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Sample records for inadequate anaesthesiological protection

  1. Tooth injury in anaesthesiology.

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    de Sousa, José Miguel Brandão Ribeiro; Mourão, Joana Irene de Barros

    2015-01-01

    Dental injury is the most common complication of general anaesthesia and has significant physical, economic and forensic consequences. The aim of this study is to review on the characteristics of dental injury associated with anaesthesiology and existing methods of prevention. In this review, the time of anaesthesia in which the dental injury occurs, the affected teeth, the most frequent type of injury, established risk factors, prevention strategies, protection devices and medico-legal implications inherent to its occurrence are approached. Before initiating any medical procedure that requires the use of classic laryngoscopy, a thorough and detailed pre-aesthetic evaluation of the dental status of the patient is imperative, in order to identify teeth at risk, analyze the presence of factors associated with difficult intubation and outline a prevention strategy that is tailored to the risk of dental injury of each patient. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  2. Tooth injury in anaesthesiology

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    José Miguel Brandão Ribeiro de Sousa

    2015-12-01

    Full Text Available BACKGROUND AND OBJECTIVES: Dental injury is the most common complication of general anaesthesia and has significant physical, economic and forensic consequences. The aim of this study is to review on the characteristics of dental injury associated with anaesthesiology and existing methods of prevention. CONTENTS: In this review, the time of anaesthesia in which the dental injury occurs, the affected teeth, the most frequent type of injury, established risk factors, prevention strategies, protection devices and medico-legal implications inherent to its occurrence are approached. CONCLUSIONS: Before initiating any medical procedure that requires the use of classic laryngoscopy, a thorough and detailed pre-aesthetic evaluation of the dental status of the patient is imperative, in order to identify teeth at risk, analyze the presence of factors associated with difficult intubation and outline a prevention strategy that is tailored to the risk of dental injury of each patient.

  3. [Tooth injury in anaesthesiology].

    Science.gov (United States)

    Brandão Ribeiro de Sousa, José Miguel; de Barros Mourão, Joana Irene

    2015-01-01

    Dental injury is the most common complication of general anaesthesia and has significant physical, economic and forensic consequences. The aim of this study is to review on the characteristics of dental injury associated with anaesthesiology and existing methods of prevention. In this review, the time of anaesthesia in which the dental injury occurs, the affected teeth, the most frequent type of injury, established risk factors, prevention strategies, protection devices and medico-legal implications inherent to its occurrence are approached. Before initiating any medical procedure that requires the use of classic laryngoscopy, a thorough and detailed pre-aesthetic evaluation of the dental status of the patient is imperative, in order to identify teeth at risk, analyze the presence of factors associated with difficult intubation and outline a prevention strategy that is tailored to the risk of dental injury of each patient. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  4. Antarctica's protected areas are inadequate, unrepresentative, and at risk.

    Science.gov (United States)

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

    2014-06-01

    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.

  5. Antarctica's protected areas are inadequate, unrepresentative, and at risk.

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    Justine D Shaw

    2014-06-01

    Full Text Available 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.

  6. Bridge Failure Due to Inadequate Design of Bed Protection

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    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.

  7. The future of anaesthesiology

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    Ankit Agarwal

    2012-01-01

    Full Text Available There was an era when bark of mandrake plant, boiled in wine was used to administer anesthesia. Ether, after reigning the kingdom of anaesthesiology for more than a century, came to be superseded by newer and newer agents. Anaesthesiology has witnessed tremendous developments since infancy. The introduction of advanced airway adjuncts, labour analgesia, patient controlled analgesia, fibreoptics, Bispectral Index monitors, workstations, simulators and robotic surgeries are only to name a further few. Anaesthesia for robotic surgery received much impetus and is still a dream to come true in many countries. But then, the rapid spin in technology and fast sophistication of medical field has even surpassed this. The next event to venture is entry of robots into human body made possible by a culmination of intricate medicine and fine technology that is Nanotechnology. This article briefly introduces the field of nanotechnology in relation to its potential benefits to the field of anaesthesiology. As with any new tecnique or application, nanotechnology as applied to anaesthesiology has tremendous potential for research and exploration. This article therefore orients the reader′s mind towards the immense potential and benefits that can be tapped by carrying out further studies and experimentations.The literature was searched using databases, peer reviewed journals and books for over a period of one year (till December 2011. The search was carried out using keywords as nanotechnology, robotics, anesthesiology etc. Initially a master database was formed including human as well as animal studies. Later on the broad topic area was narrowed down to developments in nanotechnology as applied to anesthesiology. Further filtering of search results were done based on selection of researches and developments relating to local, regional and general anesthesia as well as critical care and pain and palliative care.

  8. Factors influencing career choice in anaesthesiology

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    Asha Tyagi

    2012-01-01

    Full Text Available Background: There is a shortage of anaesthesiologists in India. The factors that prompt medical students to opt for anaesthesiology as their career are not known; neither do we have any mechanism to know a student′s stress-bearing ability before he/she opts for a stressful career like anaesthesiology. We conducted an anonymous, questionnaire-based, cross-sectional survey among 200 post-graduate anaesthesiology students to know various factors that they considered while opting for this speciality, and also evaluated their stress-bearing ability using Antonovsky′s 13-point sense of coherence scale. Methods: Two-hundred anaesthesiology students were asked to complete a questionnaire regarding the factors they considered important while opting for anaesthesiology, also enumerated in order of importance the three most important factors that led to opting this career. Students also answered the questions in Antonovsky′s sense of coherence (SOC scale. Results: Economic security was considered by maximum number of students (67.7%, while intellectual stimulation/challenge offered by anaesthesiology was rated first in order of importance. Influence of doctor−patient relationship was not considered by large number of students. The weak SOC score (55 (25 th percentile was not greatly different than the mean SOC score (60 in the survey. Conclusion: Increasing the exposure of students to anaesthesiology at undergraduate level and building public awareness about the speciality will prompt more students to opt for the speciality, while career counselling with regard to specific needs of a speciality and ability of a student will help in opting the speciality that best suits the student′s personality.

  9. Amalgamation of management information system into anaesthesiology practice: A boon for the modern anaesthesiologists

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    Sukhminder Jit Singh Bajwa

    2014-01-01

    Full Text Available Over the years, traditional anaesthesia record keeping system has been the backbone of anaesthesiology ever since its introduction in the 1890s by Dr. Harvey Cushing and Dr. Ernest A. Codman. Besides providing the important information regarding patients′ vital physiologic parameters, paper records had been a reliable source for various clinical research activities. The introduction of electronic monitoring gadgets and electronic record keeping systems has revolutionised the anaesthesiology practice to a large extent. Recently, the introduction of anaesthesia information management system (AIMS, which incorporates all the features of monitoring gadgets, such as electronic storage of large accurate data, quality assurance in anaesthesia, enhancing patient safety, ensuring legal protection, improved billing services and effecting an organisational change, is almost a revolution in modern-day anaesthesiology practice. The clinical research activities that are responsible for taking anaesthesiology discipline to higher peaks have also been boosted by the amalgamation of AIMS, enabling multicenter studies and sharing of clinical data. Barring few concerns in its installation, cost factors and functional aspects, the future of AIMS seems to be bright and will definitely prove to be a boon for modern-day anaesthesiology practice.

  10. Harmonisation of anaesthesiology training in Europe

    DEFF Research Database (Denmark)

    Van Gessel, Elisabeth F; Ostergaard, Helle Thy; Niemi-Murola, Leila

    2012-01-01

    The last 20 years has seen many changes in medical education, with reforms taking place in undergraduate health-care studies with the application of the Bologna principles and also transfer of the same educational principles to postgraduate medical specialty training. It is the aim of this article...... to grossly sketch and contextualise these reforms in the rapidly evolving European Union, before defining harmonisation of the medical postgraduate training and the bodies involved in this process; thereafter, the authors try to present the potential consensus points that can make the process...... of harmonisation in anaesthesiology postgraduate training in Europe become a reality. Finally, a brief outline of the potential challenges concludes the paper....

  11. Behaviorally inadequate

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    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......, but situationist critiques suggest that character traits, and environmental virtues, are not as behaviorally robust as is typically supposed. Their views present a dilemma. Because ethicists cannot rely on virtues to produce pro-environmental behaviors, the only real way of salvaging environmental virtue theory...... positive results. However, because endorsing behaviorally ineffective virtues, for whatever reason, entails that environmental ethicists are abandoning the goal of helping and protecting the environment, environmental ethicists should consider looking elsewhere than virtues and focus instead on the role...

  12. Mobbing Exposure of Anaesthesiology Residents in Turkey.

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    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.

  13. Anaesthesiological implications of Kimura's disease: a case report

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    Sorbello Massimiliano

    2009-06-01

    Full Text Available Abstract Introduction Kimura's disease is a chronic inflammatory condition belonging to the angio-lymphatic proliferative group of disorders, usually affecting young men of Asian race, but is rare in Western countries. It is a benign but locally injurious disease, of unknown aetiology, whose classical clinical features are a tumour-like swelling, usually in the head and neck, with or without satellite lymphadenopathy, often accompanied by eosinophilia and elevated serum IgE. Case presentation We report the case of a 33-year-old Caucasian woman with an atypical localization of Kimura's disease, discussing the anaesthesiological implications and reviewing the current literature on Kimura's disease. Conclusions The diagnosis of Kimura's disease can be difficult and misleading, and anaesthesiological precautions could be ignored. Patients with this disease are often evaluated for other disorders: unnecessary diagnostic tests and investigations, or even surgery, may be avoided by just being aware of Kimura's disease.

  14. Diagnostic ultrasound use in physiotherapy, emergency medicine, and anaesthesiology

    International Nuclear Information System (INIS)

    McKiernan, Sharmaine; Chiarelli, Pauline; Warren-Forward, Helen

    2010-01-01

    Background: Diagnostic ultrasound is traditionally and extensively used within the radiology department. However in recent years its use has expanded outside this traditional area into health professions such as physiotherapy, emergency medicine and anaesthesiology. Purpose: The radiology community needs to be aware of the expansion of use of diagnostic ultrasound. This article starts this exploration in the health professions mentioned, however it is acknowledged that diagnostic ultrasound use goes beyond what is covered in this article. As diagnostic ultrasound is a user dependant modality and the outcome of an examination is largely influenced by the skill and experience of the operator, the radiology community should take a guiding role in its use, training and protocol development for health professionals. Method: This article explores the literature on the use of diagnostic ultrasound within physiotherapy, emergency medicine and anaesthesiology. Literature was searched for on the databases Medline, Cinahl and Embase. Results: Diagnostic ultrasound is being used in health professions such as physiotherapy, where it is being used to provide biofeedback to patients on contraction of abdominal and pelvic floor muscles; emergency medicine, for the investigation of free fluid within the abdomen of a trauma patient and anaesthesiology, for the placement of catheters and nerve blocks. Conclusion: As members of the radiology community are considered experts in the field, they need to take the lead to guide and mentor the other health professionals who are now using the modality. To be able to achieve this they must have an understanding of what these professions are using the modality for.

  15. Diagnostic ultrasound use in physiotherapy, emergency medicine, and anaesthesiology

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    McKiernan, Sharmaine [School of Health Sciences, University of Newcastle, Callagham, NSW 2308 (Australia)], E-mail: sharmaine.mckiernan@newcastle.edu.au; Chiarelli, Pauline; Warren-Forward, Helen [School of Health Sciences, University of Newcastle, Callagham, NSW 2308 (Australia)

    2010-05-15

    Background: Diagnostic ultrasound is traditionally and extensively used within the radiology department. However in recent years its use has expanded outside this traditional area into health professions such as physiotherapy, emergency medicine and anaesthesiology. Purpose: The radiology community needs to be aware of the expansion of use of diagnostic ultrasound. This article starts this exploration in the health professions mentioned, however it is acknowledged that diagnostic ultrasound use goes beyond what is covered in this article. As diagnostic ultrasound is a user dependant modality and the outcome of an examination is largely influenced by the skill and experience of the operator, the radiology community should take a guiding role in its use, training and protocol development for health professionals. Method: This article explores the literature on the use of diagnostic ultrasound within physiotherapy, emergency medicine and anaesthesiology. Literature was searched for on the databases Medline, Cinahl and Embase. Results: Diagnostic ultrasound is being used in health professions such as physiotherapy, where it is being used to provide biofeedback to patients on contraction of abdominal and pelvic floor muscles; emergency medicine, for the investigation of free fluid within the abdomen of a trauma patient and anaesthesiology, for the placement of catheters and nerve blocks. Conclusion: As members of the radiology community are considered experts in the field, they need to take the lead to guide and mentor the other health professionals who are now using the modality. To be able to achieve this they must have an understanding of what these professions are using the modality for.

  16. 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.

  17. [Implementation of a national training assessment programme in anaesthesiology

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    Skjelsager, K.; Malling, B.; Bested, K.M.

    2008-01-01

    INTRODUCTION: In 2004, outcome-based education and in-training assessment was introduced by a reform of postgraduate medical education in Denmark. An assessment programme covering the introductory year of anaesthesiology was constructed. The purpose of this study was to explore to which degree...... this programme was implemented in daily practice in the clinical departments and whether the recommended assessment protocol was followed. MATERIALS AND METHODS: A questionnaire was distributed to 26 departments and 38 trainees. RESULTS: The response rate for both groups exceeded 90%. Individual learning plans...... were prepared by (2/3) of the trainees according to both trainees and departments. The various methods in the assessment programme were implemented to a high degree. The use of structured clinical observations was reported by more than 70% of both groups. Global assessments were applied in more than 70...

  18. Validation of core competencies during residency training in anaesthesiology

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    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

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

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    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.

  20. Awareness about scope of anaesthesiology, attitudes towards the speciality and stress levels amongst postgraduate students in anaesthesiology: A cross-sectional study

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    Chaitanya A Kamat

    2015-01-01

    Full Text Available Trends in selection of a career in medicine vary from country to country. To plan future recruitment strategies and to balance distribution of physicians among medical specialties, each country needs to examine these reasons as part of educational research. The aim of this study was to explore the Anaesthesiology postgraduate students′ knowledge about anaesthesia as a speciality, their attitude towards anaesthesia as a career choice, stress levels during the period of postgraduation, views regarding Diploma in Anaesthesiology and undergraduate exposure to the subject. Eight hundred pretested questionnaires were provided to the anaesthesia postgraduate students attending various national level conferences in India. The collected data were statistically analysed using SPSS version 20. Only 31.6% of the students were aware of scope of anaesthesiology and 42.3% of students joined the speciality out of the interest to learn the subject, whereas 55.7% joined for other reasons, including non-availability of other specialties during medical postgraduate counselling. About 70% of students were stressed out during postgraduation, 31.6% found difficulty in accommodating the demands of challenging job and 3.8% went into depression. Majority of anaesthesiology postgraduate students were unaware of the scope of Anaesthesiology at the time of medical postgraduate counselling; only two-fifth of the students joined the speciality out of interest to learn the subject and most of them felt stressed out during the period of postgraduation. Majority of the students were of the opinion that Diploma in Anaesthesia was not a viable career option and should be scrapped.

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

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    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.

  2. Embracing the new paradigm of assessment in residency training: an assessment programme for first-year residency training in anaesthesiology

    DEFF Research Database (Denmark)

    Ringsted, C; Østergaard, D; Scherpbier, A

    2003-01-01

    is to specify the evaluation situations and develop appropriate methods. This paper describes the intrinsic rational validation process in outlining an assessment programme for first-year anaesthesiology residency training according to the new paradigm. The applicability to other residency programmes and higher......-level training in anaesthesiology is discussed. Udgivelsesdato: 2003-Jan...

  3. Implementation of a formal in-training assessment programme in anaesthesiology and preliminary results of acceptability

    DEFF Research Database (Denmark)

    Ringsted, C; Østergaard, D; van der Vleuten, C P M

    2003-01-01

    in anaesthesiology developed by a working group under the Danish Society of Anaesthesiology and Intensive Care Medicine. METHODS: A questionnaire about the implementation of the programme in practice and the characteristics of the trainees was sent to the educational responsible consultant (ERC) in each of the 26...... anaesthetic departments in the country with first-year trainees in anaesthesiology. Standard evaluations of the assessment programme were regularly collected from trainees. RESULTS: Twenty-five (96%) departments returned the questionnaire. In total the departments reported on 100 trainees and 83 of these had...... the most frequently cited barriers to implementation. Evaluations from trainees showed a generally positive attitude towards most of the programme. They especially praised the programme's effect on structuring training and having a positive effect on learning. CONCLUSION: The in-training assessment...

  4. Stress prevalence and stressors among anaesthesiology and intensive care unit workers: A multicentre survey study.

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    Kwiatosz-Muc, Magdalena; Fijałkowska-Nestorowicz, Anna; Fijałkowska, Magdalena; Aftyka, Anna; Kowalczyk, Michał

    2017-12-13

    High stress levels have been commonly reported among ICU workers. Currently, anaesthesiology is safer for the patient but more stressful for the staff working in this branch of medicine. ICU and anaesthesiology personnel are prone to stress because of the specific character of their work. Our objectives were to assess stress prevalence among anaesthesiology and ICU workers to compare this stress prevalence in relation to professional groups, sex, job seniority, and type of hospital and describe the importance of major stressors at work. The ICU and anaesthesiology workers of 15 randomly selected Polish hospitals were surveyed. To assess stress prevalence, the Perceived Stress Scale (PSS-10) was used. The analysis included 544 surveys. The examined population was divided into two groups. Group N consisted of 406 nurses (74.60%) and group P of 138 physicians (25.40%). The mean result in the PSS-10 scale for the N group was 19.00 and for the P group 17.00. Both group results were related to a 6 sten score, which implied a medium level of stress. In the N group, the PSS-10 results were significantly higher than in the P group. Women showed higher levels of stress than men. Stress levels among ICU and anaesthesiology personnel were of a medium range. Nurses showed significantly higher levels of stress than physicians. Female personnel showed higher levels of stress than male personnel. Age, job seniority and type of hospital did not have an influence on stress levels. The most stressful circumstances for anaesthesiology and ICU personnel included night shifts and duty overload. Copyright © 2017 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

  5. CONSORT item adherence in top ranked anaesthesiology journals in 2011: a retrospective analysis.

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    Münter, Nils H; Stevanovic, Ana; Rossaint, Rolf; Stoppe, Christian; Sanders, Robert D; Coburn, Mark

    2015-02-01

    Randomised controlled trials (RCTs) are the gold standard for measuring the efficacy of any medical intervention. The present study assesses the implementation of the CONSORT statement in the top 11 anaesthesiology journals in 2011. We designed this study in order to determine how well authors in the top 11 ranked anaesthesiology journals follow the CONSORT statement's criteria. A retrospective cross-sectional data analysis. The study was performed at the RWTH Aachen University Hospital. Journals included Pain, Anesthesiology, British Journal of Anaesthesia, Regional Anesthesia and Pain Medicine, European Journal of Pain, Anesthesia and Analgesia, Anaesthesia, Minerva Anestesiologica, Canadian Journal of Anesthesia, Journal of Neurosurgical Anesthesiology and the European Journal of Anaesthesiology. All articles in the online table of contents from the top 11 anaesthesiology journals according to the ISI Web of Knowledge were screened for RCTs published in 2011. The RCTs were assessed using the CONSORT checklist. We also analysed the correlation between the number of citations and the adherence to CONSORT items. We evaluated 319 RCTs and found that, more than ten years after the publication of the CONSORT statement, the RCTs satisfied a median of 60.0% of the CONSORT criteria. Only 72.1% of the articles presented clearly defined primary and secondary outcome parameters. The number of citations is only weakly associated with the fulfilment of the CONSORT statement (r = 0.023). Adherence to the CONSORT criteria remains low in top-ranked anaesthesiology journals. We found only a very weak correlation between the number of citations and fulfilment of the requirements of the CONSORT statement.

  6. Psychosocial risks in Psychiatry and Anaesthesiology residents in a Portuguese General and University Hospital.

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    Alves de Moura, Pedro; Serranheira, Florentino; Sacadura-Leite, Ema

    2016-03-24

    Medical Doctors (MD), although at the front line of response to patients and their families, are seldom study subjects for occupational psychosocial risks and work related stress. Assess psychiatry and anaesthesiology residents in a central and university Portuguese Hospital for the presence of psychosocial risks at work. We used the Copenhagen Psychosocial Questionnaire version 2 (COPSOQ), which was applied face-to-face in two group settings, in April 2014. It comprised a sample of 19 Psychiatry residents and 20 Anaesthesiology residents. Statistical analysis was done by correlational analysis using Pearson's coefficient (r) and the t-student test for categorical variables. An occupational health risk (red flag) was found for residents in the "Cognitive demands" dimension of COPSOQ and a health risk (red flag) in the "Work influence" dimension for the female Anaesthesiology sub-group. A possible risk (yellow flag) was found in 17 dimensions. Results also showed moderate correlations between various COPSOQ dimensions and the emergency department workload, workload, home study, number of children, year of training and the medical specialty variables. These results suggest that residents have a health risk which derives from the cognitive demands of their work and that it increases with the workload.  This implicates the need for occupational health measures to be taken to manage and reduce these psychological risks.

  7. 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.

  8. 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.)

  9. [Inadequate treatment of affective disorders].

    Science.gov (United States)

    Bergsholm, P; Martinsen, E W; Holsten, F; Neckelmann, D; Aarre, T F

    1992-08-30

    Inadequate treatment of mood (affective) disorders is related to the mind/body dualism, desinformation about methods of treatment, the stigma of psychiatry, low funding of psychiatric research, low educational priority, and slow acquisition of new knowledge of psychiatry. The "respectable minority rule" has often been accepted without regard to the international expertise, and the consequences of undertreatment have not been weighed against the benefits of optimal treatment. The risk of chronicity increases with delayed treatment, and inadequately treated affective disorders are a leading cause of suicide. During the past 20 years the increase in suicide mortality in Norway has been the second largest in the world. Severe mood disorders are often misclassified as schizophrenia or other non-affective psychoses. Atypical mood disorders, notably rapid cycling and bipolar mixed states, are often diagnosed as personality, adjustment, conduct, attention deficit, or anxiety disorders, and even mental retardation. Neuroleptic drugs may suppress the most disturbing features of mood disorders, a fact often misinterpreted as supporting the diagnosis of a schizophrenia-like disorder. Treatment with neuroleptics is not sufficient, however, and serious side effects may often occur. The consequences are too often social break-down and post-depression syndrome.

  10. [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.

  11. Technology and Information Tool Preferences of Academics in the Field of Anaesthesiology.

    Science.gov (United States)

    Akkaya, Akcan; Bilgi, Murat; Demirhan, Abdullah; Kurt, Adem Deniz; Tekelioğlu, Ümit Yaşar; Akkaya, Kadir; Koçoğlu, Hasan; Tekçe, Hikmet

    2014-12-01

    Researchers use a large number of information technology tools from the beginning until the publication of a scientific study. The aim of the study is to investigate the technology and data processing tool usage preferences of academics who produce scientific publications in the field of anaesthesiology. A multiple-choice survey, including 18 questions regarding the use of technology to assess the preferences of academicians, was performed. PubMed has been the most preferred article search portal, and the second is Google Academic. Medscape has become the most preferred medical innovation tracking website. Only 12% of academicians obtain a clinical trial registration number for their randomized clinical research. In total, 28% of respondents used the Consolidated Standards of Reporting Trials checklist in their clinical trials. Of all participants, 21% was using Dropbox and 9% was using Google-Drive for sharing files. Google Chrome was the most preferred internet browser (32.25%) for academic purposes. English language editing service was obtained from the Scribendi (21%) and Textcheck (12%) websites. Half of the academics were getting help from their specialist with a personal relationship, 27% was doing it themselves, and 24% was obtaining professional assistance for statistical requirements. Sixty percent of the participants were not using a reference editing program, and 21% was using EndNote. Nine percent of the academics were spending money for article writing, and the mean cost was 1287 Turkish Liras/year. Academics in the field of anaesthesiology significantly benefit from technology and informatics tools to produce scientific publications.

  12. Anaesthesiological maintenance in total endo-prosthesis of large joints

    Directory of Open Access Journals (Sweden)

    Prigorodov М.V.

    2013-06-01

    Full Text Available Purpose: To improve the quality of anesthetic protection in prosthetics of large joints based on a steady state energy balance. Materials and methods: Prospective, randomized study on the basis of a controlled hemodilution (CM double mask has been performed. In the first group of patients (32-19 women hemodilution (HS has not been done. The second group of patients (31-17 consisted of patients with HS. Three phases of the survey have been selected — before surgery, traumatic phase of the operation, after the operation. Analyzed the parameters of central hemodynamics (Cl (I/ min/m2 and total peripheral vascular resistance TPVR (dyn * sec1 * cm5, gas exchange (DO (ml / min and V02 (ml / min, energy metabolism (kcal / min; kcal / day. For data processing statistical package STATISTICA6,0 was used. Results: Central hemodynamic parameters in both groups did not significantly change, and did not differ between the groups. A significant reduction in D02. DO differences between groups of patients at all stages of the studies found has been determined in both groups of patients. Oxygen consumption in the first group of patients decreased significantly to traumatic phase of the operation, and the next stage rose to baseline. Oxygen consumption in the group with CM increased by traumatic phase of the operation, but then returned to baseline. In patients with CM oxygen consumption was significantly higher than in patients without CM at all time points. It is found that there is a significant drop in energy metabolism in the first group of patients in traumatic phase of the operation, followed by reduction of the energy poten- tial. It is noted that insignificant increase of energy on stage traumatic operation in the second group of patients, with a subsequent decrease to the original level. Energy exchange at all stages of the study was significantly higher in the second group of patients. Logistic regression analysis found that controlled hemodilution is

  13. Anaesthesiologic protocol for kidney transplantation in two patients with Fabry Disease: a case series

    Science.gov (United States)

    Sorbello, Massimiliano; Veroux, Massimiliano; Cutuli, Melania; Morello, Gianluigi; Paratore, Annalaura; Sidoti, Mirko Tindaro; Maugeri, Jessica Giuseppina; Gagliano, Massimiliano; Giuffrida, Giuseppe; Corona, Daniela; Veroux, Pierfrancesco

    2008-01-01

    Fabry's Disease is a rare genetic syndrome, with a classic X-linked alpha -galactosidase A deficiency phenotype, responsible for glico-sphyngolypids metabolism impairment with clinical effects in several organs and functions. We describe the anaesthesiologic implications of two patients with Fabry disease who underwent a kidney transplantation from a deceased donor. We recommend careful preoperative evaluation, including cardiac sonography study and spirometry for Fabry disease patients, and according to our experience, we recommend advanced haemodynamic monitoring during surgery. Careful airway examination should be further performed, with particular attention to patient ventilability prediction and available alternative strategies for airway management in case of difficulties. A nephroprotective strategy and a particular care to the associated end-stage organ disease may significantly improve the long-term outcome of patients with Fabry Disease. PMID:19014714

  14. 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....

  15. Turkish Publications in Science Citation Index and Citation Index-Expanded Indexed Journals in the Field of Anaesthesiology: A Bibliographic Analysis.

    Science.gov (United States)

    Özbilgin, Şule; Hancı, Volkan

    2017-02-01

    Our study aimed to assess Turkish publications in Science Citation Index (SCI) and Science Citation Index Expanded (SCI-E) indexed journals in the field of 'anaesthesiology'. Journals related to 'anaesthesiology' in the Science Citation Index-Expanded database of 'Thomson Reuter Web of Science' were searched. The search engine of Institute for Scientific Information (ISI) Web of Science (WoS) was used in the advanced mode by typing 'IS=ISSN number' to identify publications in the journal. By typing 'IS=ISSN number AND CU=Turkey', Turkish papers on anaesthesiology were found. If Turkish and non-Turkish authors had collaborated, the article was included in the search when the corresponding author had provided a Turkey-based address. The catalogue information and statistics were used to determine Turkish publications as the percentage of total publications and the annual mean number of Turkish publications. In WoS, 'SU=anesthesiology' was used to determine the number, country, year and topic distributions of publications from 1975 to date and within the last 10 years. The citation numbers and h-indices were determined based on the country for publications within the last 10 years. From 1975 to the early 2000s Turkey was 20 th in the list of countries with highest number of publications on anaesthesiology, however in the last 10 years Turkey moved up to 18 th place. Its mean citation number has been 4.64, and it remains the 2 nd lowest country pertaining to citations among the 22 countries with the most number of publications. According to the percentage of publications in the field of anaesthesiology, the journals with highest rate of Turkish publications were Revista Brasileira de Anestesiologia, European Journal of Anaesthesiology and Journal of Anesthesia. In the field of anaesthesiology, the highest number of articles from Turkey was published in Revista Brasileira de Anestesiologia, European Journal of Anaesthesiology and Journal of Anesthesia. The mean citation

  16. Consultants' opinion on a new practice-based assessment programme for first-year residents in anaesthesiology

    DEFF Research Database (Denmark)

    Ringsted, C; ØStergaard, D; Scherpbier, A

    2002-01-01

    , organizational skills and collaborative skills, scholarly proficiencies and professionalism. Eighteen out of a total of 21 assessment instruments were used for pass/fail decisions. The aim of this study was to survey consultants' opinions of the programme in terms of the representativeness of competencies tested......BACKGROUND: Assessment in postgraduate education is moving towards using a broad spectrum of practice-based assessment methods. This approach was recently introduced in first-year residency in anaesthesiology in Denmark. The new assessment programme covers: clinical skills, communication skills......, the suitability of the programme as a basis for pass/fail decisions and the relevance and sufficiency of the content of the different assessment instruments. METHODS: A description of the assessment programme and a questionnaire were sent to all consultants of anaesthesiology in Denmark. The questionnaire...

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

    Directory of Open Access Journals (Sweden)

    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

  18. European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anaesthesiologist administration of propofol for GI endoscopy

    DEFF Research Database (Denmark)

    Dumonceau, J.M.; Riphaus, A.; Aparicio, J.R.

    2010-01-01

    ), the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) and the European Society of Anaesthesiology (ESA). These three societies have endorsed the present guideline.The guideline is published simultaneously in the Journals Endoscopy and European Journal of Anaesthesiology....

  19. 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

  20. 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

  1. 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…

  2. 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.)

  3. Financial incentives are inadequate for most companies

    Indian Academy of Sciences (India)

    Financial incentives are inadequate for most companies. market far less lucrative than for other diseases, which results in chronic underinvestment; reduced investment in TB drug R&D,. Pfizer withdrawal from TB R&D; AstraZeneca abandon TB R&D & close site; Novartis pull out; 4/22 Big Pharma producing antibacterials ...

  4. Implementing a Case-Based E-Learning Environment in a Lecture-Oriented Anaesthesiology Class: Do Learning Styles Matter in Complex Problem Solving over Time?

    Science.gov (United States)

    Choi, Ikseon; Lee, Sang Joon; Kang, Jeongwan

    2009-01-01

    This study explores how students' learning styles influence their learning while solving complex problems when a case-based e-learning environment is implemented in a conventional lecture-oriented classroom. Seventy students from an anaesthesiology class at a dental school participated in this study over a 3-week period. Five learning-outcome…

  5. 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.

  6. 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... ANALYSIS AND CRITICAL CONTROL POINT (HACCP) SYSTEMS § 417.6 Inadequate HACCP Systems. A HACCP system may be found to be inadequate if: (a) The HACCP plan in operation does not meet the requirements set forth in...

  7. Inadequate Nutritional Status of Hospitalized Cancer Patients

    Directory of Open Access Journals (Sweden)

    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.

  8. Newcastle disease virus outbreaks: vaccine mismatch or inadequate application?

    Science.gov (United States)

    Dortmans, Jos C F M; Peeters, Ben P H; Koch, Guus

    2012-11-09

    Newcastle disease (ND) is one of the most important diseases of poultry, and may cause devastating losses in the poultry industry worldwide. Its causative agent is Newcastle disease virus (NDV), also known as avian paramyxovirus type 1. Many countries maintain a stringent vaccination policy against ND, but there are indications that ND outbreaks can still occur despite intensive vaccination. It has been argued that this may be due to antigenic divergence between the vaccine strains and circulating field strains. Here we present the complete genome sequence of a highly virulent genotype VII virus (NL/93) obtained from vaccinated poultry during an outbreak of ND in the Netherlands in 1992-1993. Using this strain, we investigated whether the identified genetic evolution of NDV is accompanied by antigenic evolution. In this study we show that a live vaccine that is antigenically adapted to match the genotype VII NL/93 outbreak strain does not provide increased protection compared to a classic genotype II live vaccine. When challenged with the NL/93 strain, chickens vaccinated with a classic vaccine were completely protected against clinical disease and mortality and virus shedding was significantly reduced, even with a supposedly suboptimal vaccine dose. These results suggest that it is not antigenic variation but rather poor flock immunity due to inadequate vaccination practices that may be responsible for outbreaks and spreading of virulent NDV field strains. Copyright © 2012 Elsevier B.V. All rights reserved.

  9. [Dental trauma and anaesthesiology: epidemiology and insurance-related impact over 4 years in Rouen teaching hospital].

    Science.gov (United States)

    Laidoowoo, E; Baert, O; Besnier, E; Dureuil, B

    2012-01-01

    Dental injuries are the first cause of sinistrality in anaesthesiology. However, few insurance-related data are available concerning the publicly-owned establishments, in particular on the cost of the complaints deposited. We studied the epidemiology of dental trauma in a teaching hospital and brought it closer to the induced insurance-related costs. We conducted a retrospective study, examining the files of declaration of dental trauma, from January 2005 to December 2008. The litigations for dental injuries treated by Quality and Services Department were also analysed. Seventy-two cases of dental lesions were declared, i.e. 1/1528 general anaesthesias. Concerning the risk factors of lesion, 47 patients (65%) presented bad dental conditions identified during the pre-anaesthetic consultation; 27 patients (37%) had criteria for difficult intubation listed on the sheet of anaesthesia. The association of the 2 factors was found among 20 patients. The indication of information to the patient on the dental risk was registered on the sheet of anaesthesia in 17% of cases. The Quality and Services Department recorded 23 complaints for dental trauma over the period. In 4 cases the complaint was followed by a compensation for an average amount equal to 608 (256-1002) Euros, i.e., a total cost of 2434 Euros. The two main risk factors of dental lesion are well identified with the consultation of anaesthesia and are noted on the file. However, information to the patient on this risk is seldom notified. The incidence of dental lesions is important, but few complaints open right to financial repair for a very low insurance-related total amount. Copyright © 2011 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

  10. European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anaesthesiologist administration of propofol for GI endoscopy

    DEFF Research Database (Denmark)

    Dumonceau, J.M.; Riphaus, A.; Aparicio, J.R.

    2010-01-01

    of this evidence- and consensus-based set of guideline is to provide non-anaesthesiologists with a comprehensive framework for propofol sedation during digestive endoscopy. This guideline results from a collaborative effort from representatives of the European Society of Gastrointestinal Endoscopy (ESGE......), the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) and the European Society of Anaesthesiology (ESA). These three societies have endorsed the present guideline.The guideline is published simultaneously in the Journals Endoscopy and European Journal of Anaesthesiology....

  11. 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.

  12. [Use of a biological graft for subclavian-femoral bypassing in patients at operational-anaesthesiological risk].

