or the economic and social well-being of South African citizens. For this reason South Africa has established mechanisms to assist in preserving the integrity and security of CIIs. The measures provide inter alia for the identification of CIIs; the registration of the full names, address and contact details of the CII administrators (the persons who manage CIIs; the identification of the location(s of CIIs or their component parts; and the outlining of the general descriptions of information or data stored in CIIs.It is argued that the measures to protect CIIs in South Africa are inadequate. In particular, the measures rely on a one-size-fits-all approach to identify and classify CIIs. For this reason the South African measures are likely to lead to the adoption of a paradigm that considers every infrastructure, data or database, regardless of its significance or importance, to be key or critical.

WTO: US and Argentina settle dispute over patents and data protection.

Science.gov (United States)

Elliott, Richard

2002-12-01

In May 2000, supplementing an earlier complaint filed in May 1999, the US filed a complaint against Argentina, alleging that its patent laws violate the World Trade Organization's Agreement on Trade-Related Aspects of Intellectual Property (the TRIPS Agreement). The gist of the US complaint was that Argentina's law failed to provide: (1) adequate protection against "unfair" commercial use of undisclosed test data submitted in order to get market approval of pharmaceutical products; (2) certain safeguards for compulsory licences on an invention granted on the basis of inadequate working by the patent holder; and (3) adequate measures to prevent infringements of patent rights. The US also alleged that Argentina denies certain exclusive rights of patent holders, such as the exclusive right to import the patented product into the country. At the end of May 2002, the US and Argentina notified the WTO that they had reached a "mutually agreed solution," without prejudice to their respective rights and obligations under WTO agreements, and the US has withdrawn its complaint.

Shigellosis on Indian reserves in Manitoba, Canada: its relationship to crowded housing, lack of running water, and inadequate sewage disposal.

Science.gov (United States)

Rosenberg, T; Kendall, O; Blanchard, J; Martel, S; Wakelin, C; Fast, M

1997-09-01

This study compares incidence and hospitalization rates for shigellosis between Indians and the rest of the population in Manitoba, Canada. It examines the relationship between shigellosis and environmental conditions on reserves. Rates were calculated with surveillance data and a survey of environmental infrastructure was done. Indians had shigellosis incidence and hospitalization rates that were 29 and 12 times as high, respectively, as those of the rest of the population. Household crowding, lack of piped water, and inadequate sewage disposal were significantly associated with an increased incidence of shigellosis on reserves. Many cases of shigellosis may be prevented by improving living conditions on Indian reserves.

Defining Indicators and Standards for Tourism Impacts in Protected Areas: Cape Range National Park, Australia

Science.gov (United States)

Moore, Susan A.; Polley, Amanda

2007-03-01

Visitors’ perceptions of impacts and acceptable standards for environmental conditions can provide essential information for the sustainable management of tourist destinations, especially protected areas. To this end, visitor surveys were administered during the peak visitor season in Cape Range National Park, on the northwest coast of Western Australia and adjacent to the iconic Ningaloo Reef. The central focus was visitors’ perceptions regarding environmental conditions and standards for potential indicators. Conditions considered of greatest importance in determining visitors’ quality of experience included litter, inadequate disposal of human waste, presence of wildlife, levels of noise, and access to beach and ocean. Standards were determined, based on visitors’ perceptions, for a range of site-specific and non-site-specific indicators, with standards for facilities (e.g., acceptable number of parking bays, signs) and for negative environmental impacts (e.g., levels of littering, erosion) sought. The proposed standards varied significantly between sites for the facilities indicators; however, there was no significant difference between sites for environmental impacts. For the facilities, the standards proposed by visitors were closely related to the existing situation, suggesting that they were satisfied with the status quo. These results are considered in the context of current research interest in the efficacy of visitor-derived standards as a basis for protected area management.

Defining indicators and standards for tourism impacts in protected areas: Cape Range National Park, Australia.

Science.gov (United States)

Moore, Susan A; Polley, Amanda

2007-03-01

Visitors' perceptions of impacts and acceptable standards for environmental conditions can provide essential information for the sustainable management of tourist destinations, especially protected areas. To this end, visitor surveys were administered during the peak visitor season in Cape Range National Park, on the northwest coast of Western Australia and adjacent to the iconic Ningaloo Reef. The central focus was visitors' perceptions regarding environmental conditions and standards for potential indicators. Conditions considered of greatest importance in determining visitors' quality of experience included litter, inadequate disposal of human waste, presence of wildlife, levels of noise, and access to beach and ocean. Standards were determined, based on visitors' perceptions, for a range of site-specific and non-site-specific indicators, with standards for facilities (e.g., acceptable number of parking bays, signs) and for negative environmental impacts (e.g., levels of littering, erosion) sought. The proposed standards varied significantly between sites for the facilities indicators; however, there was no significant difference between sites for environmental impacts. For the facilities, the standards proposed by visitors were closely related to the existing situation, suggesting that they were satisfied with the status quo. These results are considered in the context of current research interest in the efficacy of visitor-derived standards as a basis for protected area management.

Efficacy and safety of vildagliptin in patients with type 2 diabetes mellitus inadequately controlled with dual combination of metformin and sulphonylurea.

Science.gov (United States)

Lukashevich, V; Del Prato, S; Araga, M; Kothny, W

2014-05-01

The broadly used combination of metformin and sulphonylurea (SU) often fails to bring patients to glycaemic goal. This study assessed the efficacy and safety of vildagliptin as add-on therapy to metformin plus glimepiride combination in patients with type 2 diabetes mellitus (T2DM) who had inadequate glycaemic control. A multicentre, double-blind, placebo-controlled study randomized patients to receive treatment with vildagliptin 50 mg bid (n = 158) or placebo (n = 160) for 24 weeks. After 24 weeks, the adjusted mean change in haemoglobin A1c (HbA1c) was -1.01% with vildagliptin (baseline 8.75%) and -0.25% with placebo (baseline 8.80%), with a between-treatment difference of -0.76% (p vildagliptin achieved the HbA1c target vildagliptin and placebo was -1.13 mmol/l (p vildagliptin reduced HbA1c by 0.74% from baseline 7.82% (between-treatment difference: -0.97%; p Vildagliptin was well tolerated with low incidence of hypoglycaemia, slightly higher than with placebo (5.1% vs. 1.9%) and no clinically relevant weight gain. Vildagliptin significantly improved glycaemic control in patients with T2DM inadequately controlled with metformin plus glimepiride combination. The addition of vildagliptin was well tolerated with low risk of hypoglycaemia and weight gain. This makes vildagliptin an attractive treatment option for patients failing on metformin plus SU particularly in patients with baseline HbA1c ≤8%. © 2013 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

Public health safety and environment in inadequate hospital and healthcare settings: a review.

Science.gov (United States)

Baguma, D

2017-03-01

Public health safety and environmental management are concerns that pose challenges worldwide. This paper briefly assesses a selected impact of the environment on public health. The study used an assessment of environmental mechanism to analyse the underlying different pathways in which the health sector is affected in inadequate hospital and health care settings. We reviewed the limited available evidence of the association between the health sector and the environment, and the likely pathways through which the environment influences health. The paper also models the use of private health care as a function of costs and benefits relative to public care and no care. The need to enhancing policies to improve the administration of health services, strengthening interventions on environment using international agreements, like Rio Conventions, including measures to control hospital-related infection, planning for human resources and infrastructure construction development have linkage to improve environment care and public health. The present study findings partly also demonstrate the influence of demand for health on the environment. The list of possible interventions includes enhancing policies to improve the administration of health services, strengthening Rio Conventions implementation on environmental concerns, control of environmental hazards and public health. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Protection of children's rights in the health care: problems and legal issues.

Science.gov (United States)

Pashkov, Vitaliy; Olefir, Andrii

Introduction: Among all categories of patients children (minors) must be protected first. It is caused so by the specificity of the treatment, their vulnerability, the need of further protection and supervision. Providing of medical care services for children are often connected with the risks of the process of treatment, and of the drug usage. The aim: To identify the problems associated with the protection of the rights of minors and, on the basis of this, the basic guarantees of their rights, as well as mark the trends in the practice of ECHR. Materials and Methods: The study is based on its own theoretical and empirical basis. The theoretical basis include scientific articles, expert reviews of legislation and communications of non-governmental organisations, and empirical - decisions of the ECHR, international legal acts and directives of the EU. Results: The main violations of the rights of minor children include the following: - legal representatives of children do not take to the account their interests (refusal of medical intervention or the choice of certain method of interference); - medical intervention under the influence of coercion; - providing of unwarranted medical care without the corresponding testimony; - providing of inadequate medical care: when the patient was only examined and ineffective treatment was prescribed, and others. As for mentally ill children, the following rights are usually violated: for life, for a fair trial. It has been proved that defects in the provision of health care are often predetermined by the poor state logistics of hospitals, lack of financing and appropriate pediatric medicines, outdated methods of treatment, and incompetence of some doctors. Conclusions: From the point of view of protecting the rights of minors, the rights of children in medicine can be classified into universal and special. The rights correspond not only to the corresponding duties of medical staff, but also of their parents (legal

Perceptions of final-year UKZN medical students about anaesthesia ...

African Journals Online (AJOL)

perceptions of anaesthesiology was the medical school rotation, with the need for ... Conclusion:The perceptions of medical students concerning anaesthesia are multi-faceted, with ... questionnaire and were thus included in the analysis. .... commonest themes that emerged in students' responses were .... A survey of factors.

Tacrolimus in the treatment of myasthenia gravis in patients with an inadequate response to glucocorticoid therapy: randomized, double-blind, placebo-controlled study conducted in China.

Science.gov (United States)

Zhou, Lei; Liu, Weibin; Li, Wei; Li, Haifeng; Zhang, Xu; Shang, Huifang; Zhang, Xu; Bu, Bitao; Deng, Hui; Fang, Qi; Li, Jimei; Zhang, Hua; Song, Zhi; Ou, Changyi; Yan, Chuanzhu; Liu, Tao; Zhou, Hongyu; Bao, Jianhong; Lu, Jiahong; Shi, Huawei; Zhao, Chongbo

2017-09-01

To determine the efficacy of low-dose, immediate-release tacrolimus in patients with myasthenia gravis (MG) with inadequate response to glucocorticoid therapy in a randomized, double-blind, placebo-controlled study. Eligible patients had inadequate response to glucocorticoids (GCs) after ⩾6 weeks of treatment with prednisone ⩾0.75 mg/kg/day or 60-100 mg/day. Patients were randomized to receive 3 mg tacrolimus or placebo daily (orally) for 24 weeks. Concomitant glucocorticoids and pyridostigmine were allowed. Patients continued GC therapy from weeks 1-4; from week 5, the dose was decreased at the discretion of the investigator. The primary efficacy outcome measure was a reduction, relative to baseline, in quantitative myasthenia gravis (QMG) score assessed using a generalized linear model; supportive analyses used alternative models. Of 138 patients screened, 83 [tacrolimus ( n = 45); placebo ( n = 38)] were enrolled and treated. The change in adjusted mean QMG score from baseline to week 24 was -4.9 for tacrolimus and -3.3 for placebo (least squares mean difference: -1.7, 95% confidence interval: -3.5, -0.1; p = 0.067). A post-hoc analysis demonstrated a statistically significant difference for QMG score reduction of ⩾4 points in the tacrolimus group (68.2%) versus the placebo group (44.7%; p = 0.044). Adverse event profiles were similar between treatment groups. Tacrolimus 3 mg treatment for patients with MG and inadequate response to GCs did not demonstrate a statistically significant improvement in the primary endpoint versus placebo over 24 weeks; however, a post-hoc analysis demonstrated a statistically significant difference for QMG score reduction of ⩾4 points in the tacrolimus group versus the placebo group. This study was limited by the low number of patients, the absence of testing for acetylcholine receptor antibody and the absence of stratification by disease duration (which led to a disparity between the two groups). Clinical

[Liability in Anaesthesiology: theory of disproportionate damage].

Science.gov (United States)

Galán Gutiérrez, J C; Galán Cortés, J C

2013-10-01

An analysis is made of the controversial application of the theory of disproportionate damage in the anaesthetic act, due to the high inherent risk, and regardless of the seriousness and importance of the surgery being performed. The existence of a disproportionate damage, that is, damage not foreseen nor accountable within the framework of the professional performance of the anaesthetist, does not by itself determine the existence of liability on the part of the anaesthetist, but the demand from the professionals themselves for a coherent explanation of the serious disagreement between the initial risk implied by their actions and the final consequence produced. Copyright © 2012 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

Strengthening the human rights framework to protect breastfeeding: a focus on CEDAW.

Science.gov (United States)

Galtry, Judith

2015-01-01

continues to be inadequately addressed in international human rights law on women. A comparison is made with CRC and its subsequent elaborations. Increasing recognition of the need to protect, promote and support breastfeeding within the framework of CRC but not that of CEDAW suggests that breastfeeding is regarded primarily as a children's rights issue but only minimally as a women's rights issue. The human rights framework requires strengthening in every direction to protect, promote and support breastfeeding. Discussion is needed regarding whether a separate strengthening of the international human rights framework on women is required with regard to breastfeeding.

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African Journals Online (AJOL)

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Anaesthesiology and Reanimation Department, Yaoundé Central Hospital, Cameroon. 3. ... corresponded to the intersection between the superior temporal line and the ... The past medical history revealed head injury (81.5%), alcoholism (12.9%), .... connected to an extracranial subgaleal redon catheter (CH n° 16 with its ...

Simulation-based training in flexible fibreoptic intubation

DEFF Research Database (Denmark)

Nilsson, Philip M; Russell, Lene; Ringsted, Charlotte

2015-01-01

: Twenty-three anaesthesia residents in their first year of training in anaesthesiology with no experience in FOI, and 10 anaesthesia consultants experienced in FOI. INTERVENTIONS: The novices to FOI were allocated randomly to receive either part-task or whole-task training of FOI on virtual reality...

Post-operative pain management in paediatric surgery at Sylvanus ...

African Journals Online (AJOL)

Background: The aim of this study was to evaluate pain management in paediatric surgery at Sylvanus Olympio University Teaching Hospital, Lome. Patients and Methods: A prospective descriptive study was conducted in the Department of Anaesthesiology and Intensive Care at Sylvanus Olympio teaching hospital from 1 ...

Research Ethics in the Context of Transition: Gaps in Policies and Programs on the Protection of Research Participants in the Selected Countries of Central and Eastern Europe.

Science.gov (United States)

Famenka, Andrei

2016-12-01

This paper examines the ability of countries in Central and Eastern Europe (CEE) to ensure appropriate protection of research participants in the field of increasingly globalizing biomedical research. By applying an analytical framework for identifying gaps in policies and programs for human subjects protection to four countries of CEE-Belarus, Latvia, Lithuania, and Poland, substantial gaps in the scope and content of relevant policies and major impediments to program performance have been revealed. In these countries, public policies on the protection of research participants lack consistency and reliable mechanisms for their implementation. Impediments to program performance most often relate to inadequacies in the national research ethics systems with regard to organizational structure, budgetary support, supervision, and training. The level of research ethics capacity varies from country to country and depends on socio-economic and political factors of post-communist transition. The breadth and depth of the problems identified suggest that the current level of protection for research participants in CEE might be inadequate to the challenges posed by the globalization of biomedical research. In CEE countries, there is a need for strengthening research ethics capacity through modification of relevant policies and improvement of program management. The differences among the countries call for further research on identifying the best approaches for filling the gaps in the policies and programs aimed at ensuring effective protection of research participants.

A booster vaccine expressing a latency-associated antigen augments BCG induced immunity and confers enhanced protection against tuberculosis.

Directory of Open Access Journals (Sweden)

Bappaditya Dey

Full Text Available BACKGROUND: In spite of a consistent protection against tuberculosis (TB in children, Mycobacterium bovis Bacille Calmette-Guerin (BCG fails to provide adequate protection against the disease in adults as well as against reactivation of latent infections or exogenous reinfections. It has been speculated that failure to generate adequate memory T cell response, elicitation of inadequate immune response against latency-associated antigens and inability to impart long-term immunity against M. tuberculosis infections are some of the key factors responsible for the limited efficiency of BCG in controlling TB. METHODS/PRINCIPAL FINDINGS: In this study, we evaluated the ability of a DNA vaccine expressing α-crystallin--a key latency antigen of M. tuberculosis to boost the BCG induced immunity. 'BCG prime-DNA boost' regimen (B/D confers robust protection in guinea pigs along with a reduced pathology in comparison to BCG vaccination (1.37 log(10 and 1.96 log(10 fewer bacilli in lungs and spleen, respectively; p<0.01. In addition, B/D regimen also confers enhanced protection in mice. Further, we show that B/D immunization in mice results in a heightened frequency of PPD and antigen specific multi-functional CD4 T cells (3(+ simultaneously producing interferon (IFNγ, tumor necrosis factor (TNFα and interleukin (IL2. CONCLUSIONS/SIGNIFICANCE: These results clearly indicate the superiority of α-crystallin based B/D regimen over BCG. Our study, also demonstrates that protection against TB is predictable by an increased frequency of 3(+ Th1 cells with superior effector functions. We anticipate that this study would significantly contribute towards the development of superior booster vaccines for BCG vaccinated individuals. In addition, this regimen can also be expected to reduce the risk of developing active TB due to reactivation of latent infection.

Adverse outcomes after percutaneous dilatational tracheostomy versus surgical tracheostomy in intensive care patients: case series and literature review

Directory of Open Access Journals (Sweden)

Jarosz K

2017-08-01

Full Text Available Konrad Jarosz,1 Bartosz Kubisa,2 Agata Andrzejewska,3 Katarzyna Mrówczyńska,3 Zbigniew Hamerlak,4 Alicja Bartkowska-Śniatkowska5 1Department of Clinical Nursing, Pomeranian Medical University, 2Thoracic Surgery and Transplantation Department, Pomeranian Medical University, 3Anaesthesiology and Intensive Care Department, Pomeranian Medical University, 4Stomatology Department, Pomeranian Medical University, 5Anaesthesiology and Pediatric Intensive Care Department, Poznan University of Medical Sciences, Szczecin, Poland Abstract: Tracheostomy is a routinely done procedure in the setting of intensive care unit (ICU in patients requiring prolonged mechanical ventilation. There are two ways of making a tracheostomy: an open surgical tracheostomy and percutaneous dilatational tracheostomy. Percutaneous dilatational tracheostomy is associated with fewer complications than open tracheostomy. In this study, we would like to compare both techniques of performing a tracheostomy in ICU patients and to present possible complications, methods of diagnosing and treating and minimizing their risk. Keywords: tracheostomy, percutaneous tracheostomy, percutaneous dilatational tracheostomy, bronchoscopy, surgical tracheostomy, tracheoesophageal fistula, tracheostomy complications

Interpreting TRIPS: globalisation of intellectual property rights and access to medicines

National Research Council Canada - National Science Library

Yamane, Hiroko

2011-01-01

...) protection and offers a global regime for IPR protection. However, the social costs of this regime often outweigh the benefits of IPR protection, particularly in the poorest countries where resources for research and development are inadequate...

Concept of assistance of the Federal Office for Radiation Protection with regard to prevention of serious cases of nuclear hazards

Energy Technology Data Exchange (ETDEWEB)

Becker, D.E. [Federal Office for Radiation Protection, Salzgitter (Germany)

2000-05-01

For the defence against the threats caused by radioactive substances, a general concept was elaborated under the overall control of the Federal Government. A number of competent organisations are involved in this, for example the Federal Office of Criminal Investigation, the Federal Armed Forces, and the Federal Office for Radiation Protection. In Germany, the 16 Federal States are responsible for the prevention of nuclear hazards. In the case of hazards caused by radioactive material, experts from the competent radiation protection authorities are consulted. For the prevention of serious cases of nuclear hazards (nuclear fuels, criticality, danger of dispersion), the Federal Office for Radiation Protection - a subordinate authority of the Federal Ministry for the Environment, Nature Conservation and Nuclear Safety responsible for radiation protection, nuclear safety, and waste management - was given order to elaborate a concept for assistance to those Federal States. The field of prevention of nuclear hazards ranges from combatting illegal trade with radioactive test sources up to the defence of nuclear fuels with the possibility to construct critical assemblies or the threatening by the distribution of airborne material which might enter the lungs. The latter are considered as serious cases of nuclear hazards. Since the expenditures for devices and personal to be trained would be inadequately high, the Federal Office for Radiation Protection (BfS) is prepared to support the Federal States if it becomes necessary. The concept includes a stand-by service, the search for radioactive material by helicopter or a ground team, analysis of the activity and the type of nuclides, risk assessment, and also measures to steam the risk. This concept will be presented. (author)

Concept of assistance of the Federal Office for Radiation Protection with regard to prevention of serious cases of nuclear hazards

International Nuclear Information System (INIS)

Becker, D.E.

2000-01-01

For the defence against the threats caused by radioactive substances, a general concept was elaborated under the overall control of the Federal Government. A number of competent organisations are involved in this, for example the Federal Office of Criminal Investigation, the Federal Armed Forces, and the Federal Office for Radiation Protection. In Germany, the 16 Federal States are responsible for the prevention of nuclear hazards. In the case of hazards caused by radioactive material, experts from the competent radiation protection authorities are consulted. For the prevention of serious cases of nuclear hazards (nuclear fuels, criticality, danger of dispersion), the Federal Office for Radiation Protection - a subordinate authority of the Federal Ministry for the Environment, Nature Conservation and Nuclear Safety responsible for radiation protection, nuclear safety, and waste management - was given order to elaborate a concept for assistance to those Federal States. The field of prevention of nuclear hazards ranges from combatting illegal trade with radioactive test sources up to the defence of nuclear fuels with the possibility to construct critical assemblies or the threatening by the distribution of airborne material which might enter the lungs. The latter are considered as serious cases of nuclear hazards. Since the expenditures for devices and personal to be trained would be inadequately high, the Federal Office for Radiation Protection (BfS) is prepared to support the Federal States if it becomes necessary. The concept includes a stand-by service, the search for radioactive material by helicopter or a ground team, analysis of the activity and the type of nuclides, risk assessment, and also measures to steam the risk. This concept will be presented. (author)

Predictors of Inadequate Linezolid Concentrations after Standard Dosing in Critically Ill Patients.

Science.gov (United States)

Taubert, Max; Zoller, Michael; Maier, Barbara; Frechen, Sebastian; Scharf, Christina; Holdt, Lesca-Miriam; Frey, Lorenz; Vogeser, Michael; Fuhr, Uwe; Zander, Johannes

2016-09-01

Adequate linezolid blood concentrations have been shown to be associated with an improved clinical outcome. Our goal was to assess new predictors of inadequate linezolid concentrations often observed in critically ill patients. Fifty-two critically ill patients with severe infections receiving standard dosing of linezolid participated in this prospective observational study. Serum samples (median, 32 per patient) were taken on four consecutive days, and total linezolid concentrations were quantified. Covariates influencing linezolid pharmacokinetics were identified by multivariate analysis and a population pharmacokinetic model. Target attainment (area under the concentration-time curve over 12 h [AUC12]/MIC ratio of >50; MIC = 2 mg/liter) was calculated for both the study patients and a simulated independent patient group (n = 67,000). Target attainment was observed for only 36% of the population on both days 1 and 4. Independent covariates related to significant decreases of linezolid concentrations included higher weight, creatinine clearance rates, and fibrinogen and antithrombin concentrations, lower concentrations of lactate, and the presence of acute respiratory distress syndrome (ARDS). Linezolid clearance was increased in ARDS patients (by 82%) and in patients with elevated fibrinogen or decreased lactate concentrations. In simulated patients, most covariates, including fibrinogen and lactate concentrations and weight, showed quantitatively minor effects on target attainment (difference of ≤9% between the first and fourth quartiles of the respective parameters). In contrast, the presence of ARDS had the strongest influence, with only ≤6% of simulated patients reaching this target. In conclusion, the presence of ARDS was identified as a new and strong predictor of insufficient linezolid concentrations, which might cause treatment failure. Insufficient concentrations might also be a major problem in patients with combined alterations of other covariate

Using a research reactor to teach practical radiation protection

International Nuclear Information System (INIS)

Musilek, A.; Steinhauser, G.

2010-01-01

To teach students about the practical handling of radioactive materials and the related radiation protection, it is advantageous to be able to produce radioactive material with specific properties. Through the neutron activation of specific samples, radio-nuclides can be produced that are precisely tailored for particular experiments, both in type of radiation (beta, gamma) as well as in activity and half-life. At the Atominstitut in Vienna, a 250 kW TRIGA Mark II research reactor is used for the production of these nuclides. In this paper, four practical exercises are presented, covering many questions and challenges that occur in radiation protection. The first exercise uses neutron activation of sodium-chloride to cover theoretical aspects of the calculation of dose rates (using dose rate constants) through the activation of Na-23, Cl-35 and Cl-37 (including cross sections, half-life, inverse square law), as well as a practical examination (handling of dose rate meters). The second exercise gives students the opportunity to decontaminate a laboratory after an incident under realistic circumstances. For this exercise, KNO 3 is activated in the reactor. The resulting K-nuclide produces no risk of inadequate decontamination for the laboratory, since the half-life of K-42 is only 12 h. The third exercise is designed to teach students how to deal with unsealed radioactive material by irradiation of ammonium dihydrogenphosphate. In this case, an only-beta-active (P-32) fertilizer is produced, which is applied to plants in subsequent chemical processing. In the following step, the 'quality of this fertilizer' is determined by measuring the absorbed activity of the plant leaves using a GM counter. The fourth exercise is another approach in working with unsealed radioactive material. It simulates the PUREX process to separate uranium from fission products using a liquid - liquid extraction. (authors)

Nuclear Protection and Safety Institute R and D activities in the field of plant ageing

Energy Technology Data Exchange (ETDEWEB)

Deletre, G; Henry, J Y; Miannay, D; Olivera, J J; Horowitz, H; Barrachin, B

1991-11-01

A part of the work carried out by the CEA's Nuclear Protection and Safety Institute (IPSN) is devoted to revealing possible modifications in nuclear reactor materials under the combined effects of time, temperature and irradiation. The current R and D programme being carried out by the IPSN in collaboration with various specialized CEA departments concentrates on three main fields: - Reactor coolant system materials, - Polymerbased materials, - Coatings and paintings used inside pressurized water reactor containments. These activities are, of course, part of a much wider context which includes operating experience feedback, particularly as regards deterioration already observed in pressurized water reactors; this deterioration is usually the result of phenomena which were overlooked or inadequately studied at the design stage (corrosion, erosion, vibratory or thermal fatigue, cavitation, etc.). With his perspective in view, the IPSN is also undertaking a number of activities to develop powerful inspection methods and increase the effectiveness of preventive maintenance programmes.

Nuclear Protection and Safety Institute R and D activities in the field of plant aging

International Nuclear Information System (INIS)

Deletre, G.; Henry, J.Y.; Miannay, D.; Olivera, J.J.; Horowitz, H.; Barrachin, B.

1991-01-01

A part of the work carried out by the CEA's Nuclear Protection and Safety Institute (IPSN) is devoted to revealing possible modifications in nuclear reactor materials under the combined effects of time, temperature and irradiation. The current R and D programme being carried out by the IPSN is collaboration with various specialized CEA departments concentrates on three main fields: Reactor coolant system materials, Polymerbased materials, Coatings and paintings used inside pressurized water reactor containments. These activities are, of course, part of a much wider context which includes operating experience feedback, particularly as regards deterioration already observed in pressurized water reactors; this deterioration is usually the result of phenomena which were overlooked or inadequately studied at the design stage (corrosion, erosion, vibratory or thermal fatigue, cavitation, etc). With this perspective in view, the IPSN is also undertaking a number of activities to develop powerful inspection methods and increase the effectiveness of preventive maintenance programmes. (author)

An embedded checklist in the Anesthesia Information Management System improves pre-anaesthetic induction setup: a randomised controlled trial in a simulation setting.

Science.gov (United States)

Wetmore, Douglas; Goldberg, Andrew; Gandhi, Nishant; Spivack, John; McCormick, Patrick; DeMaria, Samuel

2016-10-01

Anaesthesiologists work in a high stress, high consequence environment in which missed steps in preparation may lead to medical errors and potential patient harm. The pre-anaesthetic induction period has been identified as a time in which medical errors can occur. The Anesthesia Patient Safety Foundation has developed a Pre-Anesthetic Induction Patient Safety (PIPS) checklist. We conducted this study to test the effectiveness of this checklist, when embedded in our institutional Anesthesia Information Management System (AIMS), on resident performance in a simulated environment. Using a randomised, controlled, observer-blinded design, we compared performance of anaesthesiology residents in a simulated operating room under production pressure using a checklist in completing a thorough pre-anaesthetic induction evaluation and setup with that of residents with no checklist. The checklist was embedded in the simulated operating room's electronic medical record. Data for 38 anaesthesiology residents shows a statistically significant difference in performance in pre-anaesthetic setup and evaluation as scored by blinded raters (maximum score 22 points), with the checklist group performing better by 7.8 points (p<0.01). The effects of gender and year of residency on total score were not significant. Simulation duration (time to anaesthetic agent administration) was increased significantly by the use of the checklist. Required use of a pre-induction checklist improves anaesthesiology resident performance in a simulated environment. The PIPS checklist as an integrated part of a departmental AIMS warrant further investigation as a quality measure. 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/

Radiation protection in the field of environmental protection

International Nuclear Information System (INIS)

Zhao Yamin

2003-01-01

The relationship of radiation protection with environmental protection, the sources that may give rise to the environmental radiation contamination, and the system of radiation protection and the fundamental principles and requirements for radiation environmental management are introduced. Some special radiation protection problems faced with in the radiation environmental management are discussed. (author)

Effects of inadequate maternal dietary protein:carbohydrate ratios during pregnancy on offspring immunity in pigs

Directory of Open Access Journals (Sweden)

Tuchscherer Margret

2012-11-01

Full Text Available Abstract Background Inadequate nutrition in utero may retard foetal growth and alter physiological development of offspring. This study investigated the effects of low and high protein diets fed to primiparous German Landrace sows throughout pregnancy on the immune function of their offspring at different ages. Sows were fed diets with adequate (AP, 12.1%; n = 13, low (LP, 6.5%; n = 15, or high (HP, 30%; n = 14 protein content, made isoenergetic by varying carbohydrate levels. Cortisol, total protein and immunoglobulin (IgG, IgM, IgA concentrations were measured in the blood of sows over the course of pregnancy. Cortisol, total protein, immunoglobulins, lymphocyte proliferation, immune cell counts, and cytokines were assessed in the blood of offspring at baseline and under challenging conditions (weaning; lipopolysaccharide (LPS administration. Results In sows, the LP diet increased cortisol (P P P P + cell percentage and the CD4+/CD8+ ratio increased after weaning (P P = 0.09 and HP (P P  Conclusions Our results indicate that both low and high protein:carbohydrate ratios in the diet of pregnant sows can induce short-term as well as long-lasting effects on immune competence in piglets that may have serious consequences for host defence against bacterial pathogens.

Digital protection in power plants. Electrical unit and line protection. Digital protection systems for NPP

International Nuclear Information System (INIS)

Kaczmarek, A.

2000-01-01

In this presentation author deals with the digital protection systems for nuclear power plants. The evolution of protection devices, protection concept for power plants, concept of functional redundancy, references for digital protection, benefits for the customer well as concept fault recorder are presented. (author)

Vildagliptin versus insulin in patients with type 2 diabetes mellitus inadequately controlled with sulfonylurea: results from a randomized, 24 week study.

Science.gov (United States)

Forst, Thomas; Koch, Cornelia; Dworak, Markus

2015-06-01

There is limited evidence to guide the selection of second-line anti-hyperglycemic agents in patients with type 2 diabetes mellitus (T2DM) who are inadequately controlled with sulfonylurea monotherapy and are intolerant to metformin. We compared the efficacy and safety of vildagliptin 50 mg qd and Neutral Protamine Hagedorn (NPH) insulin qd in such patients. This was a 24 week, multicenter, randomized, open-label study. The co-primary endpoints were (i) proportion of patients achieving HbA1c vildagliptin (n = 83) and NPH insulin (n = 79). Similar proportion of patients achieved the composite endpoint in vildagliptin versus NPH insulin group (35.4% versus 34.2%; OR 0.985; 95% CI 0.507, 1.915; p = 0.96). After 24 weeks, 48.8% of patients in the vildagliptin group and 60.8% in the NPH insulin group achieved HbA1c vildagliptin group and 29.1% in the insulin group had at least one confirmed HE; while 11.0% in the vildagliptin group and 22.8% in the insulin group experienced weight gain. The rate of confirmed HEs was significantly lower in patients receiving vildagliptin versus NPH insulin (1.3 versus 5.1 events per year). The TSQM-9 score for 'convenience' at week 24 increased significantly more with vildagliptin than with NPH insulin. Addition of vildagliptin and NPH insulin resulted in a similar number of patients reaching HbA1c target without HEs or weight gain in T2DM patients inadequately controlled with sulfonylurea. The addition of vildagliptin to sulfonylurea could be considered as a treatment option prior to intensification with insulin, with the advantages of a lower HE rate and greater patient convenience. Study results are limited by a higher drop-out rate in the vildagliptin arm.

Operational radiation protection and radiation protection training

International Nuclear Information System (INIS)

Kraus, W.

1989-01-01

The radiation protection system in the German Democratic Republic (GDR) is reviewed. The competent authority (the SAAS) and its systems of licensing and supervision are described. Discussion covers the role of the Radiation Protection Officer, the types of radiation monitoring, medical surveillance programs and the classification of workers and work areas. Unusual occurrences in the GDR, 1963-1976, are presented and the occupational radiation protection problems at some specific types of workplaces are discussed. The GDR's system of training in radiation protection and nuclear safety is described. 5 figs., 18 tabs

Environmental Quality: Environmental Protection and Enhancement

Science.gov (United States)

2002-01-17

and maximum residual disinfectant levels (MRDLs) for three chemical disinfectants : chlorine, chloramine , and chlorine dioxide (see table 2-1 at the end... DISINFECTANT RESIDUALSl Chlorine 4 Monthlyq Monthlyq Chloramine 4 Monthlyq Monthlyq Chlorine dioxideo 0.8 Daily Daily RADIOCHEMICALS - Monitoring in...Adequate filtration/ disinfection must be provided to meet applicable CT [product of disinfectant concentration (c) and disinfectant contact time ( T

Histopathologic Findings Related to the Indeterminate or Inadequate Results of Fine-Needle Aspiration Biopsy and Correlation with Ultrasonographic Findings in Papillary Thyroid Carcinomas

International Nuclear Information System (INIS)

Jung, So Lyung; Jung, Chan Kwon; Kim, Sung Hun; Kang, Bong Joo; Ahn, Kook Jin; Kim, Bum Soo; Ahn, Myeong Im; Im, Dong Jun; Bae, Ja Sung; Chung, Soo Kyo

2010-01-01

To determine histopathologic findings related to the indeterminate or inadequate result of fine-needle aspiration biopsy (FNAB) in papillary thyroid carcinomas (PTCs) and to correlate histopathological findings with ultrasonographic features of tumors. We retrospectively reviewed the medical records of FNAB, histopathologic characteristics, and sonographic findings of the solid portion of 95 PTCs in 95 patients. All cases were pathologically confirmed by surgery. Histopathologic characteristics were analyzed for tumor distribution, microcystic changes, fibrosis, and tumor component. We assumed several histopathologic conditions to be the cause of indeterminate or inadequate results of FNAB, including: 1) an uneven tumor distribution, 2) > 30% microcystic changes, 3) > 30% fibrosis, and 4) < 30% tumor component. Ultrasonographic findings of each PTC were evaluated for echotexture (homogeneous or heterogeneous), echogenicity (markedly hypoechoic, hypoechoic, isoechoic, or hyperechoic), and volume of the nodule. We correlated histopathologic characteristics of the PTC with results of the FNAB and ultrasonographic findings. From 95 FNABs, 71 cases (74%) were confirmed with malignancy or suspicious malignancy (PTCs), 21 (22%) had indeterminate results (atypical cells), and three (4%) were negative for malignancy. None of the assumed variables influenced the diagnostic accuracy of FNAB. Tumor distribution and fibrosis were statistically correlated with ultrasonographic findings of the PTCs (p < 0.05). Uneven tumor distribution was related with small tumor volume, and fibrosis over 30% was correlated with homogeneous echotexture, markedly hypoechoic and hypoechoic echogenicity, and small tumor volume (p < 0.05). No histopathologic component was found to correlate with improper results of FNAB in PTCs. In contrast, two histopathologic characteristics, uneven distribution and fibrosis, were correlated with ultrasonographic findings

Are physicians aware enough of patient radiation protection? Results from a survey among physicians of Pavia District- Italy.

Science.gov (United States)

Campanella, Francesca; Rossi, Laura; Giroletti, Elio; Micheletti, Piero; Buzzi, Fabio; Villani, Simona

2017-06-14

Radiological practices are the first anthropic sources of ionizing radiation exposure of the population. However, a review of recent publications underlines inadequate doctors' knowledge about doses imparted in medical practices and about patient protection that might explain unnecessary radiological prescriptions. We investigated the knowledge of the physicians of Pavia District (Italy) on the risk of radiation exposure. A cross sectional study was performed involving the Medical Association of Pavia District. Data were collected with a self-administered questionnaire, available on-line with private login and password. Four hundred nineteen physicians fulfilled the questionnaire; 48% of participants reported training about radiation protection. The average percentage of correct answers on the knowledge on ionizing radiation was 62.29%, with a significantly higher result between radiologist. Around 5 and 13% of the responders do not know that, respectively, ultrasonography and magnetic resonance do not expose patients to ionizing radiations. Only 5% of the physicians properly identified the cancer risk rate associated to abdomen computed tomography. The findings show a quite good level of the general knowledge about ionizing radiations, higher that reported in literature. Nevertheless, we believe the usefulness of training on the risk linked to radiation exposure in medicine for physicians employed in every area.

Risk factors for inadequate TB case finding in Rural Western Kenya: a comparison of actively and passively identified TB patients.

Directory of Open Access Journals (Sweden)

Anna H Van't Hoog

Full Text Available The findings of a prevalence survey conducted in western Kenya, in a population with 14.9% HIV prevalence suggested inadequate case finding. We found a high burden of infectious and largely undiagnosed pulmonary tuberculosis (PTB, that a quarter of the prevalent cases had not yet sought care, and a low case detection rate.We aimed to identify factors associated with inadequate case finding among adults with PTB in this population by comparing characteristics of 194 PTB patients diagnosed in a health facility after self-report, i.e., through passive case detection, with 88 patients identified through active case detection during the prevalence survey. We examined associations between method of case detection and patient characteristics, including HIV-status, socio-demographic variables and disease severity in univariable and multivariable logistic regression analyses.HIV-infection was associated with faster passive case detection in univariable analysis (crude OR 3.5, 95% confidence interval (CI 2.0-5.9, but in multivariable logistic regression this was largely explained by the presence of cough, illness and clinically diagnosed smear-negative TB (adjusted OR (aOR HIV 1.8, 95% CI 0.85-3.7. Among the HIV-uninfected passive case detection was less successful in older patients aOR 0.76, 95%CI 0.60-0.97 per 10 years increase, and women (aOR 0.27, 95%CI 0.10-0.73. Reported current or past alcohol use reduced passive case detection in both groups (0.42, 95% CI 0.23-0.79. Among smear-positive patients median durations of cough were 4.0 and 6.9 months in HIV-infected and uninfected patients, respectively.HIV-uninfected patients with infectious TB who were older, female, relatively less ill, or had a cough of a shorter duration were less likely found through passive case detection. In addition to intensified case finding in HIV-infected persons, increasing the suspicion of TB among HIV-uninfected women and the elderly are needed to improve TB case

Evaluation of protection factor of respiratory protective equipment using indigenously developed protection factor test facility

International Nuclear Information System (INIS)

Patkulkar, D.S.; Ganesh, G.; Tripathi, R.M.

2018-01-01

Assigned protection factor (APF) is an indicator representing effectiveness of a respirator and it provides workplace level of respiratory protection for workers in providing protection against exposure to airborne contaminants Occupational Safety and Health Administration (OSHA) specifies 'Respirator APF' and 'Maximum Use Concentration' (MUC - a term derived using APF) shall be an integral part of Respirator Protection Standard. MUC establishes the maximum airborne concentration of a contaminant in which a respirator with a given APF may be used. The use of particulate respirators such as half face mask, full face mask and powered air purifying respirators is essential for radioactive jobs in nuclear facilities to prevent any intake of radionuclide. With this impetus, the Protection Factor Test Facility (PFTF) for testing and evaluation of respiratory protective equipment meeting relevant applicable standards was designed, fabricated and installed in Respiratory Protective Equipment Laboratory of Health Physics Division

Poverty within watershed and environmentally protected areas: the case of the indigenous community in Peninsular Malaysia.

Science.gov (United States)

Kari, Fatimah Binti; Masud, Muhammad Mehedi; Yahaya, Siti Rohani Binti; Saifullah, Md Khaled

2016-03-01

"Indigenous people" have been acknowledged as among the poorest and most socio-economically and culturally marginalized all over the world. This paper explores the socio-economic status of the indigenous people and their poverty profile within watershed and environmentally protected areas in Peninsular Malaysia. The findings of the study indicate that the "indigenous community" is likely to be poor if they live in environmentally sensitive and unprotected areas as compared to families under the new resettlement scheme. Inadequate access to basic education and employment contributed significantly to their poor economic status. The findings further reveal that the indigenous community is facing difficulties in receiving access and support in terms of basic needs such as housing, education, economic livelihood, and other social infrastructure. Moreover, the regulatory structure for the management of watershed areas as well as the emphasis for commodity crops such as palm oil and natural rubber have indirectly contributed toward the poverty level of the indigenous people.

Diplomatic Protection

OpenAIRE

Režná, Jana

2006-01-01

Final thesis Topic: Diplomatic protection Thesis supervisor: JUDr. Vladimír Balaš, CSc. Student: Marek Čermák Thesis on the topic of diplomatic protection deals with the granting of exercise of diplomatic protection by the states and is divided into seven chapters which follow each other. The first chapter describes the diplomatic protection and its historical foundations. The second chapter focuses on the possibility of exercise of diplomatic protection in respect of natural persons and the ...

Evaluation of Knowledge, Attitude and Practice of Personnel in Operating Room, ERCP, and ESWL Towards Radiation Hazards and Protection

Directory of Open Access Journals (Sweden)

Shima Moshfegh

2017-07-01

Full Text Available Background Recently, X-rays radiation hazards rise with the exposure of patients and personnel. Exposure of people to radiation in the operating rooms is an important problem to study the safety of personnel and patients. To date, few studies are accomplished to evaluate knowledge, attitude, and practice (KAP among personnel in hospitals. The current study aimed at evaluating KAP level of radiation hazards and protection amongst personnel in the operating room. Methods A questionnaire-based, cross sectional study was conducted in 11 provinces of Iran from 2014 to 2015. Respondents in the current study were 332 personnel of operating room, endoscopic retrograde cholangiopancreatography, and extracorporeal shock-wave lithotripsy. Demographic characteristics, as well as knowledge, attitude, and practice levels of operating room personnel were collected. The selected hospitals were 3 types (educational, non-educational, and private clinics located in 5 different regions of Iran (Tehran, Center, East, North, and West. Data were analyzed using SPSS version 16.0 and statistical analyses were accomplished with the one-way ANOVA. Results The current study results showed no statistically significant difference in the KAP level of operating room personnel towards radiation protection for both genders (P = 0.1, time since graduation (P = 0.4, and work experience (P = 0.1. According to the analyses, the highest level of KAP concerning radiation protection was observed in the personnel of private clinics (mean score = 53.60 and the lowest value was observed in non-educational hospitals (mean score = 45.61. Besides, the KAP level was significantly higher in the Northern region (P < 0.0001 and the lowest was observed in the hospital personnel of the Central region (mean score = 34.27. Conclusions The current study findings showed that the level of KAP regarding radiation protection among operating room personnel was inadequate and it is necessary to pay

Predicting sun protection behaviors using protection motivation variables.

Science.gov (United States)

Ch'ng, Joanne W M; Glendon, A Ian

2014-04-01

Protection motivation theory components were used to predict sun protection behaviors (SPBs) using four outcome measures: typical reported behaviors, previous reported behaviors, current sunscreen use as determined by interview, and current observed behaviors (clothing worn) to control for common method bias. Sampled from two SE Queensland public beaches during summer, 199 participants aged 18-29 years completed a questionnaire measuring perceived severity, perceived vulnerability, response efficacy, response costs, and protection motivation (PM). Personal perceived risk (similar to threat appraisal) and response likelihood (similar to coping appraisal) were derived from their respective PM components. Protection motivation predicted all four SPB criterion variables. Personal perceived risk and response likelihood predicted protection motivation. Protection motivation completely mediated the effect of response likelihood on all four criterion variables. Alternative models are considered. Strengths and limitations of the study are outlined and suggestions made for future research.

Physical protection

International Nuclear Information System (INIS)

Myers, D.A.

1989-01-01

Physical protection is defined and its function in relation to other functions of a State System of Accounting for and Control of Nuclear Materials is described. The need for a uniform minimum international standard for physical protection as well as the need for international cooperation in physical protection is emphasized. The IAEA's INFCIRC/225/Rev. 1 (Annex 1) is reviewed. The Convention on the Physical Protection of Nuclear Material (Annex 2) is discussed. Photographs show examples of typical physical protection technology (Annex 3)

PROTECTION OF WORKS TITLES FROM THE PERSPECTIVE OF COPYRIGHT PROTECTION AND TRADEMARK PROTECTION

Directory of Open Access Journals (Sweden)

George-Mihai IRIMESCU

2017-05-01

Full Text Available The main purpose of the paper is assessing the possibilities of protecting the titles of works. One possibility is the protection by means of registered or unregistered trademarks. This route presents difficulties because of the distinctiveness perspective. In this sense, the European case-law has recently developed a constant practice and outlined a series of criteria that should be taken into consideration when examining a trademark consisting of a title. Another possibility is protecting the title under the provisions of the copyright law. From this respect, the practice has not yet determined a constant practice. However, the dominant opinion is that the originality criterion should be taken into consideration when assessing the protection of a tile. Finally, brief conclusion are made, including short remarks on the cumulative protection of titles, both as trademarks and under the copyright law.

Pain in Osteoarthritis

African Journals Online (AJOL)

Rev Dr Olaleye

2. Imarengiaye CO. 1Department of Anaesthesiology, Our Lady of Lourdes Hospital ... related joint pain experienced on most days in any given month, for which no other cause is ... and loss/limitation of function in the affected joint. ... 1.75 million people have symptomatic OA .... cord and transmission of the nerve impulse to.

Designing physical protection technology for insider protection

International Nuclear Information System (INIS)

Trujillo, A.A.; Waddoups, I.G.

1986-01-01

Since its inception, the nuclear industry has been engaged in providing protection against an insider threat. Although insider protection activities have been fairly successful in the past, present societal conditions require increased protection to further minimize the existence of an insider or the consequences of an insider-perpetrated incident. Integration of insider protection techniques into existing administrative and operational procedures has resulted in economic and operational impacts. Future increases in insider protection may result in even greater impacts, so we must proceed wisely as new approaches are developed. Increased emphasis on background investigations, security clearances, human reliability programs, security awareness activities, and the development of technology to address the insider threat are evidence of continuing concern in this area. Experience ranging from operational test and evaluation of developmental equipment to conceptual designs for new facilities has led to the development of general principles and conclusions for mitigating the insider threat while minimizing adverse impacts on site operations. Important principles include real-time monitoring of personnel and material and requiring that the physical protection and material control and accounting systems to be much more coordinated and integrated than in the past

Why nutrition education is inadequate in the medical curriculum: a qualitative study of students' perspectives on barriers and strategies.

Science.gov (United States)

Mogre, Victor; Stevens, Fred C J; Aryee, Paul A; Amalba, Anthony; Scherpbier, Albert J J A

2018-02-12

The provision of nutrition care by doctors is important in promoting healthy dietary habits, and such interventions can lead to reductions in disease morbidity, mortality, and medical costs. However, medical students and doctors report inadequate nutrition education and preparedness during their training at school. Previous studies investigating the inadequacy of nutrition education have not sufficiently evaluated the perspectives of students. In this study, students' perspectives on doctors' role in nutrition care, perceived barriers, and strategies to improve nutrition educational experiences are explored. A total of 23 undergraduate clinical level medical students at the 5th to final year in the School of Medicine and Health Sciences of the University for Development Studies in Ghana were purposefully selected to participate in semi-structured individual interviews. Students expressed their opinions and experiences regarding the inadequacy of nutrition education in the curriculum. Each interview was audio-recorded and later transcribed verbatim. Using the constant comparison method, key themes were identified from the data and analysis was done simultaneously with data collection. Students opined that doctors have an important role to play in providing nutrition care to their patients. However, they felt their nutrition education was inadequate due to lack of priority for nutrition education, lack of faculty to provide nutrition education, poor application of nutrition science to clinical practice and poor collaboration with nutrition professionals. Students opined that their nutrition educational experiences will be improved if the following strategies were implemented: adoption of innovative teaching and learning strategies, early and comprehensive incorporation of nutrition as a theme throughout the curriculum, increasing awareness on the importance of nutrition education, reviewing and revision of the curriculum to incorporate nutrition, and involving

Dutch healthcare professionals inadequately perceived if three- and four-year-old preschool children were overweight.

Science.gov (United States)

Bocca, Gianni; Corpeleijn, Eva; Broens, Jasper; Stolk, Ronald P; Sauer, Pieter J

2016-10-01

We studied whether healthcare professionals adequately perceived if preschool children were overweight and whether this was influenced by their own body mass index (BMI). We sent 716 Dutch healthcare professionals questionnaires containing seven pictures and seven sketches of three- and four-year-old children showing body weights from underweight to morbidly obese. The professionals rated the pictures on a five-point scale from too heavy to too light and chose the sketch that they felt best depicted the child's body shape. They also reported their own height and weight and their BMI was calculated. Of the 716 questionnaires, 346 (48.3%) were returned with complete information and analysed. Healthcare professionals mostly chose sketches that showed children as being lighter than they really were. Depending on their own BMI group, the overweight child was perceived as having a normal weight by 74-79% of the healthcare professionals. The obese children were rated correctly by 44-52% of the professionals, but 14-15% said their weight was normal. The morbidly obese child was adequately assessed by 93-98% of the professionals. Healthcare professionals inadequately perceived whether three- and four-year-old children were overweight and this may have hindered early interventions, leading to overweight children becoming overweight adolescents. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Walk on the wild side: estimating the global magnitude of visits to protected areas.

Directory of Open Access Journals (Sweden)

Andrew Balmford

2015-02-01

Full Text Available How often do people visit the world's protected areas (PAs? Despite PAs covering one-eighth of the land and being a major focus of nature-based recreation and tourism, we don't know. To address this, we compiled a globally-representative database of visits to PAs and built region-specific models predicting visit rates from PA size, local population size, remoteness, natural attractiveness, and national income. Applying these models to all but the very smallest of the world's terrestrial PAs suggests that together they receive roughly 8 billion (8 x 109 visits/y-of which more than 80% are in Europe and North America. Linking our region-specific visit estimates to valuation studies indicates that these visits generate approximately US $600 billion/y in direct in-country expenditure and US $250 billion/y in consumer surplus. These figures dwarf current, typically inadequate spending on conserving PAs. Thus, even without considering the many other ecosystem services that PAs provide to people, our findings underscore calls for greatly increased investment in their conservation.

Effect of adjunct metformin treatment in patients with type-1 diabetes and persistent inadequate glycaemic control. A randomized study

DEFF Research Database (Denmark)

Lund, S.S.; Tarnow, L.; Astrup, A.S.

2008-01-01

BACKGROUND: Despite intensive insulin treatment, many patients with type-1 diabetes (T1DM) have longstanding inadequate glycaemic control. Metformin is an oral hypoglycaemic agent that improves insulin action in patients with type-2 diabetes. We investigated the effect of a one-year treatment...... with metformin versus placebo in patients with T1DM and persistent poor glycaemic control. METHODOLOGY/PRINCIPAL FINDINGS: One hundred patients with T1DM, preserved hypoglycaemic awareness and HaemoglobinA(1c) (HbA(1c)) > or = 8.5% during the year before enrolment entered a one-month run-in on placebo treatment....... Thereafter, patients were randomized (baseline) to treatment with either metformin (1 g twice daily) or placebo for 12 months (double-masked). Patients continued ongoing insulin therapy and their usual outpatient clinical care. The primary outcome measure was change in HbA(1c) after one year of treatment...

Do we need more than just powerful blood pressure reductions? New paradigms in end-organ protection

Directory of Open Access Journals (Sweden)

Domenico Galzerano

2010-06-01

Full Text Available Domenico Galzerano1, Cristina Capogrosso1, Sara Di Michele2, Emanuele Bobbio3, Paola Paparello1, Carlo Gaudio21Department of Cardiology, San Gennaro Hospital, Naples, Italy; 2Department of Heart and Great Vessels, A. Reale, La Sapienza University, Rome, Italy; 3Department of Cardiovascular Sciences, Federico II University, Naples, ItalyAbstract: Antihypertensive therapy can lower the risk of cardiovascular morbidity and mortality. Yet, partly because of inadequate dosing, wrong pharmacological choices, and poor patient adherence, hypertension control remains suboptimal in the majority of hypertensive patients. Achieving greater blood pressure control requires a multifaceted approach that raises awareness of hypertension, uses effective therapies, and improves adherence. Particular classes of antihypertensive therapy have beneficial actions beyond blood pressure and studies have evaluated differences in cardiovascular protection among classes. The LIFE and HOPE studies showed between-class differences that may be due to effects other than blood pressure-lowering. In the ONTARGET study, telmisartan and ramipril provided similar cardiovascular protection but adherence was higher with telmisartan, which was better tolerated. This difference in compliance is likely to be important for long-term therapy. The selection of an agent for cardiovascular protection should depend on an appreciation of its composite properties, including any beneficial effects on tolerability and increased patient adherence, as these are likely to be advantageous for the long-term management of hypertension. This review examines the evidence that the effects beyond blood pressure provided by some antihypertensive agents can also lower the risk of cardiovascular, cerebrovascular, and renal events in patients with hypertension.Keywords: angiotensin II receptor blocker, cardiovascular continuum, cardiovascular disease, hypertension, renin–angiotensin system, telmisartan

Tropical countries may be willing to pay more to protect their forests

Science.gov (United States)

Vincent, Jeffrey R.; Carson, Richard T.; DeShazo, J. R.; Schwabe, Kurt A.; Ahmad, Ismariah; Chong, Siew Kook; Chang, Yii Tan; Potts, Matthew D.