    Science.gov (United States)

    Sukovatykh, B S; Belikov, L N; Rodionov, O A; Rodionov, A O

    2015-01-01

    Analysed herein are the results of an experimental study performed on 30 rabbits and a clinical study of treating a total of 60 patients presenting with critical ischaemia of lower limbs on the background of bilateral atherosclerotic lesions of the aortoiliac segment and running high operational-anaesthesiological risk. The animals were subdivided into three groups: an intact group consisting of 6 animals and two study groups comprising 12 rabbits each. In the first study group onto the wall of the abdominal aorta we implanted a synthetic polytetrafluoroethylene prosthesis, the second study group animals received biological graft "Kemangioprotez" from bovine internal thoracic arteries. The biological prosthesis on day three after implantation onto the arterial wall induced 3.2 times and on day seven 1.2 times more pronounced inflammatory reaction than the polytetrafluoroethylene prosthesis. 30 days after implantation of the synthetic graft the degree of repair connective-tissue processes in the arterial wall was 1.8-fold and 70 days after was 3.3-fold more pronounced than after implantation of the biological prosthesis at the same terms. In the connective-tissue capsule around the synthetic prosthesis predominated cellular elements while around the biological prosthesis - fibrous structures predominated. The patients were subdivided into 2 groups consisting of 30 patients each. In Group One patients the shunt used was a synthetic polytetrafluoroethylene prosthesis, in Group Two being a biological graft from bovine internal thoracic arteries. All patients suffered from severe concomitant diseases in the decompensation stage and a multi-level lesion of lower-limb arteries. Revascularization of the ischaemized extremity was carried out through the system of the deep femoral artery system. The use of a biological prosthesis made it possible in the immediate postoperative period to decrease the frequency of early postoperative complications by 13.3%, that of late graft

  13. Analysis of inadequate cervical smears using Shewhart control charts

    Directory of Open Access Journals (Sweden)

    Wall Michael K

    2004-06-01

    Full Text Available Abstract Background Inadequate cervical smears cannot be analysed, can cause distress to women, are a financial burden to the NHS and may lead to further unnecessary procedures being undertaken. Furthermore, the proportion of inadequate smears is known to vary widely amongst providers. This study investigates this variation using Shewhart's theory of variation and control charts, and suggests strategies for addressing this. Methods Cervical cytology data, from six laboratories, serving 100 general practices in a former UK Health Authority area were obtained for the years 2000 and 2001. Control charts of the proportion of inadequate smears were plotted for all general practices, for the six laboratories and for the practices stratified by laboratory. The relationship between proportion of inadequate smears and the proportion of negative, borderline, mild, moderate or severe dyskaryosis as well as the positive predictive value of a smear in each laboratory was also investigated. Results There was wide variation in the proportion of inadequate smears with 23% of practices showing evidence of special cause variation and four of the six laboratories showing evidence of special cause variation. There was no evidence of a clinically important association between high rates of inadequate smears and better detection of dyskaryosis (R2 = 0.082. Conclusions The proportion of inadequate smears is influenced by two distinct sources of variation – general practices and cytology laboratories, which are classified by the control chart methodology as either being consistent with common or special cause variation. This guidance from the control chart methodology appears to be useful in delivering the aim of continual improvement.

  14. Protective

    Directory of Open Access Journals (Sweden)

    Wessam M. Abdel-Wahab

    2013-10-01

    Full Text Available Many active ingredients extracted from herbal and medicinal plants are extensively studied for their beneficial effects. Antioxidant activity and free radical scavenging properties of thymoquinone (TQ have been reported. The present study evaluated the possible protective effects of TQ against the toxicity and oxidative stress of sodium fluoride (NaF in the liver of rats. Rats were divided into four groups, the first group served as the control group and was administered distilled water whereas the NaF group received NaF orally at a dose of 10 mg/kg for 4 weeks, TQ group was administered TQ orally at a dose of 10 mg/kg for 5 weeks, and the NaF-TQ group was first given TQ for 1 week and was secondly administered 10 mg/kg/day NaF in association with 10 mg/kg TQ for 4 weeks. Rats intoxicated with NaF showed a significant increase in lipid peroxidation whereas the level of reduced glutathione (GSH and the activity of superoxide dismutase (SOD, catalase (CAT, glutathione S-transferase (GST and glutathione peroxidase (GPx were reduced in hepatic tissues. The proper functioning of the liver was also disrupted as indicated by alterations in the measured liver function indices and biochemical parameters. TQ supplementation counteracted the NaF-induced hepatotoxicity probably due to its strong antioxidant activity. In conclusion, the results obtained clearly indicated the role of oxidative stress in the induction of NaF toxicity and suggested hepatoprotective effects of TQ against the toxicity of fluoride compounds.

  15. Drug Errors in Anaesthesiology

    Directory of Open Access Journals (Sweden)

    Rajnish Kumar Jain

    2009-01-01

    Full Text Available Medication errors are a leading cause of morbidity and mortality in hospitalized patients. The incidence of these drug errors during anaesthesia is not certain. They impose a considerable financial burden to health care systems apart from the patient losses. Common causes of these errors and their prevention is discussed.

  16. The impact of inadequate wastewater treatment on the receiving ...

    African Journals Online (AJOL)

    The impact of inadequate wastewater treatment on the receiving water bodies – Case study: Buffalo City and Nkokonbe Municipalities of the Eastern Cape ... into their respective receiving water bodies (Tembisa Dam, the Nahoon and Eastern Beach which are part of the Indian Ocean; the Tyume River and the Kat River).

  17. The impact of inadequate wastewater treatment on the receiving ...

    African Journals Online (AJOL)

    7950 = Water SA (on-line). 687. The impact of inadequate wastewater treatment on the receiving water bodies – Case study: Buffalo City and. Nkokonbe Municipalities of the Eastern Cape Province. MNB Momba1*, AN Osode2 and M Sibewu1.

  18. Inadequate Information in Laboratory Test Requisition in a Tertiary ...

    African Journals Online (AJOL)

    Aim: Laboratory investigations are important aspect of patient management and inadequate information or errors arising from the process of filling out laboratory Request Forms can impact significantly on the quality of laboratory result and ultimately on patient care. Objectives: This study examined the pattern of deficiencies ...

  19. Inadequate sleep and muscle strength: Implications for resistance training.

    Science.gov (United States)

    Knowles, Olivia E; Drinkwater, Eric J; Urwin, Charles S; Lamon, Séverine; Aisbett, Brad

    2018-02-02

    Inadequate sleep (e.g., an insufficient duration of sleep per night) can reduce physical performance and has been linked to adverse metabolic health outcomes. Resistance exercise is an effective means to maintain and improve physical capacity and metabolic health, however, the outcomes for populations who may perform resistance exercise during periods of inadequate sleep are unknown. The primary aim of this systematic review was to evaluate the effect of sleep deprivation (i.e. no sleep) and sleep restriction (i.e. a reduced sleep duration) on resistance exercise performance. A secondary aim was to explore the effects on hormonal indicators or markers of muscle protein metabolism. A systematic search of five electronic databases was conducted with terms related to three combined concepts: inadequate sleep; resistance exercise; performance and physiological outcomes. Study quality and biases were assessed using the Effective Public Health Practice Project quality assessment tool. Seventeen studies met the inclusion criteria and were rated as 'moderate' or 'weak' for global quality. Sleep deprivation had little effect on muscle strength during resistance exercise. In contrast, consecutive nights of sleep restriction could reduce the force output of multi-joint, but not single-joint movements. Results were conflicting regarding hormonal responses to resistance training. Inadequate sleep impairs maximal muscle strength in compound movements when performed without specific interventions designed to increase motivation. Strategies to assist groups facing inadequate sleep to effectively perform resistance training may include supplementing their motivation by training in groups or ingesting caffeine; or training prior to prolonged periods of wakefulness. Copyright © 2018. Published by Elsevier Ltd.

  20. European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anesthesiologist administration of propofol for GI endoscopy

    DEFF Research Database (Denmark)

    Dumonceau, J.M.; Riphaus, A.; Aparicio, J.R.

    2010-01-01

    of this evidence- and consensus-based set of guideline is to provide non-anesthesiologists with a comprehensive framework for propofol sedation during digestive endoscopy. This guideline results from a collaborative effort from representatives of the European Society of Gastrointestinal Endoscopy (ESGE......), the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) and the European Society of Anaesthesiology (ESA). These three societies have endorsed the present guideline....

  1. Inadequate Empirical Antibiotic Therapy in Hospital Acquired Pneumonia.

    Science.gov (United States)

    Dahal, S; Rijal, B P; Yogi, K N; Sherchand, J B; Parajuli, K; Parajuli, N; Pokhrel, B M

    2015-01-01

    Inadequate empirical antibiotic therapy for HAP is a common phenomena and one of the indicators of the poor stewardship. This study intended to analyze the efficacy of empirical antibiotics in the light of microbiological data in HAP cases. Suspected cases of HAP were followed for clinico-bacterial evidence, antimicrobial resistance and pre and post culture antibiotic use. The study was taken from February,2014 to July 2014 in department of Microbiology and department of Respiratory medicine prospectively. Data was analyzed by Microsoft Office Excel 2007. Out of 758 cases investigated, 77(10 %) cases were HAP, 65(84%) of them were culture positive and 48(74 %) were late in onset. In early onset cases, isolates were Acinetobacter 10(42%), Escherichia coli 5(21%), S.aureus 4(17%), Klebsiella 1(4%) and Pseudomonas 1(4%). From the late onset cases Acinetobacter 15(28%), Klebsiella 17(32%) and Pseudomonas 13(24%) were isolated. All Acinetobacter, 78% Klebsiella and 36% Pseudomonas isolates were multi drug resistant. Empirical therapies were inadequate in 12(70%) of early onset cases and 44(92%) of late onset type. Cephalosporins were used in 7(41%) of early onset infections but found to be adequate only in 2(12%) cases. Polymyxins were avoided empirically but after cultures were used in 9(19%) cases. Empirical antibiotics were vastly inadequate, more frequently so in late onset infections. Use of cephalosporins empirically in early onset infections and avoiding empirical use of polymyxin antibiotics in late onset infections contributed largely to the findings. Inadequate empirical regimen is a real time feedback for a practitioner to update his knowledge on the local microbiological trends.

  2. Deferasirox pharmacokinetics in patients with adequate versus inadequate response

    Science.gov (United States)

    Chirnomas, Deborah; Smith, Amber Lynn; Braunstein, Jennifer; Finkelstein, Yaron; Pereira, Luis; Bergmann, Anke K.; Grant, Frederick D.; Paley, Carole; Shannon, Michael

    2009-01-01

    Tens of thousands of transfusion-dependent (eg, thalassemia) patients worldwide suffer from chronic iron overload and its potentially fatal complications. The oral iron chelator deferasirox has become commercially available in many countries since 2006. Although this alternative to parenteral deferoxamine has been a major advance for patients with transfusional hemosiderosis, a proportion of patients have suboptimal response to the maximum approved doses (30 mg/kg per day), and do not achieve negative iron balance. We performed a prospective study of oral deferasirox pharmacokinetics (PK), comparing 10 transfused patients with inadequate deferasirox response (rising ferritin trend or rising liver iron on deferasirox doses > 30 mg/kg per day) with control transfusion-dependent patients (n = 5) with adequate response. Subjects were admitted for 4 assessments: deferoxamine infusion and urinary iron measurement to assess readily chelatable iron; quantitative hepatobiliary scintigraphy to assess hepatic uptake and excretion of chelate; a 24-hour deferasirox PK study following a single 35-mg/kg dose of oral deferasirox; and pharmacogenomic analysis. Patients with inadequate response to deferasirox had significantly lower systemic drug exposure compared with control patients (P deferasirox must be determined. This trial has been registered at http://www.clinicaltrials.gov under identifier NCT00749515. PMID:19724055

  3. Inadequate evaluation and management of threats in Australia's Marine Parks, including the Great Barrier Reef, misdirect Marine conservation.

    Science.gov (United States)

    Kearney, Bob; Farebrother, Graham

    2014-01-01

    The magnificence of the Great Barrier Reef and its worthiness of extraordinary efforts to protect it from whatever threats may arise are unquestioned. Yet almost four decades after the establishment of the Great Barrier Reef Marine Park, Australia's most expensive and intensely researched Marine Protected Area, the health of the Reef is reported to be declining alarmingly. The management of the suite of threats to the health of the reef has clearly been inadequate, even though there have been several notable successes. It is argued that the failure to prioritise correctly all major threats to the reef, coupled with the exaggeration of the benefits of calling the park a protected area and zoning subsets of areas as 'no-take', has distracted attention from adequately addressing the real causes of impact. Australia's marine conservation efforts have been dominated by commitment to a National Representative System of Marine Protected Areas. In so doing, Australia has displaced the internationally accepted primary priority for pursuing effective protection of marine environments with inadequately critical adherence to the principle of having more and bigger marine parks. The continuing decline in the health of the Great Barrier Reef and other Australian coastal areas confirms the limitations of current area management for combating threats to marine ecosystems. There is great need for more critical evaluation of how marine environments can be protected effectively and managed efficiently.

  4. 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.

  5. Inadequate doses of hemodialysis. Predisposing factors, causes and prevention

    Directory of Open Access Journals (Sweden)

    Pehuén Fernández

    2017-04-01

    Full Text Available Patients receiving sub-optimal dose of hemodialysis have increased morbidity and mortality. The objectives of this study were to identify predisposing factors and causes of inadequate dialysis, and to design a practical algorithm for the management of these patients. A cross-sectional study was conducted. Ninety patients in chronic hemodialysis at Hospital Privado Universitario de Córdoba were included, during September 2015. Twenty two received sub-optimal dose of hemodialysis. Those with urea distribution volume (V greater than 40 l (72 kg body weight approximately are 11 times more likely (OR = 11.6; CI 95% = 3.2 to 51.7, p < 0.0001 to receive an inadequate dose of hemodialysis, than those with a smaller V. This situation is more frequent in men (OR = 3.5; 95% CI 1.01-15.8; p = 0.0292. V greater than 40 l was the only independent predictor of sub-dialysis in the multivariate analysis (OR = 10.3; 95% CI 2.8-37; p < 0.0004. The main cause of suboptimal dialysis was receiving a lower blood flow (Qb than the prescribed (336.4 ± 45.8 ml/min vs. 402.3 ± 28.8 ml/min respectively, p < 0.0001 (n = 18. Other causes were identified: shorter duration of the session (n = 2, vascular access recirculation (n = 1, and error in the samples (n = 1. In conclusion, the only independent predisposing factor found in this study for sub-optimal dialysis is V greater than 40 l. The main cause was receiving a slower Qb than prescribed. From these findings, an algorithm for the management of these patients was developed

  6. 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.

  7. 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.

  8. 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 ...

  9. Inadequate housing among families under investigation for child abuse and neglect: prevalence from a national probability sample.

    Science.gov (United States)

    Fowler, Patrick J; Henry, David B; Schoeny, Michael; Landsverk, John; Chavira, Dina; Taylor, Jeremy J

    2013-09-01

    This study aimed to estimate the prevalence of inadequate housing that threaten out-of-home placement among families under investigation by child welfare. Data came from the National Survey of Child and Adolescent Well-Being, a nationally representative longitudinal survey of child welfare-involved families. Child protective services caseworkers as well as caregivers provided information on families whose child remained in the home after initial investigation (N = 3,867). Multilevel latent class analyses tested the presence of inadequately housed subgroups using 4 housing problem indicators at baseline. Logistic regressions assessed convergent and predictive validity. A two class latent solution best fit the data. Findings indicated that inadequate housing contributed to risk for out-of-home placement in approximately 16 % of intact families under investigation by child protective services. These families were 4 times more likely to need housing services 12 months later. Federal legislation emphasizes integration of social services as necessary to end homelessness. This study demonstrates overlap across public agencies. Enhanced coordination of child welfare and housing services facilitates interventions to prevent and mitigate homelessness.

  10. 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

  11. 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.

  12. The association of xerostomia and inadequate intake in older adults.

    Science.gov (United States)

    Rhodus, N L; Brown, J

    1990-12-01

    Recent studies indicate that nearly one in five older adults has xerostomia (dry mouth). Salivary gland dysfunction and/or inadequate saliva increases the difficulty of these older adults in obtaining proper nutrition. Problems in lubricating, masticating, tolerating, tasting, and swallowing food contribute notably to the complex physiological and psychological manifestations of aging. To our knowledge, the literature has not demonstrated an association between xerostomia and malnutrition in the elderly. We randomly selected 67 older adults from institutionalized and free-living geriatric populations. Nutritional intake analysis was performed on both groups of study subjects, who were found to have xerostomia by use of sialometry, and on control subjects matched for age, sex, and physical status. Intake of total energy, protein, dietary fiber, total fat, saturated fat, cholesterol, sodium, potassium, vitamin A, vitamin C, thiamin, riboflavin, vitamin B-6, calcium, iron, and zinc was compared with the 1989 Recommended Dietary Allowances. Subjects' intakes were also compared with that of a control group. Medical systemic information and number and types of medications were compared among the groups. Statistical analysis of the data indicated significant (p less than .001) inadequacies in the nutritional intake patterns of institutionalized and free-living older adults with xerostomia. Subjects with xerostomia (more than 75% of the free-living and institutionalized seniors) had significant deficiencies of fiber, potassium, vitamin B-6, iron, calcium, and zinc. Taste and food perception were significantly reduced in the elders with xerostomia. Our study indicates the potential contribution of xerostomia to the high prevalence of geriatric malnutrition in the United States.

  13. Inadequate pain relief among patients with primary knee osteoarthritis.

    Science.gov (United States)

    Laires, Pedro A; Laíns, Jorge; Miranda, Luís C; Cernadas, Rui; Rajagopalan, Srini; Taylor, Stephanie D; Silva, José C

    Despite the widespread treatments for osteoarthritis (OA), data on treatment patterns, adequacy of pain relief, and quality of life are limited. The prospective multinational Survey of Osteoarthritis Real World Therapies (SORT) was designed to investigate these aspects. To analyze the characteristics and the patient reported outcomes of the Portuguese dataset of SORT at the start of observation. Patients ≥50 years with primary knee OA who were receiving oral or topical analgesics were eligible. Patients were enrolled from seven healthcare centers in Portugal between January and December 2011. Pain and function were evaluated using the Brief Pain Inventory (BPI) and WOMAC. Quality of life was assessed using the 12-Item Short Form Health Survey (SF-12). Inadequate pain relief (IPR) was defined as a score >4/10 on item 5 of the BPI. Overall, 197 patients were analyzed. The median age was 67.0 years and 78.2% were female. Mean duration of knee OA was 6.2 years. IPR was reported by 51.3% of patients. Female gender (adjusted odds ratio - OR 2.15 [95%CI 1.1, 4.5]), diabetes (OR 3.1 [95%CI 1.3, 7.7]) and depression (OR 2.24 [95%CI 1.2, 4.3]) were associated with higher risk of IPR. Patients with IPR reported worst outcomes in all dimensions of WOMAC (p<0.001) and in all eight domains and summary components of SF-12 (p<0.001). Our findings indicate that improvements are needed in the management of pain in knee OA in order to achieve better outcomes in terms of pain relief, function and quality of life. Copyright © 2016 Elsevier Editora Ltda. All rights reserved.

  14. Public health effects of inadequately managed stormwater runoff.

    Science.gov (United States)

    Gaffield, Stephen J; Goo, Robert L; Richards, Lynn A; Jackson, Richard J

    2003-09-01

    This study investigated the scale of the public health risk from stormwater runoff caused by urbanization. We compiled turbidity data for municipal treated drinking water as an indication of potential risk in selected US cities and compared estimated costs of waterborne disease and preventive measures. Turbidity levels in other US cities were similar to those linked to illnesses in Milwaukee, Wis, and Philadelphia, Pa. The estimated annual cost of waterborne illness is comparable to the long-term capital investment needed for improved drinking water treatment and stormwater management. Although additional data on cost and effectiveness are needed, stormwater management to minimize runoff and associated pollution appears to make sense for protecting public health at the least cost.

  15. Increasing Trends in Orthopedic Fellowships Are Not due to Inadequate Residency Training

    Directory of Open Access Journals (Sweden)

    K. A. Almansoori

    2015-01-01

    Full Text Available Orthopedic residents have one of the highest fellowship participation rates among medical specialities and there are growing concerns that inadequate residency training may be contributing to this trend. Therefore, a mixed-exploratory research survey was distributed to all 148 graduating Canadian orthopedic residents to investigate their perceptions and attitudes for pursuing fellowships. A response rate of 33% (n=49 was obtained with the majority of residents undertaking one (27% or two (60% fellowships. Surgical-skill development was reported as the most common motivating factor, followed by employment and marketability; malpractice protection and financial reasons were the least relevant. The overwhelming majority of residents (94%, n=46 felt adequately prepared by their residency training for independent general practice, and 84% (n=41 of respondents did not feel that current fellowship trends were due to poor residency training. Three common themes were expressed in their comments: the growing perceived expectation by healthcare professionals and employers to be fellowship-certified, the integration of fellowship training into the surgical education hierarchy, and the failure of residency training curriculums to accommodate for this trend. In conclusion, Canadian orthopedic residents are confident of their residency training and are increasingly pursuing fellowships to primarily develop their surgical skills and expertise.

  16. 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.

  17. 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

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

    OpenAIRE

    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.

  19. 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.

  20. Predictors of Inadequate Inpatient Colonoscopy Preparation and Its Association with Hospital Length of Stay and Costs.

    Science.gov (United States)

    Yadlapati, Rena; Johnston, Elyse R; Gregory, Dyanna L; Ciolino, Jody D; Cooper, Andrew; Keswani, Rajesh N

    2015-11-01

    Adequate bowel preparation is essential to safe and effective inpatient colonoscopy. Predictors of poor inpatient colonoscopy preparation and the economic impacts of inadequate inpatient preparations are not defined. The aims of this study were to (1) determine risk factors for inadequate inpatient bowel preparations, and (2) examine the association between inadequate inpatient bowel preparation and hospital length of stay (LOS) and costs. We performed a retrospective cohort study of adult patients undergoing inpatient colonoscopy preparation over 12 months (1/1/2013-12/31/2013). Of 524 identified patients, 22.3% had an inadequate preparation. A multiple logistic regression model identified the following potential predictors of inadequate bowel preparation: lower income (OR 1.11; 95% CI 1.04, 1.22), opiate or tricyclic antidepressant (TCA) use (OR 1.55; 0.98, 2.46), and afternoon colonoscopy (OR 1.66; 1.07, 2.59); as well as American Society of Anesthesiologists (ASA) class ≥3 (OR 1.15; 1.05, 1.25) and symptoms of nausea/vomiting (OR 1.14; 1.04, 1.25) when a fair preparation was considered inadequate. Inadequate bowel preparation was associated with significantly increased hospital LOS (model relative mean estimate 1.25; 95% CI 1.03, 1.51) and hospital costs (estimate 1.31; 1.03, 1.67) when compared to adequate preparations. The rate of inadequate inpatient bowel preparations is high and associated with a significant increase in hospital LOS and costs. We identified five potential predictors of inadequate inpatient preparation: lower socioeconomic class, opiate/TCA use, afternoon colonoscopies, ASA class ≥3, and pre-preparation nausea/vomiting; these data should guide future initiatives to improve the quality of inpatient bowel preparations.

  1. Proposed biodiversity conservation areas: gap analysis and spatial prioritization on the inadequately studied Qinghai Plateau, China

    Directory of Open Access Journals (Sweden)

    Renqiang Li

    2018-01-01

    Full Text Available Global biodiversity priorities are primarily addressed through the establishment or expansion of conservation areas (CAs. Spatial prioritization of these CAs can help minimize biodiversity loss by accounting for the uneven distribution of biodiversity and conservation considerations (e.g., accessibility, cost, and biodiversity threats. Furthermore, optimized spatial priorities can help facilitate the judicious use of limited conservation resources by identifying cost effective CA designs. Here, we demonstrate how key species and ecosystems can be incorporated into systematic conservation planning to propose the expansion and addition of new CAs in the biodiversity-unique and data-poor region of Qinghai Plateau, China. We combined species distribution models with a systematic conservation planning tool, MARXAN to identify CAs for biodiversity on Qinghai Plateau. A set of 57 optimal CAs (273,872 km2, 39.3 % of this Province were required to achieve the defined conservation targets in Qinghai Province. We also identified 29 new CAs (139,216 km2, 20% of Qinghai Province outside the existing nature reserve (NRs that are necessary to fully achieve the proposed conservation targets. The conservation importance of these 29 new CAs was also indicated, with 10 labeled as high priority, 11 as medium priority, and 8 as low priority. High priority areas were more abundant in the eastern and southeastern parts of this region. Our results suggest that many species remain inadequately protected within the Qinghai Plateau, with conservation gaps in eastern and northwestern regions. The proposed more representative and effective CAs can provide useful information for adjusting the existing NRs and developing the first National Park in China.

  2. 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

  3. 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.

  4. 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.

  5. 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

  6. 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.

  7. 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...

  8. Wearable Devices for Classification of Inadequate Posture at Work Using Neural Networks.

    Science.gov (United States)

    Barkallah, Eya; Freulard, Johan; Otis, Martin J-D; Ngomo, Suzy; Ayena, Johannes C; Desrosiers, Christian

    2017-09-01

    Inadequate postures adopted by an operator at work are among the most important risk factors in Work-related Musculoskeletal Disorders (WMSDs). Although several studies have focused on inadequate posture, there is limited information on its identification in a work context. The aim of this study is to automatically differentiate between adequate and inadequate postures using two wearable devices (helmet and instrumented insole) with an inertial measurement unit (IMU) and force sensors. From the force sensors located inside the insole, the center of pressure (COP) is computed since it is considered an important parameter in the analysis of posture. In a first step, a set of 60 features is computed with a direct approach, and later reduced to eight via a hybrid feature selection. A neural network is then employed to classify the current posture of a worker, yielding a recognition rate of 90%. In a second step, an innovative graphic approach is proposed to extract three additional features for the classification. This approach represents the main contribution of this study. Combining both approaches improves the recognition rate to 95%. Our results suggest that neural network could be applied successfully for the classification of adequate and inadequate posture.

  9. The Inadequacy of Academic Environment Contributes to Inadequate Teaching and Learning Phenomena

    Science.gov (United States)

    Quasim, Shahla; Arif, Muhammad Shahbaz

    2014-01-01

    This study aims at the inadequacy of academic environment as an indicator contributing to the inadequate teaching and learning situation in Pakistan. The main focus is to look into the low proficiency of students in the subject of English at secondary school level. A comprehensive questionnaire was designed from the literature concerned and The…

  10. 25 CFR 170.811 - What happens if lack of funds results in inadequate maintenance?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What happens if lack of funds results in inadequate 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...

  11. 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.

  12. Sleep deprivation in the last trimester of pregnancy and inadequate vitamin D: Is there a relationship?

    Directory of Open Access Journals (Sweden)

    Suzan Gunduz

    2016-01-01

    Conclusion: Inadequate vitamin D and poor sleep quality are prevalent in pregnant women, but low levels of vitamin D are not associated with poor sleep quality. Further studies with larger sample sizes and studies that include preterm deliveries and special sleep disorders should be performed to understand this issue better.

  13. 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…

  14. 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...

  15. Donepezil: A cause of inadequate muscle relaxation and delayed neuromuscular recovery

    Directory of Open Access Journals (Sweden)

    Alka Bhardwaj

    2011-01-01

    Full Text Available A 74-year-old female with diabetes mellitus type II and Alzheimer′s disease, taking donepezil for 4 months was operated for right modified radical mastectomy under general anesthesia. During the procedure a higher dose of non-depolarizing muscle relaxant was required than those recommended for her age yet the muscle relaxation was inadequate intra-operatively. Residual neuromuscular blockade persisted postoperatively, due to the cumulative effect of large doses of non-depolarizing muscle relaxant, needing post-operative ventilatory assistance. After ruling out other causes of resistance to non-depolarizing muscle relaxants, we concluded that acetylcholinesterase inhibitor donepezil was primarily responsible for inadequate muscle relaxation and delayed post-operative neuromuscular recovery.

  16. 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.

  17. 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...

  18. Global trends in dietary micronutrient supplies and estimated prevalence of inadequate intakes.

    Directory of Open Access Journals (Sweden)

    Ty Beal

    Full Text Available Understanding dietary patterns is vital to reducing the number of people experiencing hunger (about 795 million, micronutrient deficiencies (2 billion, and overweight or obesity (2.1 billion. We characterize global trends in dietary quality by estimating micronutrient density of the food supply, prevalence of inadequate intake of 14 micronutrients, and average prevalence of inadequate intake of these micronutrients for all countries between 1961 and 2011. Over this 50-year period, the estimated prevalence of inadequate intakes of micronutrients has declined in all regions due to increased total production of food and/or micronutrient density. This decline has been particularly strong in East and Southeast Asia and weaker in South Asia and sub-Saharan Africa. Sub-Saharan Africa is the only region where dietary micronutrient density has declined over this 50-year period. At the global level, micronutrients with the lowest levels of adequate estimated intake are calcium, iron, vitamin A, and zinc, but there are strong differences between countries and regions. Fortification has reduced the estimated prevalence of inadequate micronutrient intakes in all low-income regions, except South Asia. The food supply in many countries is still far below energy requirements, which suggests a need to increase the availability and accessibility of nutritious foods. Countries where the food energy supply is adequate show a very large variation in dietary quality, and in many of these countries people would benefit from more diverse diets with a greater proportion of micronutrient-dense foods. Dietary quality can be improved through fortification, biofortification, and agricultural diversification, as well as efforts to improve access to and use of micronutrient-dense foods and nutritional knowledge. Reducing poverty and increasing education, especially of women, are integral to sustainably addressing malnutrition.

  19. Global trends in dietary micronutrient supplies and estimated prevalence of inadequate intakes.

    Science.gov (United States)

    Beal, Ty; Massiot, Eric; Arsenault, Joanne E; Smith, Matthew R; Hijmans, Robert J

    2017-01-01

    Understanding dietary patterns is vital to reducing the number of people experiencing hunger (about 795 million), micronutrient deficiencies (2 billion), and overweight or obesity (2.1 billion). We characterize global trends in dietary quality by estimating micronutrient density of the food supply, prevalence of inadequate intake of 14 micronutrients, and average prevalence of inadequate intake of these micronutrients for all countries between 1961 and 2011. Over this 50-year period, the estimated prevalence of inadequate intakes of micronutrients has declined in all regions due to increased total production of food and/or micronutrient density. This decline has been particularly strong in East and Southeast Asia and weaker in South Asia and sub-Saharan Africa. Sub-Saharan Africa is the only region where dietary micronutrient density has declined over this 50-year period. At the global level, micronutrients with the lowest levels of adequate estimated intake are calcium, iron, vitamin A, and zinc, but there are strong differences between countries and regions. Fortification has reduced the estimated prevalence of inadequate micronutrient intakes in all low-income regions, except South Asia. The food supply in many countries is still far below energy requirements, which suggests a need to increase the availability and accessibility of nutritious foods. Countries where the food energy supply is adequate show a very large variation in dietary quality, and in many of these countries people would benefit from more diverse diets with a greater proportion of micronutrient-dense foods. Dietary quality can be improved through fortification, biofortification, and agricultural diversification, as well as efforts to improve access to and use of micronutrient-dense foods and nutritional knowledge. Reducing poverty and increasing education, especially of women, are integral to sustainably addressing malnutrition.

  20. 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...

  1. Growth inhibition in rats fed inadequate and incomplete proteins: repercussion on mandibular biomechanics

    OpenAIRE

    Bozzini, Clarisa; Champin, Graciela Monica; Bozzini, Carlos Eduardo Jose; Alippi, Rosa Maria

    2015-01-01

    This study describes the effects of feeding growing rats with a diet containing inadequate and incomplete proteins on both the morphological and the biomechanical properties of the mandible. Female rats aged 30 d were fed freely with one of two diets, control (CD, 301 Cal/100g) and experimental (ED, 359 Cal/100g). CD was a standard laboratory diet, while ED was a synthetic diet containing cornflower supplemented with vitamins and minerals. Both diets had the same physical characteristics. Con...

  2. 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.

  3. Inadequate vocal hygiene habits associated with the presence of self-reported voice symptoms in telemarketers.

    Science.gov (United States)

    Fuentes-López, Eduardo; Fuente, Adrian; Contreras, Karem V

    2017-12-18

    The aim of this study is to determine possible associations between vocal hygiene habits and self-reported vocal symptoms in telemarketers. A cross-sectional study that included 79 operators from call centres in Chile was carried out. Their vocal hygiene habits and self-reported symptoms were investigated using a validated and reliable questionnaire created for the purposes of this study. Forty-five percent of telemarketers reported having one or more vocal symptoms. Among them, 16.46% reported that their voices tense up when talking and 10.13% needed to clear their throat to make their voices clearer. Five percent mentioned that they always talk without taking a break and 40.51% reported using their voices in noisy environments. The number of working hours per day and inadequate vocal hygiene habits were associated with the presence of self-reported symptoms. Additionally, an interaction between the use of the voice in noisy environments and not taking breaks during the day was observed. Finally, the frequency of inadequate vocal hygiene habits was associated with the number of symptoms reported. Using the voice in noisy environments and talking without taking breaks were both associated with the presence of specific vocal symptoms. This study provides some evidence about the interaction between these two inadequate vocal hygiene habits that potentiates vocal symptoms.

  4. 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.

  5. Predictors of inadequate initial echocardiography in suspected Kawasaki disease: Criteria for sedation.

    Science.gov (United States)

    Lorenzoni, Raymond P; Choi, Jaeun; Choueiter, Nadine F; Munjal, Iona M; Katyal, Chhavi; Stern, Kenan W D

    2018-03-09

    Kawasaki disease is the primary cause of acquired pediatric heart disease in developed nations. Timely diagnosis of Kawasaki disease incorporates transthoracic echocardiography for visualization of the coronary arteries. Sedation improves this visualization, but not without risks and resource utilization. To identify potential sedation criteria for suspected Kawasaki disease, we analyzed factors associated with diagnostically inadequate initial transthoracic echocardiography performed without sedation. This retrospective review of patients Kawasaki disease from 2009 to 2015 occurred at a medium-sized urban children's hospital. The primary outcome was diagnostically inadequate transthoracic echocardiography without sedation due to poor visualization of the coronary arteries, determined by review of clinical records. The associations of the primary outcome with demographics, Kawasaki disease type, laboratory data, fever, and antipyretic or intravenous immunoglobulin treatment prior to transthoracic echocardiography were analyzed. In total, 112 patients (44% female, median age 2.1 years, median BSA 0.54 m 2 ) underwent initial transthoracic echocardiography for suspected Kawasaki disease, and 99 were not sedated. Transthoracic echocardiography was diagnostically inadequate in 19 out of these 99 patients (19.2%) and was associated with age ≤ 2.0 years, weight ≤ 10.0 kg, and antipyretic use ≤ 6 hours before transthoracic echocardiography (all P Kawasaki disease. These factors should be considered when deciding which patients to sedate for initial Kawasaki disease transthoracic echocardiography. © 2018 Wiley Periodicals, Inc.

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Inadequate Models of Adolescent Substance Use Prevention: Looking for Options to Promote Pro-Social Change and Engagement.

    Science.gov (United States)

    Ostaszewski, Krzysztof

    2015-01-01

    In the adolescent substance use prevention two competing models can be found: negative and positive. The negative model is entirely focused on risks and problems that young people should avoid. The positive model goes beyond that problem-oriented perspective and calls for positive youth growth and development. Both models of prevention seems to be inadequate to address effectively the challenging problem of adolescent substance use associated consequences. Both models are in fact flawed, but in different ways. Old, negative model neglects the power of individual strengths and ecological developmental assets, while new, positive model is often instrumentally used by politicians and other stakeholders for completely different goals than an informed, science-based prevention. As a result many substance use prevention programs implemented at schools and in communities are neither theoretically nor empirically informed. In order to address these flaws, the model of balanced prevention was outlined. It posits that triple well informed efforts are needed to achieve both specific substance use prevention goals and youth personal/social development. These efforts include protection building, risks reducing and individual assets development support. The proposed model is an ongoing work in progress. It can be considered as an encouragement for international dialogue to build a balanced conceptual foundation for adolescent substance use prevention.

  9. 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.

  10. 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...... was examined. Clinical, histopathologic, and operative variables were related to the surgical margin status. Furthermore postoperative treatment data were compared with margin status. RESULTS: Univariate statistically significant associations were found between the tumor site in the floor of mouth, more...

  11. The role of abutment-attachment selection in resolving inadequate interarch distance: a clinical report.

    Science.gov (United States)

    Alsiyabi, Abdullah S; Felton, David A; Cooper, Lyndon F

    2005-09-01

    A critical factor that needs to be evaluated during the diagnosis and treatment planning phase for patients seeking an implant-tissue-supported overdenture or metal-resin implant fixed denture is the presence of adequate interarch distance. The amount of interarch distance is critical to the selection of appropriate implant abutments and attachments for both implant-tissue-supported overdentures and metal-resin implant fixed complete dentures. This clinical report describes a patient with complications related to the failure to diagnose inadequate interarch distance, and the methods used to resolve the patient's chief complaint. A guide for abutment-attachment selection using one commercially available implant system is given.

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Approach to the patients with inadequate response to colchicine in familial Mediterranean fever.

    Science.gov (United States)

    Gül, Ahmet

    2016-04-01

    Familial Mediterranean fever (FMF) is the most common form of monogenic autoinflammatory conditions, and response to colchicine has been considered as one of its distinctive features among other hereditary periodic fever disorders. Prophylactic colchicine has been shown to be effective in the prevention of inflammatory attacks and development of amyloidosis. However, the highest tolerable doses of colchicine may not be adequate enough to manage these goals in approximately 5% of FMF patients. Inadequate response to colchicine in fully compliant FMF patients may be associated with genetic and/or environmental factors affecting disease severity and colchicine bioavailability. Clarification of the molecular pathogenic mechanisms of FMF has revealed that interleukin-1 beta (IL-1β) cytokine is the most likely target to attack, and several case reports and case series have already documented the efficacy and safety of available anti-IL-1 agents, such as anakinra, rilonacept, and canakinumab in those patients inadequately responding to colchicine. Characterization and early identification of those FMF patients with uncontrolled inflammatory activity have become more important after the availability of new treatment options for the prevention of disease-associated complications and permanent damages. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. Defining localities of inadequate treatment for childhood asthma: A GIS approach

    Directory of Open Access Journals (Sweden)

    Pliskin Joseph S

    2006-01-01

    Full Text Available Abstract Background The use of Geographic Information Systems (GIS has great potential for the management of chronic disease and the analysis of clinical and administrative health care data. Asthma is a chronic disease associated with substantial morbidity, mortality, and health care use. Epidemiologic data from all over the world show an increasing prevalence of asthma morbidity and mortality despite the availability of effective treatment. These facts led to the emergence of strategies developed to improve the quality of asthma care. The objective To develop an efficient tool for quality assurance and chronic disease management using a Geographic Information System (GIS. Geographic location The southern region of Israel. January 1998 – October 2000. Databases Administrative claims data of the largest HMO in Israel: drug dispensing registry, demographic data, Emergency Room visits, and hospitalization data bases. Methods We created a list of six markers for inadequate pharmaceutical treatment of childhood asthma from the Israeli clinical guidelines. We used this list to search the drug dispensing registry to identify asthmatic children who received inadequate treatment and to assess their health care utilization and bad outcomes: emergency room visits and hospitalizations. Using GIS we created thematic maps on which we located the clinics with a high percentage of children for whom the treatment provided was not in adherence with the clinical guidelines. Results 81% of the children were found to have at least one marker for inadequate treatment; 17.5% were found to have more than one marker. Children with markers were found to have statistically significant higher rates of Emergency Room visits, hospitalizations and longer length of stay in hospital compared with children without markers. The maps show in a robust way which clinics provided treatment not in accord with the clinical guidelines. Those clinics have high rates of Emergency Room

  19. 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)] <18.5) increased from the lowest to highest quartiles of psychological distress scores. Psychological distress in Vietnamese female marriage immigrants living in 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

  20. Avoidable waste of research related to inadequate methods in clinical trials.

    Science.gov (United States)

    Yordanov, Youri; Dechartres, Agnes; Porcher, Raphaël; Boutron, Isabelle; Altman, Douglas G; Ravaud, Philippe

    2015-03-24

    To assess the waste of research related to inadequate methods in trials included in Cochrane reviews and to examine to what extent this waste could be avoided. A secondary objective was to perform a simulation study to re-estimate this avoidable waste if all trials were adequately reported. Methodological review and simulation study. Trials included in the meta-analysis of the primary outcome of Cochrane reviews published between April 2012 and March 2013. We collected the risk of bias assessment made by the review authors for each trial. For a random sample of 200 trials with at least one domain at high risk of bias, we re-assessed risk of bias and identified all related methodological problems. For each problem, possible adjustments were proposed that were then validated by an expert panel also evaluating their feasibility (easy or not) and cost. Avoidable waste was defined as trials with at least one domain at high risk of bias for which easy adjustments with no or minor cost could change all domains to low risk. In the simulation study, after extrapolating our re-assessment of risk of bias to all trials, we considered each domain rated as unclear risk of bias as missing data and used multiple imputations to determine whether they were at high or low risk. Of 1286 trials from 205 meta-analyses, 556 (43%) had at least one domain at high risk of bias. Among the sample of 200 of these trials, 142 were confirmed as high risk; in these, we identified 25 types of methodological problem. Adjustments were possible in 136 trials (96%). Easy adjustments with no or minor cost could be applied in 71 trials (50%), resulting in 17 trials (12%) changing to low risk for all domains. So the avoidable waste represented 12% (95% CI 7% to 18%) of trials with at least one domain at high risk. After correcting for incomplete reporting, avoidable waste due to inadequate methods was estimated at 42% (95% CI 36% to 49%). An important burden of wasted research is related to inadequate

  1. Risk Factors for Inadequate Defibrillation Safety Margins Vary With the Underlying Cardiac Disease: Implications for Selective Testing Strategies

    NARCIS (Netherlands)

    Bonnes, J.L.; Westra, S.W.; Bouwels, L.H.; Boer, M.J. de; Brouwer, M.A.; Smeets, J.L.R.M.

    2016-01-01

    INTRODUCTION: In view of the shift from routine toward no or selective defibrillation testing, optimization of the current risk stratification for inadequate defibrillation safety margins (DSMs) could improve individualized testing decisions. Given the pathophysiological differences in myocardial

  2. 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...... will be of great importance to the future organisation of cervical and colorectal cancer screening programmes in Denmark, but will also have international interest because of their similar challenges....

  3. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Predictors of an inadequate defibrillation safety margin at ICD implantation: insights from the National Cardiovascular Data Registry.

    Science.gov (United States)

    Hsu, Jonathan C; Marcus, Gregory M; Al-Khatib, Sana M; Wang, Yongfei; Curtis, Jeptha P; Sood, Nitesh; Parker, Matthew W; Kluger, Jeffrey; Lampert, Rachel; Russo, Andrea M

    2014-07-22

    Defibrillation testing is often performed to establish effective arrhythmia termination, but predictors and consequences of an inadequate defibrillation safety margin (DSM) remain largely unknown. The aims of this study were to develop a simple risk score predictive of an inadequate DSM at implantable cardioverter-defibrillator (ICD) implantation and to examine the association of an inadequate DSM with adverse events. A total of 132,477 ICD Registry implantations between 2010 and 2012 were analyzed. Using logistic regression models, factors most predictive of an inadequate DSM (defined as the lowest successful energy tested 3 days (odds ratio: 1.24; 95% confidence interval: 1.19 to 1.30; p < 0.0001), and in-hospital mortality (odds ratio: 1.96; 95% confidence interval: 1.63 to 2.36; p < 0.0001). A simple risk score identified ICD recipients at risk for an inadequate DSM. An inadequate DSM was associated with an increased risk for in-hospital adverse events. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  6. 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 ...

  7. pipelines cathodic protection design methodologies for impressed ...

    African Journals Online (AJOL)

    HOD

    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 ...

  8. 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

  9. 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

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. Inadequate child supervision: The role of alcohol outlet density, parent drinking behaviors, and social support.

    Science.gov (United States)

    Freisthler, Bridget; Johnson-Motoyama, Michelle; Kepple, Nancy J

    2014-08-01

    Supervisory neglect, or the failure of a caregiver to appropriately supervise a child, is one of the predominant types of neglectful behaviors, with alcohol use being considered a key antecedent to inadequate supervision of children. The current study builds on previous work by examining the role of parental drinking and alcohol outlet densities while controlling for caregiver and child characteristics. Data were obtained from 3,023 participants via a telephone survey from 50 cities throughout California. The telephone survey included items on neglectful parenting practices, drinking behaviors, and socio-demographic characteristics. Densities of alcohol outlets were measured for each of the 202 zip codes in the study. Multilevel Bernoulli models were used to analyze the relationship between four supervisory neglect parenting practices and individual-level and zip code-level variables. In our study, heavy drinking was only significantly related to one of our four outcome variables (leaving a child where he or she may not be safe). The density of on premise alcohol outlets was positively related to leaving a child home alone when an adult should be present. This study demonstrates that discrete relationships exist between alcohol related variables, social support, and specific supervisory neglect subtypes at the ecological and individual levels.

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

    Directory of Open Access Journals (Sweden)

    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

  16. 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.

  17. 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

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

    Directory of Open Access Journals (Sweden)

    Søren Søgaard Lund

    Full Text Available 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.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. At enrolment, mean (standard deviation HbA(1c was 9.48% (0.99 for the metformin group (n = 49 and 9.60% (0.86 for the placebo group (n = 51. Mean (95% confidence interval baseline-adjusted differences after 12 months with metformin (n = 48 versus placebo (n = 50 were: HbA(1c, 0.13% (-0.19; 0.44, p = 0.422; Total daily insulin dose, -5.7 U/day (-8.6; -2.9, p<0.001; body weight, -1.74 kg (-3.32; -0.17, p = 0.030. Minor and overall major hypoglycaemia was not significantly different between treatments. Treatments were well tolerated.In patients with poorly controlled T1DM, adjunct metformin therapy did not provide any improvement of glycaemic control after one year. Nevertheless, adjunct metformin treatment was associated with sustained reductions of insulin dose and body weight. Further investigations into the potential cardiovascular-protective effects of metformin therapy in patients with T1DM are warranted.ClinicalTrials.gov NCT00118937.

  19. 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.

  20. 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

  1. Risk Factors for Inadequate Defibrillation Safety Margins Vary With the Underlying Cardiac Disease: Implications for Selective Testing Strategies.

    Science.gov (United States)

    Bonnes, Judith L; Westra, Sjoerd W; Bouwels, Leon H R; DE Boer, Menko Jan; Brouwer, Marc A; Smeets, Joep L R M

    2016-05-01

    In view of the shift from routine toward no or selective defibrillation testing, optimization of the current risk stratification for inadequate defibrillation safety margins (DSMs) could improve individualized testing decisions. Given the pathophysiological differences in myocardial substrate between ischemic and nonischemic heart disease (IHD/non-IHD) and the accompanying differences in clinical characteristics, we studied inadequate DSMs and their predictors in relation to the underlying etiology. Cohort of routine defibrillation tests (n = 785) after first implantable cardioverter defibrillator (ICD)-implantations at the Radboud UMC (2005-2014). A defibrillation threshold >25 J was regarded as an inadequate DSM. In total, 4.3% of patients had an inadequate DSM; in IHD 2.5% versus 7.3% in non-IHD (P = 0.002). We identified a group of non-IHD patients at high risk (13-42% inadequate DSM); the remainder of the cohort (>70%) had a risk of only 2% (C-statistic entire cohort 0.74; C-statistic non-IHD 0.82). This was based upon two identified interaction terms: (1) non-IHD and age (aOR 0.94 [95% CI 0.91-0.97]); (2) non-IHD and the indexed left ventricular (LV) internal diastolic diameter (aOR 3.50 [95% CI 2.10-5.82]). The present study on risk stratification for an inadequate DSM not only confirms the importance of making a distinction between IHD and non-IHD, but also shows that risk factors in an entire cohort (LV dilatation, age) may only apply to a subgroup (non-IHD). Appreciation of this concept could favorably affect current risk stratification. If confirmed, our approach may be used to optimize individualized testing decisions in an upcoming era of non-routine testing. © 2016 Wiley Periodicals, Inc.

  2. Income-related inequalities in inadequate dentition over time in Australia, Brazil and USA adults.

    Science.gov (United States)

    Peres, Marco A; Luzzi, Liana; Peres, Karen G; Sabbah, Wael; Antunes, Jose L; Do, Loc G

    2015-06-01

    To assess changes over time of the absolute and relative household income-related inequalities in inadequate dentition (ID) among Australians, Brazilians and USA adults. This study used nationwide oral health survey data from Australia (n = 1200 in 1999; n = 2729 in 2005), Brazil (n = 13 431 in 2003; n = 9779 in 2010) and USA (n = 2542 in 1999; n = 1596 in 2005). Absolute income inequalities were calculated using Absolute Concentration Index (ACI) and Slope Index of Inequality (SII), while relative inequalities were calculated using Relative Concentration Index (RCI) and Relative Index of Inequality (RII). Prevalence of ID in the studied period dropped from 8.7% to 3.1% in Australia; from 42.1% to 22.4% in Brazil; and remained stable in USA, nearly 8.0%. Absolute income inequalities were highest in Brazil, followed by the USA and Australia; relative inequalities were lower in Brazil than in Australia and the USA. ID was higher among Brazilian females (2010) and for the poorest group in all countries and periods. A remarkable reduction in absolute inequalities were found in Australia [Slope Index of Inequality (SII) and AIC 60%] and in Brazil (SII 25%; ACI 33%) while relative inequalities increased both in Australia (RCI and RII 40%) and in Brazil (RCI 24%; RII 38%). No changes in absolute and relative income inequalities were found in the USA. There were still persistent absolute and relative income inequalities in ID in all examined countries. There has been a reduction in absolute income inequalities in ID but an increase in relative income inequalities. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Inadequate dietary intake of children and adolescents with juvenile idiopathic arthritis and systemic lupus erythematosus.

    Science.gov (United States)

    Caetano, Michelle C; Ortiz, Thaís T; Terreri, Maria Teresa S R L A; Sarni, Roseli O S; Silva, Simone G L; Souza, Fabíola I S; Hilário, Maria Odete E

    2009-01-01

    To evaluate the dietary intake of children and adolescents with juvenile idiopathic arthritis (JIA) and juvenile systemic lupus erythematosus (JSLE) using a 24-hour diet recall and relating it to the patients' clinical and anthropometric characteristics and to the drugs used in their treatment. By means of a cross-sectional study, we assessed the 24-hour diet recalls of outpatients. Their nutritional status was classified according to the CDC (2000). The computer program NutWin UNIFESP-EPM was used for food intake calculation. The Recommended Dietary Allowances and the Brazilian food pyramid were used for quantitative and qualitative analysis. Median age was 12 years for JIA patients and 16.5 years for JSLE patients. Among the JIA patients, 37.5% had active disease, and among the JSLE patients, 68.2% showed Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) > 4. Malnutrition was found in 8.3 and 4.5% of the JIA and JSLE patients, respectively, and obesity was present in 16.7 and 18.2%. For JIA patients, the excessive intake of energy, protein, and lipids was 12.5, 75, and 31.3%, respectively. For JSLE patients, the excessive intake of energy, protein, and lipids was 13.6, 86.4, and 36.4%, respectively. Low intake of iron, zinc, and vitamin A was found in 29.2 and 50, 87.5 and 86.4, and 87.5 and 95.2% of the JIA and JSLE patients, respectively. There was not a significant association between intake, disease activity, and nutritional status. Patients with rheumatic diseases have inadequate dietary intake. There is excessive intake of lipids and proteins and low intake of micronutrients.

  4. 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.

  5. 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.

  6. Anemia in ST-Elevation Myocardial Infarction Patients with Markers of Inadequate Bone Marrow Response.

    Science.gov (United States)

    Arbel, Yaron; Milwidsky, Assi; Finkelstein, Ariel; Halkin, Amir; Revivo, Miri; Berliner, Shlomo; Ellis, Martin; Herz, Itzhak; Keren, Gad; Banai, Shmuel

    2015-08-01

    Anemia confers an adverse prognosis in patients with ST-elevation myocardial infarction (STEMI). Several mechanisms have been implicated in the etiology of anemia in this setting, including inflammation, blood loss, and the presence of comorbidities such as renal failure. To evaluate the adequacy of bone marrow response as potentially reflected by elevation in blood and reticulocyte counts. Consecutive men with STEMI who underwent primary percutaneous intervention within 6 hours of symptom onset and who presented to our catheterization laboratory during a 36 month period were included in the study. The cohort was divided into quartiles according to hemoglobin concentration, and differences in clinical and laboratory characteristics between the groups were evaluated. A total of 258 men with STEMI were recruited, 22% of whom suffered from anemia according to the World Health Organization classification (hemoglobin < 13 g/dl). Men in the lowest quartile of hemoglobin concentration presented with significantly lower white blood cell and platelet counts (9.6 ± 2.9 vs. 12.6 ± 3.6 x 103/μl, P < 0.001) and (231 ± 79 vs. 263 ± 8 x 103/μl, P < 0.01), respectively, despite higher inflammatory biomarkers (C-reactive protein and fibrinogen) compared with patients in the upper hemoglobin concentration quartile. Reticulocyte production index was not significantly higher in anemic patients, with a value of 1.8, 1.4, 1.5 and 1.6 in the ascending hemoglobin quartiles, respectively (P = 0.292). Anemic men with STEMI have relatively lower leukocyte and platelet counts as well as a reduced reticulocyte count despite higher inflammatory biomarkers. These findings might suggest inadequate bone marrow response.

  7. 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

  8. Cancers in Australia in 2010 attributable to inadequate consumption of fruit, non-starchy vegetables and dietary fibre

    Science.gov (United States)

    Nagle, Christina M; Wilson, Louise F; Hughes, Maria Celia B; Ibiebele, Torukiri I; Miura, Kyoko; Bain, Christopher J; Whiteman, David C; Webb, Penelope M

    2015-01-01

    Objectives To estimate the number and proportion of cancers occurring in Australia in 2010 attributable to consumption deficits in fruit, non-starchy vegetables and dietary fibre. Methods We estimated the population attributable fraction (PAF) for cancers causally associated with inadequate intake of fruit and non-starchy vegetables (oral cavity, pharynx, oesophageal squamous cell carcinoma, stomach, larynx); inadequate intake of fruit (lung); and insufficient intake of fibre (colorectum). We used standard formulae incorporating prevalence of exposure (1995 National Nutrition Survey) and relative risks from independent studies. Results Overall, 1,555 (1.4% of all) and 311 (0.3% of all) cancers were attributable to inadequate intakes of fruit and non-starchy vegetables, respectively. A further 2,609 colorectal cancers (18% of colorectal) were attributable to insufficient fibre intake. If Australians increased their fibre intake by eating the recommended daily intakes of fruit and vegetables, an estimated 1,293 (8.8%) colorectal cancers could be prevented. Conclusions One in six colorectal cancer cases was attributable to inadequate intake of dietary fibre and about 1,800 cancers at other sites were attributable to insufficient fruit and non-starchy vegetable consumption. Implications Increasing the proportion of Australians who consume the recommended intake of fruit, vegetables and fibre could prevent up to 4% of all cancers. PMID:26437726

  9. 20 CFR 411.321 - Under what conditions will SSA terminate an agreement with an EN due to inadequate performance?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Under what conditions will SSA terminate an agreement with an EN due to inadequate performance? 411.321 Section 411.321 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO WORK AND SELF-SUFFICIENCY PROGRAM Employment Networks § 411.321 Under...

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

    Directory of Open Access Journals (Sweden)

    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.

  11. 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

  12. 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

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

    NARCIS (Netherlands)

    van't Hoog, Anna H.; Marston, Barbara J.; Ayisi, John G.; Agaya, Janet A.; Muhenje, Odylia; Odeny, Lazarus O.; Hongo, John; Laserson, Kayla F.; Borgdorff, Martien W.

    2013-01-01

    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

  14. 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

  15. Confidence versus Performance as an Indicator of the Presence of Alternative Conceptions and Inadequate Problem-Solving Skills in Mechanics

    Science.gov (United States)

    Potgieter, Marietjie; Malatje, Esther; Gaigher, Estelle; Venter, Elsie

    2010-01-01

    This study investigated the use of performance-confidence relationships to signal the presence of alternative conceptions and inadequate problem-solving skills in mechanics. A group of 33 students entering physics at a South African university participated in the project. The test instrument consisted of 20 items derived from existing standardised…

  16. 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.

  17. Inadequate treatment of ventilator-associated and hospital-acquired pneumonia: Risk factors and impact on outcomes

    Directory of Open Access Journals (Sweden)

    Piskin Nihal

    2012-10-01

    Full Text Available Abstract Background Initial antimicrobial therapy (AB is an important determinant of clinical outcome in patients with severe infections as pneumonia, however well-conducted studies regarding prognostic impact of inadequate initial AB in patients who are not undergoing mechanical ventilation (MV are lacking. In this study we aimed to identify the risk factors for inadequate initial AB and to determine its subsequent impact on outcomes in both ventilator associated pneumonia (VAP and hospital acquired pneumonia (HAP. Methods We retrospectively studied the accuracy of initial AB in patients with pneumonia in a university hospital in Turkey. A total of 218 patients with HAP and 130 patients with VAP were included. For each patient clinical, radiological and microbiological data were collected. Stepwise multivariate logistic regression analysis was used for risk factor analysis. Survival analysis was performed by using Kaplan-Meier method with Log-rank test. Results Sixty six percent of patients in VAP group and 41.3% of patients in HAP group received inadequate initial AB. Multiple logistic regression analysis revealed that the risk factors for inadequate initial AB in HAP patients were; late-onset HAP (OR = 2.35 (95% CI, 1.05-5.22; p = 0.037 and APACHE II score at onset of HAP (OR = 1.06 (95% CI, 1.01-1.12; p = 0.018. In VAP patients; antibiotic usage in the previous three months (OR = 3.16 (95% CI, 1.27-7.81; p = 0.013 and admission to a surgical unit (OR = 2.9 (95% CI, 1.17-7.19; p = 0.022 were found to be independent risk factors for inadequate initial AB. No statistically significant difference in crude hospital mortality and 28-day mortality was observed between the treatment groups in both VAP and HAP. However we showed a significant increase in length of hospital stay, duration of mechanical ventilation and a prolonged clinical resolution in the inadequate AB group in both VAP and HAP. Conclusion Our data

  18. Inadequate treatment of ventilator-associated and hospital-acquired pneumonia: risk factors and impact on outcomes.

    Science.gov (United States)

    Piskin, Nihal; Aydemir, Hande; Oztoprak, Nefise; Akduman, Deniz; Comert, Fusun; Kokturk, Furuzan; Celebi, Guven

    2012-10-24

    Initial antimicrobial therapy (AB) is an important determinant of clinical outcome in patients with severe infections as pneumonia, however well-conducted studies regarding prognostic impact of inadequate initial AB in patients who are not undergoing mechanical ventilation (MV) are lacking. In this study we aimed to identify the risk factors for inadequate initial AB and to determine its subsequent impact on outcomes in both ventilator associated pneumonia (VAP) and hospital acquired pneumonia (HAP). We retrospectively studied the accuracy of initial AB in patients with pneumonia in a university hospital in Turkey. A total of 218 patients with HAP and 130 patients with VAP were included. For each patient clinical, radiological and microbiological data were collected. Stepwise multivariate logistic regression analysis was used for risk factor analysis. Survival analysis was performed by using Kaplan-Meier method with Log-rank test. Sixty six percent of patients in VAP group and 41.3% of patients in HAP group received inadequate initial AB. Multiple logistic regression analysis revealed that the risk factors for inadequate initial AB in HAP patients were; late-onset HAP (OR = 2.35 (95% CI, 1.05-5.22; p = 0.037) and APACHE II score at onset of HAP (OR = 1.06 (95% CI, 1.01-1.12); p = 0.018). In VAP patients; antibiotic usage in the previous three months (OR = 3.16 (95% CI, 1.27-7.81); p = 0.013) and admission to a surgical unit (OR = 2.9 (95% CI, 1.17-7.19); p = 0.022) were found to be independent risk factors for inadequate initial AB. No statistically significant difference in crude hospital mortality and 28-day mortality was observed between the treatment groups in both VAP and HAP. However we showed a significant increase in length of hospital stay, duration of mechanical ventilation and a prolonged clinical resolution in the inadequate AB group in both VAP and HAP. Our data suggests that the risk factors for inadequate initial AB

  19. 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)

  20. Negotiating Protection

    DEFF Research Database (Denmark)

    Bille, Mikkel

    strategies are entangled in cultural, religious, and national identities. Using ethnographic methods, I investigate protection against selected risks: harm from evil eyes, violation of domestic sanctity, and cultural heritage dilapidation. Protection against these risks is examined through studies...

  1. [Protective eyeglasses].

    Science.gov (United States)

    Hermans, G

    1997-01-01

    Reminder of the materials used for the manufacture of corrective lenses. Belgian statistics concerning eye accidents at work and European legislation concerning the prevention of eye accidents, personal protective equipment, P.P.E. Eye protection for sports.

  2. 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

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

    Science.gov (United States)

    Teixeira, Maria Cristina Triguero Veloz; Marino, Regina Luisa de Freitas; Carreiro, Luiz Renato Rodrigues

    2015-01-01

    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.

  4. Brazilians' experiences with iron fortification: evidence of effectiveness for reducing inadequate iron intakes with fortified flour policy.

    Science.gov (United States)

    Vieira, Diva Aliete Dos Santos; Steluti, Josiane; Verly, Eliseu; Marchioni, Dirce Maria; Fisberg, Regina Mara

    2017-02-01

    To assess Fe intake, calculate the prevalence of inadequate Fe intake and identify food contributors to Fe intake during 2003 and 2008 in a population-based study, reflecting before and after the mandatory fortification of flour with Fe. Two cross-sectional population-based studies conducted in 2003 and 2008. Dietary intake was evaluated by 24 h recall and the Software for Intake Distribution Estimation (PC-SIDE) was used to estimate within-person variance and prevalence of inadequate Fe intake. The statistical analysis was conducted considering the complex survey design. São Paulo, Brazil. Adolescents, adults and elderly adults of both sexes, interviewed in 2003 (n 2386) and 2008 (n 1661). The Fe intake mean increased in all populations in the post-fortification period. A reduction of over 90 % was observed in the prevalence of inadequate Fe intake among men for all age groups analysed. When evaluating women, despite the substantial reduction (over 63 %), prevalence of inadequate Fe intake remained high (34 %) in those aged 19-50 years. Major food contributors to Fe intake before fortification were beans, beef, vegetables and dairy. There was an alteration in the contributors in the post-fortification period, with bread, beef, beans and biscuits as main contributors. The mandatory fortification with Fe significantly furthered the reduction in the prevalence of inadequacy, except among women of reproductive age, and changed the main contributors to this nutrient in the studied population. Therefore, monitoring of Fe addition in flour is essential to assess compliance to the fortified flour policy and to guarantee a safe Fe intake for all the population.

  5. An implant-supported removable partial denture on milled bars to compromise the inadequate treatment plan: a clinical report

    OpenAIRE

    Kim, Jee-Hwan; Lee, Jae-Hoon

    2010-01-01

    Presurgical prosthetic treatment planning is critical for the success of the implant prosthesis. Inadequate treatment plan, due to insufficient discussion between prosthodontist, and surgeon, may result in poor prognosis. A 26-year-old male patient was referred for prosthodontic treatment after implant was placed in the area of teeth #17, 16, 22, 25 and 27, without adequate discussion nor the treatment planning between oral surgeon and prosthodontist. It was found that the patient had two hop...

  6. Prevalence and risk factors of inadequate cervical dilation following laminaria insertion in second-trimester abortion--case control study.

    Science.gov (United States)

    Ben-Ami, Ido; Stern, Sharon; Vaknin, Zvi; Smorgick, Noam; Schneider, David; Halperin, Reuvit

    2015-04-01

    The objective was to explore the prevalence of and risk factors for inadequate cervical dilation following insertion of a single set of laminaria in women scheduled for dilation & evacuation (D&E) at 14-24 weeks' gestation. We retrospectively reviewed all cases of women who underwent pregnancy termination by D&E at 14-24 weeks' gestation between January 2003 and December 2013. All cases in which the surgical procedure was cancelled due to failure to achieve adequate cervical dilation after a single set of laminaria inadequate cervical dilation were included. The control group was women who underwent D&E following adequate cervical dilation after a single set of laminaria, and were matched according to gestational week in a ratio of 1:3. The overall dilation failure rate was 3.2%, with 4.0% among the induced-abortion patients and 1.5% among the patients with fetal demise (p=.002). Patients who had inadequate cervical dilation had lower rates of gravidity (p=.002) and previous spontaneous vaginal delivery (plaminaria insertion, namely, previous cesarean section (p=.002) and previous cervical procedure (plaminaria. Women who are scheduled for D&E, and in whom one of these risk factors exists, might benefit from additional interventions to achieve better cervical preparation. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Inadequate vertical bone dimension managed by bone-added osteotome sinus floor elevation (BAOSFE): a literature review and case report.

    Science.gov (United States)

    Kolhatkar, Shilpa; Cabanilla, Leyvee; Bhola, Monish

    2009-05-01

    The purpose of this report is to provide a brief literature review of the bone-added osteotome sinus floor elevation (BAOSFE) procedure and to present a case utilizing this technique. Implant placement in the posterior maxillary region is often compromised due to anatomic limitations. In clinical situations where there is inadequate vertical bone dimension, the BAOSFE technique can be employed to increase bone height and allow placement of implants with an appropriate length dimension. A case of a 60-year-old female with inadequate vertical bone dimension in the area of an extracted #13 is presented. The BAOSFE technique was performed which facilitated the placement of a 3.75 X 13 mm implant. Anatomic limitations such as inadequate vertical bone dimension in the posterior maxillary region may result in placement of shorter implants. Sinus floor elevation (SFE) procedures using a crestal approach such as the BAOSFE, in certain selected cases, can effectively and predictably increase bone height. The BAOSFE technique is an excellent procedure that can overcome limitations associated with the posterior maxillary region.

  8. 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....

  9. Emergency Department Visits for Homelessness or Inadequate Housing in New York City before and after Hurricane Sandy.

    Science.gov (United States)

    Doran, Kelly M; McCormack, Ryan P; Johns, Eileen L; Carr, Brendan G; Smith, Silas W; Goldfrank, Lewis R; Lee, David C

    2016-04-01

    Hurricane Sandy struck New York City on October 29, 2012, causing not only a large amount of physical damage, but also straining people's health and disrupting health care services throughout the city. In prior research, we determined that emergency department (ED) visits from the most vulnerable hurricane evacuation flood zones in New York City increased after Hurricane Sandy for several medical diagnoses, but also for the diagnosis of homelessness. In the current study, we aimed to further explore this increase in ED visits for homelessness after Hurricane Sandy's landfall. We performed an observational before-and-after study using an all-payer claims database of ED visits in New York City to compare the demographic characteristics, insurance status, geographic distribution, and health conditions of ED patients with a primary or secondary ICD-9 diagnosis of homelessness or inadequate housing in the first week after Hurricane Sandy's landfall versus the baseline weekly average in 2012 prior to Hurricane Sandy. We found statistically significant increases in ED visits for diagnosis codes of homelessness or inadequate housing in the week after Hurricane Sandy's landfall. Those accessing the ED for homelessness or inadequate housing were more often elderly and insured by Medicare after versus before the hurricane. Secondary diagnoses among those with a primary ED diagnosis of homelessness or inadequate housing also differed after versus before Hurricane Sandy. These observed differences in the demographic, insurance, and co-existing diagnosis profiles of those with an ED diagnosis of homelessness or inadequate housing before and after Hurricane Sandy suggest that a new population cohort-potentially including those who had lost their homes as a result of storm damage-was accessing the ED for homelessness or other housing issues after the hurricane. Emergency departments may serve important public health and disaster response roles after a hurricane, particularly for

  10. Inadequate thickness of the weight-bearing surface of claws in ruminants : clinical review

    Directory of Open Access Journals (Sweden)

    A.S. Shakespeare

    2009-05-01

    Full Text Available The term 'thin soles' refers to the suboptimal thickness of the weight-bearing surface of claws in ruminants. These palmar / plantar surfaces of the claws support the weight of the animal and consist of the distal wall horn, the sole proper, the heel and the minute white line area. The sole should normally only bear weight on uneven or undulating surfaces. A decrease in the thickness of the weight-bearing claw surface will decrease the protective function of this structure and may alter the proportion of weight-bearing by each section with possible detrimental effects on hoof function. Horn tissue readily absorbs water and becomes softer which can lead to increased wear rates. Growth rates normally match wear rates but, unlike the latter, time is needed for the growth rate response to adapt to changes in wear rate. Concrete surfaces can be abrasive and dairy cows that spend their lactation cycle on these floors should be let out to pasture in the dry period so that their claws can recoup lost horn. Frictional coefficient is a measure of the 'slipperiness' of hooves on various surfaces. Newly laid or fresh concrete is not only abrasive but the thin surface suspension of calcium hydroxide that forms has a very alkaline pH which causes keratin degradation and is mostly responsible for the excessive claw wear that occurs. Four case studies are used to illustrate the importance of the distal wall horn, the dangers of over-trimming and the effects of disease and concrete on horn growth and wear rates.

  11. Health effects of World Trade Center (WTC) Dust: An unprecedented disaster's inadequate risk management.

    Science.gov (United States)

    Lippmann, Morton; Cohen, Mitchell D; Chen, Lung-Chi

    2015-07-01

    The World Trade Center (WTC) twin towers in New York City collapsed on 9/11/2001, converting much of the buildings' huge masses into dense dust clouds of particles that settled on the streets and within buildings throughout Lower Manhattan. About 80-90% of the settled WTC Dust, ranging in particle size from ∼2.5 μm upward, was a highly alkaline mixture of crushed concrete, gypsum, and synthetic vitreous fibers (SVFs) that was readily resuspendable by physical disturbance and low-velocity air currents. High concentrations of coarse and supercoarse WTC Dust were inhaled and deposited in the conductive airways in the head and lungs, and subsequently swallowed, causing both physical and chemical irritation to the respiratory and gastroesophageal epithelia. There were both acute and chronic adverse health effects in rescue/recovery workers; cleanup workers; residents; and office workers, especially in those lacking effective personal respiratory protective equipment. The numerous health effects in these people were not those associated with the monitored PM2.5 toxicants, which were present at low concentrations, that is, asbestos fibers, transition and heavy metals, polyaromatic hydrocarbons or PAHs, and dioxins. Attention was never directed at the very high concentrations of the larger-sized and highly alkaline WTC Dust particles that, in retrospect, contained the more likely causal toxicants. Unfortunately, the initial focus of the air quality monitoring and guidance on exposure prevention programs on low-concentration components was never revised. Public agencies need to be better prepared to provide reliable guidance to the public on more appropriate means of exposure assessment, risk assessment, and preventive measures.

  12. Health effects of World Trade Center (WTC) Dust: An unprecedented disaster with inadequate risk management

    Science.gov (United States)

    Lippmann, Morton; Cohen, Mitchell D.; Chen, Lung-Chi

    2015-01-01

    The World Trade Center (WTC) twin towers in New York City collapsed on 9/11/2001, converting much of the buildings’ huge masses into dense dust clouds of particles that settled on the streets and within buildings throughout Lower Manhattan. About 80–90% of the settled WTC Dust, ranging in particle size from ~2.5 μm upward, was a highly alkaline mixture of crushed concrete, gypsum, and synthetic vitreous fibers (SVFs) that was readily resuspendable by physical disturbance and low-velocity air currents. High concentrations of coarse and supercoarse WTC Dust were inhaled and deposited in the conductive airways in the head and lungs, and subsequently swallowed, causing both physical and chemical irritation to the respiratory and gastroesophageal epithelia. There were both acute and chronic adverse health effects in rescue/recovery workers; cleanup workers; residents; and office workers, especially in those lacking effective personal respiratory protective equipment. The numerous health effects in these people were not those associated with the monitored PM2.5 toxicants, which were present at low concentrations, that is, asbestos fibers, transition and heavy metals, polyaromatic hydrocarbons or PAHs, and dioxins. Attention was never directed at the very high concentrations of the larger-sized and highly alkaline WTC Dust particles that, in retrospect, contained the more likely causal toxicants. Unfortunately, the initial focus of the air quality monitoring and guidance on exposure prevention programs on low-concentration components was never revised. Public agencies need to be better prepared to provide reliable guidance to the public on more appropriate means of exposure assessment, risk assessment, and preventive measures. PMID:26058443

  13. Insider protection

    Energy Technology Data Exchange (ETDEWEB)

    Waddoups, I.G.

    1993-07-01

    The government community is broadly addressing the insider threat. The first section of this paper defines protection approaches and the latter sections present various applicable technology developments. The bulk of the paper discusses technology developments applied to (1) personnel and material tracking and inventory, (2) classified document protection, and (3) protecting security systems. The personnel and material tracking system uses a PC based-host to (1) collect information from proximity tags and material movement sensors, (2) apply rules to this input to assure that the ongoing activity meets the site selectable rules and, (3) forward the results to either an automated inventory system or an alarm system. The document protection system uses a PC network to efficiently and securely control classified material which is stored on write-once-read-mostly optical media. The protection of sensor to multiplexer communications in a security system is emphasized in the discussion of protecting security systems.

  14. Inadequate Loading Stimulus on ISS Results in Bone and Muscle Loss

    Science.gov (United States)

    Rice, A. J.; Genc, K. O.; Maender, C. C.; Gopalakrishnan, R.; Kuklis, M. M.; Cavanagh, P. R.

    2011-01-01

    INTRODUCTION Exercise has been the primary countermeasure to combat musculoskeletal changes during International Space Station (ISS) missions. However, these countermeasures have not been successful in preventing loss of bone mineral density (BMD) or muscle volume in crew members. METHODS We examined lower extremity loading during typical days on-orbit and on Earth for four ISS crew members. In-shoe forces were monitored using force-measuring insoles placed inside the shoes. BMD (by DXA), muscle volumes (by MRI), and strength were measured before and after long-duration spaceflight (181 +/- 15 days). RESULTS The peak forces measured during ISS activity were significantly less than those measured in 1g for the same activities. Typical single-leg loads on-orbit during walking and running were 0.89 +/- 0.17 body weights (BW) and 1.28 +/- 0.18 BW compared to 1.18 +/- 0.11 BW and 2.36 +/- .22 BW in 1g, respectively [2]. Crew members were only loaded for an average of 43.17 +/- 14.96 min a day while performing exercise on-orbit even though 146.8 min were assigned for exercise each day. Areal BMD decreased in the femoral neck and total hip by 0.71 +/- 0.34% and 0.81 +/- 0.21% per month, respectively. Changes in muscle volume were observed in the lower extremity (-10 to -16% calf; -4 to -7% thigh) but there were no changes in the upper extremity (+0.4 to -0.8%). Decrements in isometric and isokinetic strength at the knee (range: -10.4 to -24.1%), ankle (range: -4 to -22.3%), and elbow (range: -7.5 to - 16.7%) were also observed. Knee extension endurance tests showed an overall decline in total work (-14%) but an increased resistance to fatigue post-flight. DISCUSSION AND CONCLUSIONS Our findings support the conclusion that the measured exercise durations and/or loading stimuli were insufficient to protect bone and muscle health.