2014-01-01

Inadequate funding from developed countries has hampered international efforts to conserve biodiversity in tropical forests. We present two complementary research approaches that reveal a significant increase in public demand for conservation within tropical developing countries as those countries reach upper-middle-income (UMI) status. We highlight UMI tropical countries because they contain nearly four-fifths of tropical primary forests, which are rich in biodiversity and stored carbon. The first approach is a set of statistical analyses of various cross-country conservation indicators, which suggests that protective government policies have lagged behind the increase in public demand in these countries. The second approach is a case study from Malaysia, which reveals in a more integrated fashion the linkages from rising household income to increased household willingness to pay for conservation, nongovernmental organization activity, and delayed government action. Our findings suggest that domestic funding in UMI tropical countries can play a larger role in (i) closing the funding gap for tropical forest conservation, and (ii) paying for supplementary conservation actions linked to international payments for reduced greenhouse gas emissions from deforestation and forest degradation in tropical countries. PMID:24982171

Whistleblower Protection

Science.gov (United States)

The Whistleblower Protection Enhancement Act of 2012 (WPA) and the Whistleblower Protection Act of 1989 Enhanced by the Act of 2012 provides protection rights for Federal employees against retaliation for whistleblowing activities.

Environmental protection: Shifting the focus toward the protected object

Directory of Open Access Journals (Sweden)

Cvetić Radenka

2013-01-01

Full Text Available This article is an attempt to provide a comprehensive overview of the rationale which led to developments in the law of environmental protection in a direction of an even more efficient protection of environment from human beings. There has been a transformation of the constitutionally protected right to a healthy environment to the Constitutional guarantee which involves both duty and responsibility for its protection. There has also been a shift from declaratory protection toward enforceable prohibitions and orders. These transformations have occurred when the society faced, under dramatic circumstances, the situation which shows that failure to protect the common good could lead to catastrophic consequences. The system of environmental protection, which enables sustainable development, is based on the primacy of the precautionary principle which deals with prevention and reduction of probability of harm, as well as on the no fault liability of the polluter for the environmental harm even in the absence of the claim for damages. The efficacy of the environmental protection could be improved by raising the awareness of the preservation of environment. The understanding that the protection of environment amounts to a survival of a mankind could lead to creating rights for the environment as such.

Assessing perioperative complications associated with use of intraoperative magnetic resonance imaging during glioma surgery - a single centre experience with 516 cases.

Science.gov (United States)

Ahmadi, Rezvan; Campos, Benito; Haux, Daniel; Rieke, Jörn; Beigel, Bernhard; Unterberg, Andreas

2016-08-01

Intraoperative magnetic resonance imaging (io-MRI) improves the extent of glioma resection. Due to the magnetic field, patients have to be covered with sterile drape and are then transferred into an io-MRI chamber, where ferromagnetic anaesthesia monitors and machines must be kept at distance and can only be applied with limitations. Despite the development of specific paramagnetic equipment for io-MRI use, this method is suspected to carry a higher risk for anaesthesiological and surgical complications. Particularly, serial draping and un-draping cycles as well as the extended surgery duration might increase the risk of perioperative infection. Given the importance of io-MRI for glioma surgery, the question regarding io-MRI safety needs to be answered. We prospectively evaluate the perioperative anaesthesiological and surgical complications for 516 cases of brain tumour surgery involving io-MRI (MRI cohort). As a control group, we evaluate a cohort of 610 cases of brain tumour surgery, performed without io-MRI (control group). The io-MRI procedure (including draping/undraping, transfer to and from the MRI cabinet and io-MRI scan) significantly extended surgery, defined as "skin to skin" time, by 57 min (SD = 16 min) (p ≤ 0.01). Still, we show low and comparable rates of surgical complications in the MRI cohort and the control group. Postoperative haemorrhage (3.7% versus 3.0% in MRI cohort versus control group; p = 0.49) and infections (2.2% versus 1.8% in MRI cohort versus control group; p = 0.69) were not significantly different between both groups. No anaesthesiological disturbances were reported. Despite prolonged surgery and serial draping and un-draping cycles, io-MRI was not linked to higher rates of infections and postoperative haemorrhage in this study.

Nanoparticle-Fusion Protein Complexes Protect against Mycobacterium tuberculosis Infection.

Science.gov (United States)

Hart, Peter; Copland, Alastair; Diogo, Gil Reynolds; Harris, Shane; Spallek, Ralf; Oehlmann, Wulf; Singh, Mahavir; Basile, Juan; Rottenberg, Martin; Paul, Matthew John; Reljic, Rajko

2018-03-07

Tuberculosis (TB) is the leading cause of death from infectious disease, and the current vaccine, Bacillus Calmette-Guerin (BCG), is inadequate. Nanoparticles (NPs) are an emerging vaccine technology, with recent successes in oncology and infectious diseases. NPs have been exploited as antigen delivery systems and also for their adjuvantic properties. However, the mechanisms underlying their immunological activity remain obscure. Here, we developed a novel mucosal TB vaccine (Nano-FP1) based upon yellow carnauba wax NPs (YC-NPs), coated with a fusion protein consisting of three Mycobacterium tuberculosis (Mtb) antigens: Acr, Ag85B, and HBHA. Mucosal immunization of BCG-primed mice with Nano-FP1 significantly enhanced protection in animals challenged with low-dose, aerosolized Mtb. Bacterial control by Nano-FP1 was associated with dramatically enhanced cellular immunity compared to BCG, including superior CD4 + and CD8 + T cell proliferation, tissue-resident memory T cell (Trm) seeding in the lungs, and cytokine polyfunctionality. Alongside these effects, we also observed potent humoral responses, such as the generation of Ag85B-specific serum IgG and respiratory IgA. Finally, we found that YC-NPs were able to activate antigen-presenting cells via an unconventional IRF-3-associated activation signature, without the production of potentially harmful inflammatory mediators, providing a mechanistic framework for vaccine efficacy and future development. Copyright © 2017. Published by Elsevier Inc.

Radiation protection - Revision of French radiation protection regulations (1988)

International Nuclear Information System (INIS)

Mayoux, J.C.

1989-01-01

This article analyses the recent amendments to the 1966 and 1975 Decrees on general radiation protection principles and radiation protection of workers in large nuclear installations respectively and also describes national radiation protection law. In particular, the amendments incorporate the revised EURATOM basic radiation protection standards and the new international units (sievert and becquerel replace rem and curie) in the Decrees. (NEA) [fr

Knowledge, Attitude, and Practices Regarding Occupational HIV Exposure and Protection among Health Care Workers in China: Census Survey in a Rural Area.

Science.gov (United States)

Wu, Qian; Xue, Xiao Fei; Shah, Dimpy; Zhao, Jian; Hwang, Lu-Yu; Zhuang, GuiHua

2016-09-01

Health care workers (HCWs) seek, treat, and care for patients living with HIV/AIDS on a daily basis and thus face a significant risk to work-related infections. To assess the knowledge, attitude, and practices regarding occupational HIV exposure and protection among HCWs in low HIV prevalence areas of rural China. A cross-sectional questionnaire survey was carried out among all medical units in Pucheng County, Shaanxi, China. Response rate of this study was 94%. The average overall knowledge score of HCWs was 10.9 of 21.0. Deficiencies in general, transmission, exposure, and protection knowledge were identified among HCWs at all levels. A high rate of occupational exposure (85%) and lack of universal precautions practice behavior were recorded. Significant predictors of universal precautions practice behavior were female sex, prior training, and greater knowledge about HIV/AIDS. Health care workers at various levels have inadequate knowledge on HIV/AIDS and do not practice universal precautions. Nurses and medical technicians at the county level faced more occupation risk than other HCWs. The key of AIDS training for different levels of HCWs should be distinguished. © The Author(s) 2014.

Focus radiation protection

International Nuclear Information System (INIS)

Ebermann, Lutz

2016-01-01

The publication of the Bundesamt fuer Strahlenschutz on radiation protection covers the following issues: (i) exposure from natural sources: health hazard due to radon, radiation protection in residential homes, radon in Germany, natural raw materials in industrial processes; (ii) clearance of radioactive wastes: clearance in the frame of nuclear power plant dismantling, the situation in Germany and Europe; (iii) emergency management: principles of radiation protection, fictive sequence of accident events; (iiii) other actual radiation protection topics: more limits - more protection? radiation protection in medicine, occupational radiation protection.

Protecting the Amazon with protected areas

Science.gov (United States)

Walker, Robert; Moore, Nathan J.; Arima, Eugenio; Perz, Stephen; Simmons, Cynthia; Caldas, Marcellus; Vergara, Dante; Bohrer, Claudio

2009-01-01

This article addresses climate-tipping points in the Amazon Basin resulting from deforestation. It applies a regional climate model to assess whether the system of protected areas in Brazil is able to avoid such tipping points, with massive conversion to semiarid vegetation, particularly along the south and southeastern margins of the basin. The regional climate model produces spatially distributed annual rainfall under a variety of external forcing conditions, assuming that all land outside protected areas is deforested. It translates these results into dry season impacts on resident ecosystems and shows that Amazonian dry ecosystems in the southern and southeastern basin do not desiccate appreciably and that extensive areas experience an increase in precipitation. Nor do the moist forests dry out to an excessive amount. Evidently, Brazilian environmental policy has created a sustainable core of protected areas in the Amazon that buffers against potential climate-tipping points and protects the drier ecosystems of the basin. Thus, all efforts should be made to manage them effectively. PMID:19549819

Combined group ECC protection and subgroup parity protection

Science.gov (United States)

Gara, Alan G.; Chen, Dong; Heidelberger, Philip; Ohmacht, Martin

2013-06-18

A method and system are disclosed for providing combined error code protection and subgroup parity protection for a given group of n bits. The method comprises the steps of identifying a number, m, of redundant bits for said error protection; and constructing a matrix P, wherein multiplying said given group of n bits with P produces m redundant error correction code (ECC) protection bits, and two columns of P provide parity protection for subgroups of said given group of n bits. In the preferred embodiment of the invention, the matrix P is constructed by generating permutations of m bit wide vectors with three or more, but an odd number of, elements with value one and the other elements with value zero; and assigning said vectors to rows of the matrix P.

Protective relay

International Nuclear Information System (INIS)

Lim, Mu Ji; Jung, Hae Sang

1974-10-01

This book is divided into two chapters, which deals with protective relay. The first chapter deals with the basic knowledge of relay on development of relay, classification of protective relay, rating of protective relay general structure of protective relay, detecting of ground protection, about point of contact, operating relay and trip relaying. The second chapter is about structure and explanation of relay on classification by structure such as motor type and moving-coil type, explanation of other relays over current relay, over voltage relay, short voltage relay, relay for power, relay for direction, test of over voltage relay, test of short voltage relay and test of directional circuit relay.

To protect or not to protect: examining reasons for sun protection among young women at risk for skin cancer.

Science.gov (United States)

Auerbach, M V; Heckman, C J; Darlow, S

2018-03-27

We aimed to further the understanding of the low rates of sun protection in young women at risk for skin cancer. Six-hundred-sixty-one daily diary entries were received via text message over 14 days from 56 young women at moderate to high risk of developing skin cancer. Women reported whether or not they used sun protection and also listed what their reasons were for using protection or not using sun protection each day. Multi-level modeling was used to examine the influence of study variables when predicting daily sun protection or lack of protection. The number of days in which sun protection was reported was positively associated with "habit" and "prevention" as reasons for protection and negatively associated with "not-needed" and "unprepared" as reasons for non-protection. Self-reported sun protection increased over the 14-day study period. Results of this study suggest the potential value of interventions aimed at motives for sun-protection behaviors.

The Protective Effect of Hippophae Rhamnoides Carotenoid Extract Against Lipid Peroxidation in Crude Vegetable Oils

Directory of Open Access Journals (Sweden)

Sanda Andrei

2014-11-01

Full Text Available Vegetable oils are important elements of the human diet because they contain essential nutritional factors. Due to the manufacturing processes or inadequate conditions of storage, they may also contain lipid oxidation products that are toxic to the body. The purpose of this paper is to test the protective effect of carotenoid-rich extracts obtained from the fruits of Hippophae rhamnoides on crude sunflower, pumpkin and olive oils oxidative processes. In order to evaluate the effect of antioxidant carotenoids, three stages were followed: thermal induction of lipid peroxidation in the presence of AAPH (2,2'-Azobis(2-amidinopropane dihydrochloride; determination of the level of lipid peroxidation in oxidized oils in the presence and absence of antioxidants, by quantifying the concentration of conjugated dienes and malonyl dialdehyde (MDA; determination of the level of lipid peroxidation by evaluating the profile of the fatty acids and the ratio between the saturated and unsaturated fatty acids (UFA / SFA, using an GC-MS method. In the case of sunflower oil, it was observed that sea buckthorn fruit extract significantly decreased MDA concentration but does not significantly reduce the concentration of conjugated dienes. The protective effect of carotenoids is more evident in the case of oil from pumpkin seeds. In the olive oil, unlike the first two types of oils, the carotenoids extract inhibits both the MDA and the conjugated dienes formation to a lesser extent, statistically insignificant. Overall, the ratio UFA / SFA decreases in crude oxidized oils. In the oils in which carotenoids were added was observed an increase in the UFA / SFA ratio. Carotenoids fraction from sea buckthorn fruits, rich in xanthophylls’ esters, possess a good antioxidant effect, protecting vegetable oils against peroxidation processes induced in the presence of AAPH

Informed consent for anaesthesiological and intensive care unit ...

African Journals Online (AJOL)

2013-03-04

Mar 4, 2013 ... Contemporary codes and guidelines for ethical health research developed in response to the Nazi atrocities exposed at the post-war Nuremberg trials of Nazi doctors.4. Landmark dates and publications are the Nuremberg Code. (1947),5 the World Medical Association (WMA) Declaration of Helsinki (1964 ...

Informed consent for anaesthesiological and intensive care unit ...

African Journals Online (AJOL)

2013-03-04

Mar 4, 2013 ... care unit research: a South African perspective. De Roubaix JAM, MBChB, .... (g) the development of new applications of health technology. The last two items .... Consent in emergency and ICU care: SA regulatory guidelines.

Professionalism in anaesthesiology practice: ethical reflection on the ...

African Journals Online (AJOL)

patient relations, improving quality of and access to care, ... and are possibly artificial, and that they influence and .... the recognition of need in our fellow human beings, having the .... wisdom (practical intelligence or phronesis in Aristotle's.

Tocilizumab in patients with active rheumatoid arthritis and inadequate response to disease-modifying antirheumatic drugs or tumor necrosis factor inhibitors: subanalysis of Spanish results of an open-label study close to clinical practice.

Science.gov (United States)

Álvaro-Gracia, José M; Fernández-Nebro, Antonio; García-López, Alicia; Guzmán, Manuel; Blanco, Francisco J; Navarro, Francisco J; Bustabad, Sagrario; Armendáriz, Yolanda; Román-Ivorra, José A

2014-01-01

To analyze the Spanish experience in an international study which evaluated tocilizumab in patients with rheumatoid arthritis (RA) and an inadequate response to conventional disease-modifying antirheumatic drugs (DMARDs) or tumor necrosis factor inhibitors (TNFis) in a clinical practice setting. Subanalysis of 170 patients with RA from Spain who participated in a phase IIIb, open-label, international clinical trial. Patients presented inadequate response to DMARDs or TNFis. They received 8mg/kg of tocilizumab every 4 weeks in combination with a DMARD or as monotherapy during 20 weeks. Safety and efficacy of tocilizumab were analyzed. Special emphasis was placed on differences between failure to a DMARD or to a TNFi and the need to switch to tocilizumab with or without a washout period in patients who had previously received TNFi. The most common adverse events were infections (25%), increased total cholesterol (38%) and transaminases (15%). Five patients discontinued the study due to an adverse event. After six months of tocilizumab treatment, 71/50/30% of patients had ACR 20/50/70 responses, respectively. A higher proportion of TNFi-naive patients presented an ACR20 response: 76% compared to 64% in the TNFi group with previous washout and 66% in the TNFi group without previous washout. Safety results were consistent with previous results in patients with RA and an inadequate response to DMARDs or TNFis. Tocilizumab is more effective in patients who did not respond to conventional DMARDs than in patients who did not respond to TNFis. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Multiplicative disadvantage of being an unmarried and inadequately insured woman living in poverty with colon cancer: historical cohort exploration in California.

Science.gov (United States)

Levitz, Naomi R; Haji-Jama, Sundus; Munro, Tonya; Gorey, Kevin M; Luginaah, Isaac N; Bartfay, Emma; Zou, Guangyong; Wright, Frances C; Kanjeekal, Sindu M; Hamm, Caroline; Balagurusamy, Madhan K; Holowaty, Eric J

2015-01-01

Many Americans diagnosed with colon cancer do not receive indicated chemotherapy. Certain unmarried women may be particularly disadvantaged. A 3-way interaction of the multiplicative disadvantages of being an unmarried and inadequately insured woman living in poverty was explored. California registry data were analyzed for 2,319 women diagnosed with stage II to IV colon cancer between 1996 and 2000 and followed until 2014. Socioeconomic data from the 2000 census classified neighborhoods as high poverty (≥30% of households poor), middle (5-29%) or low poverty (Primary health insurance was private, Medicare, Medicaid or none. Comparisons of chemotherapy rates used standardized rate ratios (RR). We respectively used logistic and Cox regression models to assess chemotherapy and survival. A statistically significant 3-way marital status by health insurance by poverty interaction effect on chemotherapy receipt was observed. Chemotherapy rates did not differ between unmarried (39.0%) and married (39.7%) women who lived in lower poverty neighborhoods and were privately insured. But unmarried women (27.3%) were 26% less likely to receive chemotherapy than were married women (37.1%, RR = 0.74, 95% CI 0.58, 0.95) who lived in high poverty neighborhoods and were publicly insured or uninsured. When this interaction and the main effects of health insurance, poverty and chemotherapy were accounted for, survival did not differ by marital status. The multiplicative barrier to colon cancer care that results from being inadequately insured and living in poverty is worse for unmarried than married women. Poverty is more prevalent among unmarried women and they have fewer assets so they are probably less able to absorb the indirect and direct, but uncovered, costs of colon cancer care. There seem to be structural inequities related to the institutions of marriage, work and health care that particularly disadvantage unmarried women that policy makers ought to be cognizant of as

Field selection of chemical protective clothing and respiratory protection

International Nuclear Information System (INIS)

Pinette, S.; Dodgen, C.; Morley, M.

1991-01-01

Safety professionals who must choose appropriate personal protective equipment for hazardous substance response or hazardous waste sites require useable information about the effectiveness of the various products available. Each hazardous waste operation involves a unique combination of chemical hazards requiring a unique combination of protective apparel. A chemical protective suit or respirator must be chosen for each site and each operation on the site. No single protective suit is effective against all chemical hazards. No single respirator is the best choice in every situation. Various sources of information on the effectiveness of protective clothing products will be discussed. Site-specific permeation testing of the proposed protective clothing options will also be discussed. It is both possible and practical to obtain specific information about the degree of protection afforded by a particular suit against a particular chemical mixture. It is also important to know how long the suit will last. Choosing adequate respiratory protection is a complex process. Respirator cartridge performance depends on various environmental factors as well as upon the combination and concentration of chemicals in the air. Once characterization of the air at a site has been accomplished, it may be appropriate to select an alternative to airline respirators and SCBAs. Respirator cartridges can be tested against specific chemical mixtures using worse case environmental factors. The results can be used to predict both the effectiveness and duration of protection afforded by respirator cartridges which can reduce costs and worker fatigue

Protecting knowledge

DEFF Research Database (Denmark)

Sofka, Wolfgang; de Faria, Pedro; Shehu, Edlira

2018-01-01

Most firms use secrecy to protect their knowledge from potential imitators. However, the theoretical foundations for secrecy have not been well explored. We extend knowledge protection literature and propose theoretical mechanisms explaining how information visibility influences the importance...... of secrecy as a knowledge protection instrument. Building on mechanisms from information economics and signaling theory, we postulate that secrecy is more important for protecting knowledge for firms that have legal requirements to reveal information to shareholders. Furthermore, we argue that this effect...... and a firm's investment in fixed assets. Our findings inform both academics and managers on how firms balance information disclosure requirements with the use of secrecy as a knowledge protection instrument....

Safety of persons protected by the Government Protection Bureau

Directory of Open Access Journals (Sweden)

Wojciech Lis

2015-12-01

Full Text Available The state is the organizational structure, which unites the whole nation by providing optimal conditions for the functioning and development. One of the conditions for the basic functions of the state is efficient administration headed by a person with the role of management. They not only hold the highest position, but also represent the authority of the state. For this reason, they need special protection. Each attack undermines the authority of the administration and trust in the state institutions. For the protection of persons performing managerial functions in the state corresponds to the Government Protection Bureau that providing them protection at the same time protect the state.

Level of customer orientation and customer protection in hotels in Serbia

Directory of Open Access Journals (Sweden)

Ćirić Maja

2014-01-01

Full Text Available Hotels present an engine of tourism development. Their standard and orientation towards specific target groups of customers determine the strength of tourism offer. In addition, they contribute to the agricultural development, too, because they are the great buyers of agricultural products. According to official data, the existing potentials of Serbian tourism have been insufficiently valorised and Serbian hotels are in pretty poor condition- compared to international standards. Taking these facts into consideration, we can raise a question whether the key problems of Serbian hotels lie exclusively in inadequate accommodation capacities, or perhaps that there is a lack of customer- oriented business philosophy. Also the question is to what extent the legal regulations contribute to the protection of customer rights and their satisfaction. Therefore, the purpose of this paper is to ascertain the level of customer orientation in Serbian hotels, so as to find out whether members of hotel staff are acquainted with the notion of customer orientation and determine the degree to which this approach has been applied in practice. Conclusions and recommendations for improvement of competitiveness of hotels in Serbia are derived on the basis of research conducted by interviewing the employees of a sample of hotels in Serbia.

Protected area certificates: gaining ground for better ecosystem protection?

Science.gov (United States)

Segerstedt, Anna; Grote, Ulrike

2015-06-01

Protected areas are vital to sustain a number of ecosystem services. Yet, many protected areas are underfinanced and lack management effectiveness. Protected area certificates have been suggested as a way to resolve these problems. This instrument would allow land managers to certify an area if it meets certain conservation criteria. The certificates could then be sold on an international market, for example to companies and any consumers that are interested in environmental protection. Some pilot initiatives have been launched, yet little is known about future demand and features of protected area certificates. To fill this knowledge gap, we conduct a choice experiment with close to 400 long-distance tourists from Germany as a potential group of buyers. Our results indicate that the respondents have the highest willingness to pay for certificates that conserve sensitive ecosystems and in addition to this lead to poverty reduction and safeguard water resources. For other attributes such as a greenhouse gas reduction, the preferences are less significant. Overall, the results are rather homogenous irrespective of where the protected areas are located. These insights are important for the future design and marketing of protected area certificates.

Loft fire protection

International Nuclear Information System (INIS)

White, E.R.; Jensen, J.D.

1980-01-01

Quantified criteria that was developed and applied to provide in-depth fire protection for the Loss of Fluid Test (LOFT) Facility are presented. The presentation describes the evolution process that elevated the facility's fire protection from minimal to that required for a highly protected risk or improved risk. Explored are some infrequently used fire protection measures that are poorly understood outside the fire protection profession

Inadequate birth spacing is perceived as riskier than all family planning methods, except sterilization and abortion, in a qualitative study among urban Nigerians.

Science.gov (United States)

Schwandt, Hilary M; Skinner, Joanna; Hebert, Luciana Estelle; Cobb, Lisa; Saad, Abdulmumin; Odeku, Mojisola

2017-09-11

Fertility is high in Nigeria and contraceptive use is low. Little is known about how urban Nigerians perceive the risk of contraceptive use in relation to pregnancy and birth. This study examines and compares the risk perception of family planning methods and pregnancy related scenarios among urban Nigerians. A total of 26 focus group discussions with 243 participants were conducted in September and October 2010 in Ibadan and Kaduna. The groups were stratified by sex, age, family planning use, and city. Study participants were asked to identify the risk associated with six different family planning methods and four pregnancy related risks. The data were coded in ATLAS.ti 6 and analyzed using the thematic content analysis approach. The ten family planning and pregnancy related items ranked as follows from most to least risky: sterilization, abortion, getting pregnant soon after having a baby (no birth spacing), pill, IUD, injectable, having a birth under 18 years of age (teenage motherhood), condom use, having six children, and fertility awareness methods. Risk of family planning methods was often categorized in terms of side effects and complications. Positive perceptions of teenage motherhood and having many children influenced the low ranking of these items. Inadequate birth spacing was rated as more risky than all contraceptive methods and pregnancy related events except for sterilization and abortion. Some of the participants' risk perceptions of contraceptives and pregnancy related scenarios does not correspond to actual risk of methods and practices. Instead, the items' perceived riskiness largely correspond with prevailing social norms. However, there was a high level of understanding of the risks of inadequate birth spacing. This study is not a randomized control trial so the study has not been registered as such.

Can an inadequate cervical cytology sample in ThinPrep be converted to a satisfactory sample by processing it with a SurePath preparation?

Science.gov (United States)

Sørbye, Sveinung Wergeland; Pedersen, Mette Kristin; Ekeberg, Bente; Williams, Merete E Johansen; Sauer, Torill; Chen, Ying

2017-01-01

The Norwegian Cervical Cancer Screening Program recommends screening every 3 years for women between 25 and 69 years of age. There is a large difference in the percentage of unsatisfactory samples between laboratories that use different brands of liquid-based cytology. We wished to examine if inadequate ThinPrep samples could be satisfactory by processing them with the SurePath protocol. A total of 187 inadequate ThinPrep specimens from the Department of Clinical Pathology at University Hospital of North Norway were sent to Akershus University Hospital for conversion to SurePath medium. Ninety-one (48.7%) were processed through the automated "gynecologic" application for cervix cytology samples, and 96 (51.3%) were processed with the "nongynecological" automatic program. Out of 187 samples that had been unsatisfactory by ThinPrep, 93 (49.7%) were satisfactory after being converted to SurePath. The rate of satisfactory cytology was 36.6% and 62.5% for samples run through the "gynecology" program and "nongynecology" program, respectively. Of the 93 samples that became satisfactory after conversion from ThinPrep to SurePath, 80 (86.0%) were screened as normal while 13 samples (14.0%) were given an abnormal diagnosis, which included 5 atypical squamous cells of undetermined significance, 5 low-grade squamous intraepithelial lesion, 2 atypical glandular cells not otherwise specified, and 1 atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion. A total of 2.1% (4/187) of the women got a diagnosis of cervical intraepithelial neoplasia 2 or higher at a later follow-up. Converting cytology samples from ThinPrep to SurePath processing can reduce the number of unsatisfactory samples. The samples should be run through the "nongynecology" program to ensure an adequate number of cells.

Philosophy of radiological protection and radiation hazard protection law

International Nuclear Information System (INIS)

Kai, Michiaki; Kawano, Takao

2013-01-01

The radiation protection and the human safety in radiation facilities are strictly controlled by law. There are rules on the radiation measurement, too. In the present review, philosophy of the radiological protection and the radiation hazard protection law is outlined with reference to ICRP recommendations. (J.P.N.)

Comparison of Registered and Reported Outcomes in Randomized Clinical Trials Published in Anesthesiology Journals.

Science.gov (United States)

Jones, Philip M; Chow, Jeffrey T Y; Arango, Miguel F; Fridfinnson, Jason A; Gai, Nan; Lam, Kevin; Turkstra, Timothy P

2017-10-01

Randomized clinical trials (RCTs) provide high-quality evidence for clinical decision-making. Trial registration is one of the many tools used to improve the reporting of RCTs by reducing publication bias and selective outcome reporting bias. The purpose of our study is to examine whether RCTs published in the top 6 general anesthesiology journals were adequately registered and whether the reported primary and secondary outcomes corresponded to the originally registered outcomes. Following a prespecified protocol, an electronic database was used to systematically screen and extract data from RCTs published in the top 6 general anesthesiology journals by impact factor (Anaesthesia, Anesthesia & Analgesia, Anesthesiology, British Journal of Anaesthesia, Canadian Journal of Anesthesia, and European Journal of Anaesthesiology) during the years 2007, 2010, 2013, and 2015. A manual search of each journal's Table of Contents was performed (in duplicate) to identify eligible RCTs. An adequately registered trial was defined as being registered in a publicly available trials registry before the first patient being enrolled with an unambiguously defined primary outcome. For adequately registered trials, the outcomes registered in the trial registry were compared with the outcomes reported in the article, with outcome discrepancies documented and analyzed by the type of discrepancy. During the 4 years studied, there were 860 RCTs identified, with 102 RCTs determined to be adequately registered (12%). The proportion of adequately registered trials increased over time, with 38% of RCTs being adequately registered in 2015. The most common reason in 2015 for inadequate registration was registering the RCT after the first patient had already been enrolled. Among adequately registered trials, 92% had at least 1 primary or secondary outcome discrepancy. In 2015, 42% of RCTs had at least 1 primary outcome discrepancy, while 90% of RCTs had at least 1 secondary outcome discrepancy

Efficacy of obeticholic acid in patients with primary biliary cirrhosis and inadequate response to ursodeoxycholic acid.

Science.gov (United States)

Hirschfield, Gideon M; Mason, Andrew; Luketic, Velimir; Lindor, Keith; Gordon, Stuart C; Mayo, Marlyn; Kowdley, Kris V; Vincent, Catherine; Bodhenheimer, Henry C; Parés, Albert; Trauner, Michael; Marschall, Hanns-Ulrich; Adorini, Luciano; Sciacca, Cathi; Beecher-Jones, Tessa; Castelloe, Erin; Böhm, Olaf; Shapiro, David

2015-04-01

We evaluated the efficacy and safety of obeticholic acid (OCA, α-ethylchenodeoxycholic acid) in a randomized controlled trial of patients with primary biliary cirrhosis who had an inadequate response to ursodeoxycholic acid therapy. We performed a double-blind study of 165 patients with primary biliary cirrhosis (95% women) and levels of alkaline phosphatase (ALP) 1.5- to 10-fold the upper limit of normal. Patients were randomly assigned to groups given 10 mg, 25 mg, or 50 mg doses of OCA or placebo, once daily for 3 months. Patients maintained their existing dose of ursodeoxycholic acid throughout the study. The primary outcome was change in level of ALP from baseline (day 0) until the end of the study (day 85 or early termination). We also performed an open-label extension of the trial in which 78 patients were enrolled and 61 completed the first year. OCA was superior to placebo in achieving the primary end point. Subjects given OCA had statistically significant relative reductions in mean ALP from baseline to the end of the study (P ursodeoxycholic acid. The incidence and severity of pruritus were lowest among patients who received 10 mg/d OCA. Biochemical responses to OCA were maintained in a 12-month open-label extension trial. ClinicalTrials.gov ID: NCT00550862. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

Information booklet on personal protective equipment: arm and hand protection

International Nuclear Information System (INIS)

1992-01-01

Fire, heat, cold, electro-magnetic and ionising radiation, electricity, chemicals, impacts, cuts, abrasion, etc. are the common hazards for arms and hands at work. The gloves chosen for protection of the arm and hand should cover those parts adequately and the material of the gloves should be capable of offering protection against the specific hazard involved. Criteria for choosing arm and hand protection equipment will be based on their shape and part of the arm and hand protected. Guide lines for choosing such personal protection equipment for nuclear facilities are given. (M.K.V.). 3 annexures, 1 appendix

Comparative efficacy and safety of tocilizumab, rituximab, abatacept and tofacitinib in patients with active rheumatoid arthritis that inadequately responds to tumor necrosis factor inhibitors: a Bayesian network meta-analysis of randomized controlled trials.

Science.gov (United States)

Lee, Young Ho; Bae, Sang-Cheol

2016-11-01

This study aimed to assess the relative efficacy and safety of biologics and tofacitinib in patients with rheumatoid arthritis (RA) showing an inadequate response to tumor necrosis factor (TNF) inhibitors. We performed a Bayesian network meta-analysis to combine the direct and indirect evidence from randomized controlled trials (RCTs) examining the efficacy and safety of tocilizumab, rituximab, abatacept and tofacitinib in patients with RA that inadequately responds to TNF inhibitors. Four RCTs including 1796 patients met the inclusion criteria. The tocilizumab 8 mg group showed a significantly higher American College of Rheumatology 20% (ACR20) response rate than the abatacept and tofacitinib groups. Ranking probability based on surface under the cumulative ranking curve (SUCRA) indicated that tocilizumab 8 mg had the highest probability of being the best treatment for achieving the ACR20 response rate (SUCRA = 0.9863), followed by rituximab (SUCRA = 0.6623), abatacept (SUCRA = 0.5428), tocilizumab 4 mg (SUCRA = 0.4956), tofacitinib 10 mg (SUCRA = 0.4715), tofacitinib 5 mg (SUCRA = 0.3415) and placebo (SUCRA = 0). In contrast, the safety based on the number of withdrawals due to adverse events did not differ significantly among the treatment options. Tocilizumab 8 mg was the second-line non-TNF biologic with the highest performance regarding an early good response based on ACR20 response rate and acceptable safety profile, followed by rituximab, abatacept and tofacitinib in patients with RA and an inadequate response to anti-TNF therapy, and none of these treatments were associated with a significant risk of withdrawal due to adverse events. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

Information booklet on personal protective equipment: eye and face protection

International Nuclear Information System (INIS)

1992-01-01

In all work places where hazards of various kinds are present and the same cannot be totally controlled by engineering methods, suitable personal protective equipment (PPE) shall be used. There are several types of eye and face protection devices available in the market and it is important that employees use the proper type for the particular job. The main classes of eye and face protection devices required for the industrial operations are as follows: (a) eye protection devices which includes: (i) safety goggles (ii) safety spectacles (iii) safety clipons and eye and face protection devices which are (i) eye shield, (ii) face shield, (iii) wire mesh screen guard. Guide lines for selecting appropriate ear and face protection equipment for nuclear installations are given. (M.K.V.). 4 annexures, 1 appendix

Extraglottic airway devices: technology update

Directory of Open Access Journals (Sweden)

Sharma B

2017-08-01

Full Text Available Bimla Sharma, Chand Sahai, Jayashree Sood Department of Anaesthesiology, Pain and Perioperative Medicine, Sir Ganga Ram Hospital, New Delhi, India Abstract: Extraglottic airway devices (EADs have revolutionized the field of airway management. The invention of the laryngeal mask airway was a game changer, and since then, there have been several innovations to improve the EADs in design, functionality, safety and construction material. These have ranged from changes in the shape of the mask, number of cuffs and material used, like rubber, polyvinylchloride and latex. Phthalates, which were added to the construction material in order to increase device flexibility, were later omitted when this chemical was found to have serious adverse reproductive outcomes. The various designs brought out by numerous companies manufacturing EADs resulted in the addition of several devices to the airway market. These airway devices were put to use, many of them with inadequate or no evidence base regarding their efficacy and safety. To reduce the possibility of compromising the safety of the patient, the Difficult Airway Society (DAS formed the Airway Device Evaluation Project Team (ADEPT to strengthen the evidence base for airway equipment and vet the new extraglottic devices. A preuse careful analysis of the design and structure may help in better understanding of the functionality of a particular device. In the meantime, the search for the ideal EAD continues. Keywords: extraglottic airway devices, laryngeal mask airway, other extraglottic airway devices, safety, technology update

Protection of industrial and business secrets in environmental protection law

International Nuclear Information System (INIS)

Breuer, R.

1986-01-01

The author investigates the relation between environmental protection and data protection, especially concerning the protection of industrial and business secrets. For this kind of conflict there are only general administrative and procedural provisions with little systematic order. Special provisions of data protection covering all aspects of industrial and business secrets, as for example in social or tax law, do not exist in German law until now. (WG) [de

Gonad protection for the antero-posterior projection of the pelvis in diagnostic radiography in Dublin hospitals

Energy Technology Data Exchange (ETDEWEB)

Doolan, Aoife; Brennan, Patrick C. E-mail: patrick.brennan@ucd.ie; Rainford, Louise A.; Healy, Jan

2004-02-01

Gonad shielding during diagnostic X-ray procedures is an effective way of reducing radiation dose to patients' reproductive organs and reduces the risk of genetic effects in future generations. The utilisation of gonad shielding, the availability of shields and the existence of written protocols for the use of radiation shielding for antero-posterior projections of the male and female pelvis were examined in four major Dublin hospitals. A retrospective study of 198 pelvic radiographs revealed that only 2% (n=4) of images had evidence of gonad shielding. All four images that demonstrated shielding showed that the shield was malpositioned with either important bony anatomy obscured or gonads not sufficiently protected. Some of the hospitals surveyed had inadequate supplies of gonad shields in the general radiography rooms and no written protocols were available. The results of this study indicate that patients in the hospitals investigated are receiving avoidable gonad irradiation due to the omission, or malpositioning of gonad shields during pelvis examinations. In line with recent EC recommendations appropriate shielding of the gonads during pelvis AP examinations should be encouraged.

Gonad protection for the antero-posterior projection of the pelvis in diagnostic radiography in Dublin hospitals

International Nuclear Information System (INIS)

Doolan, Aoife; Brennan, Patrick C.; Rainford, Louise A.; Healy, Jan

2004-01-01

Gonad shielding during diagnostic X-ray procedures is an effective way of reducing radiation dose to patients' reproductive organs and reduces the risk of genetic effects in future generations. The utilisation of gonad shielding, the availability of shields and the existence of written protocols for the use of radiation shielding for antero-posterior projections of the male and female pelvis were examined in four major Dublin hospitals. A retrospective study of 198 pelvic radiographs revealed that only 2% (n=4) of images had evidence of gonad shielding. All four images that demonstrated shielding showed that the shield was malpositioned with either important bony anatomy obscured or gonads not sufficiently protected. Some of the hospitals surveyed had inadequate supplies of gonad shields in the general radiography rooms and no written protocols were available. The results of this study indicate that patients in the hospitals investigated are receiving avoidable gonad irradiation due to the omission, or malpositioning of gonad shields during pelvis examinations. In line with recent EC recommendations appropriate shielding of the gonads during pelvis AP examinations should be encouraged

Numerical differential protection

CERN Document Server

Ziegler, Gerhard

2012-01-01

Differential protection is a fast and selective method of protection against short-circuits. It is applied in many variants for electrical machines, trans?formers, busbars, and electric lines.Initially this book covers the theory and fundamentals of analog and numerical differential protection. Current transformers are treated in detail including transient behaviour, impact on protection performance, and practical dimensioning. An extended chapter is dedicated to signal transmission for line protection, in particular, modern digital communication and GPS timing.The emphasis is then pla

Personal protective equipment

International Nuclear Information System (INIS)

2004-01-01

This Practical Radiation Technical Manual is one of a series that has been designed to provide guidance on radiological protection for employers, radiation protection officers, managers and other technically competent persons who have responsibility for ensuring the safety of employees working with ionizing radiation. The Manual may be used with the appropriate IAEA Practical Radiation Safety Manuals to provide training, instruction and information for all employees engaged in work with ionizing radiation. Personal protective equipment (PPE) includes clothing or other special equipment that is issued to individual workers to provide protection against actual or potential exposure to ionizing radiations. It is used to protect each worker against the prevailing risk of external or internal exposure in circumstances in which it is not reasonably practicable to provide complete protection by means of engineering controls or administrative methods. Adequate personal protection depends on PPE being correctly selected, fitted and maintained. Appropriate training for the users and arrangements to monitor usage are also necessary to ensure that PPE provides the intended degree of protection effectively. This Manual explains the principal types of PPE, including protective clothing and respiratory protective equipment (RPE). Examples of working procedures are also described to indicate how PPE should be used within a safe system of work. The Manual will be of most benefit if it forms part of a more comprehensive training programme or is supplemented by the advice of a qualified expert in radiation protection. Some of the RPE described in this Manual should be used under the guidance of a qualified expert

Inadequate dietary calcium and vitamin D intakes in renal-transplant recipients in Ireland.

LENUS (Irish Health Repository)

Lynch, Irene T

2012-02-03

vitamin D intakes in adult renal-transplant patients are in many cases inadequate.

Adaptive protection scheme

Directory of Open Access Journals (Sweden)

R. Sitharthan

2016-09-01

Full Text Available This paper aims at modelling an electronically coupled distributed energy resource with an adaptive protection scheme. The electronically coupled distributed energy resource is a microgrid framework formed by coupling the renewable energy source electronically. Further, the proposed adaptive protection scheme provides a suitable protection to the microgrid for various fault conditions irrespective of the operating mode of the microgrid: namely, grid connected mode and islanded mode. The outstanding aspect of the developed adaptive protection scheme is that it monitors the microgrid and instantly updates relay fault current according to the variations that occur in the system. The proposed adaptive protection scheme also employs auto reclosures, through which the proposed adaptive protection scheme recovers faster from the fault and thereby increases the consistency of the microgrid. The effectiveness of the proposed adaptive protection is studied through the time domain simulations carried out in the PSCAD⧹EMTDC software environment.

Primary iris claw IOL retrofixation with intravitreal triamcinolone acetonide in cases of inadequate capsular support.

Science.gov (United States)

Kelkar, Aditya; Shah, Rachana; Vasavda, Viraj; Kelkar, Jai; Kelkar, Shreekant

2018-02-01

To assess the outcomes and analyze complication rates following primary iris claw IOL retrofixation with intravitreal triamcinolone acetonide. This is a retrospective interventional case series. Patients with poor capsular support-diagnosed preoperatively or owing to intraoperative complications-were treated with iris claw IOL retrofixation with intravitreal triamcinolone acetonide. The data were retrospectively analyzed. 104 eyes of 102 patients with poor capsular support who underwent the procedure between 2010 and 2013 were analyzed. The minimum follow-up period was 12 months (ranging from 12 to 36 months). Iris claw IOL was implanted in-traumatic subluxated cataracts-24 cases (23.07%), non-traumatic subluxated cataracts in 16 cases (15.38%), or as a complication of cataract surgery-intraoperative posterior capsular rent in 48 cases (46.15%) and intraoperative nucleus drop in 16 cases (15.38%). The final mean best-corrected logMAR visual acuity improved from 1.36 ± 0.64 preoperatively to 0.36 ± 0.32 at 1-year follow-up. Complications included pupil ovalization in 11 cases (10.57%), transient elevation in intraocular pressure in 7 eyes (6.73%), postoperative hypotony in 5 eyes (4.80%), cystoid macular edema in 2 eyes (1.92%), retinal detachment in 1 eye (0.96%), vitreous hemorrhage in 1 eye (0.96%), and hyphema in 1 eye (0.96%). Primary iris claw IOL retrofixation provided excellent alternative in patients with inadequate capsular support. The visual outcomes were good along with favorable rates of complications. The addition of triamcinolone acetonide helps in reducing the chances of cystoid macular edema.

Numerical distance protection

CERN Document Server

Ziegler, Gerhard

2011-01-01

Distance protection provides the basis for network protection in transmission systems and meshed distribution systems. This book covers the fundamentals of distance protection and the special features of numerical technology. The emphasis is placed on the application of numerical distance relays in distribution and transmission systems.This book is aimed at students and engineers who wish to familiarise themselves with the subject of power system protection, as well as the experienced user, entering the area of numerical distance protection. Furthermore it serves as a reference guide for s

Machine Protection

CERN Document Server

Schmidt, R

2014-01-01

The protection of accelerator equipment is as old as accelerator technology and was for many years related to high-power equipment. Examples are the protection of powering equipment from overheating (magnets, power converters, high-current cables), of superconducting magnets from damage after a quench and of klystrons. The protection of equipment from beam accidents is more recent. It is related to the increasing beam power of high-power proton accelerators such as ISIS, SNS, ESS and the PSI cyclotron, to the emission of synchrotron light by electron–positron accelerators and FELs, and to the increase of energy stored in the beam (in particular for hadron colliders such as LHC). Designing a machine protection system requires an excellent understanding of accelerator physics and operation to anticipate possible failures that could lead to damage. Machine protection includes beam and equipment monitoring, a system to safely stop beam operation (e.g. dumping the beam or stopping the beam at low energy) and an ...

Initial dose of vancomycin based on body weight and creatinine clearance to minimize inadequate trough levels in Japanese adults.

Science.gov (United States)

Maki, N; Ohkuchi, A; Tashiro, Y; Kim, M R; Le, M; Sakamoto, T; Matsubara, S; Hakamata, Y

2012-10-01

Our aims were to elucidate the factors that affected vancomycin (VCM) serum trough levels and to find the optimal initial dose based on creatinine clearance (CrCl) and body weight (BW) to minimize inadequate trough levels in a retrospective observational study among Japanese adults. One hundred and six inpatients, in whom VCM trough levels were measured after completing the third dosing, were consecutively recruited into our study in a tertiary hospital. We considered the frequency of initial VCM total daily dose, CrCl, and BW were independent risk factors of VCM trough levels. In patients with CrCl ≥30 and level of ≥20 mcg/mL, regardless of BW. In patients with CrCl ≥50 mL/min, 2 g/day yielded low frequencies of a trough level of initial total daily dose may be 1 g/day in patients with CrCl ≥30 and <50 mL/min regardless of BW and 2 g/day in patients weighing <55 kg with CrCl ≥50 mL/min among Japanese adults.

The Gauteng Conservation Plan: Planning for biodiversity in a rapidly urbanising province

Directory of Open Access Journals (Sweden)

Michèle F. Pfab

2017-11-01

Conclusion: The existing protected area network is inadequate for the conservation of biodiversity in Gauteng. The Gauteng Conservation Plan identifies a set of areas that are required to achieve conservation targets. It is important that identified areas currently not in the protected area network are protected either formally or through legislated land use management processes.

Concepts of radiation protection

International Nuclear Information System (INIS)

2013-01-01

This seventh chapter presents the concepts and principles of safety and radiation protection, emergency situations; NORM and TENORM; radiation protection care; radiation protection plan; activities of the radiation protection service; practical rules of radiation protection and the radiation symbol

Vaccine induced Hepatitis A and B protection in children at risk for cystic fibrosis associated liver disease.

Science.gov (United States)

Shapiro, Adam J; Esther, Charles R; Leigh, Margaret W; Dellon, Elisabeth P

2013-01-30

Hepatitis A (HAV) and Hepatitis B (HBV) infections can cause serious morbidity in patients with liver disease, including cystic fibrosis associated liver disease (CFALD). HAV and HBV vaccinations are recommended in CFALD, and maintenance of detectable antibody levels is also recommended with chronic liver disease. A better understanding of factors predicting low HAV and HBV antibodies may help physicians improve protection from these viruses in CFALD patients. We examined HAV and HBV vaccine protection in children at risk for CFALD. Clinical and vaccine histories were reviewed, and HAV and HBV antibody titers measured. Those with no vaccination history or low HAV or HBV titers received primary or booster vaccinations, and responses were measured. Thirty-four of 308 children were at risk for CFALD per project criteria. Ten had previous HAV vaccination, of which 90% had positive anti-HAV antibodies. Thirty-three of 34 had previously received primary HBV vaccination (most in infancy), but only 12 (35%) had adequate anti-HBs levels (≥10mIU/mL). Children with adequate anti-HBs levels were older at first HBV vaccine (median 2.3 vs. 0.1 years, p<0.01), and at final HBV vaccine (median 4.0 vs. 0.8 years, p=0.01). Fourteen of 19 (74%) responded to HBV boosters. Z-scores for BMI at HBV booster were significantly lower in booster non-responders (p=0.04). Children at increased risk of CFALD have inadequate HAV and HBV antibody levels, and HBV antibody protection can be enhanced through vaccine boosters. HBV antibody titers should be assessed in CFALD patients with a history of vaccination, particularly in those who received HBV vaccines in infancy or who are malnourished. Copyright © 2012 Elsevier Ltd. All rights reserved.

Bolder science needed now for protected areas.

Science.gov (United States)

Watson, James E M; Darling, Emily S; Venter, Oscar; Maron, Martine; Walston, Joe; Possingham, Hugh P; Dudley, Nigel; Hockings, Marc; Barnes, Megan; Brooks, Thomas M

2016-04-01

Recognizing that protected areas (PAs) are essential for effective biodiversity conservation action, the Convention on Biological Diversity established ambitious PA targets as part of the 2020 Strategic Plan for Biodiversity. Under the strategic goal to "improve the status of biodiversity by safeguarding ecosystems, species, and genetic diversity," Target 11 aims to put 17% of terrestrial and 10% of marine regions under PA status by 2020. Additionally and crucially, these areas are required to be of particular importance for biodiversity and ecosystem services, effectively and equitably managed, ecologically representative, and well-connected and to include "other effective area-based conservation measures" (OECMs). Whereas the area-based targets are explicit and measurable, the lack of guidance for what constitutes important and representative; effective; and OECMs is affecting how nations are implementing the target. There is a real risk that Target 11 may be achieved in terms of area while failing the overall strategic goal for which it is established because the areas are poorly located, inadequately managed, or based on unjustifiable inclusion of OECMs. We argue that the conservation science community can help establish ecologically sensible PA targets to help prioritize important biodiversity areas and achieve ecological representation; identify clear, comparable performance metrics of ecological effectiveness so progress toward these targets can be assessed; and identify metrics and report on the contribution OECMs make toward the target. By providing ecologically sensible targets and new performance metrics for measuring the effectiveness of both PAs and OECMs, the science community can actively ensure that the achievement of the required area in Target 11 is not simply an end in itself but generates genuine benefits for biodiversity. © 2016 Society for Conservation Biology.

Radiation protection

International Nuclear Information System (INIS)

Koelzer, W.

1975-01-01

Physical and radiological terms, quantities, and units. Basic principles of radiation protection (ICRP, IAEA, EURATOM, FRG). Biological effects of ionizing radiation. Objectives of practical radiation protection. (HP) [de

Machine Protection

International Nuclear Information System (INIS)

Schmidt, R

2014-01-01

The protection of accelerator equipment is as old as accelerator technology and was for many years related to high-power equipment. Examples are the protection of powering equipment from overheating (magnets, power converters, high-current cables), of superconducting magnets from damage after a quench and of klystrons. The protection of equipment from beam accidents is more recent. It is related to the increasing beam power of high-power proton accelerators such as ISIS, SNS, ESS and the PSI cyclotron, to the emission of synchrotron light by electron–positron accelerators and FELs, and to the increase of energy stored in the beam (in particular for hadron colliders such as LHC). Designing a machine protection system requires an excellent understanding of accelerator physics and operation to anticipate possible failures that could lead to damage. Machine protection includes beam and equipment monitoring, a system to safely stop beam operation (e.g. dumping the beam or stopping the beam at low energy) and an interlock system providing the glue between these systems. The most recent accelerator, the LHC, will operate with about 3 × 10 14 protons per beam, corresponding to an energy stored in each beam of 360 MJ. This energy can cause massive damage to accelerator equipment in case of uncontrolled beam loss, and a single accident damaging vital parts of the accelerator could interrupt operation for years. This article provides an overview of the requirements for protection of accelerator equipment and introduces the various protection systems. Examples are mainly from LHC, SNS and ESS

Radiation protection principles

International Nuclear Information System (INIS)

Ismail Bahari

2007-01-01

The presentation outlines the aspects of radiation protection principles. It discussed the following subjects; radiation hazards and risk, the objectives of radiation protection, three principles of the system - justification of practice, optimization of protection and safety, dose limit

Ozone Layer Protection

Science.gov (United States)

... and Research Centers Contact Us Share Ozone Layer Protection The stratospheric ozone layer is Earth’s “sunscreen” – protecting ... GreenChill Partnership Responsible Appliance Disposal (RAD) Program Ozone Protection vs. Ozone Pollution This website addresses stratospheric ozone ...

Bypass during Liver Transplantation: Anachronism or Revival? Liver Transplantation Using a Combined Venovenous/Portal Venous Bypass—Experiences with 163 Liver Transplants in a Newly Established Liver Transplantation Program

Directory of Open Access Journals (Sweden)

Anne Mossdorf

2015-01-01

Full Text Available Introduction. The venovenous/portal venous (VVP bypass technique has generally become obsolete in liver transplantation (LT today. We evaluated our experience with 163 consecutive LTs that used a VVP bypass. Patients and Methods. The liver transplant program was started in our center in 2010. LTs were performed using an extracorporal bypass device. Results. Mean operative time was 269 minutes and warm ischemic time 43 minutes. The median number of transfusion of packed cells and plasma was 7 and 14. There was no intraoperative death, and the 30-day mortality was 3%. Severe bypass-induced complications did not occur. Discussion. The introduction of a new LT program requires maximum safety measures for all of the parties involved. Both surgical and anaesthesiological management (reperfusion can be controlled very reliably using a VVP bypass device. Particularly when using marginal grafts, this approach helps to minimise both surgical and anaesthesiological complications in terms of less volume overload, less use of vasopressive drugs, less myocardial injury, and better peripheral blood circulation. Conclusion. Based on our experiences while establishing a new liver transplantation program, we advocate the reappraisal of the extracorporeal VVP bypass.

Radiological protection

International Nuclear Information System (INIS)

Azorin N, J.; Azorin V, J. C.

2010-01-01

This work is directed to all those people related with the exercise of the radiological protection and has the purpose of providing them a base of knowledge in this discipline so that they can make decisions documented on technical and scientist factors for the protection of the personnel occupationally exposed, the people in general and the environment during the work with ionizing radiations. Before de lack of a text on this matter, this work seeks to cover the specific necessities of our country, providing a solid presentation of the radiological protection, included the bases of the radiations physics, the detection and radiation dosimetry, the radiobiology, the normative and operational procedures associates, the radioactive wastes, the emergencies and the transport of the radioactive material through the medical and industrial applications of the radiations, making emphasis in the relative particular aspects to the radiological protection in Mexico. The book have 16 chapters and with the purpose of supplementing the given information, are included at the end four appendixes: 1) the radioactive waste management in Mexico, 2-3) the Mexican official standards related with the radiological protection, 4) a terms glossary used in radiological protection. We hope this book will be of utility for those people that work in the investigation and the applications of the ionizing radiations. (Author)

Machine protection systems

CERN Document Server

Macpherson, A L

2010-01-01

A summary of the Machine Protection System of the LHC is given, with particular attention given to the outstanding issues to be addressed, rather than the successes of the machine protection system from the 2009 run. In particular, the issues of Safe Machine Parameter system, collimation and beam cleaning, the beam dump system and abort gap cleaning, injection and dump protection, and the overall machine protection program for the upcoming run are summarised.

Information protection playbook

CERN Document Server

Kane, Greg

2013-01-01

The primary goal of the Information Protection Playbook is to serve as a comprehensive resource for information protection (IP) professionals who must provide adequate information security at a reasonable cost. It emphasizes a holistic view of IP: one that protects the applications, systems, and networks that deliver business information from failures of confidentiality, integrity, availability, trust and accountability, and privacy. Using the guidelines provided in the Information Protection Playbook, security and information technology (IT) managers will learn how to

Value of ultrasonography as a marker of early response to abatacept in patients with rheumatoid arthritis and an inadequate response to methotrexate

DEFF Research Database (Denmark)

D'Agostino, Maria-Antonietta; Wakefield, Richard J; Berner-Hammer, Hilde

2016-01-01

OBJECTIVES: To study the responsiveness of a combined power Doppler and greyscale ultrasound (PDUS) score for assessing synovitis in biologic-naïve patients with rheumatoid arthritis (RA) starting abatacept plus methotrexate (MTX). METHODS: In this open-label, multicentre, single-arm study......, patients with RA (MTX inadequate responders) received intravenous abatacept (∼10 mg/kg) plus MTX for 24 weeks. A composite PDUS synovitis score, developed by the Outcome Measures in Rheumatology-European League Against Rheumatism (OMERACT-EULAR)-Ultrasound Task Force, was used to evaluate individual joints......-week treatment period. The earliest PDUS sign of improvement in synovitis was at week 1 (mean change in GLOESS (MCPs 2-5): -0.7 (95% CIs -1.2 to -0.1)), with continuous improvement to week 24. Early improvement was observed in the component scores (power Doppler signal at week 1, synovial hyperplasia...