  15. Assessing the effectiveness of protected area management in the ...

    African Journals Online (AJOL)

    ajl yemi

    2011-11-28

    Nov 28, 2011 ... protected areas (PAs) have serious problems in implementing basic management functions such as ... was similar throughout Turkey. In general, policy environment scores were remarkably below the average, showing that the importance and priority of ... management include visitor impacts, inadequate.

  16. 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.

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

    African Journals Online (AJOL)

    The coastal forests also contain many Red Data Book species, particularly Insectivora. These forests are, however, inadequately protected in the Port St Johns region. In this analysis data for the Insectívora were used to compare point and range data. The results indicate that patterns emerging from range maps provide a ...

  18. 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.

  19. Inadequate prescription of chronic consumption of proton pump inhibitors in a hospital in Mexico: Cross-sectional study

    Directory of Open Access Journals (Sweden)

    Jaime Alberto Sánchez-Cuén

    2013-03-01

    Full Text Available Introduction: PPIs have been an enormous therapeutic advance in acid-related diseases. However, it has been detected an abuse in its consumption. The aim of this study was to determine the frequency of inadequate prescription of chronic use of PPIs in outpatients in a speciality hospital. Material and methods: we performed a cross-sectional descriptive study review. The study population were patients, chronic users of proton pump inhibitors (PPIs, attending outpatient consult in a hospital of government workers. We defined as chronic user of PPIs that patient that takes medication daily for over a year and inappropriate prescription, that one that has not been approved by the clinical guidelines. A simple random sampling was utilized. The following parameters were investigated: diagnosis and prescription of PPIs, time of use, at which level of care PPIs were prescribed (primary care or specialist, self-medication, with or without endoscopy. For the statistical analysis, we used Student's t-test and Chi-square, 95% confidence intervals and significance 0.05 %. Results: we reviewed 153 patients, 40 (26.1 % men and 113 (73.9 % women, mean age 58 ± 11.4 years. The prescription of chronic treatment with PPIs was adequate in 64.7 % of patients and inadequate in 35.3 %. The most common appropriate prescription (31.3 % of chronic use of PPIs was due to gastroesophageal reflux disease. The most common inadequate prescription was absence of diagnosis (22.2 %, polypharmacy without nonsteroidal antiinflammatory drugs (16.6 % and chronic gastritis (16.6 %. History of endoscopy were not statistically significant. Conclusions: the frequency of inappropriate prescriptions of chronic use of PPIs was high, around 35.3 %, similar to those reported in hospitals in developed countries.

  20. 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

  1. 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.

  2. Depression, obesity, and smoking were independently associated with inadequate glycemic control in patients with type 1 diabetes.

    Science.gov (United States)

    Melin, Eva O; Thunander, Maria; Svensson, Ralph; Landin-Olsson, Mona; Thulesius, Hans O

    2013-06-01

    The aim of this study was to explore the associations between inadequate glycemic control of diabetes and psychological, anthropometric, and lifestyle variables in a population-based cohort of type 1 diabetes patients. Cross-sectional study. In this study, 292 patients with type 1 diabetes, aged 1859 years, participated. psychological data were assessed by self-report instruments: Hospital Anxiety and Depression Scale and Toronto Alexithymia Scale-20. Anthropometrics, blood analyses, data from medical records, and data from the Swedish National Diabetes Registry were collected. Self-reported depression (adjusted odds ratio (AOR) 4.8), obesity (AOR 4.3), and smoking (AOR 3.0) were independently associated with inadequate glycemic control of diabetes (HbA1c>8.6%). Gender-stratified analyses showed that self-reported depression (AOR 19.8) and obesity (AOR 7.0) in women and smoking in men (AOR 4.2) were associated with HbA1c>8.6%. Alexithymia, antidepressant medication, and physical inactivity were associated with HbA1c>8.6% only in bivariate analyses. Alexithymia, self-rated anxiety, physical inactivity, and absence of abdominal obesity were associated with self-reported depression. Depression was the only psychological factor independently associated with HbA1c>8.6%. The association was of comparable importance as obesity and smoking, well-known risk factors for inadequate glycemic control and diabetes complications. The association between depression and HbA1c>8.6% was particularly strong for women. Alexithymia, which is a relatively stable personality trait, was associated with depression. In the future care of patients with diabetes, psychological aspects should be considered alongside anthropometrics and lifestyle factors in order to achieve the goals for HbA1c.

  3. Circulating sclerostin and estradiol levels are associated with inadequate response to bisphosphonates in postmenopausal women with osteoporosis.

    Science.gov (United States)

    Morales-Santana, Sonia; Díez-Pérez, Adolfo; Olmos, José M; Nogués, Xavier; Sosa, Manuel; Díaz-Curiel, Manuel; Pérez-Castrillón, José L; Pérez-Cano, Ramón; Torrijos, Antonio; Jodar, Esteban; Rio, Luis Del; Caeiro-Rey, José R; Reyes-García, Rebeca; García-Fontana, Beatriz; González-Macías, Jesús; Muñoz-Torres, Manuel

    2015-12-01

    The biological mechanisms associated with an inadequate response to treatment with bisphosphonates are not well known. This study investigates the association between circulating levels of sclerostin and estradiol with an inadequate clinical outcome to bisphosphonate therapy in women with postmenopausal osteoporosis. This case-control study is based on 120 Spanish women with postmenopausal osteoporosis being treated with oral bisphosphonates. Patients were classified as adequate responders (ARs, n=66, mean age 68.2±8 years) without incident fractures during 5 years of treatment, or inadequate responders (IRs, n=54, mean age 67±9 years), with incident fractures between 1 and 5 years of treatment. Bone mineral density (DXA), structural analysis of the proximal femur and structural/fractal analysis of the distal radius were assessed. Sclerostin concentrations were measured by ELISA and 17β-estradiol levels by radioimmunoassay based on ultrasensitive methods. In the ARs group, sclerostin serum levels were significantly lower (p=0.02) and estradiol concentrations significantly higher (p=0.023) than in the IRs group. A logistic regression analysis was performed, including as independent variables in the original model femoral fracture load, 25 hydroxyvitamin D, previus history of fragility fracture, sclerostin and estradiol. Only previous history of fragility fracture (OR 14.04, 95% CI 2.38-82.79, p=0.004) and sclerostin levels (OR 1.11, 95% CI 1.02-1.20, p=0.011), both adjusted by estradiol levels remained associated with IRs. Also, sclerostin concentrations were associated with the index of resistance to compression (IRC) in the fractal analysis of the distal radius, a parameter on bone microstructure. Sclerostin and estradiol levels are associated with the response to bisphosphonate therapy in women with postmenopausal osteoporosis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  4. Eye Protection

    Science.gov (United States)

    ... is very important to read the product safety materials before using any new chemicals. The appropriate personal protective equipment for eye protection will be listed. This is particularly important for applying and handling pesticides, working with caustics such as lime fertilizer, ...

  5. 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)

  6. 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.

  7. Schoolchildren have similar predicted prevalences of inadequate intakes as toddlers in village populations in Egypt, Kenya, and Mexico.

    Science.gov (United States)

    Murphy, S P; Calloway, D H; Beaton, G H

    1995-09-01

    To examine the probability of inadequacy of schoolchild nutrient intakes; to compare the predicted adequacy of schoolchild diets to previously published data for toddler diets and to examine the relative adequacy of the diets of sibling pairs. Food consumption data were measured 2 days per month across approximately one year. Mean nutrient intakes were calculated and compared to international standards using a probability approach. Villages in Egypt, Kenya, and Mexico. 285 school-age children (7-9 years of age) and 255 toddlers (18-30 months of age) including 94 sibling pairs. Within a country, there was a striking similarity between the nutrients predicted to be inadequate in schoolchild and toddler diets across all nutrients except vitamin B12, which was more likely to be inadequate among schoolchildren. Nutrients of concern for both ages in one or more countries included iron, zinc, calcium, riboflavin, and vitamins B12, D, E, and A. For 94 toddler-schoolchild pairs, siblings at high risk of nutrient inadequacy could be identified from an indicator child with a sensitivity of 43-100% and a specificity of 59-100%. Nutrient adequacy tends to be a household characteristic for these two ages of children. Nutritional interventions that target the household have a high probability of benefitting multiple age groups of children.

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

    Directory of Open Access Journals (Sweden)

    Anne Lise Brantsæter

    2018-02-01

    Full Text Available 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.

  9. Pregabalin for the treatment of patients with generalized anxiety disorder with inadequate treatment response to antidepressants and severe depressive symptoms.

    Science.gov (United States)

    Olivares, José M; Álvarez, Enrique; Carrasco, José L; Pérez Páramo, María; López-Gómez, Vanessa

    2015-09-01

    To evaluate the effectiveness of pregabalin in patients with resistant generalized anxiety disorder (GAD) and severe depressive symptoms, we carried out a post-hoc analysis of a multicenter, prospective, and observational 6-month study. We included patients who were at least 18 years old, fulfilled the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria for GAD, showed inadequate responses to previous courses of antidepressant treatment, had Montgomery-Asberg Rating Scale scores of at least 35, had not received pregabalin previously, and were prescribed pregabalin upon entry into this study. We included 1815 patients fulfilling the DSM-IV criteria for GAD, and 133 (7.3%) fulfilled the selection criteria for these analyses. Ninety-seven percent of the patients received pregabalin (mean dose: 222 mg/day) in combination with other psychotropics. The Hamilton Anxiety Scale total score was reduced by a mean of 20.3 points (95% confidence interval, 22.1-18.4) (57.2% reduction) at month 6. Pregabalin also ameliorated comorbid depressive symptoms, with a reduction in the mean score of the Montgomery-Asberg Rating Scale of 22.3 points (95% confidence interval, 24.2-20.4) (56.6% reduction). Our results suggest that pregabalin, as part of a combination regimen with antidepressants and/or benzodiazepines, might be effective for the treatment of patients with GAD who have shown inadequate response to previous antidepressants and have severe depressive symptoms.

  10. 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)

  11. Pollinator Protection

    Science.gov (United States)

    What the EPA is doing to protect bees and other pollinators from pesticides; including addressing the issue of Colony Collapse Disorder (CCD), risk assessment, decline in pollinator health in general, and why pollinators are important.

  12. Protective clothing

    International Nuclear Information System (INIS)

    Malet, J.C.; Regnier, J.

    1979-01-01

    The present operational and intervention suits are described. Research work is currently in progress to improve the performance of the existing suits and to develop more resistant protective clothing. (author)

  13. Memory protection

    Science.gov (United States)

    Denning, Peter J.

    1988-01-01

    Accidental overwriting of files or of memory regions belonging to other programs, browsing of personal files by superusers, Trojan horses, and viruses are examples of breakdowns in workstations and personal computers that would be significantly reduced by memory protection. Memory protection is the capability of an operating system and supporting hardware to delimit segments of memory, to control whether segments can be read from or written into, and to confine accesses of a program to its segments alone. The absence of memory protection in many operating systems today is the result of a bias toward a narrow definition of performance as maximum instruction-execution rate. A broader definition, including the time to get the job done, makes clear that cost of recovery from memory interference errors reduces expected performance. The mechanisms of memory protection are well understood, powerful, efficient, and elegant. They add to performance in the broad sense without reducing instruction execution rate.

  14. Radiation protection

    International Nuclear Information System (INIS)

    Ures Pantazi, M.

    1994-01-01

    This work define procedures and controls about ionizing radiations. Between some definitions it found the following topics: radiation dose, risk, biological effects, international radioprotection bodies, workers exposure, accidental exposure, emergencies and radiation protection

  15. Protective Eyewear

    Science.gov (United States)

    ... Whether you’re on the basketball court, in chemistry class, or sitting by the pool, wearing protective ... remember to wear safety goggles. Using chemicals in chemistry class? Look like a real scientist by wearing ...

  16. Negotiating Protection

    DEFF Research Database (Denmark)

    Bille, Mikkel

    of architecture, the social use of luminosity, prophylactic items, saint veneration, Qur'anic items, and heritage production. The thesis challenges the preoccupation with "meaning" in material culture studies, by focusing on conceptualizations of "presence" and "absence" as equally important to protective...... strategies are confirming their efficacy, and act as material anchors for negotiating Bedouin identities in response to a rapid transformation from nomadic pastoralists to sedentary wageworkers. The tensions surrounding the materiality of protection, along with the role of the past in the present is further...... investigated through the contested public representations of Ammarin culture, along with a detailed study of the process leading to the protection of Bedouin culture by UNESCO Intangible Cultural Heritage. The overall conclusion of this research is that negotiating efficacious protection against perceived...

  17. Corrosion protection

    Science.gov (United States)

    Brown, Donald W.; Wagh, Arun S.

    2003-05-27

    There has been invented a chemically bonded phosphate corrosion protection material and process for application of the corrosion protection material for corrosion prevention. A slurry of iron oxide and phosphoric acid is used to contact a warm surface of iron, steel or other metal to be treated. In the presence of ferrous ions from the iron, steel or other metal, the slurry reacts to form iron phosphates which form grains chemically bonded onto the surface of the steel.

  18. 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

  19. 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

  20. Radiation Protection

    International Nuclear Information System (INIS)

    Loos, M.

    2001-01-01

    Major achievements of SCK-CEN's Radiation Protection Department in 2000 are described. The main areas for R and D of the department remain neutron dosimetry and neutron activation analysis, safeguards information handling and non-destructive assay techniques. Further activities include low-level radioactivity measurements in environmental and biological samples and radiation protection research. Finally, achievements in decision strategy research and social sciences in nuclear research are reported

  1. 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...

  2. A survey of breakfast-skipping and inadequate breakfast-eating among young schoolchildren in Nova Scotia.

    Science.gov (United States)

    McIntyre, L

    1993-01-01

    The prevalence of breakfast-skipping and inadequate breakfast-eating among schoolchildren in Nova Scotia was determined by surveying 2,500 children in Grades 1 to 3 in 25 randomly selected schools. Breakfast-skipping was measured on two occasions using a validated survey instrument administered by videotaped child entertainers. 4.8% of children came to school without eating or drinking anything on the morning of testing. Breakfast omission was significantly related to grade with 6.1% of Grade 1 children skipping breakfast compared with 3.2% in Grade 3. Boys were significantly more likely to skip breakfast than girls but the absolute differences were small. 86% of children consumed a breakfast including two food groups; 56% three food groups. Adequacy of consumption was poorer in lower grades but did not vary by other sociodemographic variables. Breakfast omission in Nova Scotia children attending Grades 1, 2 or 3 does not warrant a provincial public health response.

  3. The Effect of Inadequate Initial Empiric Antimicrobial Treatment on Mortality in Critically Ill Patients with Bloodstream Infections: A Multi-Centre Retrospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Rachel D Savage

    Full Text Available Hospital mortality rates are elevated in critically ill patients with bloodstream infections. Given that mortality may be even higher if appropriate treatment is delayed, we sought to determine the effect of inadequate initial empiric treatment on mortality in these patients. A retrospective cohort study was conducted across 13 intensive care units in Canada. We defined inadequate initial empiric treatment as not receiving at least one dose of an antimicrobial to which the causative pathogen(s was susceptible within one day of initial blood culture. We evaluated the association between inadequate initial treatment and hospital mortality using a random effects multivariable logistic regression model. Among 1,190 patients (1,097 had bacteremia and 93 had candidemia, 476 (40% died and 266 (22% received inadequate initial treatment. Candidemic patients more often had inadequate initial empiric therapy (64.5% versus 18.8%, as well as longer delays to final culture results (4 vs 3 days and appropriate therapy (2 vs 0 days. After adjustment, there was no detectable association between inadequate initial treatment and mortality among bacteremic patients (Odds Ratio (OR: 1.02, 95% Confidence Interval (CI 0.70-1.48; however, candidemic patients receiving inadequate treatment had nearly three times the odds of death (OR: 2.89, 95% CI: 1.05-7.99. Inadequate initial empiric antimicrobial treatment was not associated with increased mortality in bacteremic patients, but was an important risk factor in the subgroup of candidemic patients. Further research is warranted to improve early diagnostic and risk prediction methods in candidemic patients.

  4. Whistleblower protection.

    Science.gov (United States)

    2001-03-01

    The American Nurses Association's Code for Nurses states that "The nurse acts to safeguard the client and the public when health care and safety are affected by incompetent, unethical, or illegal practice by any person." In the interpretive statements which accompany the Code for Nurses, it is stated that "As an advocate for the client, the nurse must be alert to and take appropriate action regarding any instances of incompetent, unethical, or illegal practice by any member of the health care team or the health care system, or any action on the part of others that places the rights of best interests of the client in jeopardy." As of March of 2000, 22 states have whistleblower legislation introduced, 3 states had legislation enacted in the year 2000, and 10 states had legislation enacted in prior years. In a recent national survey of registered nurses, 56% of the nurses responding believed that their time available for direct patient care had decreased and 75% of those responding believed that the quality of nursing care had declined in their work setting during the last two years. Reasons for the declining care included: inadequate staffing, decreased nurse satisfaction, and a delay in providing basic care.

  5. Distinguishing the impacts of inadequate prey and vessel traffic on an endangered killer whale (Orcinus orca population.

    Directory of Open Access Journals (Sweden)

    Katherine L Ayres

    Full Text Available 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.

  6. Capillary Blood Ketone Levels as an Indicator of Inadequate Breast Milk Intake in the Early Neonatal Period.

    Science.gov (United States)

    Futatani, Takeshi; Shimao, Ayako; Ina, Shihomi; Higashiyama, Hiroyuki; Fujita, Shuhei; Ueno, Kazuyuki; Igarashi, Noboru; Hatasaki, Kiyoshi

    2017-12-01

    To determine the utility of capillary blood ketone levels as an indicator of inadequate intake of breast milk in the early postnatal period. Levels of capillary blood beta-hydroxybutyrate (βOHB), the main ketone body in the blood, were measured with a bedside ketone meter in 585 full-term neonates aged 48-95 hours who were breastfed exclusively. Relationships between weight-loss percentage, blood sodium, glucose, pH, partial pressure of carbon dioxide, base-deficit levels, and βOHB levels were investigated. The diagnostic accuracy of βOHB for predicting excessive weight loss (weight loss ≥10% of birth weight) and hypernatremic dehydration (blood sodium level ≥150 mEq/L) was determined. βOHB levels were correlated positively with weight-loss percentage and blood sodium levels and were correlated negatively with blood glucose levels. The diagnostic accuracy of βOHB was 0.846 (optimal cut off, 1.55 mmol/L; sensitivity, 80.9%, specificity, 74.0%) for predicting excessive weight loss and 0.868 (optimal cut off, 1.85 mmol/L; sensitivity, 94.3%; specificity, 69.9%) for predicting hypernatremic dehydration according to the area under the receiver operating characteristic curve. Multiple logistic analysis revealed that βOHB and weight loss percentage were the only independent predictors of hypernatremic dehydration. Increases in βOHB levels also were associated with worsening metabolic acidosis and hypocapnia. High βOHB levels were associated with inadequate intake of breast milk in the early postnatal period. The use of bedside capillary blood ketone levels may be clinically useful as an indicator of dehydration, energy depletion, and acid-base imbalance in breastfeeding infants in the early postnatal period. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. 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 ...

  8. Lightning Protection

    Science.gov (United States)

    1994-01-01

    Kit-built airplanes are more affordable because they are assembled by the owner and do not require Federal Aviation Administration (FAA) certification. The Glasair III, is an advanced technology homebuilt, constructed of a fiberglass and graphite fiber composite material, and equipped with digital instruments. Both technologies make the airplane more susceptible to lightning effects. When Glasair manufacturer, Stoddard-Hamilton, decided that lightning protection would enable more extensive instrument flight and make the plane more marketable, they proposed a joint development program to NASA Langley Research Center (LAR). Under a Small Business Innovation Research (SBIR) contract, Langley contractors designed and tested a lightning protection system, and the Glasair III-LP became the first kit-built composite aircraft to be lightning tested and protection-verified under FAA guidelines for general aviation aircraft.

  9. 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.

  10. Noise Protection

    Science.gov (United States)

    1980-01-01

    Environmental Health Systems puts forth an increasing effort in the U.S. to develop ways of controlling noise, particularly in industrial environments due to Federal and State laws, labor union insistence and new findings relative to noise pollution impact on human health. NASA's Apollo guidance control system aided in the development of a noise protection product, SMART. The basis of all SMART products is SMART compound a liquid plastic mixture with exceptional energy/sound absorbing qualities. The basic compound was later refined for noise protection use.

  11. Radiation protection

    CERN Multimedia

    CERN. Geneva

    2001-01-01

    This will be a simple explanation of the reasons why CERN has to be careful about radiation protections issues, a practical guide on how to recognize radiation dangers, the monitoring systems that make sure radiation levels are well tolerable norms, and a quick summary of what radiation levels mean in terms of personal risk.

  12. Protective Clothing

    Science.gov (United States)

    1981-01-01

    Beta Glass material, originating from the Apollo program is supplied to Fyrepel by Owens-Corning and incorporated into Fyrepel's Fyretex and Beta-Mex aluminized fabrics. Fabrics are used in fire entry suits, several other types of protective suits for wear in hot industrial environments and such accessory items as heat-reflecting curtains for industrial applications.

  13. 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

  14. Protection Myopia

    DEFF Research Database (Denmark)

    Laursen, Keld; Salter, Ammon; Li, Cher

    from having an orientation towards legal appropriability, we conjecture that protection myopia may lead some firms to allocate too much attention to legal appropriability, in particular when the behavioral and structural contingencies are unfavorable. Examining a panel of three successive waves......The strategies firms use to protect their intellectual property and knowledge can strongly influence their ability to capture the benefits of their innovative efforts. Using the attention-based theory, we explore positive and negative sides of legal appropriability. While asserting the benefits...... of a large-scale survey data of UK manufacturing firms, we find that an orientation towards legal appropriability is curvilinearly (taking an inverted U-shape) related to innovative performance. However, this effect is only present when the firms? product innovations are radical or when they are involved...

  15. Protective articles

    International Nuclear Information System (INIS)

    Wardley, R.B.

    1983-01-01

    This patent specification describes an article affording protection against radiation, and especially against X-rays comprising at least one flexible layer of lead filled material in an envelope of, or sandwiched between two layers of a knitted, woven or non-woven fabric preferably of synthetic fibrous material, carrying on its outer surface a coating of flexible polyurethane. The outer fabric provides a resilient, extremely tough and cut resistant covering for the relatively soft lead filled material. (author)

  16. Pre-bisection of a single skin biopsy does not produce technically inadequate specimens for direct immunofluorescence: a review of 3450 specimens.

    Science.gov (United States)

    Loh, Ern; Armstrong, April W; Fung, Maxwell A

    2014-11-01

    Evaluation of a potential immunobullous disorder typically requires two pieces of tissue obtained by skin biopsy: one placed in formalin for conventional microscopy and a second placed in a different transport medium suitable for direct immunofluorescence (DIF) testing. Clinical practice in this area is not standardized, with dermatologists either obtaining two biopsies or dividing (pre-bisecting) a single biopsy. Some DIF specimens are technically inadequate for interpretation of subepidermal imunobullous disorders because the basement membrane zone is not intact, but it is unknown whether pre-bisecting the tissue increases the risk of compromising the specimen. To investigate whether technically inadequate DIF specimens are associated with pre-bisection. DIF specimens were consecutively sampled from a single referral center and identified as whole (non-bisected) biopsy specimens or pre-bisected biopsy specimens. The proportion of inadequate specimens was calculated for both groups. A total of 3450 specimens were included. The percentage of inadequate specimens was 5.072% (153/3016) for whole (non-bisected) specimens and 5.299% for pre-bisected specimens. This difference was not significant (chi square, p = 0.84). The study was sufficiently powered to detect a relative risk of 1.685. Pre-bisection of a single skin biopsy does not significantly increase the risk of a technically inadequate specimen for direct immunofluorescence testing. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. 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.

  18. 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.

  19. A new positive pressure ventilation delivery system: its impact on lung ventilation studies that are technically inadequate or non diagnostic

    International Nuclear Information System (INIS)

    Bui, C.; Leiper, C.; Lee, K.; Saunders, C.; Dixson, H.; Elison, B.; Bennett, G.; Gibian, T.; Rutland, J.; Tse, V.; Elzein, H.; Babicheva, R.

    2000-01-01

    Full text: The objective of this study was to evaluate the efficacy and safety of an improved Positive Pressure Ventilation Delivery System (PVDS) in the investigation of Pulmonary Embolism (PE). The major component of PVDS is a commercially available, self-inflating 1.6L Hudson Resuscitator Bag, filled with either oxygen or air (if the patient has CO 2 retention), which is squeezed by the operator to push Technegas from the Technegas Generator Chamber to the patient via the Patient Administration Set synchronously with patient inspiration. 27 spontaneously breathing in-patients (12 males, 15 females, age range 64-89, 21 with chronic airflow limitation), whose conventional lung ventilation images were technically inadequate or non diagnostic, were re-scanned using PVDS within four days after the conventional ventilation study. Randomised blinded visual interpretation of conventional ventilation/perfusion scan vs. PVDS-assisted ventilation/perfusion scan was performed by consensus reading with two experienced observers. In conclusion PVDS was safe and well tolerated. PVDS improved the image quality of the lung ventilation scans in this cohort of patients. This technique has the potential to improve the accuracy of lung scanning in patients with severe lung disease. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

  20. 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.

  1. IDegLira Versus Alternative Intensification Strategies in Patients with Type 2 Diabetes Inadequately Controlled on Basal Insulin Therapy

    DEFF Research Database (Denmark)

    Freemantle, Nick; Mamdani, Muhammad; Vilsbøll, Tina

    2015-01-01

    glycated hemoglobin (HbA1c) and other outcomes. METHODS: A pooled analysis of five completed Novo Nordisk randomized clinical trials in patients with type 2 diabetes inadequately controlled on basal insulin was used to compare indirectly IDegLira (N = 199) with: addition of liraglutide to basal insulin (N...... = 225) [glucagon-like peptide-1 receptor agonist (GLP-1RA) add-on strategy]; basal-bolus (BB) insulin [insulin glargine (IGlar) + insulin aspart] (N = 56); or up-titration of IGlar (N = 329). A supplementary analysis was performed with the BB arm including patients who received IGlar or IDeg as basal...... of study, differences between IDegLira and BB or up-titrated IGlar, respectively, were as follows: reduction in HbA1c -0.30%, 95% confidence interval (-0.58; -0.01) and -0.65% (-0.83; -0.47); change in body weight -6.89 kg (-7.92; -5.86) and -4.04 kg (-4.69; -3.40) all in favor of IDegLira. Confirmed...

  2. Negative energy balance secondary to inadequate dietary intake of patients on the waiting list for liver transplantation.

    Science.gov (United States)

    Ferreira, Lívia Garcia; Ferreira Martins, Aline Isabel; Cunha, Carolina Elisa; Anastácio, Lucilene Rezende; Lima, Agnaldo Soares; Correia, Maria Isabel Toulson Davisson

    2013-10-01

    The aim of this study was to evaluate the energy balance (EB) of patients on the waiting list for liver transplantation, using total energy expenditure (TEE) assessment and total caloric intake (TCI). We analyzed nutrient adequacy and factors associated with it. EB was obtained by subtracting the TCI (obtained by 3-d food record) from TEE, which was measured as resting energy expenditure and physical activity factor calculation. Socioeconomic and clinical data also were evaluated. Univariate and multiple linear regressions were used (P 0.05). Women, less-educated patients, those with ascites, and those who were malnourished presented with lower TCI (P Liver Disease scores were associated with EB (P fiber (94.5%) inadequacies also were high. The percentage of adequate intake was less than 10% for vitamins B5 and D, calcium, folic acid, and potassium, and higher percentages of adequate intake (>80%) were found for iron and vitamins B1 and B12. Moreover, 54.8% and 16.4% of the patients had excessive sodium and cholesterol intakes, respectively. Negative EB was highly prevalent among patients on the waiting list for liver transplantation, and was associated with the severity of liver disease. Negative EB was primarily affected by low food intake. The food intake data were characterized by low overall energy and protein intake and inadequate composition of the patient's diet plan, which tended to be characterized by specific nutrient deficiencies and excesses. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. 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.

  4. Ribonuclease protection.

    Science.gov (United States)

    Thorvaldsen, J L; Bartolomei, M S

    2001-01-01

    The ribonuclease protection assay (RPA) is a sensitive technique for the analysis of total cellular RNA. It involves generating a specific antisense riboprobe, hybridizing the probe to total RNA, removing unprotected RNA by RNases, and finally isolating and analyzing the protected RNA on a denaturing gel. Although the RPA is somewhat more labor-intensive than Northern analysis, it has the advantage of being more sensitive (as little as 0.1 pg of target RNA can be detected with ideal hybridization conditions). RPAs are also more tolerant of partially degraded RNA (provided the area that is protected is intact). Although RPAs are not as sensitive as polymerase chain reaction (PCR)-based RNA analyses, the target RNA is analyzed directly; a reverse transcription step is not required. Finally, the RPA is quantitative as long as the probe is in excess. More important for the study of imprinted genes, the RPA can be designed to detect allele-specific expression of the target gene of interest.

  5. 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

  6. 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

  7. Environmental protection

    International Nuclear Information System (INIS)

    Hull, A.P.

    1979-01-01

    Environmental Studies and Internal Dosimetry projects include: Environmental Protection; 1977 Environmental Monitoring Report; Sewage Sludge Disposal on the Sanitary Landfill; Radiological Analyses of Marshall Islands Environmental Samples, 1974 to 1976; External Radiation Survey and Dose Predictions for Rongelap, Utirik, Rongerik, Ailuk, and Wotje Atolls; Marshall Islands - Diet and Life Style Study; Dose Reassessment for Populations on Rongelap and Utirik Following Exposure to Fallout from BRAVO Incident (March 1, 1954); Whole Body Counting Results from 1974 to 1979 for Bikini Island Residents; Dietary Radioactivity Intake from Bioassay Data, a Model Applied to 137 Cs Intake by Bikini Island Residents; and External Exposure Measurements at Bikini Atoll

  8. Protecting Antarctica

    Science.gov (United States)

    Carlowicz, Michael

    House Science Committee Chairman Robert Walker (R-Pa.) has introduced a bill into Congress to give the United States the legislative authority to implement the 1991 Environmental Protocol to the Antarctic Treaty. That protocol established rules and principles to shield the Antarctic environment from human spoilage—placing limits on the discharge of pollutants, protecting plant and animal life, and requiring environmental impact assessments before new activities and programs are launched. The protocol also forbids prospecting or developing of mineral resources except for scientific research.

  9. Combination of empagliflozin and linagliptin as second-line therapy in subjects with type 2 diabetes inadequately controlled on metformin.

    Science.gov (United States)

    DeFronzo, Ralph A; Lewin, Andrew; Patel, Sanjay; Liu, Dacheng; Kaste, Renee; Woerle, Hans J; Broedl, Uli C

    2015-03-01

    To evaluate the efficacy and safety of combinations of empagliflozin/linagliptin as second-line therapy in subjects with type 2 diabetes inadequately controlled on metformin. Subjects were randomized to a combination of empagliflozin 25 mg/linagliptin 5 mg (n = 137), empagliflozin 10 mg/linagliptin 5 mg (n = 136), empagliflozin 25 mg (n = 141), empagliflozin 10 mg (n = 140), or linagliptin 5 mg (n = 132) as add-on to metformin for 52 weeks. The primary end point was change from baseline in HbA1c at week 24. At week 24, reductions in HbA1c (mean baseline 7.90-8.02% [62.8-64.1 mmol/mol]) with empagliflozin/linagliptin were superior to those with empagliflozin or linagliptin alone as add-on to metformin; adjusted mean (SE) changes from baseline were -1.19% (0.06) (-13.1 mmol/mol [0.7]) with empagliflozin 25 mg/linagliptin 5 mg, -1.08% (0.06) (-11.8 mmol/mol [0.7]) with empagliflozin 10 mg/linagliptin 5 mg, -0.62% (0.06) (-6.8 mmol/mol [0.7]) with empagliflozin 25 mg, -0.66% (0.06) (-7.2 mmol/mol [0.7]) with empagliflozin 10 mg, and -0.70% (0.06) (-7.6 mmol/mol [0.7]) with linagliptin 5 mg (P empagliflozin/linagliptin as second-line therapy for 52 weeks significantly reduced HbA1c compared with the individual components and were well tolerated. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  10. Lifestyle constraints, not inadequate nutrition education, cause gap between breakfast ideals and realities among Japanese in Tokyo.

    Science.gov (United States)

    Melby, Melissa K; Takeda, Wakako

    2014-01-01

    Japanese public health nutrition often promotes 'traditional' cuisine. In-depth interviews with 107 Japanese adults were conducted in Tokyo from 2009 to 2011, using free-listing methods to examine dietary ideals and realities to assess the extent to which realities reflect inadequate nutrition education or lifestyle constraints. Ideal-reality gaps were widest for breakfast. Most people reported Japanese ideals: rice and miso soup were prototypical foods. However, breakfast realities were predominantly western (bread-based). While those aged 40-59 were more likely to hold Japanese ideals (P=0.063), they were less likely to achieve them (P=0.007). All those reporting western ideals achieved them on weekdays, while only 64% of those with Japanese ideals achieved them (PJapanese ideals were positively correlated with proportion of cooking-related housework, and negatively correlated with living standard and income. Ideal menu content was in line with current Japanese nutrition advice, suggesting that more nutrition education may not change dietary ideals or behavior. Participant-reported reasons for ideal-reality discordance demonstrate that work-life balance issues, especially lack of time and family structure/life rhythm, are the largest obstacles to the attainment of dietary ideals. People reporting 'no time' as a primary reason for ideal-reality gaps were less likely to achieve their Japanese ideals (odds ratio=0.212). Time realities of people's lives may undermine educational efforts promoting Japanese breakfasts. When dietary reality/behavior departs from guidelines, it is often assumed that people lack knowledge. If ideals are in line with dietary guidelines, then lack of knowledge is not the likely cause and nutrition education is not the optimal solution. By asking people about the reasons for gaps between their ideals and realities, we can identify barriers and design more effective policies and programs to achieve dietary ideals. Copyright © 2013 Elsevier

  11. An analysis of US fertility centre educational materials suggests that informed consent for preimplantation genetic diagnosis may be inadequate.

    Science.gov (United States)

    LaBonte, Michelle Lynne

    2012-08-01

    The use of preimplantation genetic diagnosis (PGD) has expanded both in number and scope over the past 2 decades. Initially carried out to avoid the birth of children with severe genetic disease, PGD is now used for a variety of medical and non-medical purposes. While some human studies have concluded that PGD is safe, animal studies and a recent human study suggest that the embryo biopsy procedure may result in neurological problems for the offspring. Given that the long-term safety of PGD has not been clearly established in humans, this study sought to determine how PGD safety is presented to prospective patients by means of a detailed website analysis. The websites of 262 US fertility centres performing PGD were analysed and comments about safety and risk were catalogued. Results of the analysis demonstrated that 78.2% of centre websites did not mention safety or risk of PGD at all. Of the 21.8% of centres that did contain safety or risk information about PGD, 28.1% included statements highlighting the potential risks, 38.6% presented information touting the procedure as safe and 33.3% included statements highlighting potential risks and the overall safety of the procedure. Thus, 86.6% of PGD-performing centres state that PGD is safe and/or fail to disclose any risks on their websites despite the fact that the impact of the procedure on the long-term health of offspring is unproven. This lack of disclosure suggests that informed consent is inadequate; this study examines numerous factors that are likely to inhibit comprehensive discussions of safety.

  12. Inadequate knowledge of neonatal danger signs among recently delivered women in southwestern rural Uganda: a community survey.