Radiation Protection Ordinance. Preventive Radiation Protection Act. 3. rev. and enlarged ed.

International Nuclear Information System (INIS)

Kramer, R.; Zerlett, G.

1990-01-01

This 3rd edition presents the official explanations of the legislative intent behind the Radiation Protection Ordinance of 1976 and the 2nd amending ordinance, and the commentaries which as usual refer to the legal aspects and the related medical, scientific, and technical aspects. As a consequence of the reactor accident at Chernobyl, the existing radiation protection law has been extended by the Act for Preventive Measures for Pretection of the Population Against the Hazards of Ionizing Radiation (Preventive Radiation Protection Act), establishing preventive legal provisions and measures, so that this new edition has likewise been extended by commentaries on the Protective Radiation Protection Act and an introduction to the new area of law. The material also includes the Act for Establishment of a Federal Office for Radiation Protection, of October 9, 1989, which amended the Atomic Energy Act and the Preventive Radiation Protection Act. The correction of the Radiation Protection Ordinance of October 16, 1989 (BGBl. I p. 1926) has been incorporated into the text of the amended version of the Radiation Protection Ordinance. Court decisions and literature referred to cover material published up to the first months of 1989. (orig.) [de

Susceptibility of modern relay protection: Will protection from cyber attacks help?

Directory of Open Access Journals (Sweden)

Gurevich Vladimir

2014-01-01

Full Text Available Modern trends in relay protection (RP based on the substitution of electromechanical protection relays (EMPR by digital protective relays (DPR have resulted in the emergence of an absolutely new problem, which was not known before. This problem is the possibility of an intentional remote destructive impact (IRDI on relay protection in order to put it out of action or make it perform functions that have nothing to do with the current operational mode of protected electric equipment. Traditional and well-known methods ensuring information safety cannot fully prevent unauthorized actions of RP. The article describes a new way for the problem solution.

Strengthening the radiation protection culture: a priority of EDF radiation protection policy

International Nuclear Information System (INIS)

Garcier, Y.

2006-01-01

Full text of publication follows: In order to improve the management of radiation protection at EDF nuclear power plants, the Human Factors Group of the Research and Development Division of EDF has performed some studies on the appropriation process of the radiation protection requirements. These studies have notably shown that an efficient application of the radiation protection requirements lies on a comprehension by all workers of the meaning of these requirements. Furthermore, they should not be applied under the constraint or because of the fear of a sanction, but the workers need to perceive and understand the benefits in terms of protection associated with the radiation protection requirements. The strengthening of the radiation protection culture is therefore a key element of the radiation protection policy developed by EDF. This culture lies on an awareness of the health risks potentially associated with low levels of ionising radiations, as well as on the knowledge of tools, techniques and good practices developed to control the level of exposures and improve the radiation protection. Various type of actions have been undertaken to reinforce among the relevant players (exposed and non-exposed workers, contractors, all levels of management,... ) an awareness of radiation protection in order to integrate it in their day to day work: elaboration of a 'radiation protection system of reference' explaining how the radiation protection regulatory requirements are applied at EDF, publication of a 'radiation protection handbook' available for all workers (including contractors), training sessions, creation of networks of specialists from the various nuclear power plants on specific radiation protection issues, organisation of feed-back experience forum, etc. Beyond these specific actions, i t is also important to ensure a support and an assistance on the field by dedicated specialists. In this perspective, the health physicists have to play a key role in order to

Possibilities of technologies that replace in-patient facilities in uroandrology

Directory of Open Access Journals (Sweden)

T. I. Derevyanko

2015-01-01

Full Text Available One of the main directions in improvement of medical service became invasion of stationary substitute technologies. In Stavropol since 2007 has been organized the Men, s health protection service based on Regional clinical specialized uroandrological center. In uroandrological short stay surgical department successfully provides treatment in all forms of male genital in children and adult pathology with using minimally invasive methodics in short stay conditions and absence postsurgical complications. The operation rooms are staffed with all necessary equipment for carry out activities in full volume. All patients treated in urological department had sorted by anaesthesiological and somatic criterias.The main strategical directions are male reproductive health, pediatric urology-andrology, oncouroandrology. Human resources, high technology staff and intelligent work organization are fundamental for modern stationary substitute service. Human resource conception is urologist-andrologist – urologist – surgeon with laparoscopic, transurethral, microsurgery, reconstructive and plastic technique with endocrinology and psychiatric skills.Work indicators of medical center tells about high effectiveness and possibility of release profile urological beds for “big” surgical help and transfer male genital surgery on stationary substitute technologies.

Factors Controlling Vegetation Fires in Protected and Non-Protected Areas of Myanmar

Science.gov (United States)

Biswas, Sumalika; Vadrevu, Krishna Prasad; Lwin, Zin Mar; Lasko, Kristofer; Justice, Christopher O.

2015-01-01

Fire is an important disturbance agent in Myanmar impacting several ecosystems. In this study, we quantify the factors impacting vegetation fires in protected and non-protected areas of Myanmar. Satellite datasets in conjunction with biophysical and anthropogenic factors were used in a spatial framework to map the causative factors of fires. Specifically, we used the frequency ratio method to assess the contribution of each causative factor to overall fire susceptibility at a 1km scale. Results suggested the mean fire density in non-protected areas was two times higher than the protected areas. Fire-land cover partition analysis suggested dominant fire occurrences in the savannas (protected areas) and woody savannas (non-protected areas). The five major fire causative factors in protected areas in descending order include population density, land cover, tree cover percent, travel time from nearest city and temperature. In contrast, the causative factors in non-protected areas were population density, tree cover percent, travel time from nearest city, temperature and elevation. The fire susceptibility analysis showed distinct spatial patterns with central Myanmar as a hot spot of vegetation fires. Results from propensity score matching suggested that forests within protected areas have 11% less fires than non-protected areas. Overall, our results identify important causative factors of fire useful to address broad scale fire risk concerns at a landscape scale in Myanmar. PMID:25909632

Factors controlling vegetation fires in protected and non-protected areas of myanmar.

Directory of Open Access Journals (Sweden)

Sumalika Biswas

Full Text Available Fire is an important disturbance agent in Myanmar impacting several ecosystems. In this study, we quantify the factors impacting vegetation fires in protected and non-protected areas of Myanmar. Satellite datasets in conjunction with biophysical and anthropogenic factors were used in a spatial framework to map the causative factors of fires. Specifically, we used the frequency ratio method to assess the contribution of each causative factor to overall fire susceptibility at a 1km scale. Results suggested the mean fire density in non-protected areas was two times higher than the protected areas. Fire-land cover partition analysis suggested dominant fire occurrences in the savannas (protected areas and woody savannas (non-protected areas. The five major fire causative factors in protected areas in descending order include population density, land cover, tree cover percent, travel time from nearest city and temperature. In contrast, the causative factors in non-protected areas were population density, tree cover percent, travel time from nearest city, temperature and elevation. The fire susceptibility analysis showed distinct spatial patterns with central Myanmar as a hot spot of vegetation fires. Results from propensity score matching suggested that forests within protected areas have 11% less fires than non-protected areas. Overall, our results identify important causative factors of fire useful to address broad scale fire risk concerns at a landscape scale in Myanmar.

Factors controlling vegetation fires in protected and non-protected areas of myanmar.

Science.gov (United States)

Biswas, Sumalika; Vadrevu, Krishna Prasad; Lwin, Zin Mar; Lasko, Kristofer; Justice, Christopher O

2015-01-01

Fire is an important disturbance agent in Myanmar impacting several ecosystems. In this study, we quantify the factors impacting vegetation fires in protected and non-protected areas of Myanmar. Satellite datasets in conjunction with biophysical and anthropogenic factors were used in a spatial framework to map the causative factors of fires. Specifically, we used the frequency ratio method to assess the contribution of each causative factor to overall fire susceptibility at a 1km scale. Results suggested the mean fire density in non-protected areas was two times higher than the protected areas. Fire-land cover partition analysis suggested dominant fire occurrences in the savannas (protected areas) and woody savannas (non-protected areas). The five major fire causative factors in protected areas in descending order include population density, land cover, tree cover percent, travel time from nearest city and temperature. In contrast, the causative factors in non-protected areas were population density, tree cover percent, travel time from nearest city, temperature and elevation. The fire susceptibility analysis showed distinct spatial patterns with central Myanmar as a hot spot of vegetation fires. Results from propensity score matching suggested that forests within protected areas have 11% less fires than non-protected areas. Overall, our results identify important causative factors of fire useful to address broad scale fire risk concerns at a landscape scale in Myanmar.

Excessive homework, inadequate sleep, physical inactivity and screen viewing time are major contributors to high paediatric obesity.

Science.gov (United States)

Ren, Hong; Zhou, Zhixiong; Liu, Wenxi Kevin; Wang, Xiujiang; Yin, Zenong

2017-01-01

This study examined the relationships between energy balance-related behaviours (EBRBs) outside school hours and obesity in Chinese primary school students. We also explored the influence of gender on those relationships. The study sample was a cross-sectional cohort of 5032 Chinese children who were enrolled in grades 1-6 in primary schools in five Chinese cities and whose mean ages ranged from seven years and three months to 11.9 years. The children's parents completed a survey on their child's height, weight and EBRBs outside school hours. The response rate was 97%, and the reported rates of overweight and obesity were 13.6% and 13.8%, respectively. The obesity rates were higher in boys and lower grade children. Most EBRBs varied between boys and girls and with increased grade levels. The amount of time spent on academic-related activities, screen viewing, outdoor activities and sleep was mostly associated with obesity on weekdays and varied by gender. Rate of obesity was alarmingly high in the primary school Chinese children in this cohort, especially in younger children. Excessive time spent on academic-related activities outside school hours, inadequate sleep, physical inactivity and higher levels of screen viewing were major contributors to obesity in these Chinese children. ©2016 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

The South African Surgical Outcomes Study: A 7-day prospective ...

African Journals Online (AJOL)

Neurosurgery. 133 (3.4). 122 (3.2). 11 (8.9). 1.84 (0.88 - 3.85). 0.11. Thoracic. 65 (1.7). 64 (1.7). 1 (0.8). 0.32 (0.04 - 2.39). 0.32. Other. 513 (13.1). 489 (12.9) ...... Appendix 1. Full author list. B M Biccard, PhD, Perioperative Research Group, Discipline of. Anaesthesiology and Critical Care, School of Clinical Medicine,.

Contemporary social network sites: Relevance in anesthesiology teaching, training, and research

OpenAIRE

Rudrashish Haldar; Ashutosh Kaushal; Sukhen Samanta; Paurush Ambesh; Shashi Srivastava; Prabhat K Singh

2016-01-01

Objective: The phenomenal popularity of social networking sites has been used globally by medical professionals to boost professional associations and scientific developments. They have tremendous potential to forge professional liaisons, generate employment,upgrading skills and publicizing scientific achievements. We highlight the role of social networking mediums in influencing teaching, training and research in anaesthesiology. Background: The growth of social networking sites have been pr...

Radiation protection

International Nuclear Information System (INIS)

1989-01-01

A NRPB leaflet in the 'At-a-Glance' series explains in a simple but scientifically accurate way what radiation is, the biological effects and the relative sensitivity of different parts of the human body. The leaflet then discusses radiation protection principles, radiation protection in the UK and finally the effectiveness of this radiation protection as judged by a breakdown of the total dose received by an average person in the UK, a heavy consumer of Cumbrian seafood, an average nuclear industry worker and an average person in Cornwall. (UK)

Environmental protection

International Nuclear Information System (INIS)

Klinda, J.; Lieskovska, Z.

1998-01-01

In this chapter environmental protection in the Slovak Republic in 1997 are reviewed. The economics of environmental protection, state budget, Slovak state environmental fund, economic instruments, environmental laws, environmental impact assessment, environmental management systems, and environmental education are presented

The UK National DNA Database: Implementation of the Protection of Freedoms Act 2012.

Science.gov (United States)

Amankwaa, Aaron Opoku; McCartney, Carole

2018-03-01

In 2008, the European Court of Human Rights, in S and Marper v the United Kingdom, ruled that a retention regime that permits the indefinite retention of DNA records of both convicted and non-convicted ("innocent") individuals is disproportionate. The court noted that there was inadequate evidence to justify the retention of DNA records of the innocent. Since the Marper ruling, the laws governing the taking, use, and retention of forensic DNA in England and Wales have changed with the enactment of the Protection of Freedoms Act 2012 (PoFA). This Act, put briefly, permits the indefinite retention of DNA profiles of most convicted individuals and temporal retention for some first-time convicted minors and innocent individuals on the National DNA Database (NDNAD). The PoFA regime was implemented in October 2013. This paper examines ten post-implementation reports of the NDNAD Strategy Board (3), the NDNAD Ethics Group (3) and the Office of the Biometrics Commissioner (OBC) (4). Overall, the reports highlight a considerable improvement in the performance of the database, with a current match rate of 63.3%. Further, the new regime has strengthened the genetic privacy protection of UK citizens. The OBC reports detail implementation challenges ranging from technical, legal and procedural issues to sufficient understanding of the requirements of PoFA by police forces. Risks highlighted in these reports include the deletion of some "retainable" profiles, which could potentially lead to future crimes going undetected. A further risk is the illegal retention of some profiles from innocent individuals, which may lead to privacy issues and legal challenges. In conclusion, the PoFA regime appears to be working well, however, critical research is still needed to evaluate its overall efficacy compared to other retention regimes. Copyright © 2018 Elsevier B.V. All rights reserved.

The Location and Extent of Systematic Drainage in Relation to Land Use in the Past and at Present and in Relation to Soil Vulnerability to Accelerater Infiltration in the Protected Landscape Area Železné Hory

Directory of Open Access Journals (Sweden)

Petr Karásek

2015-01-01

Full Text Available This study searched for associations between the extent of hydromelioration systems and the land use (in the past and at present, degree of nature conservation, and infiltration of water through soil profile in the Protected Landscape Area (PLA Železné hory. According to the available evidence, 34.6% of arable land and 32.1% of permanent grasslands in this area are drained by the drainage systems. Analysis of the original design documentations of drainage structures indicate, that the extent of drained areas can actually be even higher. The hydromelioration systems were built namely in the second half of the 20th century. The drainage also affected alluvial meadows, wetlands, and ecologically valuable stations. After establishment of PLA Železné hory in 1991, the protected area was divided into four zones according to their significance and protection regime. This study has revealed the presence of areas drained by systematic drainage systems (101 ha of grasslands even in the zones of highest landscape protection degree (1st and 2nd protection zones. The inadequately executed drainage systems should be eliminated and the character of the land should be brought closer to its natural conditions. On the model part of the PLA we also performed a study of historical changes in the landscape in three time horizons (1839, 1950, 2014 to show differences in land use before building of drainage, at the time of building, and at present.

Biomarkers of safety and immune protection for genetically modified live attenuated leishmania vaccines against visceral leishmaniasis - discovery and implications.

Science.gov (United States)

Gannavaram, Sreenivas; Dey, Ranadhir; Avishek, Kumar; Selvapandiyan, Angamuthu; Salotra, Poonam; Nakhasi, Hira L

2014-01-01

Despite intense efforts there is no safe and efficacious vaccine against visceral leishmaniasis, which is fatal and endemic in many tropical countries. A major shortcoming in the vaccine development against blood-borne parasitic agents such as Leishmania is the inadequate predictive power of the early immune responses mounted in the host against the experimental vaccines. Often immune correlates derived from in-bred animal models do not yield immune markers of protection that can be readily extrapolated to humans. The limited efficacy of vaccines based on DNA, subunit, heat killed parasites has led to the realization that acquisition of durable immunity against the protozoan parasites requires a controlled infection with a live attenuated organism. Recent success of irradiated malaria parasites as a vaccine candidate further strengthens this approach to vaccination. We developed several gene deletion mutants in Leishmania donovani as potential live attenuated vaccines and reported extensively on the immunogenicity of LdCentrin1 deleted mutant in mice, hamsters, and dogs. Additional limited studies using genetically modified live attenuated Leishmania parasites as vaccine candidates have been reported. However, for the live attenuated parasite vaccines, the primary barrier against widespread use remains the absence of clear biomarkers associated with protection and safety. Recent studies in evaluation of vaccines, e.g., influenza and yellow fever vaccines, using systems biology tools demonstrated the power of such strategies in understanding the immunological mechanisms that underpin a protective phenotype. Applying similar tools in isolated human tissues such as PBMCs from healthy individuals infected with live attenuated parasites such as LdCen(-/-) in vitro followed by human microarray hybridization experiments will enable us to understand how early vaccine-induced gene expression profiles and the associated immune responses are coordinately regulated in normal

Complete rerouting protection

DEFF Research Database (Denmark)

Stidsen, Thomas K.; Kjærulff, Peter

2006-01-01

Protection of communication against network failures is becoming increasingly important and in this paper we present the most capacity efficient protection method possible, the complete rerouting protection method, when requiring that all communication should be restored in case of a single link...... network failure. We present a linear programming model of the protection method and a column generation algorithm. For 6 real world networks, the minimal restoration overbuild network capacity is between 13% and 78%. We further study the importance of the density of the network, derive analytical bounds...

Innovative protection cookbook

International Nuclear Information System (INIS)

Lambert, D.L.

2002-01-01

Full text: A large portion of the international community relies on expert judgment and military expertise to form the protection strategy of weapons-grade nuclear materials. This approach can be less than effectual for two primary reasons. First, much of the nuclear material that needs the most protection is not in a static form and located in easily secured storage locations. Some of the most effective measures for protection of in-process material are administrative and procedural in nature. There are basic protection differences between countries just like there are differences in baking bread. However, the necessary steps to produce bread are basically the same around the world. Certain ingredients are required to give it flavor, make it rise, and have a certain texture. So it is in the development of protection systems. A measure of intrusion detection, some access controls and searches, a pinch of computerized accounting, a layer of delay barriers, and a smidgen of armed response--and the basis for a 'cookbook' is born. Any and all protection systems can begin with simple elements that can be just as effective as the most sophisticated modern components. This paper will describe some of those simple, but effective, innovative protection measures. (author)

Radiation protection seminar

International Nuclear Information System (INIS)

2012-01-01

The Radiation Protection Seminar, was organized by the Argentina Association of Biology and Nuclear Medicine, and Bacon Laboratory, the 20 june 2012, in the Buenos Aires city of Argentina. In this event were presented some papers on the following topics: methods of decontamination, radiation protection of patients; concepts of radiation protection and dosimetry.

Resilience from coastal protection.

Science.gov (United States)

Ewing, Lesley C

2015-10-28

Coastal areas are important residential, commercial and industrial areas; but coastal hazards can pose significant threats to these areas. Shoreline/coastal protection elements, both built structures such as breakwaters, seawalls and revetments, as well as natural features such as beaches, reefs and wetlands, are regular features of a coastal community and are important for community safety and development. These protection structures provide a range of resilience to coastal communities. During and after disasters, they help to minimize damages and support recovery; during non-disaster times, the values from shoreline elements shift from the narrow focus on protection. Most coastal communities have limited land and resources and few can dedicate scarce resources solely for protection. Values from shore protection can and should expand to include environmental, economic and social/cultural values. This paper discusses the key aspects of shoreline protection that influence effective community resilience and protection from disasters. This paper also presents ways that the economic, environmental and social/cultural values of shore protection can be evaluated and quantified. It presents the Coastal Community Hazard Protection Resilience (CCHPR) Index for evaluating the resilience capacity to coastal communities from various protection schemes and demonstrates the use of this Index for an urban beach in San Francisco, CA, USA. © 2015 The Author(s).

What Otaku consumers care about: The factors influential to online purchase intention

Science.gov (United States)

Chang, Che-Chang

2013-10-01

Chinese customers and those in the rest of world share the same two principal concerns about e-commerce: inadequate information from website and inadequate legal protection for Internet purchases. This study shows that trust, information adequacy and Otakus' characteristics have a significant effect on online purchase intention. Moreover, Otakus' characteristics demonstrate an interference effect on purchasing intention online for the influential factors: information provision and trust in the website.

Experimental study of the Rapsodie protections; Etude experimentale des protections de rapsodie

Energy Technology Data Exchange (ETDEWEB)

Chapelet, M; Edeline, J; Lhiaubet, G [Commissariat a l' Energie Atomique, Fontenay-aux-Roses (France). Centre d' Etudes Nucleaires

1968-07-01

This report gives details of the protection tests which have been carried out by the Protection Sub-Commission during the starting-up trials on the reactor Rapsodie. The main types of tests reported concern the flux measurements in the core, the reflectors, the sodium and the near biological protections, the radio-protection measurements in the premises, and the activation of the principal fluids. In the last part, the results obtained are analyzed and compared to the forecast calculations. (author) [French] Ce rapport rend compte des essais de protection qui ont ete effectues dans le cadre des essais de demarrage de RAPSODIE par la Sous Commission Protection. Les principaux types d'essais rapportes sont les mesures de flux dans le coeur, les reflecteurs, le sodium et les protections biologiques proches, les mesures de radioprotection dans les locaux, et l'activation des principaux fluides. Dans la derniere partie, les resultats obtenus sont analyses et compares aux calculs previsionnels. (auteur)

Protective interest rate as tax instrument of corporate capital protection

Directory of Open Access Journals (Sweden)

Vukašinović Jovan

2015-01-01

Full Text Available This paper deals with researching negative consequences of allocation of economic (virtual gains made as a result of conventional accounting concept by facing current income with historical expenses and necessity to promote additional stimulating instruments that are at disposal by the state in order to eliminate these negative consequences. one of them is certainly protective interest as a relatively new active fiscal instrument of capital protection and recognition of price of invested owner's equity in business ventures, i.e. a specific form of compensation by the state for invested capital bearing in mind, that no source is free, including ones own sources. We also showed mechanisms of protective interest which, together with other measures of macroeconomic policy, should contribute to the protection of real purchasing power of company equity and increase of net gain, left on company's disposal for new investments, new work places, more money in the budget, protection of actual assets against taxing in the conditions of inflation, etc.

Radiation. Protection. Health. Proceedings

International Nuclear Information System (INIS)

Hajek, Michael; Maringer, Franz Josef; Steurer, Andreas; Schwaiger, Martina; Timal, Guenter

2015-01-01

The topics of the meeting are the diagnostic and therapeutic application of ionizing radiations, the application of radiation in research, industry and engineering and radiation protection. The volume includes the following chapters: Radiation protection and society, radiation protection infrastructure, population and environment, metrology and measuring techniques, 1. Workshop on population and environment, NORM and radon, 2. Update: dose - extent of damage - limiting value definition, radiation protection for personnel (except medicine), radiation protection in medicine.

Protection from visible light by commonly used textiles is not predicted by ultraviolet protection.

Science.gov (United States)

Van den Keybus, Caroline; Laperre, Jan; Roelandts, Rik

2006-01-01

Interest is increasing in the prevention of acute and chronic actinic damage provided by clothing. This interest has focused mainly on protection against ultraviolet irradiation, but it has now also turned to protection against visible light. This change is mainly due to the action spectrum in the visible light range of some photodermatoses and the increasing interest in photodynamic therapy. The ultraviolet protection provided by commercially available textiles can be graded by determining an ultraviolet protection factor. Several methods have already been used to determine the ultraviolet protection factor. The fact that protection from visible light by textiles cannot be predicted by their ultraviolet protection makes the situation more complicated. This study attempts to determine whether or not the ultraviolet protection factor value of a particular textile is a good parameter for gauging its protection in the visible light range and concludes that a protection factor of textile materials against visible light needs to be developed. This development should go beyond the protection factor definition used in this article, which has some limitations, and should take into account the exact action spectrum for which the protection is needed.

Ingestão inadequada de nutrientes na população de idosos do Brasil: Inquérito Nacional de Alimentação 2008-2009 Ingestión inadecuada de nutrientes en la población de ancianos de Brasil: pesquisa nacional de alimentación 2008-2009 Inadequate nutrient intake among the Brazilian elderly: National Dietary Survey 2008-2009

Directory of Open Access Journals (Sweden)

Rosângela Alves Pereira

2013-02-01

the highest prevalence of inadequate intake (> 80% in all regions. CONCLUSIONS: The present study found a high prevalence of inadequate intake of nutrients recognized as being protective against chronic diseases among the Brazilian elderly.

Inadequate Brain Glycogen or Sleep Increases Spreading Depression Susceptibility

KAUST Repository

Kilic, Kivilcim; Karatas, Hulya; Donmez-Demir, Buket; Eren-Kocak, Emine; Gursoy-Ozdemir, Yasemin; Can, Alp; Petit, Jean-Marie; Magistretti, Pierre J.; Dalkara, Turgay

2017-01-01

Glycogen in astrocyte endfeet contributes to maintenance of low extracellular glutamate and K+ concentrations around synapses. Sleep deprivation (SD), a common migraine trigger induces transcriptional changes in astrocytes reducing glycogen breakdown. We hypothesize that when glycogen utilization cannot match synaptic energy demand, extracellular K+ can rise to levels that activate neuronal pannexin-1 channels and downstream inflammatory pathway, which might be one of the mechanisms initiating migraine headaches.We suppressed glycogen breakdown by inhibiting glycogen phosphorylation with 1,4-dideoxy-1,4-imino-D-arabinitol (DAB) and by SD.DAB caused neuronal pannexin-1 large-pore opening and activation of the downstream inflammatory pathway as shown by procaspase-1 cleavage and HMGB1 release from neurons. Six-hour SD induced pannexin-1 mRNA. DAB and SD also lowered the cortical spreading depression (CSD) induction threshold, which was reversed by glucose or lactate supplement, suggesting that glycogen-derived energy substrates are needed to prevent CSD generation. Supporting this, knocking-down neuronal lactate transporter, MCT2 with an anti-sense oligonucleotide or inhibiting glucose transport from vessels to astrocytes with intracerebroventricularly given phloretin reduced the CSD threshold. In vivo recordings with a K+ -sensitive/selective fluoroprobe, APG-4 disclosed that DAB treatment or SD caused significant rise in extracellular K+ during whisker-stimulation, illustrating the critical role of glycogen in extracellular K+ clearance.Synaptic metabolic stress caused by insufficient glycogen-derived energy substrate supply can activate neuronal pannexin-1 channels as well as lowering the CSD threshold. Therefore, conditions that limit energy supply to synapse (e.g. SD) may predispose to migraine attacks as suggested by genetic studies associating glucose or lactate transporter deficiency with migraine. This article is protected by copyright. All rights reserved.

Inadequate Brain Glycogen or Sleep Increases Spreading Depression Susceptibility

KAUST Repository

Kilic, Kivilcim

2017-12-16

Glycogen in astrocyte endfeet contributes to maintenance of low extracellular glutamate and K+ concentrations around synapses. Sleep deprivation (SD), a common migraine trigger induces transcriptional changes in astrocytes reducing glycogen breakdown. We hypothesize that when glycogen utilization cannot match synaptic energy demand, extracellular K+ can rise to levels that activate neuronal pannexin-1 channels and downstream inflammatory pathway, which might be one of the mechanisms initiating migraine headaches.We suppressed glycogen breakdown by inhibiting glycogen phosphorylation with 1,4-dideoxy-1,4-imino-D-arabinitol (DAB) and by SD.DAB caused neuronal pannexin-1 large-pore opening and activation of the downstream inflammatory pathway as shown by procaspase-1 cleavage and HMGB1 release from neurons. Six-hour SD induced pannexin-1 mRNA. DAB and SD also lowered the cortical spreading depression (CSD) induction threshold, which was reversed by glucose or lactate supplement, suggesting that glycogen-derived energy substrates are needed to prevent CSD generation. Supporting this, knocking-down neuronal lactate transporter, MCT2 with an anti-sense oligonucleotide or inhibiting glucose transport from vessels to astrocytes with intracerebroventricularly given phloretin reduced the CSD threshold. In vivo recordings with a K+ -sensitive/selective fluoroprobe, APG-4 disclosed that DAB treatment or SD caused significant rise in extracellular K+ during whisker-stimulation, illustrating the critical role of glycogen in extracellular K+ clearance.Synaptic metabolic stress caused by insufficient glycogen-derived energy substrate supply can activate neuronal pannexin-1 channels as well as lowering the CSD threshold. Therefore, conditions that limit energy supply to synapse (e.g. SD) may predispose to migraine attacks as suggested by genetic studies associating glucose or lactate transporter deficiency with migraine. This article is protected by copyright. All rights reserved.

Radiation protection law

International Nuclear Information System (INIS)

Hebert, J.

1981-01-01

This article first reviews the general radiation protection law at international and national level, with particular reference to the recommendations of the International Commission on Radiological Protection (ICRP) which, although not mandatory, are nevertheless taken into consideration by international organisations establishing basic radiation protection standards such as the UN, IAEA, NEA and Euratom, at Community level, and by national legislation. These standards are therefore remarkably harmonized. Radiation protection rule applied in France for the different activities and uses of radioactive substances are then described, and finally, a description is given of the regulations governing artificial radioisotopes and radioactive effluents. (NEA) [fr

Sun protection

Science.gov (United States)

... sun exposure. The start of summer is when UV rays can cause the most skin damage. Use sun protection, even on cloudy days. Clouds and haze don't protect you from the sun. Avoid surfaces that reflect light, such as water, sand, concrete, snow, and areas ...

Iron assessment to protect the developing brain.

Science.gov (United States)

Georgieff, Michael K

2017-12-01

Iron deficiency (ID) before the age of 3 y can lead to long-term neurological deficits despite prompt diagnosis of ID anemia (IDA) by screening of hemoglobin concentrations followed by iron treatment. Furthermore, pre- or nonanemic ID alters neurobehavioral function and is 3 times more common than IDA in toddlers. Given the global prevalence of ID and the enormous societal cost of developmental disabilities across the life span, better methods are needed to detect the risk of inadequate concentrations of iron for brain development (i.e., brain tissue ID) before dysfunction occurs and to monitor its amelioration after diagnosis and treatment. The current screening and treatment strategy for IDA fails to achieve this goal for 3 reasons. First, anemia is the final state in iron depletion. Thus, the developing brain is already iron deficient when IDA is diagnosed owing to the prioritization of available iron to red blood cells over all other tissues during negative iron balance in development. Second, brain ID, independently of IDA, is responsible for long-term neurological deficits. Thus, starting iron treatment after the onset of IDA is less effective than prevention. Multiple studies in humans and animal models show that post hoc treatment strategies do not reliably prevent ID-induced neurological deficits. Third, most currently used indexes of ID are population statistical cutoffs for either hematologic or iron status but are not bioindicators of brain ID and brain dysfunction in children. Furthermore, their relation to brain iron status is not known. To protect the developing brain, there is a need to generate serum measures that index brain dysfunction in the preanemic stage of ID, assess the ability of standard iron indicators to detect ID-induced brain dysfunction, and evaluate the efficacy of early iron treatment in preventing ID-induced brain dysfunction. © 2017 American Society for Nutrition.

Protecting nuclear material and facilities: Is a new approach needed?

International Nuclear Information System (INIS)

Steinhausler, F.; Bunn, G.

2002-01-01

Full text: The main reason why national physical protection (PP) systems for nuclear and other radioactive material need to be strengthened further is that, after the attacks on the US on 11 September 2001, the threat of dangerous, suicidal radiological and nuclear terrorism can no longer be excluded as a possibility. Existing PP systems were not designed to deal with the threat of suicidal terrorists having the numbers, skills, training, and resources available to the commandos attacking on 11 September. Moreover, there are no mandatory international standards for domestic PP systems for nuclear or radioactive material, and this has produced great variation in protection provided from country to country. IAEA recommended standards, while useful, were not designed with the new terrorist threat in mind. Moreover, they are often not followed in practice. The result is inadequate protection against the new form of terrorism in most countries. The Director General of the IAEA expressed a similar view after 11 September, but achieving a consensus to amend the Convention on the Physical Protection of Nuclear Material (CPPNM) to require specific standards of protection for different amounts and kinds of nuclear material used or stored domestically (not in international transport) has been impossible in the year since 11 September. In the case of radiological materials, a new effort to provide required international standards for protection against the new form of terrorism has not begun. In the summer of 2001, leaders of the G-8 countries agreed to a Global Partnership to prevent the new terrorists from acquiring nuclear and radiological as well as other materials related to weapons of mass destruction. Perhaps in part because of the failure to date to achieve agreement on an effective amendment to the CPPNM, the first principle of this partnership is to strengthen 'multilateral treaties and other instruments whose aim is to prevent the proliferation or illicit

45 CFR 164.522 - Rights to request privacy protection for protected health information.

Science.gov (United States)

2010-10-01

... ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS SECURITY AND PRIVACY Privacy of Individually Identifiable Health Information § 164.522 Rights to request privacy protection for protected health information. (a)(1... 45 Public Welfare 1 2010-10-01 2010-10-01 false Rights to request privacy protection for protected...

What should I tell my patient? Disclosure in anaesthesiology ...

African Journals Online (AJOL)

information that is highly technical and difficult to understand, ... sense thereof by relating new information to their unique frames of .... e.g. when discussing repairs to a motor car or appliance. ..... read-the-journal/all-issues/2010-2019/2015/.

Radiation protection

International Nuclear Information System (INIS)

Jain, Aman; Sharma, Shivam; Parasher, Abhishek

2014-01-01

Radiation dose measurement, field of radiobiology, is considered to be critical factor for optimizing radiation protection to the health care practitioners, patients and the public. This lead to equipment that has dose - area product meters permanently installed. In many countries and even institution, the range of equipment is vast and with the opportunity for radiation protection and dose recording varies considerably. Practitioners must move with the changed demands of radiation protection but in many cases without assistance of modern advancements in technology Keeping the three basic safety measures Time, Dose and Shielding we can say 'Optimum dose is safe dose' instead of 'No dose is safe dose'. The purpose enclosed within the title 'Radiation Protection'. The use of radiation is expanding widely everyday around the world and crossing boundaries of medical imaging, diagnostic and. The way to get the ''As low as reasonably achievable' is only achievable by using methodology of radiation protection and to bring the concern of general public and practitioners over the hazards of un-necessary radiation dose. Three basic principles of radiation protection are time, distance and shielding. By minimizing the exposure time increasing the distance and including the shielding we can reduce the optimum range of dose. The ability of shielding material to attenuate radiation is generally given as half value layer. This is the thickness of the material which will reduce the amount of radiation by 50%. Lab coat and gloves must be worn when handling radioactive material or when working in a labeled radiation work area. Safety glasses or other appropriate splash shields should be used when handling radioactive material. 1. Reached to low dose level to occupational workers, public as per prescribed dose limit. 2. By mean of ALARA principle we achieved the protection from radiation besides us using the radiation for our benefit

Biomarkers of safety and immune protection for genetically modified live attenuated Leishmania vaccines against visceral leishmaniasis-Discovery and implications

Directory of Open Access Journals (Sweden)

Sreenivas eGannavaram

2014-05-01

Full Text Available Despite intense efforts there is no safe and efficacious vaccine against visceral leishmaniasis, which is fatal and endemic in many tropical countries. A major shortcoming in the vaccine development against blood borne parasitic agents such as Leishmania is the inadequate predictive power of the early immune responses mounted in the host against the experimental vaccines. Often immune correlates derived from in-bred animal models do not yield immune markers of protection that can be readily extrapolated to humans. The limited efficacy of vaccines based on DNA, sub-unit, heat killed parasites has led to the realization that acquisition of durable immunity against the protozoan parasites requires a controlled infection with a live attenuated organism. Recent success of irradiated malaria parasites as a vaccine candidate further strengthens this approach to vaccination. We developed several gene deletion mutants in L. donovani as potential live attenuated vaccines and reported extensively on the immunogenicity of LdCentrin1 deleted mutant in mice, hamsters and dogs. Additional limited studies using genetically modified live attenuated Leishmania parasites as vaccine candidates have been reported. However, for the live attenuated parasite vaccines, the primary barrier against widespread use remains the absence of clear biomarkers associated with protection and safety. Recent studies in evaluation of vaccines e.g., influenza and yellow fever vaccines, using systems biology tools demonstrated the power of such strategies in understanding the immunological mechanisms that underpin a protective phenotype. Applying similar tools in isolated human tissues such as PBMCs from healthy individuals infected with live attenuated parasites such as LdCen1-/- in vitro followed by human microarray hybridization experiments will enable us to understand how early vaccine-induced gene expression profiles and the associated immune responses are coordinately regulated

Buffer moisture protection system

International Nuclear Information System (INIS)

Ritola, J.; Peura, J.

2013-11-01

With the present knowledge, bentonite blocks have to be protected from the air relative humidity and from any moisture leakages in the environment that might cause swelling of the bentonite blocks during the 'open' installation phase before backfilling. The purpose of this work was to design the structural reference solution both for the bottom of the deposition hole and for the buffer moisture protection and dewatering system with their integrated equipment needed in the deposition hole. This report describes the Posiva's reference solution for the buffer moisture protection system and the bottom plate on basis of the demands and functional requirements set by long-term safety. The reference solution with structural details has been developed in research work made 2010-2011. The structural solution of the moisture protection system has not yet been tested in practice. On the bottom of the deposition hole a copper plate which protects the lowest bentonite block from the gathered water is installed straight to machined and even rock surface. The moisture protection sheet made of EPDM rubber is attached to the copper plate with an inflatable seal. The upper part of the moisture protection sheet is fixed to the collar structures of the lid which protects the deposition hole in the disposal tunnel. The main function of the moisture protection sheet is to protect bentonite blocks from the leaking water and from the influence of the air humidity at their installation stage. The leaking water is controlled by the dewatering and alarm system which has been integrated into the moisture protection liner. (orig.)

The psychology of chronic post-surgical pain: new frontiers in risk factor identification, prevention and management.

Science.gov (United States)

Weinrib, Aliza Z; Azam, Muhammad A; Birnie, Kathryn A; Burns, Lindsay C; Clarke, Hance; Katz, Joel

2017-11-01

In an era of considerable advances in anaesthesiology and pain medicine, chronic pain after major surgery continues to be problematic. This article briefly reviews the known psychological risk and protective factors associated with the development of chronic postsurgical pain (CPSP). We begin with a definition of CPSP and then explain what we mean by a risk/protective factor. Next, we summarize known psychological risk and protective factors for CPSP. Psychological interventions that target risk factors and may impact postsurgical pain are reviewed, including the acceptance and commitment therapy (ACT)-based approach to CPSP prevention and management we use in the Transitional Pain Service (TPS) at the Toronto General Hospital. Finally, we conclude with recommendations for research in risk factor identification and psychological interventions to prevent CPSP. Several pre-surgical psychological risk factors for CPSP have been consistently identified in recent years. These include negative affective constructs, such as anxiety symptoms, depressive symptoms, pain catastrophizing and general psychological distress. In contrast, relatively few studies have examined psychological protective factors for CPSP. Psychological interventions that target known psychological risk factors while enhancing protective psychological factors may reduce new incidence of CPSP. The primary goal of our ACT intervention is to teach patients a mindful way of responding to their postsurgical pain that empowers them to interrupt the negative cycle of pain, distress, behavioural avoidance and escalating opioid use that can limit functioning and quality of life while paradoxically amplifying pain over time. Early clinical outcome data suggest that patients who receive care from TPS physicians reduce their pain and opioid use, yet patients who also receive our ACT intervention have a larger decrease in daily opioid dose while reporting less pain interference and lower depression scores.

Study of a new X-ray protective apron with composite protective sheet

International Nuclear Information System (INIS)

Kanzaki, Ryuji; Ohtsuka, Akiyoshi; Okayama, Akio

1997-01-01

Lead powder and oxygenated lead are widely used as materials in conventional protective aprons. However, the use of lead alone limits weight reduction in an apron. Because the amount of lead can not be decreased without reducing X-ray absorption rate. In this study, we report the efficiency of a new X-ray protective apron with a composite protective sheet. The X-ray absorption rate of the composite sheet was 4.5 percent less than that of the lead sheet. However, the effective protective efficiency of the composite sheet was the same as that of the lead sheet. The uniformity of the new X-ray protective apron was good, and the differences among products were small. The new X-ray protective apron was about 30 percent lighter than a lead apron with a 0.25 mm lead equivalent. The new lighter aprons are more comfortable for the radiology staff. Therefore, the use of a composite protective apron provides the advantages of weight reduction and increased comfort without reducing X-ray absorption rate. (author)

Training in radiation protection

International Nuclear Information System (INIS)

Schreiber, F.

1998-01-01

Persons who are exposed to ionizing radiation at their workplace have to be trained in radiation protection. According to the Radiation Protection Ordinance the person with responsibility in radiation protection has to guarantee that the training is performed twice a year. Our training material was created especially for the persons defined in the Radiation Protection Ordinance and the X-ray Ordinance. It enables persons who teach (generally the radiation protection officer) to perform the training without tedious study and preparation of the documents. Our material is not just another textbook for radiation protection but rather a folder with colour transparencies and explanatory texts which make a difference in volume and price in comparison to other existing materials. (orig.) [de

Nature and landscape protection

International Nuclear Information System (INIS)

Klinda, J.; Lieskovska, Z.

1998-01-01

In accordance with National Council of the Slovak Republic Act N. 287/1994 Coll. on Nature and Landscape Protection, the system of complex nature landscape protection has been designed based on five levels of protection. Categories of protected areas as well as cultural monuments in the Slovak Republic are reviewed.Slovak contribution to the world heritage is included

DOE groundwater protection strategy

International Nuclear Information System (INIS)

Lichtman, S.

1988-01-01

EH is developing a DOE-wide Groundwater Quality Protection Strategy to express DOE's commitment to the protection of groundwater quality at or near its facilities. This strategy responds to a September 1986 recommendation of the General Accounting Office. It builds on EPA's August 1984 Ground-Water Protection Strategy, which establishes a classification system designed to protect groundwater according to its value and vulnerability. The purposes of DOE's strategy are to highlight groundwater protection as part of current DOE programs and future Departmental planning, to guide DOE managers in developing site-specific groundwater protection practices where DOE has discretion, and to guide DOE's approach to negotiations with EPA/states where regulatory processes apply to groundwater protection at Departmental facilities. The strategy calls for the prevention of groundwater contamination and the cleanup of groundwater commensurate with its usefulness. It would require long-term groundwater protection with reliance on physical rather than institutional control methods. The strategy provides guidance on providing long-term protection of groundwater resources; standards for new remedial actions;guidance on establishing points of compliance; requirements for establishing classification review area; and general guidance on obtaining variances, where applicable, from regulatory requirements. It also outlines management tools to implement this strategy

Theory of vibration protection

CERN Document Server

Karnovsky, Igor A

2016-01-01

This text is an advancement of the theory of vibration protection of mechanical systems with lumped and distributed parameters. The book offers various concepts and methods of solving vibration protection problems, discusses the advantages and disadvantages of different methods, and the fields of their effective applications. Fundamental approaches of vibration protection, which are considered in this book, are the passive, parametric and optimal active vibration protection. The passive vibration protection is based on vibration isolation, vibration damping and dynamic absorbers. Parametric vibration protection theory is based on the Shchipanov-Luzin invariance principle. Optimal active vibration protection theory is based on the Pontryagin principle and the Krein moment method. The book also contains special topics such as suppression of vibrations at the source of their occurrence and the harmful influence of vibrations on humans. Numerous examples, which illustrate the theoretical ideas of each chapter, ar...

Efficacy and safety of teneligliptin in Indian patients with inadequately controlled Type 2 diabetes mellitus: A randomized, double-blind study

Directory of Open Access Journals (Sweden)

Piyush Agarwal

2018-01-01

Full Text Available Aims: This study evaluated the efficacy and safety of teneligliptin in patients with inadequately controlled type 2 diabetes mellitus (T2DM. Settings and Design: This was a randomized, doubleblind, placebocontrolled, parallelgroup, multicenter, Phase III study. Subjects and Methods: Patients with T2DM and inadequate glycemic control (glycosylated hemoglobin [HbA1c]: >7.0-≤8.5% were enrolled. Patients were randomly assigned (ratio: 2:1 to receive teneligliptin 20 mg (Glenmark or placebo. The primary efficacy variable was change from baseline in HbA1c at week 16. Additional analyses included the proportion of patients who achieved target of HbA1c ≤7.0%, changes in fasting plasma glucose (FPG, and postprandial glucose (PPG. Statistical Analysis: Mean change in HbA1c was analyzed using an analysis of covariance model, least square (LS means, 95% confidence intervals (CIs, and P values were calculated. Results: Overall, 237 patients were included. Patients of the teneligliptin group showed reduced HbA1c levels (LS mean difference = −0.304% for intent-to-treat [ITT]; −0.291% for per-protocol (PP populations after 16 weeks of treatment, and a statistically significant difference was observed between the ITT (LS mean difference = 0.555; 95% CI: 0.176–0.934; P = 0.0043 and PP populations (LS mean difference = 0.642; 95% CI: 0.233–1.052; P = 0.0023. Target HbA1c level was achieved by a greater proportion of teneligliptin group patients (ITT, 43.4%; PP, 43.6% than placebo group patients (ITT, 27.3%; PP, 26.6%. Reduction in FPG levels was observed in ITT (LS mean difference: 8.829; 95% CI: −4.357–22.016; P = 0.1883 and PP populations (LS mean difference: 11.710 mg/dL; 95% CI: −2.893-26.312; P = 0.1154. Reduction in PPG levels was higher in teneligliptin group than placebo group in both ITT (LS mean difference = 25.849 mg/dL; 95% CI: 7.143–44.556; P = 0.0070 and PP populations (LS mean difference = 25.683 mg/dL; 95% CI: 5.830–45.536; P

Estimated exposure of hands inside the protective gloves used by non-occupational handlers of agricultural pesticides.

Science.gov (United States)

Beránková, Martina; Hojerová, Jarmila; Peráčková, Zuzana

2017-11-01

Exposure of handlers'/operators' hands is a main route of agricultural pesticides entry into their body. Non-occupational handlers still lack information about appropriate selection of protective gloves to minimize exposure and reduce adverse effects of these chemicals. According to the results of our previous survey, six commercially available, water-resistant gloves commonly used by non-professional gardeners were evaluated for permeation of Acetamiprid, Pirimicarb, and Chlorpyrifos-methyl (Chlorp-m) pesticides by means of in vitro testing. In-use conditions were mimicked as close as possible. Chlorp-m through latex was observed inside the glove from >10 to ⩽15 min; however, Acetamiprid and Pirimicarb through neoprene/latex and all the three pesticides through butyl were not observed inside gloves for the duration of the experiments (the Breakthrough time (BT)>8 h). The 1-h exposure proved the interior glove contamination with Chlorp-m through disposable latex, vinyl, and nitrile gloves (51, 33, and 41% of applied dose (AD), respectively) just as with Acetamiprid and Pirimicarb through latex glove (11 and 14%AD, respectively). However, when storing the used gloves for 4 days after the exposure, no release of the three pesticides from the butyl and Acetamiprid from neoprene/latex gloves was detected. In all other cases, pesticides were found in the interior glove (36-79, 31-63, and 51-81%AD for Acetamiprid, Pirimicarb, and Chlorp-m, respectively). If used repeatedly, gloves contaminated in this way lose their protective function but give the user a false sense of security. The results suggest that (i) water-resistant gloves are not necessarily pesticide resistant; (ii) disposable latex gloves commonly worn by non-professional gardeners provide inadequate protection even for a short-time contact with pesticides; (iii) to assess the efficiency of reusable gloves, not only BT value but also the reservoir/release effect of parent pesticide and its degradation

Biomarkers of Safety and Immune Protection for Genetically Modified Live Attenuated Leishmania Vaccines Against Visceral Leishmaniasis – Discovery and Implications

Science.gov (United States)

Gannavaram, Sreenivas; Dey, Ranadhir; Avishek, Kumar; Selvapandiyan, Angamuthu; Salotra, Poonam; Nakhasi, Hira L.

2014-01-01

Despite intense efforts there is no safe and efficacious vaccine against visceral leishmaniasis, which is fatal and endemic in many tropical countries. A major shortcoming in the vaccine development against blood-borne parasitic agents such as Leishmania is the inadequate predictive power of the early immune responses mounted in the host against the experimental vaccines. Often immune correlates derived from in-bred animal models do not yield immune markers of protection that can be readily extrapolated to humans. The limited efficacy of vaccines based on DNA, subunit, heat killed parasites has led to the realization that acquisition of durable immunity against the protozoan parasites requires a controlled infection with a live attenuated organism. Recent success of irradiated malaria parasites as a vaccine candidate further strengthens this approach to vaccination. We developed several gene deletion mutants in Leishmania donovani as potential live attenuated vaccines and reported extensively on the immunogenicity of LdCentrin1 deleted mutant in mice, hamsters, and dogs. Additional limited studies using genetically modified live attenuated Leishmania parasites as vaccine candidates have been reported. However, for the live attenuated parasite vaccines, the primary barrier against widespread use remains the absence of clear biomarkers associated with protection and safety. Recent studies in evaluation of vaccines, e.g., influenza and yellow fever vaccines, using systems biology tools demonstrated the power of such strategies in understanding the immunological mechanisms that underpin a protective phenotype. Applying similar tools in isolated human tissues such as PBMCs from healthy individuals infected with live attenuated parasites such as LdCen−/− in vitro followed by human microarray hybridization experiments will enable us to understand how early vaccine-induced gene expression profiles and the associated immune responses are coordinately regulated in normal

Fire Protection Program Manual

Energy Technology Data Exchange (ETDEWEB)

Sharry, J A

2012-05-18

This manual documents the Lawrence Livermore National Laboratory (LLNL) Fire Protection Program. Department of Energy (DOE) Orders 420.1B, Facility Safety, requires LLNL to have a comprehensive and effective fire protection program that protects LLNL personnel and property, the public and the environment. The manual provides LLNL and its facilities with general information and guidance for meeting DOE 420.1B requirements. The recommended readers for this manual are: fire protection officers, fire protection engineers, fire fighters, facility managers, directorage assurance managers, facility coordinators, and ES and H team members.

Protecting genetic privacy.

Science.gov (United States)

Roche, P A; Annas, G J

2001-05-01

This article outlines the arguments for and against new rules to protect genetic privacy. We explain why genetic information is different to other sensitive medical information, why researchers and biotechnology companies have opposed new rules to protect genetic privacy (and favour anti-discrimination laws instead), and discuss what can be done to protect privacy in relation to genetic-sequence information and to DNA samples themselves.

Clinical evaluation of a water-in-oil emulsion with protective and regenerative properties for the anogenital area

Directory of Open Access Journals (Sweden)

Küppers V

2015-11-01

Full Text Available Volkmar Küppers,1 Michael Kemper,2 Christoph Abels2 1Gynecological Practice, Dysplasia-Clinic, Düsseldorf, Germany; 2Dr August Wolff GmbH & Co KG Arzneimittel, Bielefeld, Germany Abstract: Inadequate hygiene, aggressive cleansing, and chafing skin folds, as well as urine, feces, and sweat may trigger irritative contact dermatitis in the anogenital area. Serious recommendations for protection of the skin toward irritants include hygienic aspects and the use of appropriate skin care. Furthermore, preventing an accumulation of irritants on unprotected skin is mandatory. An intraindividual comparison study with 30 participants (17 female, 13 male; age: 44.2±8.3 years was performed to evaluate the properties of a newly developed water-in-oil (W/O balm on artificial sodium dodecyl sulfate-damaged epidermal barrier. The balm was applied 14 days twice daily, and transepidermal water loss and erythema were investigated. A significant improvement of both parameters after 12 days and even after 21 days could be confirmed. Two major clinical trials were performed to evaluate the safety and efficacy regarding protective and regenerative properties of the W/O balm on irritated skin in the anogenital area. Therefore, 29 children were enrolled (14 male, 15 female, age: 15.5±7.8 months in an open-labeled 4-week clinical study. The balm was used in the area under disposable diapers at least after diaper change or if required. Furthermore, in a second open, multicenter study, 43 women (mean age: 46.2±16.9 with predisposition to skin irritation in the outer anogenital region were included. The product was applied for 4 weeks 1–2 times daily. In both studies, skin tolerability, applicability, scent, spreadability, and removability of the balm were evaluated by participants and practitioners predominantly as good or even very good, also skin hydration, protection, and regeneration were judged positively. The studies confirmed that the newly developed W/O balm

Environmental protection economically viable

International Nuclear Information System (INIS)

Dartsch, B.; Hildebrandt, T.

1994-01-01

The Environmental Technology Forum for Industry and Research (Utech) was held for the fifth time this year at the International Congress Centre in Berlin. The main themes of this year's Utech were additive environmental protection, production-integrated environmental protection, management and economic aspects of environmental protection, research and development in environmental protection as well as environmental information legislation. (orig.) [de

Challenges of implementing national guidelines for the control and prevention of methicillin-resistant Staphylococcus aureus colonization or infection in acute care hospitals in the Republic of Ireland.

LENUS (Irish Health Repository)

Fitzpatrick, Fidelma

2009-03-01

Of the 49 acute care hospitals in Ireland that responded to the survey questionnaire drafted by the Infection Control Subcommittee of the Health Protection Surveillance Centre\\'s Strategy for the Control of Antimicrobial Resistance in Ireland, 43 reported barriers to the full implementation of national guidelines for the control and prevention of methicillin-resistant Staphylococcus aureus infection; these barriers included poor infrastructure (42 hospitals), inadequate laboratory resources (40 hospitals), inadequate staffing (39 hospitals), and inadequate numbers of isolation rooms and beds (40 hospitals). Four of the hospitals did not have an educational program on hand hygiene, and only 17 had an antibiotic stewardship program.

Ventilator-Associated Pneumonia and Causative Microorganisms in Intensive Care Unit: A Two Year Retrospective Analysis

OpenAIRE

Onur Palabıyık; Yaşar Toptaş; Aziz Öğütlü

2016-01-01

Objective: Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in the intensive care units (ICUs). It causes prolonged hospital stay and increases mortality. In this study, we aimed to investigate the rate of VAP, causative microorganisms, and their antibiotic susceptibilities in anaesthesiology and reanimation ICU (ARICU). Material and Method: This retrospective study included patients who were admitted to 12-bed ARICU between January 2013 and December 2014. The ...

Anæstesi til patienter med kroniske sår

DEFF Research Database (Denmark)

Hjort, Mathias; Hyllested, Mette; Jørgensen, Bo

2015-01-01

Perioperative management of chronic wounds demands a multidisciplinary approach. Severe co-morbidities leave these patients prone to post-operative complications. To optimize wound healing, minimally invasive methods, both surgical and anaesthesiological, are applied. Ultrasound-guided peripheral...... nerveblocks (PNB) are an ideal anaesthesia method for wound revisions, amputations and split skin transplantations. The implementation of PNB allows continued anticoagulant treatment, provides post-operative analgesia, lowers opioid consumption and facilitates mobilization....