    Directory of Open Access Journals (Sweden)

    Jacob Sandberg

    Full Text Available BACKGROUND: Early detection of neonatal illness is an important step towards improving newborn survival. Every year an estimated 3.07 million children die during their first month of life and about one-third of these deaths occur during the first 24 hours. Ninety-eight percent of all neonatal deaths occur in low- and middle-income countries like Uganda. Inadequate progress has been made globally to reduce the amount of neonatal deaths that would be required to meet Millennium Development Goal 4. Poor knowledge of newborn danger signs delays care seeking. The aim of this study was to explore the knowledge of key newborn danger signs among mothers in southwestern Uganda. METHODS: Results from a community survey of 765 recently delivered women were analyzed using univariate and multivariate logistic regressions. Six key danger signs were identified, and spontaneous responses were categorized, tabulated, and analyzed. RESULTS: Knowledge of at least one key danger sign was significantly associated with being birth prepared (adjusted OR 1.7, 95% CI 1.2-2.3. Birth preparedness consisted of saving money, identifying transportation, identifying a skilled birth attendant and buying a delivery kit or materials. Overall, respondents had a poor knowledge of key newborn danger signs: 58.2% could identify one and 14.8% could identify two. We found no association between women attending the recommended number of antenatal care visits and their knowledge of danger signs (adjusted OR 1.0, 95% CI 0.8-1.4, or between women using a skilled birth attendant at delivery and their knowledge of danger signs (adjusted OR 1.2, 95% CI 0.9-1.7. CONCLUSIONS: Our findings indicate the need to enhance education of mothers in antenatal care as well as those discharged from health facilities after delivery. Further promotion of birth preparedness is encouraged as part of the continuum of maternal care.

  13. Complementary foods consumed by 6-12-month-old rural infants in South Africa are inadequate in micronutrients.

    Science.gov (United States)

    Faber, Mieke

    2005-06-01

    To determine the nutrient composition of complementary foods consumed by 6-12-month-old South African infants. Nutrient intake was determined for infants who were recruited to participate in a randomised controlled trial using a single 24-hour dietary recall. Infants aged 6-12 months (n=475) residing in The Valley of a Thousand Hills, a rural area in KwaZulu-Natal, South Africa. Energy and protein intakes from complementary foods were adequate. Infants who consumed infant products (commercially available fortified infant cereals/ready-to-eat canned baby foods/formula milk powder) had significantly higher intakes of calcium, iron, zinc, vitamin A, thiamine, riboflavin, niacin, vitamin B6, vitamin B12 and vitamin C than infants who did not consume any infant products. For infants who consumed infant cereals (n=142), these cereals provided 51% of total iron intake. Infant cereals provided more than 25% of total intake for magnesium, thiamine, niacin and vitamin B12. For infants consuming ready-to-eat canned baby foods (n=77), these products contributed less than 15% of total intake for all the micronutrients. The nutrient density of the complementary diet was less than half the desired density for calcium, iron and zinc. Animal products were consumed by 17% of infants, 26% consumed dairy products and 18% consumed vitamin-A-rich fruit and vegetables during the 24-hour recall period. The nutrient composition of complementary foods among rural South African infants was inadequate, especially for iron, zinc and calcium. Strategies should be developed to improve the nutritional quality of their diets.

  14. A randomized trial of the efficacy and safety of quilizumab in adults with inadequately controlled allergic asthma.

    Science.gov (United States)

    Harris, Jeffrey M; Maciuca, Romeo; Bradley, Mary S; Cabanski, Christopher R; Scheerens, Heleen; Lim, Jeremy; Cai, Fang; Kishnani, Mona; Liao, X Charlene; Samineni, Divya; Zhu, Rui; Cochran, Colette; Soong, Weily; Diaz, Joseph D; Perin, Patrick; Tsukayama, Miguel; Dimov, Dimo; Agache, Ioana; Kelsen, Steven G

    2016-03-18

    Quilizumab, a humanized IgG1 monoclonal antibody, targets the M1-prime segment of membrane-expressed IgE, leading to depletion of IgE-switched and memory B cells. In patients with mild asthma, quilizumab reduced serum IgE and attenuated the early and late asthmatic reaction following whole lung allergen challenge. This study evaluated the efficacy and safety of quilizumab in adults with allergic asthma, inadequately controlled despite high-dose inhaled corticosteroids (ICS) and a second controller. Five hundred seventy-eight patients were randomized to monthly or quarterly dosing regimens of subcutaneous quilizumab or placebo for 36 weeks, with a 48-week safety follow-up. Quilizumab was evaluated for effects on the rate of asthma exacerbations, lung function, patient symptoms, serum IgE, and pharmacokinetics. Exploratory analyses were conducted on biomarker subgroups (periostin, blood eosinophils, serum IgE, and exhaled nitric oxide). Quilizumab was well tolerated and reduced serum total and allergen-specific IgE by 30-40 %, but had no impact on asthma exacerbations, lung function, or patient-reported symptom measures. At Week 36, the 300 mg monthly quilizumab group showed a 19.6 % reduction (p = 0.38) in the asthma exacerbation rate relative to placebo, but this was neither statistically nor clinically significant. Biomarker subgroups did not reveal meaningful efficacy benefits following quilizumab treatment. Quilizumab had an acceptable safety profile and reduced serum IgE. However, targeting the IgE pathway via depletion of IgE-switched and memory B cells was not sufficient for a clinically meaningful benefit for adults with allergic asthma uncontrolled by standard therapy. ClinicalTrials.gov NCT01582503.

  15. Protective Coatings

    Science.gov (United States)

    1980-01-01

    General Magnaplate Corporation's pharmaceutical machine is used in the industry for high speed pressing of pills and capsules. Machine is automatic system for molding glycerine suppositories. These machines are typical of many types of drug production and packaging equipment whose metal parts are treated with space spinoff coatings that promote general machine efficiency and contribute to compliance with stringent federal sanitation codes for pharmaceutical manufacture. Collectively known as "synergistic" coatings, these dry lubricants are bonded to a variety of metals to form an extremely hard slippery surface with long lasting self lubrication. The coatings offer multiple advantages; they cannot chip, peel or be rubbed off. They protect machine parts from corrosion and wear longer, lowering maintenance cost and reduce undesired heat caused by power-robbing friction.

  16. Fire protection

    International Nuclear Information System (INIS)

    Janetzky, E.

    1980-01-01

    Safety and fire prevention measurements have to be treated like the activities developing, planning, construction and erection. Therefore it is necessary that these measurements have to be integrated into the activities mentioned above at an early stage in order to guarantee their effectiveness. With regard to fire accidents the statistics of the insurance companies concerned show that the damage caused increased in the last years mainly due to high concentration of material. Organization of fire prevention and fire fighting, reasons of fire break out, characteristics and behaviour of fire, smoke and fire detection, smoke and heat venting, fire extinguishers (portable and stationary), construction material in presence of fire, respiratory protection etc. will be discussed. (orig./RW)

  17. Protective clothing

    International Nuclear Information System (INIS)

    Winnett, G.F.

    1979-01-01

    A protective suit used for isolating its wearer from radioactively contaminated areas is described in three parts. The first part includes the covering for the wearer's head, arms and upper body and at the waist is releasably fitted around an opening into the contaminated area. The second part includes the legs of the suit and is releasably connectible to the first part of the suit to enclose the wearer who is then supplied with air through an umbilical pipe. A further part surrounds the second part and is releasably connectible to it, enclosing a space between the parts. This further part is also releasably connectible to the opening at the waist to prevent egress from the contaminated area. The releasable connections between the parts may be bayonet type fittings or may be rotating T-shaped projections which engage in T-shaped grooves. (author)

  18. Offspring Protection

    Directory of Open Access Journals (Sweden)

    Eric T. Steiner

    2016-08-01

    Full Text Available Parental aggression, that is, offspring protection aggression, can be viewed as a type of parental investment. Most mammalian males do not exhibit parental investment and therefore exhibit little, if any, parental aggression. Men demonstrate parental investment, and are typically more physically aggressive than women, but parental physical aggression in humans has been largely unexplored. The current study examined potential sex differences in estimates of parental physical aggression involving hypothetical situations, while controlling for general physical aggression. A self-report measure was administered to 217 students from a western U.S. university (55 male nonparents, 50 female nonparents, 54 fathers, and 58 mothers. Male nonparents reported higher parental physical aggression than female nonparents, but there was no difference between mothers and fathers. The results are interpreted in light of ancestral effects of sexual selection and proximal effects of sex differences in testosterone, risk taking, and fear aversion.

  19. 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

  20. Efficacy and safety of tregalizumab in patients with rheumatoid arthritis and an inadequate response to methotrexate: results of a phase IIb, randomised, placebo-controlled trial

    NARCIS (Netherlands)

    van Vollenhoven, Ronald F.; Keystone, Edward Clark; Strand, Vibeke; Pacheco-Tena, Cesar; Vencovský, Jiří; Behrens, Frank; Racewicz, Arthur; Zipp, Daniela; Rharbaoui, Faiza; Wolter, Ralf; Knierim, Luise; Schmeidl, Rainer; Zhou, Xuefei; Aigner, Silke; Dälken, Benjamin; Wartenberg-Demand, Andrea; Aelion, Jacob; Arreola, Jorge Aguilar; Arias, Maria Araujo; Back, Johan; Baranauskaite, Asta; Bennett, Ralph; Bookman, Arthur; Brzezicki, Jan; Butrimiene, Irena; Churchill, Melvin; Djacenko, Svetlana; Dokoupilova, Eva; Drescher, Edit; Dudek, Anna; Edwards, William; Eliseeva, Larisa; Ershova, Olga; Fortin, Isabelle; Galatikova, Dagmar; de la Torre, Ignacio Garcia; Garmish, Olena; Gasanov, Yuriy; Gnylorybov, Andriy; Goldberg, Marc; Golovchenko, Oleksandr; Gordeev, Ivan; Hiepe, Falk; Sil, Gabriela Huerta; Husarova, Viola; Iaremenko, Oleg; Jeka, Slawomir; Kamburova, Daniela; Kavanaugh, Arthur; Keszthelyi, Peter; Keystone, Edward; Knyazeva, Larisa; Krechikova, Diana; Kuzmanova, Stefka; Lapcikova, Angelika; Levinson, Dennis; Lopez Garcia, Jesus Alberto; Lymar, Iurii; Marinova, Natalia; Moiseev, Sergey; Musilova, Lucie; Nagy, Magdolna; Najam, Sabeen; Nedovic, Jovan; Nemeth, Eleonora; Novosad, Libor; Ochoa-Ortega, Luis; Oparanov, Boycho; Tena, Cesar Pacheco; Penev, Dimitar; Pesant, Yves; Podrazilova, Lucie; Pulka, Grazyna; Racewicz, Artur; Raskina, Tatiana; Rekalov, Dmytro; Reshetko, Olga; Riega Torres, Janett Carmen; Rubbert-Roth, Andrea; Rychlewska-Hanczewska, Anna; Savina, Ludmila; Schulze-Koops, Hendrik; Bukilica, Mirjana Sefik; Shevchuk, Sergii; Simoncsics, Eszter; Simova, Lubomira; Sitek-Ziolkowska, Karina; Skublova, Andrea; Sliwowska, Beata; Smakotina, Svetlana; Spieler, Wolfgang; Stanislavchuk, Mykola; Stefanovic, Dusan; Stejfova, Zuzana; Stoilov, Rumen; Strapkova, Maria; Stryuk, Raisa; Sulyok, Gabriella; Sylwestrzak, Anna; Szombati, Istvan; Theander, Jan; Tomkova, Sona; Trapp, Robert; Tseluyko, Vira; Tälli, Jaak; Vencovsky, Jiri; Vitek, Petr; Vladeva, Stoyanka; Vo, Jacqueline; Vujasinovic-Stupar, Nada; Wassenberg, Siegfried; Wollenhaupt, Juergen; Zielinska, Agnieszka

    2018-01-01

    To evaluate the efficacy, biological activity and safety of tregalizumab in patients with active rheumatoid arthritis (RA) and an inadequate response to methotrexate (MTX). 321 patients were randomised (1:1:1:1) to placebo or tregalizumab 25, 100 or 200 mg once-weekly subcutaneously in addition to

  1. Absence of diabetic retinopathy in a patient who has had diabetes mellitus for 69 years, and inadequate glycemic control: case presentation: response

    Directory of Open Access Journals (Sweden)

    Raman Rajiv

    2010-03-01

    Full Text Available Abstract A response to Jorge Esteves, Carolina Maurente da Rosa, Caroline Kaercher Kramer, Luiz Eduardo Osowski, Stéfano Milano and Luís Henrique Canani: Absence of diabetic retinopathy in a patient who has had diabetes mellitus for 69 years, and inadequate glycemic control: case presentation. Diabetology & Metabolic syndrome 2009, 1:13.

  2. Prevalence and determinants of inadequate use of folic acid supplementation in Japanese pregnant women: the Japan Environment and Children's Study (JECS).

    Science.gov (United States)

    Obara, Taku; Nishigori, Hidekazu; Nishigori, Toshie; Metoki, Hirohito; Ishikuro, Mami; Tatsuta, Nozomi; Mizuno, Satoshi; Sakurai, Kasumi; Nishijima, Ichiko; Murai, Yuriko; Fujiwara, Ikuma; Arima, Takahiro; Nakai, Kunihiko; Mano, Nariyasu; Yaegashi, Nobuo; Kuriyama, Shinichi

    2017-03-01

    The aim of the study was to clarify the prevalence and determinants of inadequate use of folic acid supplementation in pregnant Japanese women. This study was part of the Japan Environment and Children's Study, a nationwide and government-funded birth cohort study. We collected information on the use of folic acid supplementation before and during pregnancy and characteristics of participants using self-administered questionnaire. Among 9849 women who completed the data collection for this study, the prevalence of inadequate users was 92.6% of the total population and varied from 84.5% to 96.2% among regions. On the basis of multivariate logistic regression analysis, younger age, not married, lower family income, multipara, natural conception and no history of spontaneous abortion were found to be determinants for inadequate users of folic acid supplementation. Most Japanese pregnant women show inadequate folic acid supplementation use. Japanese women of child-bearing age need to be specifically informed about the need for periconceptional intake of folic acid to prevent neural tube defects.

  3. Lifesaving emergency obstetric services are inadequate in south-west Ethiopia: a formidable challenge to reducing maternal mortality in Ethiopia

    Science.gov (United States)

    2013-01-01

    qualifying facilities serve this large population which is below the UN’s minimum recommendation. The utilization of the existing facilities for delivery was also low, which is clearly inadequate to reduce maternal deaths to the MDG target. PMID:24180672

  4. Changes in Ultrasonographic Vascularity Upon Initiation of Adalimumab Combination Therapy in Rheumatoid Arthritis Patients With an Inadequate Response to Methotrexate.

    Science.gov (United States)

    Kaeley, Gurjit S; Nishio, Midori J; Goyal, Janak R; MacCarter, Daryl K; Wells, Alvin F; Chen, Su; Kupper, Hartmut; Kalabic, Jasmina

    2016-11-01

    To assess joint disease activity by ultrasound (US) in patients with rheumatoid arthritis (RA) initiating treatment with adalimumab (ADA) plus methotrexate (MTX). Data for this post hoc analysis originated from the MUSICA trial (ClinicalTrials.gov identifier: NCT01185288), which evaluated the efficacy of initiating ADA (40 mg every other week) plus 7.5 or 20 mg/week MTX in 309 patients with RA with an inadequate response to MTX. Synovial vascularization over 24 weeks was assessed bilaterally at metacarpophalangeal joint 2 (MCP2), MCP3, MCP5, metatarsophalangeal joint 5, and the wrists by power Doppler US (PDUS). A semiquantitative 4-grade scale was used. Disease activity was assessed using the Disease Activity Score in 28 joints using the C-reactive protein level (DAS28-CRP) and Simplified Disease Activity Index (SDAI). The correlation between continuous variables was assessed using Pearson's correlation coefficient. After 24 weeks of treatment with ADA plus MTX, rapid improvements in the mean synovial vascularity score were observed; the greatest improvements were in MCP2 (-0.5), MCP3 (-0.4), and the wrist (-0.4). At week 24, patients with the lowest DAS28-CRP ( 0.9). Synovial vascularity scores correlated poorly with DAS28, swollen joint count in 66 joints (SJC66), SJC28, tender joint count in 68 joints (TJC68), TJC28, Clinical Disease Activity Index (CDAI), SDAI, physician's global assessment, patient's global assessment of pain, and disease duration (ρ < 0.2). Thirty-two (70%) of 46 patients with a DAS28-CRP of <2.6, and 11 (58%) of 19 patients with an SDAI indicating remission had at least 1 joint with a synovial vascularity score of ≥1. PDUS detects changes in synovial vascularity in RA patients treated with ADA plus MTX, and residual synovial vascularity in patients in whom clinical disease control has been achieved. © 2016 The Authors. Arthritis & Rheumatology published by Wiley Periodicals, Inc. on behalf of the American College of Rheumatology.

  5. An economic analysis of inadequate prescription of antiulcer medications for in-hospital patients at a third level institution in Colombia

    Directory of Open Access Journals (Sweden)

    Jorge Enrique Machado-Alba

    2014-02-01

    Full Text Available Introduction: The prescription and costs of antiulcer medications for in-hospital use have increased during recent years with reported inadequate use and underused. Aim: To determine the patterns of prescription-indication and also perform an economic analysis of the overcost caused by the non-justified use of antiulcer medications in a third level hospital in Colombia. Materials and methods: Cross-sectional study of prescription-indication of antiulcer medications for patients hospitalized in "Hospital Universitario San Jorge" of Pereira during July of 2012. Adequate or inadequate prescription of the first antiulcer medication prescribed was determined as well as for others prescribed during the hospital stay, supported by clinical practice guidelines from the Zaragoza I sector workgroup, clinical guidelines from the Australian Health Department, and finally the American College of Gastroenterology Criteria for stress ulcer prophylaxis. Daily defined dose per bed/day was used, as well as the cost for 100 beds/day and the cost of each bed/drug. A multivariate analysis was carried out using SPSS 21.0. Results: 778 patients were analyzed, 435 men (55.9% and 343 women, mean age 56.6 ± 20.1 years. The number of patients without justification for the prescription of the first antiulcer medication was 377 (48.5%, and during the whole in-hospital time it was 336 (43.2%. Ranitidine was the most used medication, in 438 patients (56.3%. The cost/month for poorly justified antiulcer medications was € 3,335.6. The annual estimated cost for inadequate prescriptions of antiulcer medications was € 16,770.0 per 100 beds. Conclusion: A lower inadequate prescription rate of antiulcer medications was identified compared with other studies; however it was still high and is troubling because of the major costs that these inadequate prescriptions generates for the institution.

  6. 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.

  7. The quality of water from protected springs in Katwe and Kisenyi ...

    African Journals Online (AJOL)

    Background: In the sub-urban areas of Kampala city, springs are a major source of water for domestic use. Though spring water is considered to be aesthetically acceptable for domestic use, presence of poorly designed pit latrines, poor solid waste management as well as poor and inadequate spring protection, may lead to ...

  8. Effect of herbal choline and rumen-protected methionine on lamb ...

    African Journals Online (AJOL)

    Elizabeth A Mendoza B MD

    2018-01-30

    Jan 30, 2018 ... Effect of herbal choline and rumen-protected methionine on lamb performance and ... successful, presumably because the diets were based on low-quality forage with inadequate lysine (Lys) and ... experiments with dairy cows showed that dietary supplementation with RPM and RPC alleviated negative ...

  9. 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

    . 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...... = 0.422; Total daily insulin dose, -5.7 U/day (-8.6; -2.9), pbody weight, -1.74 kg (-3.32; -0.17), p = 0.030. Minor and overall major hypoglycaemia was not significantly different between treatments. Treatments were well tolerated. CONCLUSIONS/SIGNIFICANCE: In patients with poorly controlled T......1DM, adjunct metformin therapy did not provide any improvement of glycaemic control after one year. Nevertheless, adjunct metformin treatment was associated with sustained reductions of insulin dose and body weight. Further investigations into the potential cardiovascular-protective effects...

  10. Simulated effects of home fortification of complementary foods with micronutrient powders on risk of inadequate and excessive intakes in West Gojjam, Ethiopia.

    Science.gov (United States)

    Abebe, Zeweter; Haki, Gulelat Desse; Baye, Kaleab

    2018-01-01

    Home fortification of complementary foods (CFs) with multiple micronutrient powders (MNPs) is being scaled up in various countries, but little is known about the prevailing complementary feeding practices and the type and nutrient gaps to be filled with MNPs. The present study evaluated the complementary feeding practices of young children and simulated the risk of inadequate and excessive intakes associated with home fortification with MNPs. We have assessed the sociodemographic status, anthropometry, and complementary feeding practices of young children (N = 122) in Mecha district, rural Ethiopia. Using a 2-day, quantitative 24-hr recall, usual intakes of energy, protein, iron, zinc, and calcium were estimated. The risks of inadequate and excessive iron and zinc intakes with or without home fortification scenarios were assessed. The simulations considered intakes from CFs assuming average breast milk contributions and additional nutrients provided by the MNPs. Stunting was highly prevalent (50%) and was associated with a lower dietary diversity (P = .009) and nutrient intakes from the CFs. Median energy, zinc, and calcium intakes were below the estimated needs from CFs; protein needs were met. Median dietary iron intake appeared adequate, but 76%, 95% CI [68%, 84%], of children had inadequate intake (assuming low bioavailability), whereas another 8%, 95% CI: [3%, 13%], had excessive intakes. Simulation of daily and alternative day's fortification with MNP decreased the prevalence of inadequate iron and zinc intake but significantly increased the risk of excessive intakes that remained unacceptably high for iron (>2.5%). Untargeted MNP interventions may lead to excessive intakes, even in settings where poor complementary feeding practices are prevalent. © 2017 John Wiley & Sons Ltd.

  11. The utility of weight loss medications after bariatric surgery for weight regain or inadequate weight loss: A multi-center study.

    Science.gov (United States)

    Stanford, Fatima Cody; Alfaris, Nasreen; Gomez, Gricelda; Ricks, Elizabeth T; Shukla, Alpana P; Corey, Kathleen E; Pratt, Janey S; Pomp, Alfons; Rubino, Francesco; Aronne, Louis J

    2017-03-01

    Patients who undergo bariatric surgery often have inadequate weight loss or weight regain. We sought to discern the utility of weight loss pharmacotherapy as an adjunct to bariatric surgery in patients with inadequate weight loss or weight regain. Two academic medical centers. We completed a retrospective study to identify patients who had undergone bariatric surgery in the form of a Roux-en-Y gastric bypass (RYGB) or a sleeve gastrectomy from 2000-2014. From this cohort, we identified patients who were placed on weight loss pharmacotherapy postoperatively for inadequate weight loss or weight regain. We extracted key demographic data, medical history, and examined weight loss in response to surgery and after the initiation of weight loss pharmacotherapy. A total of 319 patients (RYGB = 258; sleeve gastrectomy = 61) met inclusion criteria for analysis. More than half (54%; n = 172) of all study patients lost≥5% (7.2 to 195.2 lbs) of their total weight with medications after surgery. There were several high responders with 30.3% of patients (n = 96) and 15% (n = 49) losing≥10% (16.7 to 195.2 lbs) and≥15% (25 to 195.2 lbs) of their total weight, respectively, Topiramate was the only medication that demonstrated a statistically significant response for weight loss with patients being twice as likely to lose at least 10% of their weight when placed on this medication (odds ratio = 1.9; P = .018). Regardless of the postoperative body mass index, patients who underwent RYGB were significantly more likely to lose≥5% of their total weight with the aid of weight loss medications. Weight loss pharmacotherapy serves as a useful adjunct to bariatric surgery in patients with inadequate weight loss or weight regain. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  12. 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.

  13. 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 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 benign cases. We need to pay particular attention to the collection and assessment of aspirates for these histological types of breast disease. In particular, several

  14. Sub-Federal Enforcement of Immigration Law: An Introduction to the Problem of Pretextual Enforcement and Inadequate Remedies

    Directory of Open Access Journals (Sweden)

    Carrie Rosenbaum

    2014-01-01

    Full Text Available Sub-federal enforcement of immigration law has expanded significantly in the last decade raising questions concerning policing, rights violations, and remedies. While the Fourth Amendment has historically provided an avenue for potentially suppressing evidence obtained in violation of a criminal defendant’s civil rights, its applicability in the immigration removal context has been circumscribed. Thus, the avenues to protect the rights of unauthorized noncitizens in immigration removal proceedings are less clear where sub-federal agents act outside of their authorization, particularly in the context of Secure Communities, and enforce immigration law. In the context of immigration exceptionalism, racial profiling has historically played a unique role in immigration law. The lack of adequate measures to deter rights violations where sub-federal agents enforce immigration law raises questions concerning the relationship between criminal and immigration law, and the importance of deterring civil rights violations such as racial profiling, in immigration enforcement. This article will examine the problem of sub-federal law enforcement agents’ use of criminal law violations as a pretext to enforce immigration law and the lack of adequate deterrence of civil rights violations.

  15. Inadequate supply of vitamins and DHA in the elderly: implications for brain aging and Alzheimer-type dementia.

    Science.gov (United States)

    Mohajeri, M Hasan; Troesch, Barbara; Weber, Peter

    2015-02-01

    Alzheimer's disease (AD) is the most prevalent, severe, and disabling cause of dementia worldwide. To date, AD therapy is primarily targeted toward palliative treatment of symptoms rather than prevention of disease progression. So far, no pharmacologic interventions have changed the onset or progression of AD and their use is accompanied by side effects. The major obstacle in managing AD and designing therapeutic strategies is the difficulty in retarding neuronal loss in the diseased brain once the pathologic events leading to neuronal death have started. Therefore, a promising alternative strategy is to maintain a healthy neuronal population in the aging brain for as long as possible. One factor evidently important for neuronal health and function is the optimal supply of nutrients necessary for maintaining normal functioning of the brain. Mechanistic studies, epidemiologic analyses, and randomized controlled intervention trials provide insight to the positive effects of docosahexaenoic acid (DHA) and micronutrients such as the vitamin B family, and vitamins E, C, and D, in helping neurons to cope with aging. These nutrients are inexpensive in use, have virtually no side effects when used at recommended doses, are essential for life, have established modes of action, and are broadly accepted by the general public. This review provides some evidence that the use of vitamins and DHA for the aging population in general, and for individuals at risk in particular, is a viable alternative approach to delaying brain aging and for protecting against the onset of AD pathology. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  16. Anaesthesiology and research in South Africa: a proposal for a ...

    African Journals Online (AJOL)

    Based on factors known to be associated with research productivity, a proposal is made for the establishment of a national, collaborative research group. To ensure the success of this venture, this collaborative group should address the six factors of research productivity identified by Kern: funding of the research; the quality ...

  17. Informed consent for anaesthesiological and intensive care unit ...

    African Journals Online (AJOL)

    2013-03-04

    Mar 4, 2013 ... Keywords/phrases: anaesthesia, ICU research, South Africa, guidelines and regulations, informed consent, surrogate consent, vulnerability. Abstract .... (f) the development or new application of pharmaceuticals, medicines and .... authentic informed consent.22 The vulnerability of critically ill patients is ...

  18. 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 ...

  19. Informed consent for anaesthesiological and intensive care unit ...

    African Journals Online (AJOL)

    The South African legal framework consists of the Bill of Rights, the National Health Act, and two sets of Department of Health guidelines, Medical Research Council Ethical Guidelines Book 1, and South African Health Professions Council General Ethical Guidelines for Health Researchers (Booklet 6) add an ethical overlay ...

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

    African Journals Online (AJOL)

    This requirement relates to personal ... Keywords: professionalism, anaesthetic practice, professional duty, ethics of responsibility, virtue ethics, Aristotle ..... regulation is an important professional responsibility that applies to both the individual and the collective. The individual professional should have the moral compass, ...

  1. NRC Information Notice No. 92-01: Cable damage caused by inadequate cable installation procedures and controls

    International Nuclear Information System (INIS)

    Rossi, C.E.

    1993-01-01

    In June 1989, the Tennessee Valley Authority (TVA) removed the cables from a conduit in the reactor protection system of the Watts Bar Nuclear Plant, Unit 2, to inspect for damage. TVA selected this conduit in response to an employee's concern that a welding arc that struck the conduit in response to an employee's concern that a welding arc that struck the conduit during construction may have damaged cables in the conduit. When the cables were removed, TVA found significant damage in the insulation of some cables. This damage was not attributed to heat generated by the alleged welding arc. The damage was principally attributed to the pulling stresses exerted during the initial installation of the cables. Some of the cables had insulation removed down to the conductors. To assess the extent of cable damage and determine the scope of its investigation, TVA removed more cables from conduits that constituted the most difficult pulls (worst case) and found varying degrees of damage that it attributed to pulling stresses. To fill a conduit at Watts Bar, personnel used pull cords to pull more cables through the conduits over the top of existing cables. This practice is called ''pull-by.'' This practice can cause damage to the existing cables from the sawing action of the pull cords and the friction of cables as they are pulled over existing cables. TVA instituted programs to assess the adequacy of cable installation at all its nuclear facilities and take appropriate corrective actions. At Watts Bar, TVA replaced cables in conduits which exceeded a calculated threshold value of side wall bearing pressure (SWBP) and performed a high-potential (hi-pot) tests on a number of other cables in conduits with SWBP below the calculated threshold value

  2. Environmental Protection Agency

    Science.gov (United States)

    ... United States Environmental Protection Agency Search Search U.S. Environmental Protection Agency Contact Us Share It's Small Business ... WIFIA Tweets by @EPAScottPruitt View on Twitter U.S. Environmental Protection Agency Video Highlights It's Small Business Week ...

  3. 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

  4. Source Water Protection Basics

    Science.gov (United States)

    Defines drinking water sources (source water), identifies drinking water sources, and describes source water assessments and protection, roles of government and organizations in drinking water source protection

  5. 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...

  6. 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

  7. Saxagliptin is non-inferior to glipizide in patients with type 2 diabetes mellitus inadequately controlled on metformin alone: a 52-week randomised controlled trial

    OpenAIRE

    Gause-Nilsson, Ingrid; Göke, Burkhard; Gallwitz, Baptist; Eriksson, Johan; Hellqvist, Asa

    2010-01-01

    Abstract Aim: Assess the efficacy and safety of saxagliptin vs. glipizide, as add-on therapy to metformin in patients with type 2 diabetes mellitus and inadequate glycaemic control on metformin alone. Methods and patients: A total of 858 patients (age ?18 years; glycated haemoglobin [HbA1c] >6.5?10.0%; on stable metformin doses ?1500mg/day) were randomised 1:1 to saxagliptin 5mg/day or glipizide up-titrated as needed from 5?20mg/day for 52 weeks. The primary objective wa...

  8. The Efficacy and Safety of Imeglimin as Add-on Therapy in Patients With Type 2 Diabetes Inadequately Controlled With Metformin Monotherapy

    OpenAIRE

    Fouqueray, Pascale; Pirags, Valdis; Inzucchi, Silvio E.; Bailey, Clifford J.; Schernthaner, Guntram; Diamant, Michaela; Lebovitz, Harold E.

    2013-01-01

    OBJECTIVE - A 12-week study assessed the efficacy and safety of a new oral antidiabetic agent, imeglimin, as add-on therapy in type 2 diabetes patients inadequately controlled with metformin alone. RESEARCH DESIGN AND METHODS - A total of 156 patients were randomized 1:1 to receive imeglimin (1,500mg twice a day) or placebo added to a stable dose of metformin (1,500-2,000 mg/day). Change in A1C from baseline was the primary efficacy outcome; secondary outcomes included fasting plasma glucose ...

  9. Legal Protection Reform for Children Conflicted with Law

    Directory of Open Access Journals (Sweden)

    Emy Rosna Wati

    2014-01-01

    Full Text Available The government has long been giving protection to children. Protection is reflected in the issuance of various Law. One of them is the Law No. 23 of 2003 on Child Protection. The legal protection of children in conflicted with law and child as victims of crime are regulatedin articlenumber 64. Issuance of Law No. 3 of 1997 on Juvenile Court actually originates from a passion for protecting the rights of children in conflicted with the law. However, due to inadequate understanding and mindset of Juvenile Court, which is do not have the children’s perspective, what comes up is that the substance of Law on Juvenile Court is not to protect children but to prosecute children. However, after the release of Law No. 11 of 2012 onThe Criminal Justice System of Children, legal protection of children in conflict with the law was encouragingly reformed. How To Cite: Rosna Wati, E. (2014. Legal Protection Reform for Children Conflicted with Law. Rechtsidee, 1(1, 59-70. doi:http://dx.doi.org/10.21070/jihr.v1i1.101

  10. 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…

  11. 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

  12. 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

  13. 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.

  14. Field evaluation of the error arising from inadequate time averaging in the standard use of depth-integrating suspended-sediment samplers

    Science.gov (United States)

    Topping, David J.; Rubin, David M.; Wright, Scott A.; Melis, Theodore S.

    2011-01-01

    Several common methods for measuring suspended-sediment concentration in rivers in the United States use depth-integrating samplers to collect a velocity-weighted suspended-sediment sample in a subsample of a river cross section. Because depth-integrating samplers are always moving through the water column as they collect a sample, and can collect only a limited volume of water and suspended sediment, they collect only minimally time-averaged data. Four sources of error exist in the field use of these samplers: (1) bed contamination, (2) pressure-driven inrush, (3) inadequate sampling of the cross-stream spatial structure in suspended-sediment concentration, and (4) inadequate time averaging. The first two of these errors arise from misuse of suspended-sediment samplers, and the third has been the subject of previous study using data collected in the sand-bedded Middle Loup River in Nebraska. Of these four sources of error, the least understood source of error arises from the fact that depth-integrating samplers collect only minimally time-averaged data. To evaluate this fourth source of error, we collected suspended-sediment data between 1995 and 2007 at four sites on the Colorado River in Utah and Arizona, using a P-61 suspended-sediment sampler deployed in both point- and one-way depth-integrating modes, and D-96-A1 and D-77 bag-type depth-integrating suspended-sediment samplers. These data indicate that the minimal duration of time averaging during standard field operation of depth-integrating samplers leads to an error that is comparable in magnitude to that arising from inadequate sampling of the cross-stream spatial structure in suspended-sediment concentration. This random error arising from inadequate time averaging is positively correlated with grain size and does not largely depend on flow conditions or, for a given size class of suspended sediment, on elevation above the bed. Averaging over time scales >1 minute is the likely minimum duration required

  15. 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.

  16. Are the Level of Knowledge and Practices of Pregnant Women Regarding Folic Acid Supplementation Still Inadequate? A Cross-Sectional Study in a Middle Eastern Urban Setting.

    Science.gov (United States)

    Aoun, Antoine; Faddoul, Lara; El Jabbour, Flora; El Osta, Nada; Hlais, Sani; El Osta, Lana

    2017-11-13

    This observational cross-sectional study aimed to examine the knowledge and practices of pregnant women in North Lebanon regarding periconceptional folic acid (FA) supplementation. A convenience sample of pregnant women attending gynecology clinics in North Lebanon was recruited between May and September 2013. Data were collected from a face-to-face interview performed by a trained local dietician as well as from review of obstetric charts. A total of 465 women were included in the study. Only 37 (7.9%) were aware of the role of FA in preventing birth defects, while 129 (27.7%) were able to identify one food item rich in FA or folate. Only 125 (26.9%) were taking FA supplementation before pregnancy. While 440 (94.6%) participants were taking FA supplements during pregnancy, 158 (34%) were receiving an inadequate dose. Adequate preconceptional supplementation of FA was significantly associated with the women's level of education (p =.008), planned pregnancy (p knowledge and inadequate intake of FA supplements before and during pregnancy.

  17. 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.

  18. 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.

  19. 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.

  20. The reactor accident in Fukushima Daiichi. The consequence of design deficiencies and inadequate safety engineering; Der Reaktorunfall in Fukushima Daiichi. Folge fehlerhafter Auslegung und unzureichender Sicherheitstechnik

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-03-15

    The reactor accident in Fukushima Daiichi is discussed in the frame of design deficiencies and inadequate safety engineering. The progress of the accident as consequence of the earthquake and the tsunami is described. The radiological situation for the public is supposed to be blow the dose limit of 20 mSv/year. The WHO and UNSCEAR (United Nations Scientific Committee on the Effects of Atomic radiation) did not observe acute radiation injuries. The Japanese authorities have classified the accident to 7 of the INES scale. The German Atomforum e.V. considers the safety engineering of German NPPs to be superior to the Japanese situation due to higher emergency energy supply, extensive measures to reduce the hydrogen accumulation and mitigating measures for the accident management. German NPPS are considered highly robust as the EU stress tests have shown.

  1. [Inadequate burials as an important factor in plague epidemic amongst Serbs in the Habsburg monarchy by the end of the 18th century: a historical analysis].