Focus radiation protection; Schwerpunkt Strahlenschutz

Energy Technology Data Exchange (ETDEWEB)

Ebermann, Lutz (comp.)

2016-07-01

The publication of the Bundesamt fuer Strahlenschutz on radiation protection covers the following issues: (i) exposure from natural sources: health hazard due to radon, radiation protection in residential homes, radon in Germany, natural raw materials in industrial processes; (ii) clearance of radioactive wastes: clearance in the frame of nuclear power plant dismantling, the situation in Germany and Europe; (iii) emergency management: principles of radiation protection, fictive sequence of accident events; (iiii) other actual radiation protection topics: more limits - more protection? radiation protection in medicine, occupational radiation protection.

Protection using telecommunications

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-07-01

Deregulation in both the telecommunication and electric power industry, together with new telecommunication network technologies and advances in numerical protection, has resulted in the need to reconsider traditional methods of delivering tele-protection schemes and their associated bearer services. Fibre-optic technology is commonly deployed in new telecommunication networks for inter-station communication and utility-owned and public telecommunication networks from third parties are available for protection purposes. (author)

Radiation protection in Sudan

International Nuclear Information System (INIS)

Elamin, O.I.; Hajmusa, E.A.; Shaddad, I.A.

2001-01-01

The regulatory framework as established by the Sudan Atomic Energy Commission (SAEC) Act, promulgated in 1996, is described in the report. Three levels of responsibility in meeting radiation protection requirements are established: the Board, the Radiation Protection Technical Committee as the competent authority in the field of radiation protection, and the SAEC Department of Radiation Protection and Environmental Monitoring as the implementing technical body. The report also refers to environmental activities, patient doses in diagnostic radiology, the management of disused sources, emergency preparedness and orphan sources, and the national training activities in the radiation protection field. (author)

New drugs and indications in 2010: inadequate assessment; patients at risk.

Science.gov (United States)

2011-04-01

In 2010, we rated 97 new drugs or new indications in our French edition la revue Prescrire, only 4 of which provided a therapeutic advantage. However, 19 others (1 in 5) were approved despite having more harms than benefits. More paediatric products were released in 2010 than in previous years, but few of them made any real difference and many had not been properly evaluated. Drug regulatory agencies can protect patients from exposure to dangerous drugs by refusing to grant market approval or by demanding their market withdrawal.Yet they are failing to fulfil this responsibility: so-called risk management plans and modifications to the wording in the SPC are only half-measures. Too often the authorities put companies' short-term financial interests above patients' well-being by granting premature marketing authorisation, by agreeing to high levels of reimbursement that fail to take added therapeutic value into account, and by allowing the development of "umbrella" ranges. The European authorities' questionable plans for pharmacovigilance and advertising of prescription-only drugs were restricted after public mobilisation, but they are still likely to undermine healthcare quality. Decision-makers must make patients' well-being their top priority.

Radiation Protection

International Nuclear Information System (INIS)

Loos, M.

2002-01-01

Major achievements of SCK-CEN's Radiation Protection Department in 2001 are described. The main areas for R and D of the department are enviromnental remediation, emergency planning, radiation protection research, low-level radioactvity measurements, safeguards and physics measurements, decision strategy research and policy support and social sciences in nuclear research. Main achievements for 2001 in these areas are reported

Laser Protection TIL

Data.gov (United States)

Federal Laboratory Consortium — The Laser Protection TIL conducts research and analysis of laser protection materials along with integration schemes. The lab's objectives are to limit energy coming...

Perspectives for environmental radiation protection in EU radiation protection legislation

International Nuclear Information System (INIS)

Janssens, A.

2000-01-01

The basis of EU radiation protection legislation is the EURATOM Trealy. It is discussed whether the Treaty offers a legal basis for the protection of the natural environment. The incorporation of provisions pertaining to the nuclear fuel cycle or to radioactive substances in general environmental legislation is explained, as well as the possible implications of international conventions subscribed by the European Union. The European Commission is in the process of developing an overall approach to risk analysis for the protection of health, consumer interests, and the environment. It is examined to what extent the consideration of the impact of radiation on the natural environment fits in the overall framework and whether the principles underlying classical radiation protection are applicable to biota. Specific attention is given to situations where high levels of environmental radioactivity would require intervention. (Author)

FPGA-Based Plant Protection System

Energy Technology Data Exchange (ETDEWEB)

Lee, Yoon Hee; Ha, Jae Hong; Kim, Hang Bae [KEPCO E and C, Daejeon (Korea, Republic of)

2011-08-15

This paper relates to a plant protection system which detects non-permissible conditions and determines initiation of protective actions for nuclear power plants (NPPs). Conventional plant protection systems were designed based on analog technologies. It is well known that existing protection systems for NPPs contain many components which are becoming obsolete at an increasing rate. Nowadays maintenance and repair for analog-based plant protection systems may be difficult as analog parts become obsolete or difficult to obtain. Accordingly, as an alternative to the analog technology, the digitalisation of the plant protection system was required. Recently digital plant protection systems which include programmable logic controllers (PLCs) and/or computers have been introduced. However PLC or computer-based plant protection systems use an operating system and application software, and so they may result in a common mode failure when a problem occurs in the operating system or application software. Field Programmable Gate Arrays (FPGAs) are highlighted as an alternative to conventional protection or control systems. The paper presents the design of a four-channel plant protection system whose protection functions are implemented in FPGAs without any central processing unit or operating system.

FPGA-Based Plant Protection System

International Nuclear Information System (INIS)

Lee, Yoon Hee; Ha, Jae Hong; Kim, Hang Bae

2011-01-01

This paper relates to a plant protection system which detects non-permissible conditions and determines initiation of protective actions for nuclear power plants (NPPs). Conventional plant protection systems were designed based on analog technologies. It is well known that existing protection systems for NPPs contain many components which are becoming obsolete at an increasing rate. Nowadays maintenance and repair for analog-based plant protection systems may be difficult as analog parts become obsolete or difficult to obtain. Accordingly, as an alternative to the analog technology, the digitalisation of the plant protection system was required. Recently digital plant protection systems which include programmable logic controllers (PLCs) and/or computers have been introduced. However PLC or computer-based plant protection systems use an operating system and application software, and so they may result in a common mode failure when a problem occurs in the operating system or application software. Field Programmable Gate Arrays (FPGAs) are highlighted as an alternative to conventional protection or control systems. The paper presents the design of a four-channel plant protection system whose protection functions are implemented in FPGAs without any central processing unit or operating system

Comparison of Vildagliptin and Pioglitazone in Korean Patients with Type 2 Diabetes Inadequately Controlled with Metformin.

Science.gov (United States)

Kim, Jong Ho; Kim, Sang Soo; Baek, Hong Sun; Lee, In Kyu; Chung, Dong Jin; Sohn, Ho Sang; Bae, Hak Yeon; Kim, Mi Kyung; Park, Jeong Hyun; Choi, Young Sik; Kim, Young Il; Hahm, Jong Ryeal; Lee, Chang Won; Jo, Sung Rae; Park, Mi Kyung; Lee, Kwang Jae; Kim, In Joo

2016-06-01

We compared the efficacies of vildagliptin (50 mg twice daily) relative to pioglitazone (15 mg once daily) as an add-on treatment to metformin for reducing glycosylated hemoglobin (HbA1c) levels in Korean patients with type 2 diabetes. The present study was a multicenter, randomized, active-controlled investigation comparing the effects of vildagliptin and pioglitazone in Korean patients receiving a stable dose of metformin but exhibiting inadequate glycemic control. Each patient underwent a 16-week treatment period with either vildagliptin or pioglitazone as an add-on treatment to metformin. The mean changes in HbA1c levels from baseline were -0.94% in the vildagliptin group and -0.6% in the pioglitazone group and the difference between the treatments was below the non-inferiority margin of 0.3%. The mean changes in postprandial plasma glucose (PPG) levels were -60.2 mg/dL in the vildagliptin group and -38.2 mg/dL in the pioglitazone group and these values significantly differed (P=0.040). There were significant decreases in the levels of total, low density lipoprotein, high density lipoprotein (HDL), and non-HDL cholesterol in the vildagliptin group but increases in the pioglitazone group. The mean change in body weight was -0.07 kg in the vildagliptin group and 0.69 kg in the pioglitazone group, which were also significantly different (P=0.002). As an add-on to metformin, the efficacy of vildagliptin for the improvement of glycemic control is not inferior to that of pioglitazone in Korean patients with type 2 diabetes. In addition, add-on treatment with vildagliptin had beneficial effects on PPG levels, lipid profiles, and body weight compared to pioglitazone.

Measurement of dose equivalent with personal dosemeters and instrumentation of radiological protection in the new operative magnitudes ICRU, for external fields of radiation beta. Part IV. Survey of the angular response of instruments used in radiological protection in secondary patron fields of beta radiation (90Sr/90Y (1850 MBq and 74 MBq), 204TI (18.5 MBq) and 147Pm (518 MBq)

International Nuclear Information System (INIS)

Alvarez R, J.T.

1994-02-01

Tests type were made (type test) in the following commercial instrumentation commonly used in radiological protection: Geiger-Mueller Counters (FH40 FE), Plastic Scintillators (NE-BP/6/4A), Ionization Chambers (RO-5) and Proportional Counters (HP-100A; gas:P-10). With object of checking the possibility that these they can carry out the new operative unit ICRU, H' (0.07; α). The tests consisted on determining the energy and angular response of the detectors in secondary patron fields of beta radiation, for isotopes of 90 Sr/ 90 Y (1850 MBq and 74 MBq and 147 Pm(518 MBq). The results show the inadequate of these commercial instruments for the realization of the H' operative unit (0.07; α) in beta external fields. Due to flaws in the design, construction and calibration of the instruments for this type of radiation fields (Author)

Protection of Levees against Beavers

Science.gov (United States)

Kozłowski, Wojciech; Balawejder, Adam

2017-10-01

Beavers are a protected species, so the levees must be properly protected so as not to harm the beavers and protect the levees from the destruction caused by these animals. This protection requires the use of bentonite mats as shaft seals, and wire mesh. Recently, such new protection structures began to be used successfully.

International Responses to Human Protection Crises: Responsibility to Protect and the Emerging Protection Regime*

OpenAIRE

Bellamy, Alex J.

2015-01-01

This essay examines contemporary debates about human protection by the UN Security Council and others in response to major humanitarian crises. It argues that there are clear signs of an emerging international human protection regime in the evolving practice of the Security Council and suggests that this regime is based on an accommodation between different moral accounts of humanitarian intervention. The first section examines some of the legal and moral debates that have arisen with respect...

Tritium protective clothing

International Nuclear Information System (INIS)

Fuller, T.P.; Easterly, C.E.

1979-06-01

Occupational exposures to radiation from tritium received at present nuclear facilities and potential exposures at future fusion reactor facilities demonstrate the need for improved protective clothing. Important areas relating to increased protection factors of tritium protective ventilation suits are discussed. These areas include permeation processes of tritium through materials, various tests of film permeability, selection and availability of suit materials, suit designs, and administrative procedures. The phenomenological nature of film permeability calls for more standardized and universal test methods, which would increase the amount of directly useful information on impermeable materials. Improvements in suit designs could be expedited and better communicated to the health physics community by centralizing devlopmental equipment, manpower, and expertise in the field of tritium protection to one or two authoritative institutions

Tritium protective clothing

Energy Technology Data Exchange (ETDEWEB)

Fuller, T. P.; Easterly, C. E.

1979-06-01

Occupational exposures to radiation from tritium received at present nuclear facilities and potential exposures at future fusion reactor facilities demonstrate the need for improved protective clothing. Important areas relating to increased protection factors of tritium protective ventilation suits are discussed. These areas include permeation processes of tritium through materials, various tests of film permeability, selection and availability of suit materials, suit designs, and administrative procedures. The phenomenological nature of film permeability calls for more standardized and universal test methods, which would increase the amount of directly useful information on impermeable materials. Improvements in suit designs could be expedited and better communicated to the health physics community by centralizing devlopmental equipment, manpower, and expertise in the field of tritium protection to one or two authoritative institutions.

Game Theoretic Solutions to Cyber Attack and Network Defense Problems

National Research Council Canada - National Science Library

Shen, Dan; Chen, Genshe; Cruz, Jr., , Jose B; Blasch, Erik; Kruger, Martin

2007-01-01

.... The protection and defense against cyber attacks to computer network is becoming inadequate as the hacker knowledge sophisticates and as the network and each computer system become more complex...

Machine Protection

International Nuclear Information System (INIS)

Zerlauth, Markus; Schmidt, Rüdiger; Wenninger, Jörg

2012-01-01

The present architecture of the machine protection system is being recalled and the performance of the associated systems during the 2011 run will be briefly summarized. An analysis of the causes of beam dumps as well as an assessment of the dependability of the machine protection systems (MPS) itself is being presented. Emphasis will be given to events that risked exposing parts of the machine to damage. Further improvements and mitigations of potential holes in the protection systems will be evaluated along with their impact on the 2012 run. The role of rMPP during the various operational phases (commissioning, intensity ramp up, MDs...) will be discussed along with a proposal for the intensity ramp up for the start of beam operation in 2012

Machine Protection

Energy Technology Data Exchange (ETDEWEB)

Zerlauth, Markus; Schmidt, Rüdiger; Wenninger, Jörg [European Organization for Nuclear Research, Geneva (Switzerland)

2012-07-01

The present architecture of the machine protection system is being recalled and the performance of the associated systems during the 2011 run will be briefly summarized. An analysis of the causes of beam dumps as well as an assessment of the dependability of the machine protection systems (MPS) itself is being presented. Emphasis will be given to events that risked exposing parts of the machine to damage. Further improvements and mitigations of potential holes in the protection systems will be evaluated along with their impact on the 2012 run. The role of rMPP during the various operational phases (commissioning, intensity ramp up, MDs...) will be discussed along with a proposal for the intensity ramp up for the start of beam operation in 2012.

Machine Protection

CERN Document Server

Zerlauth, Markus; Wenninger, Jörg

2012-01-01

The present architecture of the machine protection system is being recalled and the performance of the associated systems during the 2011 run will be briefly summarized. An analysis of the causes of beam dumps as well as an assessment of the dependability of the machine protection systems (MPS) itself is being presented. Emphasis will be given to events that risked exposing parts of the machine to damage. Further improvements and mitigations of potential holes in the protection systems will be evaluated along with their impact on the 2012 run. The role of rMPP during the various operational phases (commissioning, intensity ramp up, MDs...) will be discussed along with a proposal for the intensity ramp up for the start of beam operation in 2012.

Fundamentals of accounting support for economic mechanism for protection and sustainable use of land resources in Ukraine

Directory of Open Access Journals (Sweden)

Ostapchuk T.P.

2017-08-01

Full Text Available The problems of agricultural land accounting are investigated with the aim of developing methodological approaches for reliable accounting of land resources transactions that will become the basis for improving control procedures for land conservation and protection. One of the most important priorities of state policy, the condition for stability and development of the country’s national economy is a scientifically grounded land use policy, which serves as an economic indicator of the development of the state and one of the ways to overcome the financial and economic crisis in the country when it occurs. World practice has shown that the only universal exchange equivalent in the way of overcoming the economic crisis of any state is natural resources, and one of the significant, practically reproducible resources is land. Depending on the categories of lands, they may be subject to both ownership rights and full ownership. However, this property right remains inadequate, as owners of land plots cannot use them freely (sell, transfer, inherit, give, etc.. This refers to the agricultural land, for sale of which a moratorium has been established banning alienation and changing the purpose of agricultural land up to 2017, inclusive.

Neutron protection material and neutron protection devices made of such material

International Nuclear Information System (INIS)

Ries, W.

1984-01-01

This is concerned with a neutron protection material made of thermoplastic or thermosetting plastic from high molecule hydrocarbon compounds with particularly high hydrogen and carbon contents as braking or shielding material (moderator) for fast neutrons. The plastic can contain boron for absorbing low energy neutrons. The material is used to manufacture foil, plates, pipes, shielding walls, components, bodies for radiation protection equipment, devices and plant and for neutron protection clothes. (orig./HP) [de

Radiation protection standards

International Nuclear Information System (INIS)

Koelzer, W.

1980-01-01

The present paper deals with: Objectives and basic concepts of radiation protection, basic radiobiological considerations, the ICRP system of dose limitation and with operational radiation protection (limits, reference levels, occupational exposure). (RW)

Plant foods and plant-based diets: protective against childhood obesity?

Science.gov (United States)

Newby, P K

2009-05-01

The objective of this article is to review the epidemiologic literature examining the role of plant foods and plant-based diets in the prevention of childhood obesity. Available data suggest a protective effect of ready-to-eat cereal on risk of obesity, although prospective studies are still needed. Studies on fruit and vegetables; grains other than cereal; high-protein foods, including beans, legumes, and soy; fiber; and plant-based dietary patterns are inconsistent or generally null. The evidence base is limited, and most studies are fraught with methodologic limitations, including cross-sectional design, inadequate adjustment for potential confounders, and lack of consideration of reporting errors, stage of growth, and genetic influences. Well-designed prospective studies are needed. The lack of evidence showing an association between plant-based diets and childhood obesity does not mean that such diets should not be encouraged. Plant foods are highlighted in the Dietary Guidelines for Americans, and children do not meet the current recommendations for most plant foods. Although the advice to consume a plant-based, low-energy-dense diet is sound, ethical questions arise concerning the relatively high price of these diets in the United States and the way in which such diets are perceived in other parts of the world. Reducing the burden of childhood obesity, eliminating health disparities, and preventing the further spread of the disease around the globe will require not only policy interventions to ensure that plant foods are affordable and accessible to children of all income levels but also awareness of sociocultural norms that affect consumption.

Radiation protection, 1975. Annual EPA review of radiation protection activities

International Nuclear Information System (INIS)

1976-06-01

The EPA, under its Federal Guidance authorities, is responsible for advising the President on all matters pertaining to radiation and, through this mechanism, to provide guidance to other Federal agencies on radiation protection matters. Highlights are presented of significant radiation protection activities of all Federal agencies which were completed in 1975, or in which noteworthy progress was made during that period, and those events affecting members of the public. State or local activities are also presented where the effects of those events may be more far-reaching. At the Federal level significant strides have been made in reducing unnecessary radiation exposure through the efforts of the responsible agencies. These efforts have resulted in the promulgation of certain standards, criteria and guides. Improved control technologies in many areas make it feasible to reduce emissions at a reasonable cost to levels below current standards and guides. This report provides information on the significant activities leading to the establishment of the necessary controls for protection of public health and the environment. Radiation protection activities have been undertaken in other areas such as medical, occupational and consumer product radiation. In the context of radiation protection, ancillary activities are included in this report in order to present a comprehensive overview of the events that took place in 1975 that could have an effect on public health, either directly or indirectly. Reports of routine or continuing radiation protection operations may be found in publications of the sponsoring Federal agencies, as can more detailed information about activities reported in this document. A list of some of these reports is included

Anti-diphtheria immunity in Nigerian mothers and their newborns.

Science.gov (United States)

Cummings, Henry; Sadoh, Ayebo Evawere; Oviawe, Osawaru; Sadoh, Wilson Ehidiamen

2014-05-30

Immunity to diphtheria has been noted to wane with age such that previous studies have shown that a significant proportion of females with characteristics comparable to those of Nigerian women of reproductive age have inadequate levels of immunity to diphtheria. Thus, it is envisaged that Nigerian newborns may inherit inadequate levels of immunity to diphtheria from their mothers. Cord blood and peripheral maternal blood samples were collected from 231 mother-infant pairs at delivery. Anti-diphtheria antibody titres were assayed using Enzyme-linked immunosorbent assay (ELISA) technique. Recruited babies were those born at term with normal birth weight. As much as 29.9% of both mothers and their babies had no protection (antibody titrediphtheria. Ninety (39.0% CI 33%,45%) mothers and 107 (46.3% CI 40%,52%) babies were inadequately protected (antibody titrediphtheria. The difference in the geometric mean antibody titres of mothers and babies was statistically significant (pdiphtheria. Vaccination of parturient women with booster doses of diphtheria toxoid vaccine is recommended. Copyright © 2014 Elsevier Ltd. All rights reserved.

Measuring protected-area isolation and correlations of isolation with land-use intensity and protection status.

Science.gov (United States)

Seiferling, Ian S; Proulx, Raphaël; Peres-Neto, Pedro R; Fahrig, Lenore; Messier, Christian

2012-08-01

Protected areas cover over 12% of the terrestrial surface of Earth, and yet many fail to protect species and ecological processes as originally envisioned. Results of recent studies suggest that a critical reason for this failure is an increasing contrast between the protected lands and the surrounding matrix of often highly altered land cover. We measured the isolation of 114 protected areas distributed worldwide by comparing vegetation-cover heterogeneity inside protected areas with heterogeneity outside the protected areas. We quantified heterogeneity as the contagion of greenness on the basis of NDVI (normalized difference vegetation index) values, for which a higher value of contagion indicates less heterogeneous land cover. We then measured isolation as the difference between mean contagion inside the protected area and mean contagion in 3 buffer areas of increasing distance from the protected-area border. The isolation of protected areas was significantly positive in 110 of the 114 areas, indicating that vegetation cover was consistently more heterogeneous 10-20 km outside protected areas than inside their borders. Unlike previous researchers, we found that protected areas in which low levels of human activity are allowed were more isolated than areas in which high levels are allowed. Our method is a novel way to assess the isolation of protected areas in different environmental contexts and regions. ©2011 Society for Conservation Biology.

The Radiation Protection Act

International Nuclear Information System (INIS)

Persson, L.

1989-01-01

The new Radiation Protection Act (1988:220) entered into force in Sweden on July 1st, 1988. This book presents the Act as well as certain regulations connected to it. As previously, the main responsibility for public radiation protection will rest with one central radiation protection authority. According to the 1988 Act, the general obligations with regard to radiation protection will place a greater responsibility than in the past on persons carrying out activities involving radiation. Under the act, it is possible to adjust the licensing and supervisory procedures to the level of danger of the radiation source and the need for adequate competence, etc. The Act recognises standardised approval procedures combined with technical regulations for areas where the risks are well known. The Act contains several rules providing for more effective supervision. The supervising authority may in particular decide on the necessary regulations and prohibitions for each individual case. The possibilities of using penal provisions have been extended and a rule on the mandatory execution of orders has been introduced. The Ordinance on Radiation Protection (1988:293) designates the National Institute of Radiation Protection (SSI) as the central authority referred to in the Radiation Protection Act. The book also gives a historic review of radiation protection laws in Sweden, lists regulations issued by SSI and presents explanations of radiation effects and international norms in the area. (author)

Power system protection

International Nuclear Information System (INIS)

Venkata, S.S.; Damborg, M.J.; Jampala, A.K.

1991-01-01

Power systems of the 21st century will be more modern, and complex, utilizing the latest available technologies. At the same time, generating plants will have to operate with minimal spinning margins and energy transportation has to take place at critical levels due to environmental and economical constraints. These factors dictate that the power systems be protected with optimum sensitivity, selectivity and time of operation to assure maximum reliability, and security at minimal cost. With an increasing role played by digital computers in every aspect of protection, it is important to take a critical and fresh look at the art and science of relaying and protection. The main objective of this paper is to review the past, present and future of power system protection from a software point of view

Radiation protection

International Nuclear Information System (INIS)

Koelzer, W.

1976-01-01

The lecture is divided into five sections. The introduction deals with the physical and radiological terms, quantities and units. Then the basic principles of radiological protection are discussed. In the third section attention is paid to the biological effects of ionizing radiation. The fourth section deals with the objectives of practical radiological protection. Finally the emergency measures are discussed to be taken in radiation accidents. (HP) [de

Environmental protection

International Nuclear Information System (INIS)

Martinez, A.S.

1987-01-01

The question of environment protection related to the use of nuclear energy aiming to power generation, based on the harmonic concept of economic and industrial development, preserving the environment, is discussed. A brief study of environmental impacts for some energy sources, including nuclear energy, to present the systems of a nuclear power plant which aim at environmental protection, is done. (M.C.K.) [pt

XXX. Days of Radiation Protection. Conference Proceedings of the 30-th Days of Radiation Protection

Energy Technology Data Exchange (ETDEWEB)

NONE

2008-11-15

The publication has been set up as a proceedings of the conference dealing with health protection during work with ionizing radiation for different activities which involve the handling of ionizing radiation sources. The main conference topics are focused on current problems in radiation protection and radioecology. In this proceedings totally 107 papers are published. The Conference consists of following sections: Effects of ionizing radiation; Regulation of radiation protection; Dosimetry and Metrology of ionizing radiation; Radiation protection in nuclear Power plants; Medical exposure and radiation protection in diagnostic radiology, nuclear medicine and radiation oncology; Natural radioactivity issues in radiation protection; Education, societal aspects and public involvement in radiation protection, trends and perspectives.

XXX. Days of Radiation Protection. Conference Proceedings of the 30-th Days of Radiation Protection

International Nuclear Information System (INIS)

2008-11-01

The publication has been set up as a proceedings of the conference dealing with health protection during work with ionizing radiation for different activities which involve the handling of ionizing radiation sources. The main conference topics are focused on current problems in radiation protection and radioecology. In this proceedings totally 107 papers are published. The Conference consists of following sections: Effects of ionizing radiation; Regulation of radiation protection; Dosimetry and Metrology of ionizing radiation; Radiation protection in nuclear Power plants; Medical exposure and radiation protection in diagnostic radiology, nuclear medicine and radiation oncology; Natural radioactivity issues in radiation protection; Education, societal aspects and public involvement in radiation protection, trends and perspectives

Investor Protections and Economic Growth

OpenAIRE

Haidar, Jamal Ibrahim

2009-01-01

Using objective measures of investor protections in 170 countries, I establish that the level of investor protection matters for cross-country differences in GDP growth: countries with stronger protections tend to grow faster than those with poor investor protections.

Protecting plutonium: physical safeguards

International Nuclear Information System (INIS)

Ney, J.F.

1975-10-01

In the development of physical protection systems, objectives for improving overall performance include the following: (1) Increase the time required for the malefactor to achieve his goal; (2) decrease the time required for detection of malevolent activities; (3) reduce the time for adequate response force arrival; (4) increase the capability to neutralize the malefactor; (5) reduce the total protection system costs, while increasing the level of protection; (6) improve acceptance levels (social, environmental, legal, and institutional); and (7) increase nuclear fuel cycle safety. Fortunately, there is sufficient lead time and technical base to explore and develop new protection system concepts so that a completely integrated and tested protection system capable of providing unprecedented levels of security can be available when needed. Although it will be impossible to completely eliminate all risks, it should be both possible and economically feasible to install protection systems which will deter or prevent a malefactor from using the nuclear fuel cycle to disrupt society

Systematic approach in protection and ergonomics testing personal protective equipment

NARCIS (Netherlands)

Hartog. E.A. den

2009-01-01

In the area of personal protection against chemical and biological (CB) agents there is a strong focus on testing the materials against the relevant threats. The testing programs in this area are elaborate and are aimed to guarantee that the material protects according to specifications. This

Risk Factors Associated with Very Low Birth Weight in a Large Urban Area, Stratified by Adequacy of Prenatal Care.