    Science.gov (United States)

    Vasin, Goran; Božanić, Snežana; Božić, Milica Kisić

    2014-01-01

    Analysis of the archaic customs of burying the deceased in Srem, primarily amongst Serbs, in the second half of the 18th century is the essential part of the paper that aims at clarifying the consequences of this negative habit onto the spreading of plague epidemic. The Austrian Empire tried to stop and prevent the epidemic with an array of legal norms, but in practice, these orders were often not upheld. Serbian Metropolitans Pavle Nenadović and Stefan Stratimirović insisted on eradicating superstition and retrograde, often uncivilized actions in burial rituals, and they partially succeeded. The example of plague in Irig and the surroundings in 1795-1796 explicitly shows the hazardous effects of the inadequate attitude towards the deceased as one of the factors in spreading the epidemic. Using primary archives, and published sources, with adequate literature, authors depict this complex historical process.

  2. 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.

  3. 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)

  4. Antioxidants: Protecting Healthy Cells

    Science.gov (United States)

    ... and Nutrients Antioxidants - Protecting Healthy Cells Print Email Antioxidants - Protecting Healthy Cells Reviewed by Taylor Wolfram, MS, ... to cardiovascular disease and certain types of cancers. Antioxidants — such as vitamins C and E and carotenoids, ...

  5. Aircraft Fire Protection Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — The Navy Aircraft Protection Laboratory provides complete test support for all Navy air vehicle fire protection systems.The facility allows for the simulation of a...

  6. Cathodic protection -- Rectifier 46

    Energy Technology Data Exchange (ETDEWEB)

    Lane, W.M. [Westinghouse Hanford Co., Richland, WA (United States)

    1995-06-14

    This Acceptance Test Procedure (ATP) has been prepared to demonstrate that the cathodic protection system functions as required by project criteria. The cathodic protection system is for the tank farms on the Hanford Reservation. The tank farms store radioactive waste.

  7. Cathodic protection -- Rectifier 47

    Energy Technology Data Exchange (ETDEWEB)

    Lane, W.M. [Westinghouse Hanford Co., Richland, WA (United States)

    1995-06-14

    This Acceptance Test Procedure (ATP) has been prepared to demonstrate that the cathodic protection system functions as required by project criteria. The cathodic protection system is for the tank farms at the Hanford Reservation. The tank farms store radioactive waste.

  8. Cathodic protection -- Rectifier 47

    International Nuclear Information System (INIS)

    Lane, W.M.

    1995-01-01

    This Acceptance Test Procedure (ATP) has been prepared to demonstrate that the cathodic protection system functions as required by project criteria. The cathodic protection system is for the tank farms at the Hanford Reservation. The tank farms store radioactive waste

  9. Endangered Species Protection Bulletins

    Science.gov (United States)

    Endangered Species Protection Bulletins set forth geographically specific pesticide use limitations for the protection of threatened and endangered (listed) species and their designated critical habitat. Find out how to get and use Bulletins.

  10. Noise and Hearing Protection

    Science.gov (United States)

    ... ENTCareers Marketplace Find an ENT Doctor Near You Noise and Hearing Protection Noise and Hearing Protection Patient ... it is. How can I tell if a noise is dangerous? People differ in their sensitivity to ...

  11. Addressing inadequate compensation | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-08-12

    Aug 12, 2016 ... Communities' land and land use need to be fairly valuated for them to receive equitable compensation and a fair share of benefits and risks in land deals. Researchers in some projects are using “participatory valuation” processes with communities to help them appraise their lands' value and strengthening ...

  12. 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

  13. Environmental Protection Agency, Protecting Children's Environmental Health

    Science.gov (United States)

    ... Agency Search Search Contact Us Share Protecting Children's Environmental Health Children are often more vulnerable to pollutants ... during development. Learn more about children's health, the environment, and what you can do. Basic Information Children ...

  14. Introduction to radiation protection

    International Nuclear Information System (INIS)

    Choudens, H. de; Troesch, G.

    1985-01-01

    The following topics are developed through the five chapters of the manual: radiation dosimetry, basic principles, dose units and radiation protection instrumentation; protection against external irradiation and internal contamination; safety of nuclear facilities, principles, regulations and organization; radiation protection into nuclear reactors; environmental monitoring of radioactive wastes and effluents [fr

  15. 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.

  16. China's environmental protection: challenges and countermeasures.

    Science.gov (United States)

    1993-10-01

    The following suggestions are made to improve environmental quality in China: control population growth, develop ecofarming, protect biodiversity, explore new energy sources, practice safe and sustainable consumption, adopt an efficient strategy for use of natural resources, use industrial production to maintain sustainable development, strengthen management, guide urbanization, and increase international cooperation. The environmental problems are identified as the low use of industrial technology for preventing undesirable waste or emissions, increased sewage discharges in rural areas, water pollution, increased acid rain, increased pollution from solid waste and toxic chemicals, soil erosion and desertification, and agricultural pollution from chemical fertilizers. Environmental pollution is the result of economic development. Economic development should, therefore, take responsibility for the solutions. Current funding for environmental protection is an inadequate 0.67% of the gross national product. Environmental management needs to be strengthened, given greater priority, and balanced with sustainable development. The entire population should be made aware of the importance of protecting the environment. Progress has been made in increasing cultivated forest preserves, in decreasing discharges of wastes into the water, and in decreasing noise pollution. 1098 districts in 216 cities meet environmental noise control standards. The 1991 environmental protection staff consisted of 71,000 persons who were employed in 2199 monitoring stations for soot control, 61 natural reserves, and 6400 environmental pollution projects. A total investment of 1.74 billion RMB yuan was invested in environmental pollution control projects. Environmental quality has been maintained at 1980 standards, and further environmental pollution has been avoided. Atmospheric pollution in the third quarter of 1991 in large and medium-sized cities was 0.067 to 0.450 milligrams per cubic meter

  17. 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.

  18. 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

  19. 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

  20. 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)

  1. Protection of host cells by complement regulators

    Science.gov (United States)

    Schmidt, Christoph Q.; Lambris, John D.; Ricklin, Daniel

    2017-01-01

    Summary The complement cascade is an ancient immune-surveillance system that not only provides protection from pathogen invasion but has also evolved to participate in physiological processes to maintain tissue homeostasis. The alternative pathway (AP) of complement activation is the evolutionarily oldest part of this innate immune cascade. It is unique in that it is continuously activated at a low level and arbitrarily probes foreign, modified-self, and also unaltered self-structures. This indiscriminate activation necessitates the presence of preformed regulators on autologous surfaces to spare self-cells from the undirected nature of AP activation. Although the other two canonical complement activation routes, the classical and lectin pathways, initiate the cascade more specifically through pattern recognition, their activity still needs to be tightly controlled to avoid excessive reactivity. It is the perpetual duty of complement regulators to protect the self from damage inflicted by inadequate complement activation. Here, we review the role of complement regulators as preformed mediators of defense, explain their common and specialized functions, and discuss selected cases in which alterations in complement regulators lead to disease. Finally, rational engineering approaches using natural complement inhibitors as potential therapeutics are highlighted. PMID:27782321

  2. 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

  3. 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...

  4. 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.

  5. 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.

  6. A sun protection survey of New England fishermen.

    Science.gov (United States)

    Sun, Ting

    2003-05-01

    Skin cancer is the most common form of cancer in the United States, with more than 1 million cases of nonmelanoma skin cancer diagnosed annually and an estimated 53,600 cases of melanoma and 7400 deaths expected during the year 2002. Excess exposure to UV radiation has long been linked to both melanoma and nonmelanoma skin cancers. Fishing is a popular sport in the United States, and one with excessive sun exposure. Results of a survey of recreational fishermen conducted at the 23rd Annual Eastern Fishing & Outdoor Exposition found that sun protection attitudes and practices were poor or inadequate. I recommend that a tailored sun protection intervention program should take into account age, gender, and skin type, as well as the unique obstacles faced by fishermen.

  7. The efficacy and safety of imeglimin as add-on therapy in patients with type 2 diabetes inadequately controlled with sitagliptin monotherapy.

    Science.gov (United States)

    Fouqueray, Pascale; Pirags, Valdis; Diamant, Michaela; Schernthaner, Guntram; Lebovitz, Harold E; Inzucchi, Silvio E; Bailey, Clifford J

    2014-07-01

    This 12-week study assessed the efficacy and tolerability of imeglimin as add-on therapy to the dipeptidyl peptidase-4 inhibitor sitagliptin in patients with type 2 diabetes inadequately controlled with sitagliptin monotherapy. In a multicenter, randomized, double-blind, placebo-controlled, parallel-group study, imeglimin (1,500 mg b.i.d.) or placebo was added to sitagliptin (100 mg q.d.) over 12 weeks in 170 patients with type 2 diabetes (mean age 56.8 years; BMI 32.2 kg/m(2)) that was inadequately controlled with sitagliptin alone (A1C ≥7.5%) during a 12-week run-in period. The primary efficacy end point was the change in A1C from baseline versus placebo; secondary end points included corresponding changes in fasting plasma glucose (FPG) levels, stratification by baseline A1C, and percentage of A1C responders. Imeglimin reduced A1C levels (least-squares mean difference) from baseline (8.5%) by 0.60% compared with an increase of 0.12% with placebo (between-group difference 0.72%, P < 0.001). The corresponding changes in FPG were -0.93 mmol/L with imeglimin vs. -0.11 mmol/L with placebo (P = 0.014). With imeglimin, the A1C level decreased by ≥0.5% in 54.3% of subjects vs. 21.6% with placebo (P < 0.001), and 19.8% of subjects receiving imeglimin achieved a decrease in A1C level of ≤7% compared with subjects receiving placebo (1.1%) (P = 0.004). Imeglimin was generally well tolerated, with a safety profile comparable to placebo and no related treatment-emergent adverse events. Imeglimin demonstrated incremental efficacy benefits as add-on therapy to sitagliptin, with comparable tolerability to placebo, highlighting the potential for imeglimin to complement other oral antihyperglycemic therapies. © 2014 by the American Diabetes Association.

  8. 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

  9. 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

  10. 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)

  11. Radiological protection act, 1991

    International Nuclear Information System (INIS)

    1991-01-01

    This Act provides for the establishment of the Radiological Protection Institute of Ireland and dissolves An Bord Fuinnimh Nuicleigh (the Board), transferring its assets and liabilities to the Institute. It sets out a range of radiation protection measures to be taken by various Ministers in the event of a radiological emergency and gives effect at national level to the Assistance Convention, the Early Notification Convention and the Physical Protection Convention. The Institute is the competent Irish authority for the three Conventions. (NEA) [fr

  12. Emergency protection from aerosols

    International Nuclear Information System (INIS)

    Cristy, G.A.; Chester, C.V.

    1981-07-01

    Expedient methods were developed that could be used by an average person, using only materials readily available, to protect himself and his family from injury by toxic (e.g., radioactive) aerosols. The most effective means of protection was the use of a household vacuum cleaner to maintain a small positive pressure on a closed house during passage of the aerosol cloud. Protection factors of 800 and above were achieved

  13. Cathodic Protection Model Facility

    Data.gov (United States)

    Federal Laboratory Consortium — FUNCTION: Performs Navy design and engineering of ship and submarine impressed current cathodic protection (ICCP) systems for underwater hull corrosion control and...

  14. Radiation protection in Bolivia

    International Nuclear Information System (INIS)

    Miranda Cuadros, A.A.

    2001-01-01

    Radiation protection in Bolivia has gone through a number of stages. Initially, in the 1970s, the focus was mainly on the analysis of environmental sources resulting from the nuclear tests carried out by France in the Pacific Ocean. Subsequently, the focus switched somewhat to radiation protection in connection with the mining of uranium and in the area of public health. During the third stage, radiation protection in other areas became important as the use of radiation sources was introduced. Finally, during the present -- fourth -- stage, radiation protection regulations are being introduced and mechanisms for the control of radiation sources are being established. (author)

  15. 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

  16. Statistical methods to correct for verification bias in diagnostic studies are inadequate when there are few false negatives: a simulation study

    Directory of Open Access Journals (Sweden)

    Vickers Andrew J

    2008-11-01

    Full Text Available Abstract Background A common feature of diagnostic research is that results for a diagnostic gold standard are available primarily for patients who are positive for the test under investigation. Data from such studies are subject to what has been termed "verification bias". We evaluated statistical methods for verification bias correction when there are few false negatives. Methods A simulation study was conducted of a screening study subject to verification bias. We compared estimates of the area-under-the-curve (AUC corrected for verification bias varying both the rate and mechanism of verification. Results In a single simulated data set, varying false negatives from 0 to 4 led to verification bias corrected AUCs ranging from 0.550 to 0.852. Excess variation associated with low numbers of false negatives was confirmed in simulation studies and by analyses of published studies that incorporated verification bias correction. The 2.5th – 97.5th centile range constituted as much as 60% of the possible range of AUCs for some simulations. Conclusion Screening programs are designed such that there are few false negatives. Standard statistical methods for verification bias correction are inadequate in this circumstance.

  17. Potential Links between Impaired One-Carbon Metabolism Due to Polymorphisms, Inadequate B-Vitamin Status, and the Development of Alzheimer’s Disease

    Directory of Open Access Journals (Sweden)

    Barbara Troesch

    2016-12-01

    Full Text Available Alzheimer’s disease (AD is the major cause of dementia and no preventive or effective treatment has been established to date. The etiology of AD is poorly understood, but genetic and environmental factors seem to play a role in its onset and progression. In particular, factors affecting the one-carbon metabolism (OCM are thought to be important and elevated homocysteine (Hcy levels, indicating impaired OCM, have been associated with AD. We aimed at evaluating the role of polymorphisms of key OCM enzymes in the etiology of AD, particularly when intakes of relevant B-vitamins are inadequate. Our review indicates that a range of compensatory mechanisms exist to maintain a metabolic balance. However, these become overwhelmed if the activity of more than one enzyme is reduced due to genetic factors or insufficient folate, riboflavin, vitamin B6 and/or vitamin B12 levels. Consequences include increased Hcy levels and reduced capacity to synthetize, methylate and repair DNA, and/or modulated neurotransmission. This seems to favor the development of hallmarks of AD particularly when combined with increased oxidative stress e.g., in apolipoprotein E (ApoE ε4 carriers. However, as these effects can be compensated at least partially by adequate intakes of B-vitamins, achieving optimal B-vitamin status for the general population should be a public health priority.

  18. Systematic Review and Meta-Analysis of Diagnostic Accuracy of Serum Refractometry and Brix Refractometry for the Diagnosis of Inadequate Transfer of Passive Immunity in Calves.

    Science.gov (United States)

    Buczinski, S; Gicquel, E; Fecteau, G; Takwoingi, Y; Chigerwe, M; Vandeweerd, J M

    2018-01-01

    Transfer of passive immunity in calves can be assessed by direct measurement of immunoglobulin G (IgG) by methods such as radial immunodiffusion (RID) or turbidimetric immunoassay (TIA). IgG can also be measured indirectly by methods such as serum refractometry (REF) or Brix refractometry (BRIX). To determine the accuracy of REF and BRIX for assessment of inadequate transfer of passive immunity (ITPI) in calves. Systematic review and meta-analysis of diagnostic accuracy studies. Databases (PubMed and CAB Abstract, Searchable Proceedings of Animal Science) and Google Scholar were searched for relevant studies. Studies were eligible if the accuracy (sensitivity and specificity) of REF or BRIX was determined using direct measurement of IgG by RID or turbidimetry as the reference standard. The study population included calves refractometry, including the optimal cutoff, are sparse (especially for BRIX). When using REF to rule out ITPI in herds, the 5.5 g/dL cutoff may be used whereas for ruling in ITPI, the 5.2 g/dL cutoff may be used. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  19. Patients with Crohn's disease on anti-tumor necrosis factor therapy are at significant risk of inadequate response to the 23-valent pneumococcal polysaccharide vaccine.

    Science.gov (United States)

    Lee, Chang Kyun; Kim, Hyun-Soo; Ye, Byong Duk; Lee, Kang-Moon; Kim, You Sun; Rhee, Sang Youl; Kim, Hyo-Jong; Yang, Suk-Kyun; Moon, Won; Koo, Ja-Seol; Lee, Suck-Ho; Seo, Geom Seog; Park, Soo Jung; Choi, Chang Hwan; Jung, Sung-Ae; Hong, Sung Noh; Im, Jong Pil; Kim, Eun Soo

    2014-05-01

    The effect of immunosuppressants on the efficacy of a variety of vaccines is a controversial issue in patients with inflammatory bowel disease (IBD). In this study we determined whether specific immunosuppressants impair the serological response to the standard 23-valent pneumococcal polysaccharide vaccine (PPSV23) in a large cohort of patients with Crohn's disease (CD). This was a multi-center, prospective observational study of adult patients with CD at 15 academic teaching hospitals in Korea. The study population received one intramuscular injection of PPSV23. Anti-pneumococcal IgG antibody titers were measured by immunoassay prior to and 4weeks after vaccination. All vaccination-related adverse events and the effect of the vaccine on disease activity were also evaluated. The overall serological response rate was 67.5% (133/197). The serological response rate was significantly lower in patients on anti-tumor necrosis factor (anti-TNF) therapy (50.0% on anti-TNF alone; 58.0% on anti-TNF combined with an immunomodulator, IM) than patients on 5-aminosalicylate (78.4%; all P-values vs. 5-aminosalicylaterisk of an inadequate response to PPSV23. The pneumococcal vaccination strategy should be optimized for patients with CD on anti-TNF therapy. © 2013 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

  20. Effects of proximal grooves and abutment height on the resistance of resin-cemented crowns in teeth with inadequate resistance: An in vitro study.

    Science.gov (United States)

    Huang, Yi-Chen; Lin, Chun-Li; Ko, Ellen Wen-Ching

    2015-01-01

    The resistance form is a key factor for a successful crown fabrication. This in vitro study evaluates the effects of proximal grooves and abutment height on the resistance of single cast crowns in molars with inadequate resistance. Sixty extracted human molars were prepared to possess 20° of total occlusal convergence for single crown fabrication. All of the prepared teeth were divided into six groups and prepared according to three axial heights (2, 3, and 4 mm) with or without preparing a pair of proximal grooves. Alloy metal copings of 5% titanium were casted and cemented. A self-adhesive modified-resin cement was used for cementation. A lateral dislodgement test was performed with an increasing external force applied at a 45° angulation on a universal testing machine. The force required to dislodge the crown from the tooth or to break the core was recorded. Proximal grooves increased the dislodgement resistance in groups with an abutment height of 4 mm, whereas adding grooves made no significant differences in resistance in groups with abutment heights of 2 and 3 mm. The 2 mm groups exhibited worse performance than the other groups, whether they had proximal grooves or not. An abutment height of 3 mm provided adequate resistance for single cast crowns when self-adhesive modified-resin cement was used. Preparing a pair of proximal grooves on abutments shorter than 4 mm had no significant influence on the resistance.

  1. Potential Links between Impaired One-Carbon Metabolism Due to Polymorphisms, Inadequate B-Vitamin Status, and the Development of Alzheimer's Disease.

    Science.gov (United States)

    Troesch, Barbara; Weber, Peter; Mohajeri, M Hasan

    2016-12-10

    Alzheimer's disease (AD) is the major cause of dementia and no preventive or effective treatment has been established to date. The etiology of AD is poorly understood, but genetic and environmental factors seem to play a role in its onset and progression. In particular, factors affecting the one-carbon metabolism (OCM) are thought to be important and elevated homocysteine (Hcy) levels, indicating impaired OCM, have been associated with AD. We aimed at evaluating the role of polymorphisms of key OCM enzymes in the etiology of AD, particularly when intakes of relevant B-vitamins are inadequate. Our review indicates that a range of compensatory mechanisms exist to maintain a metabolic balance. However, these become overwhelmed if the activity of more than one enzyme is reduced due to genetic factors or insufficient folate, riboflavin, vitamin B6 and/or vitamin B12 levels. Consequences include increased Hcy levels and reduced capacity to synthetize, methylate and repair DNA, and/or modulated neurotransmission. This seems to favor the development of hallmarks of AD particularly when combined with increased oxidative stress e.g., in apolipoprotein E (ApoE) ε4 carriers. However, as these effects can be compensated at least partially by adequate intakes of B-vitamins, achieving optimal B-vitamin status for the general population should be a public health priority.

  2. Invasive salivary duct carcinoma ex pleomorphic adenoma of the parotid gland: a teaching case giving rise to the genuine diagnostic difficulty on an inadequate cytology specimen

    Directory of Open Access Journals (Sweden)

    Yamada Sohsuke

    2012-05-01

    Full Text Available Abstract A history of a recent rapid increase in long-standing swelling mass was presented in the right parotid gland of an 85-year-old male. The inadequate cytologic specimens contained few small clusters of three-dimensional malignant epithelial cells having hyperchromatic pleomorphic nuclei and prominent nucleoli, adjacent to a cluster of benign monomorphic myoepithelial cells. We first interpreted it merely as an adenocarcinoma, not otherwise specified. A radical parotidectomy was performed, and gross examination revealed an encapsulated and firm tumor lesion, looking grayish-blue to yellowish-white, focally associated with extracapsular invasion. On microscopic examination, the tumor was predominantly composed of a proliferation of highly atypical epithelial cells having abundant eosinophilic cytoplasm, often arranged in a Roman-bridge appearance with foci of comedo necrosis, alternating with extensive infiltration to adjacent stroma in a trabecular or alveolar fashion with severe vessel permeation. Within the background of pleomorphic adenoma, the carcinoma cells sometimes replaced ductal luminal cells while retaining an intact-like myoepithelial layer. Therefore, we finally made a diagnosis of invasive salivary duct carcinoma ex pleomorphic adenoma. We should be aware that owing to its characteristic features, cytopathologists might be able to determine correct diagnosis, based on multiple and adequate samplings. Virtual slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2126158270695815

  3. The efficacy and safety of imeglimin as add-on therapy in patients with type 2 diabetes inadequately controlled with metformin monotherapy.

    Science.gov (United States)

    Fouqueray, Pascale; Pirags, Valdis; Inzucchi, Silvio E; Bailey, Clifford J; Schernthaner, Guntram; Diamant, Michaela; Lebovitz, Harold E

    2013-03-01

    A 12-week study assessed the efficacy and safety of a new oral antidiabetic agent, imeglimin, as add-on therapy in type 2 diabetes patients inadequately controlled with metformin alone. A total of 156 patients were randomized 1:1 to receive imeglimin (1,500 mg twice a day) or placebo added to a stable dose of metformin (1,500-2,000 mg/day). Change in A1C from baseline was the primary efficacy outcome; secondary outcomes included fasting plasma glucose (FPG) and proinsulin/insulin ratio. After 12 weeks, the placebo-subtracted decrease in A1C with metformin-imeglimin was -0.44% (P < 0.001). Metformin-imeglimin also significantly improved FPG and the proinsulin/insulin ratio from baseline (-0.91 mg/dL and -7.5, respectively) compared with metformin-placebo (0.36 mg/dL and 11.81). Metformin-imeglimin therapy was generally well-tolerated with a comparable safety profile to metformin-placebo. Addition of imeglimin to metformin improved glycemic control and offers potential as a new treatment for type 2 diabetes.

  4. 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)

  5. 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.)

  6. Regulations in radiation protection

    International Nuclear Information System (INIS)

    1986-01-01

    On the occasion of the twenty fifth anniversary of the Dutch Society for Radiation Protection, a symposium was held about Regulations in Radiation Protection. The program consisted of six contributions of which four are included in this publication. The posters presented are published in NVS-nieuws, 1985, vol. 11(5). (G.J.P.)

  7. Individual protections and ergonomics

    International Nuclear Information System (INIS)

    2000-01-01

    The object of this conference was the protective clothing against radioactive contamination. The regulatory frame, the physiological constraints and the human factor are the different aspects studied through the conference with a constant objective, the optimization of radiation protection. (N.C.)

  8. Environmental protection Implementation Plan

    International Nuclear Information System (INIS)

    Holland, R. C.

    1999-01-01

    This ''Environmental Protection Implementation Plan'' is intended to ensure that the environmental program objectives of Department of Energy Order 5400.1 are achieved at SNL/California. This document states SNL/California's commitment to conduct its operations in an environmentally safe and responsible manner. The ''Environmental Protection Implementation Plan'' helps management and staff comply with applicable environmental responsibilities

  9. Radiation protection products

    International Nuclear Information System (INIS)

    1983-01-01

    The basic terms of radiation protection means, these means and their parts are defined. Radiation protection products are classified into nine groups and their outer appearance and design are described. The standard also gives equivalent terms in Czech, Russian, Polish, Hungarian, German, Bulgarian and Romanian. (E.S.)

  10. Licensing and Patent Protection

    OpenAIRE

    Aniruddha Bagchi; Arijit Mukherjee

    2010-01-01

    We show the impact of technology licensing on optimal patent policy. Strong patent protection that eliminates imitation may not be the equilibrium outcome in the presence of licensing. Depending on the cost of innovation, licensing may either increase or reduce the strength of the patent protection.

  11. Respirators and protective clothing

    International Nuclear Information System (INIS)

    1967-01-01

    The basic object in the use of protective clothing and equipment is to prevent contamination of the skin and to prevent inhalation and ingestion of radioactive isotopes or other toxic materials. This book is a guide to deciding the kind and quantity of protective equipment needed for a particular type of laboratory or operation.

  12. Deficit of IgG2 in HIV-positive pregnant women is responsible of inadequate IgG2 levels in their HIV-uninfected children in Malawi.

    Science.gov (United States)

    Baroncelli, Silvia; Galluzzo, Clementina Maria; Liotta, Giuseppe; Andreotti, Mauro; Mancinelli, Sandro; Mphwere, Robert; Bokola, Enok; Amici, Roberta; Marazzi, Maria Cristina; Palombi, Leonardo; Lucaroni, Francesca; Giuliano, Marina

    2018-02-27

    Transplacental passage of IgGs is impaired in HIV + pregnant women, possibly determining an inadequate immunological protection in their children. We aimed to determine the impact of maternal immunological IgG profile and immunoactivation status on the efficiency of transplacental passage of IgG subclasses in HIV + mothers. 16 mother/infants pairs were studied in Malawi. Mothers received antiretroviral therapy (ART) from the third trimester of pregnancy. Determinations of pre-ART levels of maternal sCD14, of IgG subclasses in mothers at delivery and in their 1-month-old infants, were performed using commercial ELISA kits. At delivery, after a median of 10 weeks of ART, 12/16 mothers were hypergammaglobulinemic, with IgG levels (20.5 mg/ml, 95% CI:18.8-26.8) directly correlated to the plasmatic levels of sCD14 (r = 0.640, p = 0.014). IgG1 levels (17.9 mg/ml) accounted for 82% of IgG, IgG3 and IgG4 levels were in the normal range. A profound deficit of IgG2 was observed both in mothers (0.60 mg/ml) and in infants (0.14 mg/ml). Placental transfer ratio (range 0.16-0.42) did not show a selective impairment between the different IgG subclasses. The transplacental passage of all IgG subclasses was decreased in the presence of maternal IgG over 16 mg/ml (significantly for IgG1, p = 0.031) and of high levels of sCD14 (p = 0.063). Transplacental passage was reduced for all IgG subclasses and inversely correlated to high levels of maternal IgGs and to the degree of immunoactivation. The profound depression of IgG2 in mothers suggests that IgG2 neonatal levels mostly reflect the maternal deficit rather than a selective impairment of IgG2 transfer.

  13. Protection of multimaterial assemblies

    Science.gov (United States)

    Mikhail, L. Zheludkevich; Silvar, Kallip; Maria, Serdechnova

    2016-01-01

    The light-weight design calls for broader utilization of multimaterial mixes (M3) in different engineering structures, especially in the transportation area. Together with joining technologies for hybrid structures, the optimization of the life cycle of such systems is an issue of prime importance. Multimaterial structures are often prone to faster degradation under service conditions because of galvanically forced electrochemical corrosion. The protection technologies traditionally used for single-material structures are not always applicable for multimaterial design because of compatibility issues and a stronger thermodynamic driving force for degradation. In this chapter different strategies for protection of multimaterials structures are briefly overviewed. The main focus is on new alternative protection systems based on combination of synergistic inhibiting mixtures introduced into protective coatings. A road map which can be followed in order to create an efficient active protection coating for hybrid structures is suggested.

  14. 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

  15. Municipal climate protection

    Energy Technology Data Exchange (ETDEWEB)

    Alber, G. [Klima-Buendnis - Alianza Clima e.V., Climate Alliance of European Cities with Indigenous Rainforest Peoples (Germany)

    2002-11-01

    Municipal climate protection is not only an important contribution to protecting the Earth's climate, but also yields local benefits such as promoting industry, or reducing emissions and noise and, not least, provides incentives for innovation and new forms of cooperation. Nonetheless, climate protection remains a challenge, for there is still a long way to go until the necessary climate change policy targets are met. Therefore, the Climate Alliance has developed a methodology as a recommendation to local authorities for the strategic development of programs of action that encompass all activity areas of relevance to climate protection. It is to support local authorities from their initial decision to engage in climate protection right through to their monitoring of the performance of measures implemented. (orig.)

  16. Introduction to Machine Protection

    CERN Document Server

    Schmidt, R

    2016-01-01

    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, although there was one paper that discussed beam-induced damage for the SLAC linac (Stanford Linear Accelerator Center) as early as in 1967. It is related to the increasing beam power of high-power proton accelerators, to the emission of synchrotron light by electron-positron accelerators and to the increase of energy stored in the beam. 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 ...

  17. Radio protective effects of the Ayurvedic medicinal plant Ocimum sanctum Linn. (Holy Basil: A memoir

    Directory of Open Access Journals (Sweden)

    Manjeshwar Shrinath Baliga

    2016-01-01

    Full Text Available The use of compounds which can selectively protect normal tissues against radiation injury is of immense use because in addition to it protecting the normal tissue, will also permits use of higher doses of radiation to obtain better cancer control and possible cure. However, most of the radio protective compounds investigated possess inadequate clinical application principally due to their inherent systemic toxicity at their optimal protective concentrations. Plants commonly used as medicinal and dietary agents have recently been the focus of attention and studies have shown that Ocimum sanctum Linn. commonly known as the Holy Basil and its water soluble flavonoids, orientin and vicenin protects experimental animals against the radiation-induced sickness and mortality at nontoxic concentrations. Studies with tumor bearing mice have also shown that both Tulsi extract and its flavonoids selectively protect the normal tissues against the tumoricidal effects of radiation. Preclinical studies have also shown that the aqueous extract of the Tulsi leaves; its flavanoids orientin and vicenin, and eugenol, the principal nonpolar constituent present in Tulsi prevent radiation-induced clastogenesis. Mechanistic studies have indicated that free radical scavenging, antioxidant, metal chelating and anti-inflammatory effects may contribute toward the observed protection. In addition, clinical studies with a small number of patients have shown that Tulsi was effective as a radio protective agent. This review summarizes the results related to the radio protective properties of Tulsi and its phytochemicals and also emphasizes the aspects that warrant future research to establish its use as a radio protective agent.

  18. 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

  19. 31P MAS refocused INADEQUATE spin-echo (REINE) NMR spectroscopy: revealing J coupling and chemical shift two-dimensional correlations in disordered solids.

    Science.gov (United States)

    Guerry, Paul; Smith, Mark E; Brown, Steven P

    2009-08-26

    Two-dimensional (2D) variations in (2)J(P(1),P(1)), (2)J(P(1),P(2)), and (2)J(P(2),P(2)) are obtained--using the REINE (REfocused INADEQUATE spin-Echo) pulse sequence presented by Cadars et al. (Phys. Chem. Chem. Phys. 2007, 9, 92-103)--from pixel-by-pixel fittings of the spin-echo modulation for the 2D correlation peaks due to linked phosphate tetrahedra (P(1)-P(1), P(1)-P(2), P(2)-P(1), and P(2)-P(2)) in a (31)P refocused INADEQUATE solid-state MAS NMR spectrum of a cadmium phosphate glass, 0.575CdO-0.425P(2)O(5). In particular, separate variations for each 2D (31)P REINE peak are obtained which reveal correlations between the J couplings and the (31)P chemical shifts of the coupled nuclei that are much clearer than those evident in previously presented 2D z-filtered (31)P spin-echo spectra. Notably, such correlations between the J couplings and the (31)P chemical shifts are observed even though the conditional probability distributions extracted using the protocol of Cadars et al. (J. Am. Chem. Soc. 2005, 127, 4466-4476) indicate that there is no marked correlation between the (31)P chemical shifts of neighboring phosphate tetrahedra. For 2D peaks at the P(2) (31)P chemical shift in the direct dimension, there can be contributions from chains of three units (P(1)-P(2)-P(1)), chains of four units (P(1)-P(2)-P(2)-P(1)), or longer chains or rings (-P(2)-P(2)-P(2)-): for the representative glass considered here, best fits are obtained assuming a glass comprised predominantly of chains of four units. The following variations are found: (2)J(P(1),P(1)) = 13.4 +/- 0.3 to 14.8 +/- 0.5 Hz, (2)J(P(1),P(2)) = 15.0 +/- 0.3 to 18.2 +/- 0.3 Hz, and (2)J(P(2),P(2)) = 5.9 +/- 0.6 to 9.1 +/- 0.9 Hz from the fits to the P(1)-P(1), P(1)-P(2), and P(2)-P(2) peaks, respectively. The correlation of a particular J coupling with the (31)P chemical shifts of the considered nucleus and the coupled nucleus is quantified by the coefficients C(F(2)) and C(F(1)) that correspond to the

  20. Efficacy and Safety of Teneligliptin in Indian Patients with Inadequately Controlled Type 2 Diabetes Mellitus: A Randomized, Double-blind Study

    Science.gov (United States)

    Agarwal, Piyush; Jindal, Chhavi; Sapakal, Vinayak

    2018-01-01

    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 = 0

  1. A higher sport-related reinjury risk does not mean inadequate rehabilitation: the methodological challenge of choosing the correct comparison group.

    Science.gov (United States)

    Shrier, Ian; Zhao, Meng; Piché, Alexandre; Slavchev, Pavel; Steele, Russell J

    2017-04-01

    Previous injury is a well-established predictor of subsequent injury in sports medicine. Some have interpreted this to mean that either our current methods of rehabilitation are inadequate or there is some permanent damage to the tissue and 100% rehabilitation is not possible. In 2011, we illustrated that these analyses and interpretations failed to account for the fact that some athletes are more prone to get injured, either physiologically, or because of their role/type of play. We suggested that the appropriate analysis would simply require using statistical methods that measured how each individual athlete's risk changed from preinjury to postinjury.In this paper, we revisit our recommendation and illustrate that it too would be flawed if the risk of injury changed over time independent of an injury ever occurring. This might be expected if general fitness were to decline over the season, or if the style of play changed between early season games and postseason championship games. Acknowledging that risk may change regardless of whether an injury occurred or not leads to three different general definitions of 100% rehabilitation: (1) a return to the baseline state, (2) a return to the immediate preinjury state and (3) a return to the state that would have been present had the initial injury never occurred. We guide the reader on how to estimate the risks for each definition and the assumptions that must be acknowledged. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Empirically Reduced Dosages of Tinzaparin in Patients with Moderate-to-Severe Renal Insufficiency Lead to Inadequate Anti-Xa Levels.

    Science.gov (United States)

    Olie, Renske H; Meertens, Nathalie E L; Henskens, Yvonne M C; Ten Cate, Hugo

    2017-01-01

    Due to the higher molecular weight of tinzaparin, the low molecular weight heparin (LMWH) is less dependent on renal excretion than other LMWH preparations. However, several international guidelines recommend the same preemptive dosage reduction for all therapeutic dose LMWHs prescribed in renal insufficient patients, to ensure that there is no accumulation of anticoagulant activity and increased risk of bleeding. This study is aimed at assessing whether a preemptive dosage reduction of tinzaparin in all renal insufficient patients (comprising 25% reduction in patients with Modification of Diet in Renal Disease - estimated glomerular filtration rate (MDRD-eGFR) 30-60 mL/min/1.73 m2 and 50% reduction in patients with MDRD-eGFR renal insufficiency (MDRD-eGFR 0.85 IU/mL for therapeutic indications. Unadjusted dosages led to a median anti-Xa activity of 0.74 IU/mL (IQR 0.56-0.92). The preemptive dosage reduction was significantly associated with anti-Xa activity below therapeutic range (p = 0.007). No difference in anti-Xa activity was observed between patients with moderate (0.71 IU/mL, IQR 0.61-0.95) versus severe (0.65 IU/mL, IQR 0.41-1.06) renal insufficiency in whom an unadjusted dose had been administered (p = 0.77). None of the anti-Xa levels were above the upper margin of the presumed therapeutic range of 2.0 IU/mL. In renal insufficient patients, the preemptive dosage reduction of tinzaparin leads to inadequate anti-Xa levels. © 2017 S. Karger AG, Basel.

  3. Association of breast-fed neonatal hyperbilirubinemia with UGT1A1 polymorphisms: 211G>A (G71R) mutation becomes a risk factor under inadequate feeding.

    Science.gov (United States)

    Sato, Hiroko; Uchida, Toshihiko; Toyota, Kentaro; Kanno, Miyako; Hashimoto, Taeko; Watanabe, Masashi; Nakamura, Tomohiro; Tamiya, Gen; Aoki, Kuraaki; Hayasaka, Kiyoshi

    2013-01-01

    Breastfeeding jaundice is a well-known phenomenon, but its pathogenesis is still unclear. Increased production of bilirubin, impaired hepatic uptake and metabolism of bilirubin, and increased enterohepatic circulation of bilirubin account for most cases of pathological neonatal hyperbilirubinemia. We previously reported that 211G>A (G71R) mutation of the UGT1A1 gene is prevalent in East Asians and is associated with the development of neonatal hyperbilirubinemia. Recently, significant association of G71R mutation with hyperbilirubinemia in breast-fed neonates was reported. We enrolled 401 full-term Japanese infants, who were exclusively breast-fed without supplementation of formula before developing hyperbilirubinemia, and classified them into two groups based on the degree of maximal body weight loss during the neonatal period. We analyzed the sex, gestational age, delivery mode, body weight at birth, maximal body weight loss and genotypes of G71R and (TA)(7) polymorphic mutations of UGT1A1. Statistical analysis revealed that maximal body weight loss during the neonatal period is the only independent risk factor for the development of neonatal hyperbilirubinemia. The effect of G71R mutation on neonatal hyperbilirubinemia is significant in neonates with 5% or greater maximal body weight loss and its influence increases in parallel with the degree of maximal body weight loss. Our study indicates that G71R mutation is a risk factor for neonatal hyperbilirubinemia only in infants with inadequate breastfeeding and suggests that adequate breastfeeding may overcome the genetic predisposing factor, G71R mutation, for the development of neonatal hyperbilirubinemia.

  4. Inadequate pain relief and large functional loss among patients with knee osteoarthritis: evidence from a prospective multinational longitudinal study of osteoarthritis real-world therapies.

    Science.gov (United States)

    Conaghan, Philip G; Peloso, Paul M; Everett, Sharlette V; Rajagopalan, Srinivasan; Black, Christopher M; Mavros, Panagiotis; Arden, Nigel K; Phillips, Ceri J; Rannou, François; van de Laar, Mart A F J; Moore, R Andrew; Taylor, Stephanie D

    2015-02-01

    To estimate the prevalence of inadequate pain relief (IPR) among patients with symptomatic knee OA prescribed analgesic therapy and to characterize patients with IPR. Patients ≥50 years old with physician-diagnosed knee OA who had taken topical or oral pain medication for at least 14 days were recruited for this prospective non-interventional study in six European countries. Pain and function were assessed using the Brief Pain Inventory (BPI) and the WOMAC; quality of life (QoL) was assessed using the 12-item short form. IPR was defined as an average pain score of >4 out of 10 on BPI question 5. Of 1187 patients enrolled, 68% were female and the mean age was 68 years (s.d. 9); 639 (54%) met the definition of IPR. Patient responses for the BPI average pain question were well correlated with responses on the WOMAC pain subscale (Spearman r = 0.64, P < 0.001). In multivariate logistic regression, patients with IPR had greater odds of being female [adjusted odds ratio (adjOR) 1.90 (95% CI 1.46, 2.48)] and having OA in both knees [adjOR 1.48 (95% CI 1.15, 1.90)], higher BMI, longer OA duration, depression or diabetes. Patients with IPR (vs non-IPR) were more likely to have worse QoL, greater function loss and greater pain interference. IPR is common among patients with knee OA requiring analgesics and is associated with large functional loss and impaired QoL. Patients at particular risk of IPR, as characterized in this study, may require greater attention towards their analgesic treatment options. https://clinicaltrials.gov/ (NCT01294696). © The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology.

  5. Addressing the risk of inadequate and excessive micronutrient intakes: traditional versus new approaches to setting adequate and safe micronutrient levels in foods

    Directory of Open Access Journals (Sweden)

    Maaike J. Bruins

    2015-01-01

    Full Text Available Fortification of foods consumed by the general population or specific food products or supplements designed to be consumed by vulnerable target groups is amongst the strategies in developing countries to address micronutrient deficiencies. Any strategy aimed at dietary change needs careful consideration, ensuring the needs of at-risk subgroups are met whilst ensuring safety within the general population. This paper reviews the key principles of two main assessment approaches that may assist developing countries in deciding on effective and safe micronutrient levels in foods or special products designed to address micronutrient deficiencies, that is, the cut-point method and the stepwise approach to risk–benefit assessment. In the first approach, the goal is to shift population intake distributions such that intake prevalences below the Estimated Average Requirement (EAR and above the Tolerable Upper Intake Level (UL are both minimized. However, for some micronutrients like vitamin A and zinc, a narrow margin between the EAR and UL exists. Increasing their intakes through mass fortification may pose a dilemma; not permitting the UL to be exceeded provides assurance about the safety within the population but can potentially leave a proportion of the target population with unmet needs, or vice versa. Risk–benefit approaches assist in decision making at different micronutrient intake scenarios by balancing the magnitude of potential health benefits of reducing inadequate intakes against health risks of excessive intakes. Risk–benefit approaches consider different aspects of health risk including severity and number of people affected. This approach reduces the uncertainty for policy makers as compared to classic cut-point methods.

  6. Scrutinized with inadequate control and support: Interns' experiences communicating with and writing referrals to hospital radiology departments – A qualitative study

    International Nuclear Information System (INIS)

    Kruse, J.; Lehto, N.; Riklund, K.; Tegner, Y.; Engström, Å.

    2016-01-01

    Introduction: Interns' experiences communicating with and writing referrals to hospital radiology departments are important for patient safety, image quality, and decision-making in the diagnostic process. Understanding roles within the department and in the diagnostic process is important for communication. This study aimed to describe interns' experiences communicating with and writing referrals to their hospital's radiology department. Method: A qualitative study design was used. Data was collected from focus discussions with ten interns in three focus groups in Northern Sweden during 2012. The data were subjected to qualitative content analysis. Results: One theme, “a feeling of being scrutinized and lacking control”, was identified in the final categories. The interns experienced that the radiology department placed high demands on them and desired more diagnostic skills training, resources and feedback. The interns suggested the following improvements: enhanced dialogue and feedback, improved education, handy guidelines, and practice writing referrals. Conclusion: Interns need more feedback from, and dialogue with, members of the Department of Radiology. They also need more knowledge of referral guidelines, appropriateness criteria and more practice to develop their knowledge and skill for writing referrals. They describe feelings of inadequate support and feel scrutinized in demanding work conditions and need more collaboration. They also need more time and more control of radiology outcomes, and they are eager to learn. - Highlights: • Interns' experiences of writing referrals are important in the diagnostic process. • Communication between referents and radiology staff influences patient safety. • Medical interns experience insufficient diagnostic skills. • Interns need more feedback from, and dialogue with radiology staff. • The learning process could benefit from knowledge of the referrers perspective.

  7. Perceived inadequate care and excessive overprotection during childhood are associated with greater risk of sleep disturbance in adulthood: the Hisayama Study.

    Science.gov (United States)

    Shibata, Mao; Ninomiya, Toshiharu; Anno, Kozo; Kawata, Hiroshi; Iwaki, Rie; Sawamoto, Ryoko; Kubo, Chiharu; Kiyohara, Yutaka; Sudo, Nobuyuki; Hosoi, Masako

    2016-07-07

    Sleep disturbance and poor sleep quality are major health problems worldwide. One potential risk factor for the development and maintenance of sleep disturbance is the parenting style experienced during childhood. However, its role in sleep disturbance in adulthood has not yet been estimated. This Japanese population study was done to clarify the relation between the parenting styles "care" and "overprotection" during childhood and sleep disturbance in adulthood. A total of 702 community-dwelling Japanese residents aged ≥ 40 years were assessed in 2011 for their perceptions of the parenting style of their parents by use of the Parental Bonding Instrument (PBI) and for sleep disturbance by use of the Pittsburgh Sleep Quality Index (PSQI). The odds ratio (OR) for sleep disturbance (a global PSQI score > 5) was calculated using a logistic regression model. The prevalence of sleep disturbance was 29 %. After adjusting for sociodemographic, lifestyle, and physical factors in a comparison with the optimal parenting styles (high care and low overprotection), the ORs for sleep disturbance by men were significantly higher for low paternal care, by 2.49 times (95 % confidence interval [CI]: 1.21-5.09), and for high overprotection, by 2.40 times (95 % CI: 1.19-4.85), while the ORs were not significant for low maternal care and high overprotection. For women the only significant factor was high maternal overprotection, by 1.62 times (95 % CI: 1.05-2.52), while the ORs were not significant for low maternal care, low paternal care and high paternal overprotection. The association remained significant for high paternal overprotection for men after additionally controlling for depression. This study suggests that parenting style, especially inadequate care and excessive overprotection during childhood, is related to sleep disturbance in adulthood and that the association is much more significant for parents of the same sex as the child.

  8. Cost-utility evaluation of vortioxetine in patients with Major Depressive Disorder experiencing inadequate response to alternative antidepressants in the United Kingdom.

    Science.gov (United States)

    Young, A H; Evitt, L; Brignone, M; Diamand, F; Atsou, K; Campbell, R; Cure, S; Danchenko, N

    2017-08-15

    Patients frequently require several lines of therapy for treatment of major depressive episodes. This economic analysis details the management of patients who responded inadequately due to lack of efficacy or intolerability to two previous antidepressants in the UK. The model included a decision tree and a Markov component. Health states considered in the decision tree were remission, response, no response, withdrawal due to adverse events, relapse, recovery, and recurrence. The time horizon was 24 months. Patients were on third-line treatment for up to a 3-month acute phase and a 6-month maintenance phase. As third-line efficacy data were not available, inputs were calculated by adjusting original second-line data to third-line based on proportionate reductions observed in STAR*D. Equivalent efficacy was assumed for all comparators. Healthcare resource use and utilities were based on UK estimates. Vortioxetine was a cost-effective treatment option at a threshold of £20,000/QALY vs. escitalopram, citalopram, sertraline, and was associated with more health benefits, less costs (was dominant) versus relevant third-line comparators venlafaxine and duloxetine. Agomelatine was found not to be a cost-effective option. The 22-month maintenance phase treatment scenario results were similar to the 6-month base case. Third-line efficacy data were not available. This highlights the need for studies in patients receiving third-line treatment. This model provides an overview for the management of patients receiving third-line treatment where limited evidence currently exists. Vortioxetine, with its novel mechanism of action, is expected to be a dominant treatment option versus relevant comparators in the UK. Copyright © 2017. Published by Elsevier B.V.

  9. Longterm safety and efficacy of abatacept through 5 years of treatment in patients with rheumatoid arthritis and an inadequate response to tumor necrosis factor inhibitor therapy.

    Science.gov (United States)

    Genovese, Mark C; Schiff, Michael; Luggen, Michael; Le Bars, Manuela; Aranda, Richard; Elegbe, Ayanbola; Dougados, Maxime

    2012-08-01

    To evaluate abatacept safety and efficacy over 5 years in patients with rheumatoid arthritis (RA) who had inadequate response to anti-tumor necrosis factor (TNF) therapy in the ATTAIN trial. Patients completing the 6-month, double-blind (DB) placebo-controlled period were eligible to enter the longterm extension (LTE), where all patients received abatacept every 4 weeks (∼10 mg/kg, according to weight range). Safety, efficacy, physical function, and health-related quality of life were monitored throughout. In total, 317 patients (218 DB abatacept, 99 DB placebo) entered the LTE; 150 (47.3%) completed it. Overall incidences of serious adverse events, infections, serious infections, malignant neoplasms, and autoimmune events did not increase during the LTE versus the DB period. American College of Rheumatology responses with abatacept at Month 6 were maintained over 5 years. At Year 5, among patients who received abatacept for 5 years and had available data, 38/103 (36.9%) achieved low disease activity as defined by the 28-joint Disease Activity Score (DAS28)/C-reactive protein (CRP); 23/103 (22.3%) achieved DAS28/CRP-defined remission. Health Assessment Questionnaire response was achieved by 62.5% of patients remaining on treatment at Year 5; mean improvements from baseline in physical component summary and mental component summary scores were 7.34 and 6.42, respectively. High proportions of patients maintained efficacy and physical function benefits or improved their disease state at each timepoint throughout the LTE, if remaining on abatacept treatment. Safety remained consistent, and abatacept efficacy was maintained from 6 months to 5 years, demonstrating the benefits of switching to abatacept in this difficult-to-treat population of patients with RA previously failing anti-TNF therapy.

  10. Phase III, efficacy and safety study of ertugliflozin monotherapy in people with type 2 diabetes mellitus inadequately controlled with diet and exercise alone.

    Science.gov (United States)

    Terra, Steven G; Focht, Kristen; Davies, Melanie; Frias, Juan; Derosa, Giuseppe; Darekar, Amanda; Golm, Gregory; Johnson, Jeremy; Saur, Didier; Lauring, Brett; Dagogo-Jack, Sam

    2017-05-01

    To conduct a phase III study to evaluate the efficacy and safety of ertugliflozin monotherapy in people with type 2 diabetes. This was a 52-week, double-blind, multicentre, randomized, parallel-group study with a 26-week, placebo-controlled treatment period (phase A), followed by a 26-week active-controlled treatment period (phase B) in 461 men and women, aged ≥18 years with inadequate glycaemic control (glycated haemoglobin [HbA1c] concentration 7.0% to 10.5% [53-91 mmol/mol], inclusive) despite diet and exercise. Results from phase A are reported in the present paper. The primary endpoint was the change in HbA1c from baseline to week 26. At week 26, the placebo-adjusted least squares mean HbA1c changes from baseline were -0.99% and -1.16% for the ertugliflozin 5 and 15 mg doses, respectively ( P  < .001 for both doses). The odds of having HbA1c <7.0% (53 mmol/mol) were significantly greater in the ertugliflozin 5 and 15 mg groups compared with the placebo group. Both doses of ertugliflozin significantly lowered fasting plasma glucose and 2-hour postprandial glucose levels and body weight. The placebo-adjusted differences in changes from baseline in systolic blood pressure were not statistically significant. A higher incidence of genital mycotic infections occurred in men and women treated with ertugliflozin compared with placebo. There was no significant difference between treatments in the proportion of participants with symptomatic hypoglycaemia or adverse events associated with urinary tract infection or hypovolaemia. Ertugliflozin 5 and 15 mg treatment for 26 weeks provides effective glycaemic control, reduces body weight and is generally well tolerated, when used as monotherapy. © 2017 John Wiley & Sons Ltd.

  11. Insufficient amounts and inadequate distribution of dietary protein intake in apparently healthy older adults in a developing country: implications for dietary strategies to prevent sarcopenia

    Directory of Open Access Journals (Sweden)

    Ruiz Valenzuela RE

    2013-09-01

    Full Text Available Roxana E Ruiz Valenzuela, José A Ponce, Gloria Guadalupe Morales-Figueroa, Karina Aguilar Muro, Virginia Ramírez Carreón, Heliodoro Alemán-Mateo Nutrition and Metabolism Department, Division of Nutrition, Research Center for Food and Development, Hermosillo, Sonora, México Background: Both low dietary protein intake and inadequate distribution of protein over the three mealtimes have been reported in older Caucasian adults, but the association between protein intake at each meal and muscle mass has not been studied. The purpose of this study was to evaluate dietary protein intake and distribution by mealtimes, and to explore their association with appendicular skeletal muscle mass in apparently healthy older adults. Methods: This was a cross-sectional pilot study that included 78 people over the age of 60 years. Caloric and protein intake were estimated on the basis of three nonconsecutive 24-hour diet recalls and appendicular skeletal muscle mass by dual-energy X-ray absorptiometry. Results: Men consumed 13.4 g of protein/day more than women (P < 0.05. The estimated value of dietary protein intake was 0.9 g/kg/day. In this sample, 28% of subjects did not cover 100% of the dietary reference intake for protein. Lower consumption of dietary protein was found at breakfast and dinnertime compared with the recommended amount of 25–30 g (P < 0.05. Also, the study observed that appendicular skeletal muscle mass in men and women who consumed <25 g of protein at each mealtime was different from that found in the group that consumed >25 g of protein at one, two, or three mealtimes. Conclusion: While protein intake was higher than current recommendations, it failed to achieve the values reported as necessary to prevent sarcopenia. In addition, there was under-consumption of protein per mealtime, especially at breakfast and dinner. Keywords: dietary protein intake, older adults, appendicular skeletal muscle mass

  12. Review of MRSA screening and antibiotics prophylaxis in orthopaedic trauma patients; The risk of surgical site infection with inadequate antibiotic prophylaxis in patients colonized with MRSA.

    Science.gov (United States)

    Iqbal, H J; Ponniah, N; Long, S; Rath, N; Kent, M

    2017-07-01

    The primary aim of this study was to determine whether orthopaedic trauma patients receive appropriate antibiotic prophylaxis keeping in view the results of their MRSA screening. The secondary aim was to analyse the risk of developing MRSA surgical site infection with and without appropriate antibiotic prophylaxis in those colonized with MRSA. We reviewed 400 consecutive orthopaedic trauma patient episodes. Preoperative MRSA screening results, operative procedures, prophylactic antibiotics and postoperative course were explored. In addition to these consecutive patients, the hospital MRSA database over the previous 5 years identified 27 MRSA colonized acute trauma patients requiring surgery. Of the 400 consecutive patient episodes, 395(98.7%) had MRSA screening performed on admission. However, in 236 (59.0%) cases, the results were not available before the surgery. Seven patient episodes (1.8%) had positive MRSA colonization. Analysis of 27 MRSA colonized patients revealed that 20(74%) patients did not have the screening results available before the surgery. Only 5(18.5%) received Teicoplanin and 22(81.4%) received cefuroxime for antibiotic prophylaxis before their surgery. Of those receiving cefuroxime, five (22.73%) patients developed postoperative MRSA surgical site infection (SSI) but none of those (0%) receiving Teicoplanin had MRSA SSI. The absolute risk reduction for SSI with Teicoplanin as antibiotic prophylaxis was 22.73% (CI=5.22%-40.24%) and NNT (Number Needed to Treat) was 5 (CI=2.5-19.2) CONCLUSION: Lack of available screening results before the surgery may lead to inadequate antibiotic prophylaxis increasing the risk of MRSA surgical site infection. Glycopeptide (e.g.Teicoplanin) prophylaxis should be considered when there is history of MRSA colonization or MRSA screening results are not available before the surgery. Copyright © 2017. Published by Elsevier Ltd.

  13. Treatment Compliance with Fixed-Dose Combination of Vildagliptin/Metformin in Patients with Type 2 Diabetes Mellitus Inadequately Controlled with Metformin Monotherapy: A 24-Week Observational Study

    Directory of Open Access Journals (Sweden)

    Grigorios Rombopoulos

    2015-01-01

    Full Text Available Objective. To evaluate the differences in treatment compliance with vildagliptin/metformin fixed-dose versus free-dose combination therapy in patients with type 2 diabetes mellitus (T2DM in Greece. Design. Adult patients with T2DM, inadequately controlled with metformin monotherapy, (850 mg bid, participated in this 24-week, multicenter, observational study. Patients were enrolled in two cohorts: vildagliptin/metformin fixed-dose combination (group A and vildagliptin metformin free-dose combination (group B. Results. 659 patients were enrolled, 360 were male, with mean BMI 30.1, mean T2DM duration 59.6 months, and mean HbA1c at baseline 8%; 366 patients were assigned to group A and 293 to group B; data for 3 patients was missing. In group A, 98.9% of patients were compliant with their treatment compared to 84.6% of group B. The odds ratio for compliance in group A versus B was (OR 18.9 (95% CI: 6.2, 57.7; P<0.001. In group A mean HbA1c decreased from 8.1% at baseline to 6.9% (P<0.001 at the study end and from 7.9% to 6.8% (P<0.001 in group B. Conclusions. Patients in group A were more compliant than patients in group B. These results are in accordance with international literature suggesting that fixed-dose combination therapies lead to increased compliance to treatment.

  14. Factors and Caregiver’s Behavior Affecting Inadequate Complementary Food of Infants Aged 6-12 Months in Naresuan University Hospital

    Directory of Open Access Journals (Sweden)

    Thitima Ngoenmak, M.D.

    2017-09-01

    Full Text Available Objective: Food plays an important role in infant nutrition. Hence, the various factors and behavior that affect the right choice of nutrition for infants aged 6-12 months by caregivers need to be investigated. The objectives were to study the associated factors and caregiver’s behavior affecting inadequate feeding of food to infants aged 6-12 months. Methods: This present work was a cross-sectional study in which 54 caregivers for infants were included. In this study, a survey was performed by using questionnaires for collecting data. The data were analyzed statistically in terms of percentage and mean and by using Chi-Square test (Fisher’s Exact Test and z-test. Results: It was found that most of the infants (79.6 % had normal weight. The age at the start of proper feeding was 5 months and 27 days old. The education level, age, occupation, and income of the caregivers were factors affecting the food choices for the infants at p< 0.05. Inappropriate feeding practices were as follows: feeding pre- masticated foods, liquid food feeding, drinking sweetened juice and soft drinks, eating sweets, and adding salt, sugar, monosodium glutamate and fish sauce to the infants’ food. The caregivers chose food by judging for age and FDA logo on product labels. Advertising did not affect their decision to purchase food. Moreover, occupation, education, and income of the caregivers were not associated with purchasing the right food for the baby. Conclusion: Occupation, income, age, and education level of the infant caregivers were associated with the food selection. The inappropriate feeding behaviors were still persisting.

  15. Inadequação do consumo de nutrientes entre adolescentes brasileiros Consumo inadecuado de nutrientes entre adolescentes brasileños Inadequate nutrient intake in Brazilian adolescents

    Directory of Open Access Journals (Sweden)

    Rosely Sichieri

    2013-02-01

    -2009. Se consideraron los factores de expansión, la complejidad de diseño de la muestra y la corrección de la variabilidad intra-personal de consumo. La prevalencia de consumo inadecuado de micronutrientes fue estimada por la proporción de adolescentes con ingestión por debajo de la necesidad promedio estimada. Para el sodio, se estimó la prevalencia de consumo por encima del valor de ingestión máxima tolerable. CONCLUSIÓN: Los promedios de consumo energético y la distribución de macronutrientes eran adecuados, sin embargo, se observaron elevadas prevalencias de consumo inadecuado de vitaminas y minerales, destacándose el consumo de sodio muy por encima de lo recomendado, consumo de calcio reducido y en las adolescentes de 14 a 18 años fue observada importante ingestión inadecuada de hierro.OBJECTIVE: To assess energy and nutrient consumption and the prevalence of inadequate micronutrient intake among Brazilian adolescents. METHODS: A random sample composed of 6,797 adolescents (49.7% girls, between 10 and 18 years old, was evaluated in the first National Dietary Survey, part of the Household Budget Survey carried out in 2008-2009. Expansion factors, sample complexity design and correction of intraindividual variability were considered. The prevalence of inadequate micronutrient intake was based on the proportion of adolescents with intake below the Estimated Average Requirement (EAR. The prevalence of intake above the Tolerable Upper Intake Level (UL was estimated for sodium. RESULTS: The mean energy intake ranged between 1,869 kcal (10 to 13 year old females and 2,198 kcal (14 to 18 year old males. Of the total energy intake, 57% came from carbohydrates, 27% from lipids and about 16% from proteins. Inadequacies were higher for calcium (> 95%, phosphorous (54% to 69% and vitamins A (66% to 85%, E (100% and C (27% to 49%. More than 70% of adolescents reported sodium intake above the UL. CONCLUSIONS: Mean energy consumption and distribution of macro

  16. 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)

  17. 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)

  18. Radiation protection infrastructure

    International Nuclear Information System (INIS)

    1990-01-01

    A prerequisite for the safe use of ionizing radiation in a country is the availability of an adequate infrastructure to achieve the desired degree of protection. The extent of such an infrastructure, generally comprising regulatory mechanisms and technical capabilities for application and enforcement of regulations, has to be commensurate with the stage of technological development. The expanding application of ionizing radiation in medicine, industry and research calls for vigorous promotion of effective radiation protection efforts, not only to prevent any unsafe practices but also to assess correctly and provide authoritative information on the safety of adopted practices. Experience reveals that radiation protection practices vary considerably from one country to another. The regulatory structures and type of organization with regard to radiation protection are very different, depending on a number of factors such as the constitutional framework, the legal and administrative systems of the country concerned, the state of technical development, the status of application of radiation sources, the existence of research and associated institutions, and the technical skills and financial resources available. Radiation protection principles evolve with time as further experience is gained and as new research evidence becomes available. Regulation of radiation protection has to take account of such changes and adapt to changing conditions. Forty-eight papers from 29 Member States and two International Organizations were presented in nine scientific sessions. Topics included radiation protection regulation and licensing notification, registration, inspection and control programmes, education and training, the role of supporting institutions such as national laboratories and research institutes, the role of professional associations, the contribution of radiation protection services, and international activities. A concluding panel addressed development strategies to

  19. Protected areas and poverty.

    Science.gov (United States)

    Brockington, Daniel; Wilkie, David

    2015-11-05

    Protected areas are controversial because they are so important for conservation and because they distribute fortune and misfortune unevenly. The nature of that distribution, as well as the terrain of protected areas themselves, have been vigorously contested. In particular, the relationship between protected areas and poverty is a long-running debate in academic and policy circles. We review the origins of this debate and chart its key moments. We then outline the continuing flashpoints and ways in which further evaluation studies could improve the evidence base for policy-making and conservation practice. © 2015 The Authors.

  20. Fall Protection Introduction, #33462

    Energy Technology Data Exchange (ETDEWEB)

    Chochoms, Michael [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-06-23

    The proper use of fall prevention and fall protection controls can reduce the risk of deaths and injuries caused by falls. This course, Fall Protection Introduction (#33462), is designed as an introduction to various types of recognized fall prevention and fall protection systems at Los Alamos National Laboratory (LANL), including guardrail systems, safety net systems, fall restraint systems, and fall arrest systems. Special emphasis is given to the components, inspection, care, and storage of personal fall arrest systems (PFASs). This course also presents controls for falling object hazards and emergency planning considerations for persons who have fallen.

  1. Ethics and radiation protection

    International Nuclear Information System (INIS)

    Hansson, Sven Ove

    2007-01-01

    Some of the major problems in radiation protection are closely connected to issues that have a long, independent tradition in moral philosophy. This contribution focuses on two of these issues. One is the relationship between the protection of individuals and optimisation on the collective level, and the other is the relative valuation of future versus immediate damage. Some of the intellectual tools that have been developed by philosophers can be useful in radiation protection. On the other hand, philosophers have much to learn from radiation protectors, not least when it comes to finding pragmatic solutions to problems that may be intractable in principle

  2. 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.)

  3. Water Quality Protection Charges

    Data.gov (United States)

    Montgomery County of Maryland — The Water Quality Protection Charge (WQPC) is a line item on your property tax bill. WQPC funds many of the County's clean water initiatives including: • Restoration...

  4. POWER SUPPLY PROTECTIVE CIRCUITRY.

    Science.gov (United States)

    A recommendation a corrective action plan was made as a solution to the high cost of common and protective circuitry in terms, of reliability of the power supply types A, B, C, D and E in the Minuteman system. (Author)

  5. Hepatitis B Vaccination Protection

    Science.gov (United States)

    Fact Sheet Hepatitis B Vaccination Protection Hepatitis B virus (HBV) is a pathogenic microorganism that can cause potentially life- threatening disease in humans. HBV infection is transmitted through exposure ...

  6. National Fire Protection Association

    Science.gov (United States)

    ... Harvey became 'a landmark in the evolution of drone usage.' Learn more in NFPA Journal Storm stats ... YouTube GooglePlus Blogger Pinterest RSSFeeds Instagram Terms of Use Privacy Policy © National Fire Protection Association (NFPA) 2017

  7. Pollinator Protection Strategic Plan

    Science.gov (United States)

    Developed by EPA, this ensures that pesticide risk assessments and risk management decisions use best available information and scientific methods, and full evaluation of pollinator protection when making registration decisions.

  8. Radiation protection in medicine

    Energy Technology Data Exchange (ETDEWEB)

    Vano, E.; Holmberg, O.; Perez, M. R.; Ortiz, P.

    2016-08-01

    Diagnostic, interventional and therapeutic used of ionizing radiation are beneficial for hundreds of millions of people each year by improving health care and saving lives. In March 2001, the first International Conference on the Radiological Protection of Patients was held in Malaga, Spain, which led to an international action plan for the radiation protection of patients. Ten years after establishing the international action plan, the International Conference on Radiation Protection in Medicine: Setting the Scene for the Next Decade was held in Bonn, Germany, in December 2012. the main outcome of this conference was the so called Bonn Call for Action that identifies then priority actions to enhance radiation protection in medicine for the next decade. The IAEA and WHO are currently working in close cooperation to foster and support the implementation of these ten priority actions in Member States, but their implementation requires collaboration of national governments, international agencies, researchers, educators, institutions and professional associations. (Author)

  9. Radiation protection in brachytherapy

    International Nuclear Information System (INIS)

    Benitez, Manuel

    1996-02-01

    It covers technical procedures in medical applications for cancer treatment. Radiation protection principles in brachytherapy. Medical uses in therapy for Sr-90, Cs-137, Co-60, Ra-226, Ir-192, Au-198, Bi-214, Pb-214. (The author)

  10. Radiation protection standards

    International Nuclear Information System (INIS)

    Fitch, J.

    1983-11-01

    Topics covered include biological radiation effects, radiation protection principles, recommendations of the ICRP and the National Health and Medical Research Council, and dose limits for individuals, particularly the limit applied to the inhalation of radon daughters

  11. 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.

  12. Physics for radiation protection

    CERN Document Server

    Martin, James E

    2013-01-01

    A much-needed working resource for health physicists and other radiation protection professionals, this volume presents clear, thorough, up-to-date explanations of the basic physics necessary to address real-world problems in radiation protection. Designed for readers with limited as well as basic science backgrounds, Physics for Radiation Protection emphasizes applied concepts and carefully illustrates all topics through examples as well as practice problems. Physics for Radiation Protection draws substantially on current resource data available for health physics use, providing decay schemes and emission energies for approximately 100 of the most common radionuclides encountered by practitioners. Excerpts of the Chart of the Nuclides, activation cross sections, fission yields, fission-product chains, photon attenuation coefficients, and nuclear masses are also provided.

  13. Protection without Protectionism.

    Science.gov (United States)

    Saur, Ricardo A. C.

    1979-01-01

    Presents a Third World approach to transborder data flow. Suggests developing local capacities for computer power, confining data flow within borders, and providing protection for local development efforts. (PD)

  14. 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

  15. High voltage protection network

    Science.gov (United States)

    Cambra, J. M.

    1972-01-01

    Circuit protects technical personnel and test equipment from hazardous currents conducted through safety barriers and into data acquisition equipment. Network isolates energy source, restricts arcing to remote area, and dissipates harmlessly residual energy transient.

  16. Asbestos: Protect Your Family

    Science.gov (United States)

    ... Related Topics: Asbestos Contact Us Share Protect Your Family How to Identify Materials That May Contain Asbestos ... Improper removal may actually increase your and your family’s exposure to asbestos fibers. Top of Page Asbestos ...

  17. Protect Yourself: Respirators

    Science.gov (United States)

    ... dust masks) can be used for dust, mists, welding fumes, etc. They do not provide protection from ... tion against most vapors, acid gases, dust or welding fumes. Cartridges/filters must match contaminant(s) and be ...

  18. 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

  19. Protected Objects in Java

    DEFF Research Database (Denmark)

    Løvengreen, Hans Henrik; Schwarzer, Jens Christian

    1998-01-01

    We present an implementation of Ada 95's notion of protected objects in Java. The implementation comprises a class library supporting entry queues and a (pre-) compiler translating slightly decorated Java classes to pure Java classes utilizing the library.......We present an implementation of Ada 95's notion of protected objects in Java. The implementation comprises a class library supporting entry queues and a (pre-) compiler translating slightly decorated Java classes to pure Java classes utilizing the library....

  20. Radiation protection forum

    International Nuclear Information System (INIS)

    Cabral, W.

    2010-01-01

    The National Director of the Nuclear Regulatory Authority and Radiation Protection of Uruguay in the first forum for radiation protection set out the following themes: activity of regulatory body, radiation safety, physical security, safeguards, legal framework, committed substantive program, use of radiation, risks and benefits, major sources of radiation, the national regulatory framework, national inventory of sources, inspections, licensing, import and export of sources control , radioactive transport, materials safety, agreements, information and teaching, radiological emergencies and prompt response.

  1. Energy and environmental protection

    International Nuclear Information System (INIS)

    Filonenko, Yu.Ya.; Korobchanskij, V.I.

    1998-01-01

    Translated version is reviewed of the book - Energy and Environmental Protection - edited by M.Kh.Pal and issued in Germany in the series ''Environmental Protection Practices''. The book written by well-known specialists gives the reader a comprehensive idea of environmentally friendly methods of lignite and coal mining, waste processing and utilization, as well as ecologically clean practices of electric power and heat production

  2. Radiation protection philosophy alters

    International Nuclear Information System (INIS)

    Firmin, G.

    1977-01-01

    Two significant events that have taken place this year in the field of radiation protection are reported. New SI units have been proposed (and effectively adopted), and the ICRP has revised its recommendations. Changes of emphasis in the latest recommendations (ICRP Publication 26) imply an altered radiation protection philosophy, in particular the relation of dose limits to estimates of average risk, an altered view of the critical organ approach and a new attitude to genetic dose to the population. (author)

  3. REDUCED PROTECTIVE CLOTHING DETERMINATIONS

    International Nuclear Information System (INIS)

    BROWN, R.L.

    2003-01-01

    This technical basis document defines conditions where reduced protective clothing can be allowed, defines reduced protective clothing, and documents the regulatory review that determines the process is compliant with the Tank Farm Radiological Control Manual (TFRCM) and Title 10, Part 835, of the Code of Federal Regulations (10CFR835). The criteria, standards, and requirements contained in this document apply only to Tank Farm Contractor (TFC) facilities

  4. Manual of Radiation Protection

    International Nuclear Information System (INIS)

    Gambini, D.J.; Granier, R.; Boisserie, G.

    1992-01-01

    This manual explains the principles and practice of radiation protection for those whose work in research, in the field of medicine or in the industry requires the use of radiation sources. It provides the information radiation users need to protect themselves and others and to understand and comply with international recommendations, regulations and legislation regarding the use of radionuclides and radiation machines. It is designed to teach a wide audience of doctors, biologists, research scientists, technicians, engineers, students and others

  5. Radiation protection instrument 1993

    International Nuclear Information System (INIS)

    1993-04-01

    The Radiation Protection Instrument, 1993 (Legislative Instrument 1559) prescribes the powers and functions of the Radiation Protection Board established under the Ghana Atomic Energy Commission by the Atomic Energy Commission (Amendment) Law, 1993 (P.N.D.C. Law 308). Also included in the Legislative Instrument are schedules on control and use of ionising radiation and radiation sources as well as procedures for notification, licensing and inspection of ionising radiation facilities. (EAA)

  6. Laser radiation protection

    International Nuclear Information System (INIS)

    Pantelic, D.; Muric, B.; Vasiljevic, D.

    2011-01-01

    We have presented the effects of laser radiation on human organism, with special emphasize on eye as the most sensitive organ. It was pointed-out that there are many parameters that should be taken into account when determining the level of protection from laser light. In that respect it is important to be aware of international standards that regulate this area. In addition, we have described a new material which efficiently protects human eye, by formation of microlens and carbonization. [sr

  7. 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...

  8. Efficacy and safety of linagliptin in Asian patients with type 2 diabetes mellitus inadequately controlled by metformin: A multinational 24-week, randomized clinical trial.