Science.gov (United States)

Xaverius, Pamela; Alman, Cameron; Holtz, Lori; Yarber, Laura

2016-03-01

This study examined risk and protective factors associated with very low birth weight (VLBW) for babies born to women receiving adequate or inadequate prenatal care. Birth records from St. Louis City and County from 2000 to 2009 were used (n = 152,590). Data was categorized across risk factors and stratified by adequacy of prenatal care (PNC). Multivariate logistic regression and population attributable risk (PAR) was used to explore risk factors for VLBW infants. Women receiving inadequate prenatal care had a higher prevalence of delivering a VLBW infant than those receiving adequate PNC (4.11 vs. 1.44 %, p < .0001). The distribution of risk factors differed between adequate and inadequate PNC regarding Black race (36.4 vs. 79.0 %, p < .0001), age under 20 (13.0 vs. 33.6 %, p < .0001), <13 years of education (35.9 vs. 77.9 %, p < .0001), Medicaid status (35.7 vs. 74.9, p < .0001), primiparity (41.6 vs. 31.4 %, p < .0001), smoking (9.7 vs. 24.5 %, p < .0001), and diabetes (4.0 vs. 2.4 %, p < .0001), respectively. Black race, advanced maternal age, primiparity and gestational hypertension were significant predictors of VLBW, regardless of adequate or inadequate PNC. Among women with inadequate PNC, Medicaid was protective against (aOR 0.671, 95 % CI 0.563-0.803; PAR -32.6 %) and smoking a risk factor for (aOR 1.23, 95 % CI 1.01, 1.49; PAR 40.1 %) VLBW. When prematurity was added to the adjusted models, the largest PAR shifts to education (44.3 %) among women with inadequate PNC. Community actions around broader issues of racism and social determinants of health are needed to prevent VLBW in a large urban area.

Radiological protection survey results about radiodiagnosis protection practices in Cuba

International Nuclear Information System (INIS)

Jova S, L.; Morales M, J.A.; Quevedo, J.R.; Medina, J.R.; Naranjo, A.M.; Fornet, O.M.

1996-01-01

In order to identify radiation protection current situation in national X-ray diagnostic practice , the State (cuban) Supervision System for Radiation and Nuclear Safety carried out in 1992 a survey which was planned for projection of future regulatory activities in this field. Survey covers the most important aspects related to radiation protection of occupationally exposed workers, patients and general population. Surveyed sample included a total of 52 X-ray units, sited in 7 dental clinics, 2 polyclinics and 13 hospitals, from 7 provinces of the country. Results showed that the organization of radiation protection in terms of personnel specially designated to carry out surveillance and control activities and level of documentation is deficient. Survey evidenced the general lack of safety and quality culture among technologists and radiologists which is mainly reflected in non regular application of basic patient protection measures (shielding, collimation, use of proper filtration among others) and non regular execution of basic quality inspection of employed radiographic systems. (authors). 4 refs., 1 fig

What causes treatment failure - the patient, primary care, secondary care or inadequate interaction in the health services?

Directory of Open Access Journals (Sweden)

Lange Ove

2011-05-01

Full Text Available Abstract Background Optimal treatment gives complete relief of symptoms of many disorders. But even if such treatment is available, some patients have persisting complaints. One disorder, from which the patients should achieve complete relief of symptoms with medical or surgical treatment, is gastroesophageal reflux disease (GERD. Despite the fact that such treatment is cheap, safe and easily available; some patients have persistent complaints after contact with the health services. This study evaluates the causes of treatment failure. Methods Twelve patients with GERD and persistent complaints had a semi-structured interview which focused on the patients' evaluation of treatment failure. The interviews were taped, transcribed and evaluated by 18 physicians, (six general practitioners, six gastroenterologists and six gastrointestinal surgeons who completed a questionnaire for each patient. The questionnaires were scored, and the relative responsibility for the failure was attributed to the patient, primary care, secondary care and interaction in the health services. Results Failing interaction in the health services was the most important cause of treatment failure, followed by failure in primary care, secondary care and the patient himself; the relative responsibilities were 35%, 28%, 27% and 10% respectively. There was satisfactory agreement about the causes between doctors with different specialities, but significant inter-individual differences between the doctors. The causes of the failures differed between the patients. Conclusions Treatment failure is a complex problem. Inadequate interaction in the health services seems to be important. Improved communication between parts of the health services and with the patients are areas of improvement.

Inadequate vitamin D levels are associated with culture positive sepsis and poor outcomes in paediatric intensive care.

Science.gov (United States)

Onwuneme, Chike; Carroll, Aoife; Doherty, Dermot; Bruell, Heike; Segurado, Ricardo; Kilbane, Mark; Murphy, Nuala; McKenna, Malachi J; Molloy, Eleanor J

2015-10-01

This study aimed to assess vitamin D status, and its determinants, in paediatric patients with suspected sepsis who were admitted to a paediatric intensive care unit (PICU). We also investigated the association between vitamin D status and clinical outcomes. Serum 25-hydroxy vitamin D (25OHD) and clinical determinants were prospectively assessed in children with suspected sepsis (<12 years old) admitted to the PICU. The relationship between 25OHD and clinical outcomes was evaluated. Vitamin D status was also assessed in control children of a similar age. We enrolled 120 children with suspected sepsis admitted to the PICU and 30 paediatric controls. 25OHD was <50 nmol/L in 59% of the children admitted to the PICU and 25OHD was lower than in the controls (47 ± 29 vs 66 ± 26 nmol/L, p < 0.001). After adjusting for potential confounders, 25OHD was strongly associated with culture positive sepsis (p < 0.001), the paediatric index of mortality (p = 0.026) and the duration of mechanical ventilation (p = 0.008). There was a negative correlation between 25OHD and C-reactive protein (CRP): each 0.1% decrease in 25OHD increased CRP (p = 0.04). Children admitted to the PICU with suspected sepsis had lower 25OHD than controls and inadequate 25OHD status was associated with confirmed sepsis and poor outcomes. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Radiological Protection Act 1970

International Nuclear Information System (INIS)

1970-01-01

This Act provides for the establishment of a Radiological Protection Board to undertake research and advise on protection from radiation hazards. Its functions include provision of advice to Government departments with responsibilities in relation to protection of sectors of the community or the community as a whole against the hazards of ionizing radiation. The Act, which lays down that the Board shall replace certain departments concerned with radiation protection, repeals several Sections of the Radioactive Substances Act 1948 and the Science and Technology Act 1965. (NEA) [fr

Protection, interlocks and diagnostics

CERN Document Server

Griffiths, S A; White, C; Theed, J E

2006-01-01

When designing any power converter it is essential to assess and incorporate adequate protection. The main objective is to offer a solution which is safe, reliable and repairable and that achieves its specification within budget. The level of protection found within each converter varies widely and will depend on the topology employed, its application and rating. This document is a guide to the types of protection engineers should consider mainly when designing power converters, as protection added during construction or after installation will always be expensive.

Observations on physical protection methods for protecting against unauthorized acts by an insider

International Nuclear Information System (INIS)

Ericson, D.M.; Goldman, L.A.; Lobner, R.R.

1983-01-01

Two basic approaches have evolved over the past several years for physical protection against sabotage by insiders. One, area-type physical protection, involves the use of access controls at area boundaries. Current practices at nuclear power plants generally fall into this category. The second, component-level physical protection, involves hardware at individual components as well as access controls at the boundary. The area-type physical protection concepts include team, area, and operational zoning. Team zoning requires the formation of multiperson teams that must be used to gain access to vital areas. Area zoning divides the plant into two or more zones, each of which is operated and maintained by separate, dedicated teams. Operational zoning is a closed-loop access control system that permits an initial vital area access, but blocks access to certain other vital areas until the operability of equipment in the first area is verified by test or inspection. Component-level physical protection is also a closed-loop system in which both area and component access are monitored. Each of the above measures can provide effective protection against an insider in certain instances, but each has weaknesses that must be recognized. An approach for protection against the insider is to take the most promising features of each of the above physical protection measures and supplement these capabilities with damage control and design changes as appropriate for a particular plant

The national radiation protection infrastructure

International Nuclear Information System (INIS)

Mastauskas, A.

1999-01-01

The state system of radiation protection is still being created after Lithuania regained its independancy and in connection with recommendations laid in the ICRP-60 publication and requirements of legislation of European Community. A new regulation institutions was established and a number of laws and regulations related to radiation protection was prepared. The Radiation Protection Centre of Ministry of Health is the regulatory authority responsible for radiation protection of public and of workers using sources of ionizing radiation in Lithuania. A new Radiation Protection Law, Nuclear Energy Law, Radioactive Waste Management Law and different regulations was approved. Preparation of legislation, creation of state system of radiation protection and its upgrading allow to presume that the necessary level of radiation protection is to be achieved. (au)

Ethical issues in radiation protection

International Nuclear Information System (INIS)

Persson, Lars

2000-03-01

Ethical theories are relevant to the current recommendations and standards for radiation protection. Radiation protection is not only a matter for science. It is also a problem of philosophy. In order for protection regulations to be respected, it must correspond to widely accepted ethical values among those who are affected by the regulations. The workshop covered the following issues: Problems in Present Protection Policy, ICRP Protection Policy - A Historical Perspective, Radiation Risk - What we know and what we believe, Present ICRP Recommendations, Ethical Values in the Context of ICRP Recommendations, Collective Responsibility for Invisible Harm, Environmental Protection - Ethical Issues, The Global Change of Values, and Procedural justice and Radiation Protection. Six workshop contributions and a workshop summary are presented in this report

Ethical issues in radiation protection

Energy Technology Data Exchange (ETDEWEB)

Persson, Lars (ed.)

2000-03-15

Ethical theories are relevant to the current recommendations and standards for radiation protection. Radiation protection is not only a matter for science. It is also a problem of philosophy. In order for protection regulations to be respected, it must correspond to widely accepted ethical values among those who are affected by the regulations. The workshop covered the following issues: Problems in Present Protection Policy, ICRP Protection Policy - A Historical Perspective, Radiation Risk - What we know and what we believe, Present ICRP Recommendations, Ethical Values in the Context of ICRP Recommendations, Collective Responsibility for Invisible Harm, Environmental Protection - Ethical Issues, The Global Change of Values, and Procedural justice and Radiation Protection. Six workshop contributions and a workshop summary are presented in this report.

The acute pulmonary oedema in the intensive-care ward

International Nuclear Information System (INIS)

Marciniak, R.; Aronski, A.

1989-01-01

760 patients suffering from acute pulmonary oedema were treated between 1980 and 1986 at the Institute of Anaesthesiology of the Medical Academy in Wroclaw. The radiological image of the pulmonary oedema was subdivided into three forms (hilar, hilar and perihilar, and hilar with massive plane-shaped infiltrates). In the treatment of acute pulmonary oedema in the intensive-care ward a thorough diagnostic programme is mandatory after the immediately necessary measures have been taken. (orig.) [de

The acute pulmonary oedema in the intensive-care ward. Das akute Lungenoedem auf der Intensivstation

Energy Technology Data Exchange (ETDEWEB)

Marciniak, R.; Aronski, A. (Akademia Medyczna, Wroclaw (Poland))

1989-07-01

760 patients suffering from acute pulmonary oedema were treated between 1980 and 1986 at the Institute of Anaesthesiology of the Medical Academy in Wroclaw. The radiological image of the pulmonary oedema was subdivided into three forms (hilar, hilar and perihilar, and hilar with massive plane-shaped infiltrates). In the treatment of acute pulmonary oedema in the intensive-care ward a thorough diagnostic programme is mandatory after the immediately necessary measures have been taken. (orig.).

[Adrenalectomy in Denmark 2002-2006

DEFF Research Database (Denmark)

Jepsen, J.V.; Kromann-Andersen, B.; Bendixen, A.

2008-01-01

INTRODUCTION: Laparoscopic adrenalectomy is replacing open adrenalectomy. The advantages are reduced mortality and morbidity, and shorter postoperative hospitalisation. The organization and short-term outcomes of adrenalectomy in Denmark are largely unknown. MATERIAL AND METHODS: Extraction, review...... of adrenalectomies performed laparoscopically is growing, currently reaching about 65%. Laparoscopic adrenalectomies are only performed at departments with a high frequency of laparoscopic surgery and specialized endocrinological and anaesthesiological support. For educational and research purposes, adrenalectomy...

Analyse der Auswirkungen zweier Infusionsregime auf den Säure-Basen-Haushalt mit Hilfe des Stewart-Modells im Rahmen einer intraoperativen zielgerichteten Hämodynamiktherapie

OpenAIRE

Hoffmann, Benedikt

2018-01-01

Objective: Intraoperative fluid and volume therapy is an essential component of anaesthesiologic patient care with the aim to maintain normovolaemia with minimal impact on acid-base balance. So far, there is little data of the effects of guided fluid regimens on the acid-base balance in the perioperative context. Therefore, the aim of this study was to investigate the effects of two different infusion regimens guided by a goal-directed intraoperative hemodynamic algorithm on th...

Special protective concretes

International Nuclear Information System (INIS)

Bouniol, P.

2001-01-01

Concrete is the most convenient material when large-scale radiation protection is needed. Thus, special concretes for nuclear purposes are used in various facilities like reactors, reprocessing centers, storage sites, accelerators, hospitals with nuclear medicine equipment, food ionization centers etc.. The recent advances made in civil engineering for the improvement of concrete durability and compactness are for a large part transposable to protection concretes. This article presents the basic knowledge about protection concretes with the associated typological and technological aspects. A large part is devoted to the intrinsic properties of concretes and to their behaviour in irradiation and temperature conditions: 1 - definition and field of application of special protective concretes; 2 - evolution of concepts and technologies (durability of structures, techniques of formulation, new additives, market evolution); 3 - design of protective structures (preliminary study, radiation characteristics, thermal constraints, damping and dimensioning, mechanical criteria); 4 - formulation of special concretes (general principles, granulates, hydraulic binders, pulverulent additives, water/cement ratio, reference composition of some special concretes); 5 - properties of special concretes (damping and thermo-mechanical properties); 6 - induced-irradiation and temperature phenomena (activation, radiolysis, mineralogical transformations, drying, shrinking, creep, corrosion of reinforcement). (J.S.)

The efficacy of tramadol/acetaminophen combination tablets (Ultracet®) as add-on and maintenance therapy in knee osteoarthritis pain inadequately controlled by nonsteroidal anti-inflammatory drug (NSAID).

Science.gov (United States)

Park, Kyung-Su; Choi, Jin-Jung; Kim, Wan-Uk; Min, June-Ki; Park, Sung-Hwan; Cho, Chul-Soo

2012-02-01

The purpose of this study is to compare the efficacy of tramadol 37.5 mg/acetaminophen 325 mg combination tablets (tramadol/APAP) with that of nonsteroidal anti-inflammatory drugs (NSAIDs) as maintenance therapy following tramadol/APAP and NSAID combination therapy in knee osteoarthritis (OA) pain which was inadequately controlled by NSAIDs. Subjects with knee OA for over 1 year and moderate pain (numerical rating scale [NRS] ≥5) despite at least 4 weeks' NSAID therapy (meloxicam 7.5 mg or 15 mg qd or aceclofenac 100 mg bid) received tramadol/APAP add-on (combination with NSAID) for 4 weeks. Thereafter, subjects with significant pain improvement (NRS pain intensity (NRS), pain relief score, and subjects' and investigators' overall medication assessments. Of 143 subjects enrolled, 112 completed the 4-week tramadol/APAP and NSAID combination phase and 97 (67.8%) experienced significant pain improvement. Of the 97 subjects randomized, 36 in tramadol/APAP group and 47 in NSAID group completed the 8-week comparator study. On days 29 and 57, WOMAC scores and pain intensities did not increase in both groups compared to measurements immediately after the combination therapy. At these two time points, there were no significant differences in WOMAC scores, pain intensities, and other secondary measures between the two groups. Overall adverse event rates were similar in both groups. Tramadol/APAP add-on significantly improved knee OA pain which had been inadequately controlled by NSAIDs. In those subjects who showed favorable response to tramadol/APAP and NSAID combination therapy, both tramadol/APAP and NSAIDs were effective at maintaining the pain-reduced state and there was no significant difference in efficacy between tramadol/APAP and NSAIDs.

Protective Behavior in Games

NARCIS (Netherlands)

Fiestras-Janeiro, G.; Borm, P.E.M.; van Megen, F.J.C.

1996-01-01

This paper introduces the notion of protective equilibrium in the context of fin ite games in strategic form.It shows that for matrix games the set of protective equilibria equals the set of proper equilibria.Moreover, in the context of bima trix games, the notion of protective behaviour is used as

Radiation protective clothing

International Nuclear Information System (INIS)

Fujinuma, Tadashi; Tamura, Shoji; Ijiri, Yasuo.

1988-01-01

Purpose: To obtain radiation protective clothings of excellent workability and durability. Constitution: Protective clothings of the present invention comprise shielding materials for the upper-half of the body having lead foils laminated on one surface and shielding materials for the lower-half of the body a resin sheet containing inorganic powders of high specific gravity. Such protective clothings have a frexibility capable of followings after the movement of the upper-half body and easily follow after the movement such as acute bending of the body near the waste in the lower-half body. (Kamimura, M.)

Healthy Watersheds Protection

Science.gov (United States)

... for restoring areas with degraded water quality, as well as protecting healthy waters from emerging problems before expensive damages occur. ... exclusively on restoring impaired waters, EPA created the Healthy ... more emphasis to proactively protecting high quality waters, following the ...

FIRE PROTECTION SYSTEMS AND TECHNOLOGIES

Directory of Open Access Journals (Sweden)

Aristov Denis Ivanovich

2016-03-01

Full Text Available The All-Russian Congress “Fire Stop Moscow” was de-voted to the analysis of the four segments of the industry of fire protection systems and technologies: the design of fire protec-tion systems, the latest developments and technologies of active and passive fire protection of buildings, the state and the devel-opment of the legal framework, the practice of fire protection of buildings and structures. The forum brought together the repre-sentatives of the industry of fire protection systems, scientists, leading experts, specialists in fire protection and representatives of construction companies from different regions of Russia. In parallel with the Congress Industrial Exhibition of fire protection systems, materials and technology was held, where manufacturers presented their products. The urgency of the “Fire Stop Moscow” Congress in 2015 organized by the Congress Bureau ODF Events lies primarily in the fact that it considered the full range of issues related to the fire protection of building and construction projects; studied the state of the regulatory framework for fire safety and efficiency of public services, research centers, private companies and busi-nesses in the area of fire safety. The main practical significance of the event which was widely covered in the media space, was the opportunity to share the views and information between management, science, and practice of business on implementing fire protection systems in the conditions of modern economic relations and market realities. : congress, fire protection, systems, technologies, fire protection systems, exhibition

VIP protection from CBRN hazards

International Nuclear Information System (INIS)

Kaszeta, D.

2009-01-01

Protection of heads of state/government from CBRN threats requires flexibility and advanced planning. The best approach to CBRN countermeasures in a close protection context combine traditional close protection techniques, sound security practices, and a good understanding of the technical nature of the threat. Poor general security practices make for poor CBRN protection. This paper addresses a methodology for assessing the viability of threats to protected persons/VIPs and provides an overview of close protection in the CBRN environment. It is important to define the scope of CBRN response in the close protection context. Some threat agents are more applicable to a military environment than to the type of attack consistent with assassination. By focussing the scope of CBRN close protection more specifically on the more technically viable threats, appropriate concepts of operation can be developed. Concepts of operation, developed with an understanding of the threat, determine the requirement for advanced preparation and the training and equipping of protective details. Most of the responses required in CBRN incidents are well served by tactically sound close protection procedures. The fundamental principles are: rapid identification of hazard, speed, use of protective technology, and medical interventions, including rapid decontamination and basic and advanced life support measures. This paper does not contain confidential or classified information and represents only the opinion of its author. It does not represent any official policy or opinion of the authors present or previous employers.(author)

Wake Shield Target Protection

International Nuclear Information System (INIS)

Valmianski, Emanuil I.; Petzoldt, Ronald W.; Alexander, Neil B.

2003-01-01

The heat flux from both gas convection and chamber radiation on a direct drive target must be limited to avoid target damage from excessive D-T temperature increase. One of the possibilities of protecting the target is a wake shield flying in front of the target. A shield will also reduce drag force on the target, thereby facilitating target tracking and position prediction. A Direct Simulation Monte Carlo (DSMC) code was used to calculate convection heat loads as boundary conditions input into ANSYS thermal calculations. These were used for studying the quality of target protection depending on various shapes of shields, target-shield distance, and protective properties of the shield moving relative to the target. The results show that the shield can reduce the convective heat flux by a factor of 2 to 5 depending on pressure, temperature, and velocity. The protective effect of a shield moving relative to the target is greater than the protective properties of a fixed shield. However, the protective effect of a shield moving under the drag force is not sufficient for bringing the heat load on the target down to the necessary limit. Some other ways of diminishing heat flux using a protective shield are discussed

Optimization in radiological protection

International Nuclear Information System (INIS)

Acosta Perez, Clarice de Freitas

1996-01-01

The optimization concept in radiation protection is, in its essence, practical. In each aspect that we deal with the man, it is necessary to take frequent decisions such as: what is the protection level to be pursued, since the protection levels under consideration provide doses lower than the appropriate annual limits. The optimization gives a basic framework of the minding that is appropriate to conduct to a balance kind of the resources available for the protection and protection level obtained against a multitude of factors and constrains in a manner to obtain the best result. In this work, was performed the optimization, from the radiation protection point of view, of a facility project who enclose two shielded hot cells where will be handled UO 2 small plate with 50% of U-235 burn-up, irradiated in the research swimming pool reactor, IEA-R1. To obtain this goal were specified the relevant factors and criteria, were applied the main techniques used in a decision-making in radiological protection, presently adopted and was performed a sensibility study of the factors and criteria used in this work. In order to obtain a greater agility in applying the techniques for decision-making was developed a micro computer program. (author)

Two Phase III randomised double-blind studies of fixed-dose TC-5214 (dexmecamylamine) adjunct to ongoing antidepressant therapy in patients with major depressive disorder and an inadequate response to prior antidepressant therapy.

Science.gov (United States)

Möller, Hans-Jürgen; Demyttenaere, Koen; Olausson, Bengt; Szamosi, Johan; Wilson, Ellis; Hosford, David; Dunbar, Geoffrey; Tummala, Raj; Eriksson, Hans

2015-10-01

To evaluate the neuronal nicotinic channel modulator TC-5214 (dexmecamylamine) as adjunct therapy in patients with major depressive disorder (MDD) and inadequate response to prior antidepressant treatment. Study 004 (D4130C00004) and Study 005 (D4130C00005) comprised an 8-week open-label antidepressant (SSRI/SNRI) treatment period followed by an 8-week randomised, active treatment with twice-daily TC-5214 (0.5, 2 or 4 mg in Study 004; 0.1, 1 or 4 mg in Study 005) or placebo, adjunct to ongoing SSRI/SNRI. Primary efficacy endpoint was change in MADRS total score from randomisation (Week 8) to treatment end (Week 16). Secondary endpoints included MADRS response and remission, and changes in SDS and HAM-D-17-item scores. Safety and tolerability were monitored throughout. Studies 004 and 005 randomised 640 and 696 patients, respectively, to TC-5214 or placebo. No statistically significant improvements in MADRS total score or any secondary endpoints were seen with TC-5214 versus placebo in either study at treatment end. The most commonly reported adverse events (> 10%) with TC-5214 were constipation, dizziness and dry mouth. TC-5214 adjunct to antidepressant was generally well tolerated. However, the studies were not supportive of an antidepressant effect for TC-5214 in patients with MDD and inadequate response to prior antidepressant therapy.

Optimisation of radiation protection

International Nuclear Information System (INIS)

1988-01-01

Optimisation of radiation protection is one of the key elements in the current radiation protection philosophy. The present system of dose limitation was issued in 1977 by the International Commission on Radiological Protection (ICRP) and includes, in addition to the requirements of justification of practices and limitation of individual doses, the requirement that all exposures be kept as low as is reasonably achievable, taking social and economic factors into account. This last principle is usually referred to as optimisation of radiation protection, or the ALARA principle. The NEA Committee on Radiation Protection and Public Health (CRPPH) organised an ad hoc meeting, in liaison with the NEA committees on the safety of nuclear installations and radioactive waste management. Separate abstracts were prepared for individual papers presented at the meeting

Comparison of Vildagliptin and Pioglitazone in Korean Patients with Type 2 Diabetes Inadequately Controlled with Metformin

Directory of Open Access Journals (Sweden)

Jong Ho Kim

2016-04-01

Full Text Available BackgroundWe compared the efficacies of vildagliptin (50 mg twice daily relative to pioglitazone (15 mg once daily as an add-on treatment to metformin for reducing glycosylated hemoglobin (HbA1c levels in Korean patients with type 2 diabetes.MethodsThe present study was a multicenter, randomized, active-controlled investigation comparing the effects of vildagliptin and pioglitazone in Korean patients receiving a stable dose of metformin but exhibiting inadequate glycemic control. Each patient underwent a 16-week treatment period with either vildagliptin or pioglitazone as an add-on treatment to metformin.ResultsThe mean changes in HbA1c levels from baseline were –0.94% in the vildagliptin group and –0.6% in the pioglitazone group and the difference between the treatments was below the non-inferiority margin of 0.3%. The mean changes in postprandial plasma glucose (PPG levels were –60.2 mg/dL in the vildagliptin group and –38.2 mg/dL in the pioglitazone group and these values significantly differed (P=0.040. There were significant decreases in the levels of total, low density lipoprotein, high density lipoprotein (HDL, and non-HDL cholesterol in the vildagliptin group but increases in the pioglitazone group. The mean change in body weight was –0.07 kg in the vildagliptin group and 0.69 kg in the pioglitazone group, which were also significantly different (P=0.002.ConclusionAs an add-on to metformin, the efficacy of vildagliptin for the improvement of glycemic control is not inferior to that of pioglitazone in Korean patients with type 2 diabetes. In addition, add-on treatment with vildagliptin had beneficial effects on PPG levels, lipid profiles, and body weight compared to pioglitazone.

Improving access to shared decision-making for Hispanics/Latinos with inadequately controlled type 2 diabetes mellitus.

Science.gov (United States)

Davidson, Jaime A; Rosales, Aracely; Shillington, Alicia C; Bailey, Robert A; Kabir, Chris; Umpierrez, Guillermo E

2015-01-01

To describe the cultural and linguistic adaptation and Spanish translation of an English-language patient decision aid (PDA) for use in supporting shared decision-making in Hispanics/Latinos with type 2 diabetes mellitus (T2DM), a group at a high risk for complications. A steering committee of endocrinologists, a primary care physician, a certified diabetes educator, and a dietician, each with extensive experience in providing care to Hispanics/Latinos was convened to assess a PDA developed for English-speaking patients with T2DM. English content was reviewed for cultural sensitivity and appropriateness for a Hispanic/Latino population. A consensus-building process and iterative version edits incorporated clinician perspectives. The content was adapted to be consistent with traditional Hispanic/Latino cultural communication precepts (eg, avoidance of hostile confrontation; value for warm interaction; respect for authority; value of family support for decisions). The PDA was translated by native-speaking individuals with diabetes expertise. The PDA underwent testing during cognitive interviews with ten Spanish-speaking Hispanics/Latinos with T2DM to ensure that the content is reflective of the experience, understanding, and language Hispanic/Latino patients use to describe diabetes and treatment. Content edits were made to assure a literacy level appropriate to the audience, and the PDA was produced for online video dissemination. High-quality, well-developed tools to facilitate shared decision-making in populations with limited access to culturally sensitive information can narrow gaps and align care with individual patient preferences. A newly developed PDA is available for shared decision-making that provides culturally appropriate treatment information for inadequately controlled Hispanics/Latinos with T2DM. The impact on the overall health of patients and care management of T2DM requires further study.

Protective Behavior in Games

OpenAIRE

Fiestras-Janeiro, G.; Borm, P.E.M.; van Megen, F.J.C.

1996-01-01

This paper introduces the notion of protective equilibrium in the context of fin ite games in strategic form.It shows that for matrix games the set of protective equilibria equals the set of proper equilibria.Moreover, in the context of bima trix games, the notion of protective behaviour is used as a refinement tool.