    Science.gov (United States)

    Wang, Weiqing; Yang, Jinkui; Yang, Gangyi; Gong, Yan; Patel, Sanjay; Zhang, Candice; Izumoto, Toshiyasu; Ning, Guang

    2016-03-01

    Despite the increasing prevalence of type 2 diabetes mellitus (T2DM) in Asia, clinical trials for glucose-lowering therapies are often dominated by Caucasian and/or Western populations. The present Phase III randomized placebo-controlled double-blind, 24-week study evaluated the efficacy and safety of the dipeptidyl peptidase-4 inhibitor linagliptin added to metformin in Asian T2DM patients. In all, 306 patients (n = 265 Chinese; n = 24 Malaysian; n = 17 Filipino), aged 18-80 years with HbA1c between ≥7.0 and ≤10.0% and on metformin therapy were randomized (2:1) to either linagliptin 5 mg daily or placebo added to metformin. Antidiabetes drugs other than metformin were washed out prior to randomization. The primary endpoint was change in mean HbA1c from baseline after 24 weeks. Baseline characteristics were well-matched between the groups (overall mean [±SD] HbA1c 8.0 ± 0.8%). Adjusted mean (±SE) HbA1c decreased in the linagliptin and placebo groups by -0.66 ± 0.05 and -0.14 ± 0.07%, respectively (placebo-corrected difference -0.52 ± 0.09%; 95% confidence interval [CI] -0.70, -0.34; P < 0.0001). In patients with baseline HbA1c ≥8.5%, the placebo-corrected decrease in HbA1c was -0.89 ± 0.17% (P < 0.0001). Adverse events occurred in similar proportions in the linagliptin and placebo patients (27.3% and 28.0%, respectively) and few were considered drug-related (2.4% and 0.0%, respectively). Hypoglycemia occurred in 1.0% of patients in both groups. Linagliptin therapy was weight neutral. Linagliptin 5 mg was efficacious and well tolerated over 24 weeks in Asian patients with T2DM inadequately controlled by metformin. © 2015 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  9. Impact of empagliflozin added on to basal insulin in type 2 diabetes inadequately controlled on basal insulin: a 78-week randomized, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Rosenstock, J; Jelaska, A; Zeller, C; Kim, G; Broedl, U C; Woerle, H J

    2015-10-01

    To investigate the efficacy and tolerability of empagliflozin added to basal insulin-treated type 2 diabetes. Patients inadequately controlled [glycated haemoglobin (HbA1c) >7 to ≤10% (>53 to ≤86 mmol/mol)] on basal insulin (glargine, detemir, NPH) were randomized to empagliflozin 10 mg (n = 169), empagliflozin 25 mg (n = 155) or placebo (n = 170) for 78 weeks. The baseline characteristics were balanced among the groups [mean HbA1c 8.2% (67 mmol/mol), BMI 32.2 kg/m(2) ]. The basal insulin dose was to remain constant for 18 weeks, then could be adjusted at investigator's discretion. The primary endpoint was change from baseline in HbA1c at week 18. Key secondary endpoints were changes from baseline in HbA1c and insulin dose at week 78. At week 18, the adjusted mean ± standard error changes from baseline in HbA1c were 0.0 ± 0.1% (-0.1 ± 0.8 mmol/mol) for placebo, compared with -0.6 ± 0.1% (-6.2 ± 0.8 mmol/mol) and -0.7 ± 0.1% (-7.8 ± 0.8 mmol/mol) for empagliflozin 10 and 25 mg, respectively (both p empagliflozin 10 and 25 mg significantly reduced HbA1c, insulin dose and weight vs placebo (all p empagliflozin 10 mg significantly reduced systolic blood pressure vs placebo (p = 0.004). Similar percentages of patients had confirmed hypoglycaemia in all groups (35-36%). Events consistent with urinary tract infection were reported in 9, 15 and 12% of patients on placebo, empagliflozin 10 and 25 mg, and events consistent with genital infection were reported in 2, 8 and 5%, respectively. Empagliflozin for 78 weeks added to basal insulin improved glycaemic control and reduced weight with a similar risk of hypoglycaemia to placebo. © 2015 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

  10. Effect of bromocriptine-QR therapy on glycemic control in subjects with type 2 diabetes mellitus whose dysglycemia is inadequately controlled on insulin.

    Science.gov (United States)

    Chamarthi, Bindu; Cincotta, Anthony H

    2017-05-01

    The concurrent use of an insulin sensitizer in type 2 diabetes mellitus (T2DM) patients with inadequate glycemic control on basal-bolus insulin may help improve glycemic control while limiting further insulin requirement. Bromocriptine-QR (B-QR), a quick release, sympatholytic, dopamine D2 receptor agonist therapy for T2DM, is a postprandial insulin sensitizer. This study evaluated the effect of B-QR on dysglycemia in T2DM subjects with suboptimal glycemic control on basal-bolus insulin plus metformin. The effect of once-daily morning administration of B-QR on dysglycemia was evaluated in 60 T2DM subjects derived from the Cycloset Safety Trial, with HbA1c >7% on basal-bolus insulin plus metformin at baseline, randomized to B-QR (N = 44) versus placebo (N = 16) and completed 12 weeks of study drug treatment. The analyses also included a subset of subjects on high-dose insulin (total daily insulin dose (TDID) ≥70 units; N = 36: 27 B-QR; 9 placebo). Subjects were well matched at baseline. After 12 weeks of B-QR treatment, mean % HbA1c decreased by -0.73% relative to baseline (p QR therapy resulted in % HbA1c reductions of -0.95 and -1.49 relative to baseline (p QR on HbA1c. The fasting plasma glucose (FPG) and TDID changes within each treatment group were not significant. More subjects achieved HbA1c ≤7 at 12 weeks with B-QR relative to placebo (36.4% B-QR vs 0% placebo, Fisher's exact 2-sided p = 0.003 in the entire cohort and 37% vs 0%, 2-sided p = 0.039 in the high-dose insulin subset). B-QR therapy improves glycemic control in T2DM subjects whose glycemia is poorly controlled on metformin plus basal-bolus insulin, including individuals on high-dose basal-bolus insulin. This glycemic impact occurred without significant change in FPG, suggesting a postprandial glucose lowering mechanism of action. Cycloset Safety Trial registration: ClinicalTrials.gov Identifier: NCT00377676.

  11. The risk and consequences of clinical miscoding due to inadequate medical documentation: a case study of the impact on health services funding.

    Science.gov (United States)

    Cheng, Ping; Gilchrist, Annette; Robinson, Kerin M; Paul, Lindsay

    As coded clinical data are used in a variety of areas (e.g. health services funding, epidemiology, health sciences research), coding errors have the potential to produce far-reaching consequences. In this study the causes and consequences of miscoding were reviewed. In particular, the impact of miscoding due to inadequate medical documentation on hospital funding was examined. Appropriate reimbursement of hospital revenue in the casemix-based (output-based) funding system in the state of Victoria, Australia relies upon accurate, comprehensive, and timely clinical coding. In order to assess the reliability of these data in a Melbourne tertiary hospital, this study aimed to: (a) measure discrepancies in clinical code assignment; (b) identify resultant Diagnosis Related Group (DRG) changes; (c) identify revenue shifts associated with the DRG changes; (d) identify the underlying causes of coding error and DRG change; and (e) recommend strategies to address the aforementioned. An internal audit was conducted on 752 surgical inpatient discharges from the hospital within a six-month period. In a blind audit, each episode was re-coded. Comparisons were made between the original codes and the auditor-assigned codes, and coding errors were grouped and statistically analysed by categories. Changes in DRGs and weighted inlier-equivalent separations (WIES) were compared and analysed, and underlying factors were identified. Approximately 16% of the 752 cases audited reflected a DRG change, equating to a significant revenue increase of nearly AU$575,300. Fifty-six percent of DRG change cases were due to documentation issues. Incorrect selection or coding of the principal diagnosis accounted for a further 13% of the DRG changes, and missing additional diagnosis codes for 29%. The most significant of the factors underlying coding error and DRG change was poor quality of documentation. It was concluded that the auditing process plays a critical role in the identification of causes

  12. A systematic review and mixed-treatment comparison of dapagliflozin with existing anti-diabetes treatments for those with type 2 diabetes mellitus inadequately controlled by sulfonylurea monotherapy

    Science.gov (United States)

    2014-01-01

    Background To compare the first-in-class sodium glucose co-transporter 2 (SGLT2) inhibitor, dapagliflozin, with existing type 2 diabetes mellitus (T2DM) treatment options available within the European Union (EU) for add-on therapy to sulfonylureas (SUs). Methods A systematic review was conducted to identify randomised controlled trials (RCTs) in T2DM patients inadequately controlled by SU monotherapy. Direct meta-analysis, Bucher indirect comparisons and Bayesian network meta-analysis (NMA) were conducted on studies meeting predefined inclusion criteria. Sufficient data were available to assess three clinical endpoints at 24 (+/- 6) weeks follow-up: mean change in HbA1c from baseline, mean change in weight from baseline, and the proportion of patients experiencing at least one episode of hypoglycaemia. The effect of confounding baseline factors was explored through covariate analyses. Results The search identified 1,901 unique citations, with 1,870 excluded based on title/abstract. From reviewing full-texts of the remaining 31 articles, 5 studies were considered eligible for analysis. All studies were comparable in terms of baseline characteristics, including: HbA1c, age and body mass index (BMI). In addition to dapagliflozin, sufficient data for meta-analysis was available for three dipeptidyl peptidase-4 (DPP-4) inhibitors and one glucagon-like peptide-1 (GLP-1) analogue. Based on fixed-effect NMA, all treatment classes resulted in statistically significant decreases in HbA1c at follow-up compared to placebo. Dapagliflozin treatment resulted in significantly decreased weight at follow-up compared to placebo (-1.54 kg; 95% CrI -2.16, -0.92), in contrast to treatment with GLP-1 analogues (-0.65 kg; 95% CrI -1.37, 0.07) and DPP-4 inhibitors (0.57 kg; 95% CrI 0.09, 1.06). The odds of hypoglycaemia were similar to placebo for dapagliflozin and DPP-4 inhibitor add-on treatment, but significantly greater than placebo for GLP-1 analogue add-on treatment (10.89; 95% Cr

  13. Concepts in radiation protection

    International Nuclear Information System (INIS)

    Oncescu, M.

    1996-01-01

    This monograph provides basic notions and principles in dosimetry and radiation protection in compliance with two fundamental works: IAEA Safety Series No.115 - International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources - and Publication no. 60 of International Commission on Radiological Protection. After the review of quantities and units necessary in radiation protection, the book presents the new values of dose limits as well as the values of 'radiation weighting factor', 'tissue weighting factor' and 'conversion factor intake-dose' (committed effective dose per unit intake) by ingestion and inhalation for 30 most important radionuclides. The new values of dose limits, lower than the old values, are a challenge for the radiation protection, especially of the 'public' where the dose limit diminished by a factor of five relative to the earlier edition. The new value of dose limit for public, 1 mSv per year (obviously over the natural exposure of 2.4 mSv per year), imposes new action ways and levels in radiation protection, especially in some cases of exacerbated natural radioactivity. The book provides the calculus of external exposure with the Gamma constant expressed in adequate units, to make the calculation easier. In the calculus of protection shield for gamma sources one uses a method, which while approximate helps save time. The calculus of internal exposure is made using the conversion factor intake-dose. Finally, the 'dosimetric watch' of the natural and artificial radioactivity of the atmosphere, hydrosphere and biosphere is intended to comply with the International Basic Safety Standards. Each chapter ends with a set of illustrative problems which enhances the reader's understanding of underlying concepts and current methods used in the field

  14. Radiation protection optimization of workers

    International Nuclear Information System (INIS)

    Lochard, J.

    1994-11-01

    This report presents the contribution of CEPN (study center on protection evaluation in nuclear area) to the Days of the French Radiation Protection Society (SFRP) on optimization of workers radiation protection in electronuclear, industrial and medical areas

  15. Digital integrated protection system

    International Nuclear Information System (INIS)

    Savornin, M.; Furet, M.

    1978-01-01

    As a result of technological progress it is now possible to achieve more elaborate protection functions able to follow more closely the phenomena to be supervised. For this reason the CEA, Framatome and Merlin/Gerin/CERCI have undertaken in commonn to develop a Digital Integrated Protection System (D.I.P.S.). This system is designed with the following aims: to improve the safety of the station, . to improve its availability, . to facilitate installation, . to facilitate tests and maintenance. The main characteristics adopted are: . possibilities of obtaining more elaborate monitoring and protection algorithm treatments, . order 4 redundancy of transducers, associated instruments and signal processing, . possibility of inhibiting part of the protection system, . standardisation of equipment, physical and electrical separation of redundant units, . use of multiplexed connections, . automation of tests. Four flow charts are presented: - DIPS with four APUP (Acquisition and Processing Unit for Protection) - APUP - LSU (Logic Safeguard Unit), number LSU corresponding to number fluidic safeguard circuits, - structure of a function unit, - main functions of the APUP [fr

  16. Instructed officers Radiation Protection

    International Nuclear Information System (INIS)

    2007-01-01

    This law contains instructions on the prevention of radiological and contains 4 articles Article I: describe the responsibilities of the institutions that operate within the scope of radiological protection in terms of the number of radiation protection officers and personal Supervisors who available in the practices radiation field. Article II: talking about the conditions of radiation protection officers that must be available in the main officers and working field in larg institutions and thecondition of specific requirements for large enterprises of work permits in the field of radiological work that issued by the Council. Article III: the functions and duties of officers in the prevention of radiological oversee the development of radiation protection programmes in the planning stages, construction and preparing the rules of local labour and what it lead of such tasks.Article IV: radiation protection officers powers: to modify and approve the programme of prevention and radiation safety at the company, stop any unsafe steps, amend the steps of the usage, operation of materials, devices and so on

  17. Sports eyewear protective standards.

    Science.gov (United States)

    Dain, Stephen J

    2016-01-01

    Eye injuries sustained during sport comprise up to 20 per cent of all injuries to the eye serious enough for medical attention to be sought. The prevalence of eye injuries in sport is not easily assessed due to lack of authoritative participation rates, so most studies report total numbers in a time period. The evidence on the proportion of all ocular injuries that are from sport is reviewed. The relative frequencies in different sports are compared in a qualitative manner and the sports with greater numbers of ocular injuries are detailed. In common with occupational injuries to the eye, most sports eye injuries are considered preventable. The hierarchy of action for occupational risk is detailed and adapted to use in a sports scenario. All the available international, regional and national standards on sports eye protection are detailed and their provisions compared. The major function of the standards is to provide adequate protection against the hazard of the sport concerned. These are detailed and compared as a function of energy transfer. Eye protection must not introduce additional or secondary hazards (for instance, fracturing into sharp fragments on impact) and not introduce features that would deter the wearing of eye protection (for instance, restricting field of view to impede playing the sport). The provisions of the standards intended to limit secondary hazards are detailed and compared. The need for future work in standards writing and the activities of the International Standardization Organization in sports eye protection are detailed. © 2016 Optometry Australia.

  18. 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.)

  19. System level ESD protection

    CERN Document Server

    Vashchenko, Vladislav

    2014-01-01

    This book addresses key aspects of analog integrated circuits and systems design related to system level electrostatic discharge (ESD) protection.  It is an invaluable reference for anyone developing systems-on-chip (SoC) and systems-on-package (SoP), integrated with system-level ESD protection. The book focuses on both the design of semiconductor integrated circuit (IC) components with embedded, on-chip system level protection and IC-system co-design. The readers will be enabled to bring the system level ESD protection solutions to the level of integrated circuits, thereby reducing or completely eliminating the need for additional, discrete components on the printed circuit board (PCB) and meeting system-level ESD requirements. The authors take a systematic approach, based on IC-system ESD protection co-design. A detailed description of the available IC-level ESD testing methods is provided, together with a discussion of the correlation between IC-level and system-level ESD testing methods. The IC-level ESD...

  20. Radiological protection report 2007

    International Nuclear Information System (INIS)

    2008-01-01

    This annual report issued by the Swiss Federal Nuclear Inspectorate (HSK) reports on the work carried out by the Inspectorate in 2007. It provides comprehensive data on radiation protection activities in Switzerland during 2007. This is the fourth annual summary report on the radiological protection issues regulated by the Inspectorate. It provides comprehensive data on doses for the staff and for individual jobs. It also includes year-to-year comparisons and comments on the continuing decline in collective and average doses for persons exposed to radiation in the course of their work. Radiation doses are commented on. Radiation in the four Swiss nuclear power stations and in four further nuclear installations in various Swiss research facilities is commented on. The Swiss radiation measurement network is commented on and the results obtained are discussed. The Inspectorate concludes that radiological protection in Swiss nuclear facilities is carried out consistently and in compliance with existing legislation

  1. Smart Machine Protection System

    International Nuclear Information System (INIS)

    Clark, S.; Nelson, D.; Grillo, A.; Spencer, N.; Hutchinson, D.; Olsen, J.; Millsom, D.; White, G.; Gromme, T.; Allison, S.; Underwood, K.; Zelazny, M.; Kang, H.

    1991-11-01

    A Machine Protection System implemented on the SLC automatically controls the beam repetition rates in the accelerator so that radiation or temperature faults slow the repetition rate to bring the fault within tolerance without shutting down the machine. This process allows the accelerator to aid in the fault diagnostic process, and the protection system automatically restores the beams back to normal rates when the fault is diagnosed and corrected. The user interface includes facilities to monitor the performance of the system, and track rate limits, faults, and recoveries. There is an edit facility to define the devices to be included in the protection system, along with their set points, limits, and trip points. This set point and limit data is downloaded into the CAMAC modules, and the configuration data is compiled into a logical decision tree for the 68030 processor. 3 figs

  2. Preventive Radiation Protection Act

    International Nuclear Information System (INIS)

    Roewer, H.

    1988-01-01

    The commentary is intended to contribute to protection of the population by a practice-oriented discussion and explanation of questions arising in connection with the Preventive Radiation Protection Act. Leaving aside discussions about abandonment of nuclear power, or criticism from any legal point of view, the commentary adopts the practical approach that accepts, and tries to help implementing, the act as it is. It is a guide for readers who are not experts in the law and gives a line of orientation by means of explanations and sometimes by citations from other acts (in footnotes). The commentary also presents the EURATOM Directive No. 3954/87 dated 22 December 1987, the EC Directive No. 3955/87 dated 22 December 1987, and the EC Directive No. 1983/88 dated 5 July 1988. A tabular survey shows the system of duties and competences defined by the Preventive Radiation Protection Act. (RST) [de

  3. Radiation protecting clothing materials

    International Nuclear Information System (INIS)

    Mio, Kotaro; Ijiri, Yasuo.

    1986-01-01

    Purpose: To provide radiation protecting clothing materials excellent in mechanical strength, corrosion resistance, flexibility and flexing strength. Constitution: The radiation protecting clothing materials according to this invention has pure lead sheets comprising a thin pure lead foil of 50 to 150 μm and radiation resistant organic materials, for example, polyethylene with high neutron shielding effect disposed to one or both surfaces thereof. The material are excellent in the repeating bending fatigue and mechanical strength, corrosion resistance and flexibility and, accordingly, radiation protecting clothings prepared by using them along or laminating them also possess these excellent characteristics. Further, they are excellent in the handlability, particularly, durability to the repeated holding and extension, as well as are preferable in the physical movability and feeling upon putting. The clothing materials may be cut into an appropriate size, or stitched into clothings made by radiation-resistant materials. In this case, pure lead sheets are used in lamination. (Horiuchi, T.)

  4. Smart machine protection system

    International Nuclear Information System (INIS)

    Clark, S.; Nelson, D.; Grillo, A.

    1992-01-01

    A Machine Protection System implemented on the SLC automatically controls the beam repetition rates in the accelerator so that radiation or temperature faults slow the repetition rate to bring the fault within tolerance without shutting down the machine. This process allows the accelerators to aid in the fault diagnostic process, and the protection system automatically restores the beams back to normal rates when the fault is diagnosed and corrected. The user interface includes facilities to monitor the performance of the system, and track rate limits, faults, and recoveries. There is an edit facility to define the devices to be included in the protection system, along with their set points, limits, and trip points. This set point and limit data is downloaded into the CAMAC modules, and the configuration data is complied into a logical decision tree for the 68030 processor. (author)

  5. Education in Radiation Protection

    International Nuclear Information System (INIS)

    Dodig, D.; Kasal, B.; Tezak, S.; Poropat, M.; Kubelka, D.

    2001-01-01

    Full text: This paper discussed the problem of the education in radiation protection. All aspects of education are included started with primary school and lasted with very specialised courses for the experts. In the last few years the lack of interest for education in radiation protection was recognised by many agencies included also IAEA and EU commission. In this paper the reasons for this situation will be presented and the way how to promote this subject again. It is not possible to prevent effects of radiation on environment and population if qualified and well educated experts do not exist. The situation in the field of education in radiation protection in Croatia will be presented, according to the new regulations in this field. (author)

  6. 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

  7. Material for radioactive protection

    Science.gov (United States)

    Taylor, R.S.; Boyer, N.W.

    A boron containing burn resistant, low-level radiation protection material useful, for example, as a liner for radioactive waste disposal and storage, a component for neutron absorber, and a shield for a neutron source is described. The material is basically composed of borax in the range of 25 to 50%, coal tar in the range of 25 to 37.5%, with the remainder being an epoxy resin mix. A preferred composition is 50% borax, 25% coal tar and 25% epoxy resin. The material is not susceptible to burning and is about 1/5 the cost of existing radiation protection material utilized in similar applications.

  8. Environmental protection implementation plan

    International Nuclear Information System (INIS)

    Holland, R.C.

    1998-03-01

    This Environmental Protection Implementation Plan is intended to ensure that the environmental program objectives of Department of Energy Order 5400.1 are achieved at SNL/California. This document states SNL/California's commitment to conduct its operations in an environmentally safe and responsible manner. The Environmental Protection Implementation Plan helps management and staff comply with applicable environmental responsibilities. SNL is committed to operating in full compliance with the letter and spirit of applicable environmental laws, regulations, and standards. Furthermore, SNL/California strives to go beyond compliance with legal requirements by making every effort practical to reduce impacts to the environment to levels as low as reasonably achievable

  9. Protection of personality rights

    OpenAIRE

    Strejcová, Klára

    2016-01-01

    The thesis deals with the legal regulation of protection of personality rights. According to the certain changes in personality protection legal regulation caused by recent adoption of new Civil Code, Law no. 89/2012 Coll., the topic appears to be up to date. The aim of this thesis is to bring current legal regulation of this issue in its general terms. The thesis is divided into eight chapters. The first chapter explains basic terms such as personality and general right of personality. Secon...

  10. Programme Biology - Health protection

    International Nuclear Information System (INIS)

    1975-01-01

    The scientific results for 1975, of the five-year Biology-Health Protection programme adopted in 1971, are presented in two volumes. In volume one, Research in Radiation Protection are developed exclusively, including the following topics: measurement and interpretation of radiation (dosimetry); transfer of radioactive nuclides in the constituents of the environment; hereditary effects of radiation; short-term effects (acute irradiation syndrome and its treatment); long-term effects and toxicology of radioactive elements. In volume, two Research on applications in Agriculture and Medicine are developed. It includes: mutagenesis; soil-plant relations; radiation analysis; food conservation; cell culture; radioentomology. Research on applications in Medicine include: Nuclear Medicine and Neutron Dosimetry

  11. Radiation Protection Dosimetry

    International Nuclear Information System (INIS)

    Kramer, H.M.; Schnuer, K.

    1992-01-01

    The contributions presented during the seminar provided clear evidence that radiation protection of the patient plays an increasingly important role for manufacturers of radiological equipment and for regulatory bodies, as well as for radiologists, doctors and assistants. The proceedings of this seminar reflect the activities and work in the field of radiation protection of the patient and initiate further action in order to harmonize dosimetric measurements and calculations, to ameliorate education and training, to improve the technical standards of the equipment and to give a push to a more effective use of ionising radiation in the medical sector

  12. Photochromic ultraviolet protective shield

    Science.gov (United States)

    Goudjil, Kamal

    2000-10-01

    Damage to the eye can result from unexpectedly low levels of light, particularly at the shorter wavelengths. UV emitting lasers such as Excimer (248 nm, 308 nm, 351 nm) and HeCd lasers (325 nm, 354 nm) are increasingly used in various applications including: medical, research (spectroscopy), stereolithography and semiconductor industries. Therefore, protection against harmful UV light is needed, but more importantly, development of a material that will react to detect the presence of UV light while completely protecting the wearer, is of great interest. Such materials have been developed with the use of lightweight clear plastics such as acrylics by incorporation of UV reactive photochromic compounds into a polymeric matrix.

  13. Radiation protection in education

    International Nuclear Information System (INIS)

    Viragh, Elemer

    1985-01-01

    The education of secondary school students in the fields of nuclear sciences was strictly limited according to the 9th recommendations of the ICRP issued in 1966 saying that people under age 18 are not allowed to deal with ionizing radiations. Due to the changes concerning the concept of radiation protection, new opportunities for teaching nuclear technology even in the secondary schools were opened. The 36th recommendations of the ICRP published in 1983 dealing with the maximum permissible doses and the measures taken for radiation protection should be kept in mind while organizing the education of the pupils between age 16 and 18. (V.N.)

  14. Protecting patron privacy

    CERN Document Server

    Beckstrom, Matthew

    2015-01-01

    In a world where almost anyone with computer savvy can hack, track, and record the online activities of others, your library can serve as a protected haven for your visitors who rely on the Internet to conduct research-if you take the necessary steps to safeguard their privacy. This book shows you how to protect patrons' privacy while using the technology that your library provides, including public computers, Internet access, wireless networks, and other devices. Logically organized into two major sections, the first part of the book discusses why the privacy of your users is of paramount

  15. Commercial Aircraft Protection

    Energy Technology Data Exchange (ETDEWEB)

    Ehst, David A. [Argonne National Lab. (ANL), Argonne, IL (United States)

    2016-10-26

    This report summarizes the results of theoretical research performed during 3 years of P371 Project implementation. In results of such research a new scientific conceptual technology of quasi-passive individual infrared protection of heat-generating objects – Spatial Displacement of Thermal Image (SDTI technology) was developed. Theoretical substantiation and description of working processes of civil aircraft individual IR-protection system were conducted. The mathematical models and methodology were presented, there were obtained the analytical dependencies which allow performing theoretical research of the affect of intentionally arranged dynamic field of the artificial thermal interferences with variable contrast onto main parameters of optic-electronic tracking and homing systems.

  16. Radiation protection glossary

    International Nuclear Information System (INIS)

    1986-01-01

    The glossary is intended to be used as a terminology standard for IAEA documentation on radiation protection. An effort has been made to use definitions contained in internationally accepted publications such as recommendations of the International Commission on Radiological Protection (ICRP), standards of the International Organization for Standardization (ISO) and of the International Electrotechnical Commission (IEC), reports of the International Commission on Radiation Units and Measurements (ICRU), with only slight modifications in order to tailor them more closely to IAEA needs. The glossary is restricted to ionizing radiation

  17. Take immediate action to protect communities and workers.

    Science.gov (United States)

    Wilding, Roberta Chase; Lewis, Sharon E

    2007-01-01

    In many areas throughout America, thousands of industrial and military facilities and agricultural operations put large numbers of people at risk of serious injury or death due to accidental chemical releases, explosions, fires, and grossly inadequate occupational exposure standards. While some companies are moving toward "greener" production, many others do the minimum required by government agencies. As evidenced by the thousands of permit violations and accidental releases of hazardous chemicals, this means that facilities across the country consistently fail to meet regulations, incorporating the cost of fines and penalties into the cost of doing business and passing that cost on to consumers. Workers at such facilities and residents of the surrounding communities cannot wait for the eventual implementation and enforcement of federal environmental laws or adequate testing of the effect chemicals may have on the human population. Immediate action is needed to protect communities and workers at risk from chemical exposures that can compromise their health.

  18. 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.

  19. International radiation protection standards

    International Nuclear Information System (INIS)

    Aghayev, J.A.

    2009-01-01

    Full text: Today the recommendations of ICRP have a profound influence on radiation protection all over the world. The latest recommendations were issued as publication no 60 (ICRP 60 1991). This document elaborated a conceptual framework for radiation protection based on ethics, experimental work, and risk assessment. The justification principle prohibits practices involving additional radiation exposures unless they produce sufficient societal benefits. The three main principles of the ICRP for proposed or continuing radiation-protection practices are: 1) the justification principle; 2)the optimization principle; 3) the dose limitation principle.The optimization principle requires managers to keep radiation exposures as low as reasonably achievable (ALARA), taking into account economic and social factors. the dose-limitation principle limits exposure of individuals to radiation. The system of radiological protection recommended by CRP for intervention is based on two additional principles: the proposed intervention should do more good than harm; one should optimize the form, scale and duration of intervention. Although the ICRP does not employ the term precautionary principle it does use the concept, at least implicitly

  20. Inflation Protected Investment Strategies

    Directory of Open Access Journals (Sweden)

    Mirco Mahlstedt

    2016-03-01

    Full Text Available In this paper, a dynamic inflation-protected investment strategy is presented, which is based on traditional asset classes and Markov-switching models. Different stock market, as well as inflation regimes are identified, and within those regimes, the inflation hedging potential of stocks, bonds, real estate, commodities and gold are investigated. Within each regime, we determine optimal investment portfolios driven by the investment idea of protection from losses due to changing inflation if inflation is rising or high, but decoupling the performance from inflation if inflation is low. The results clearly indicate that these asset classes behave differently in different stock market and inflation regimes. Whereas in the long-run, we agree with the general opinion in the literature that stocks and bonds are a suitable hedge against inflation, we observe for short time horizons that the hedging potential of each asset class, especially of real estate and commodities, depend strongly on the state of the current market environment. Thus, our approach provides a possible explanation for different statements in the literature regarding the inflation hedging properties of these asset classes. A dynamic inflation-protected investment strategy is developed, which combines inflation protection and upside potential. This strategy outperforms standard buy-and-hold strategies, as well as the well-known 1 N -portfolio.

  1. The responsibility to protect.

    Science.gov (United States)

    Deutscher, Matt

    2005-01-01

    The decision whether, if ever, to intervene in the affairs of a sovereign state with military force has become a critical issue of the post Cold War era. In 2000 the Canadian government launched the International Commission on Intervention and State Sovereignty (ICISS), which in 2001 published its findings in The Responsibility to Protect. The Commission found broad support for the notion of sovereignty not only as a right, but also a responsibility, the responsibility of a state to provide protection for its people. The primary responsibility for protecting citizens rests with states. But when states are unable or unwilling to provide this protection, or are themselves the perpetrators of atrocities, the Commission argues that the international community has a responsibility temporarily to step in, forcefully if necessary. The Commission resisted the temptation to identify human rights violations falling short of outright killing or ethnic cleansing. This eliminates the possibility of intervening on the basis of systematic oppression of human rights or intervening to remove a military dictatorship. The intention of the report was to provoke debate; to strengthen the role of the United Nations and ensure that such interventions were multilateral and meeting the wider needs of a region and not the interests of major powers. There is an ongoing need to ensure that the Security Council is effective and that resources match the political will. These debates must continue within a UN framework.

  2. Marine Mammal Protection Act

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Marine Mammal Protection Act (MMPA or Act) prohibits, with certain exceptions, the "take" of marine mammals in U.S. waters and by U.S. citizens on the high seas,...

  3. Computer Room Water Protection.

    Science.gov (United States)

    Price, Bennett J.

    1990-01-01

    Addresses the protection of computer rooms from water. Sources of water and potentially vulnerable areas in computer rooms are described. Water detection is then discussed, and several detection systems are detailed. Prices and manufacturers' telephone numbers for some of the systems are included. Water cleanup is also briefly considered. (MES)

  4. Radiation protection textbook

    International Nuclear Information System (INIS)

    Gambini, D.J.; Granier, R.

    2007-01-01

    This textbook of radiation protection presents the scientific bases, legal and statutory measures and technical means of implementation of the radioprotection in the medical and industrial sectors, research and nuclear installations. It collects the practical information (organization, analysis of post, prevention, evaluation and risks management, the controls, the training and the information) usually scattered and the theoretical knowledge allowing every person using ionizing radiation: To analyze jobs in controlled areas, to watch the respect for the current regulations, to participate in the training and in the information of the staffs exposed to intervene in accidental situation. This third edition is widely updated and enriched by the most recent scientific and legal data concerning, notably, the human exposure, the dosimetry, the optimization of the radiation protection and the epidemiological inquiries. The contents is as follows: physics of ionizing radiation, ionizing radiation: origin and interaction with matter, dosimetry and protection against ionizing radiation, detection and measurement of ionizing radiation, radiobiology, legal measures relative to radiation protection, human exposure of natural origin, human exposure of artificial origin, medical, dental and veterinarian radiology, radiotherapy, utilization of unsealed sources in medicine and research, electronuclear industry, non nuclear industrial and aeronautical activities exposing to ionizing radiation, accidental exposures. (N.C.)

  5. Radiation Protection in Guatemala

    International Nuclear Information System (INIS)

    Carazo, N.

    1979-01-01

    The tasks connected with radiation protection are allocated to the National Institute for Nuclear Energy in Guatemala. Regulatory measures are further needed to identify the responsibilities of various authorities to ensure that all radiation workers are provided with personal dosemeters. (author)

  6. Armored garment for protecting

    Science.gov (United States)

    Purvis, James W [Albuquerque, NM; Jones, II, Jack F.; Whinery, Larry D [Albuquerque, NM; Brazfield, Richard [Albuquerque, NM; Lawrie, Catherine [Tijeras, NM; Lawrie, David [Tijeras, NM; Preece, Dale S [Watkins, CO

    2009-08-11

    A lightweight, armored protective garment for protecting an arm or leg from blast superheated gases, blast overpressure shock, shrapnel, and spall from a explosive device, such as a Rocket Propelled Grenade (RPG) or a roadside Improvised Explosive Device (IED). The garment has a ballistic sleeve made of a ballistic fabric, such as an aramid fiber (e.g., KEVLAR.RTM.) cloth, that prevents thermal burns from the blast superheated gases, while providing some protection from fragments. Additionally, the garment has two or more rigid armor inserts that cover the upper and lower arm and protect against high-velocity projectiles, shrapnel and spall. The rigid inserts can be made of multiple plies of a carbon/epoxy composite laminate. The combination of 6 layers of KEVLAR.RTM. fabric and 28 plies of carbon/epoxy laminate inserts (with the inserts being sandwiched in-between the KEVLAR.RTM. layers), can meet the level IIIA fragmentation minimum V.sub.50 requirements for the US Interceptor Outer Tactical Vest.

  7. Multifactorial antimicrobial wood protectants

    Science.gov (United States)

    Robert D. Coleman; Carol A. Clausen

    2008-01-01

    It is unlikely that a single antimicrobial compound, whether synthetic or natural, will provide the ‘magic bullet’ for eliminating multiple biological agents affecting wood products. Development of synergistic combinations of selected compounds, especially those derived from natural sources, is recognized as a promising approach to improved wood protection. Recent...

  8. Painting for protection

    International Nuclear Information System (INIS)

    Stepto, G.G.C.

    1981-01-01

    Despite the use of special alloys, paint is still the most economical and practical method of protecting steel. Chlorinated rubber resin based paint systems are shown to be satisfactory in areas requiring decontamination as well as for outside exposed areas of nuclear power plants. (author)

  9. Protection of Intellectual Property.

    Science.gov (United States)

    Hoffman, Gary M.; McGrath, William T.

    1990-01-01

    The first of two articles discusses the extent to which piracy of intellectual property hurts the U.S. economy, the role of developing nations in piracy, and who benefits from the protection of intellectual property. The second explores the implications of a Supreme Court ruling on copyrighting of computer programs created by independent…

  10. Maternity Protection at Work.

    Science.gov (United States)

    World of Work, 1998

    1998-01-01

    Discusses the need for maternity benefits for working women. Suggests that although most countries provide paid maternity leave by law, there is a gap between that law and practice. Includes a chart depicting maternity protection (length of leave, cash benefits, who pays) around the world. (JOW)

  11. Applied Crop Protection 2017

    DEFF Research Database (Denmark)

    Jørgensen, Lise Nistrup; Nielsen, Bent Jørgen; Mathiassen, Solvejg Kopp

    Linket til højre henviser til rapporten i trykt format til download. This publication contains results from crop protection trials which were carried out at the Department of Agroecology within the area of gricultural crops. Most of the results come from field trials, but results from greenhouse ...

  12. Radiation protection to firemen

    International Nuclear Information System (INIS)

    Almeida, E.S. de.

    1985-01-01

    The basic Knowledge about ionizing radiation oriented for firemen, are presented. The mainly damage and effects caused by radiation exposure as well as the method of radiation protection are described in simple words. The action to be taken in case of fire involving radiation such as vehicles transporting radioactive materials are emphasized. (author)

  13. Solar collector overheating protection

    NARCIS (Netherlands)

    Slaman, M.J.; Griessen, R.P.

    Prismatic structures in a thermal solar collector are used as overheating protection. Such structures reflect incoming light efficiently back whenever less thermal power is extracted from the solar collector. Maximum thermal power is generated when the prismatic structure is surrounded by a

  14. Beyond Pain and Protection

    DEFF Research Database (Denmark)

    Lee, Jieun

    2007-01-01

    discourse on homosexual youth in Korea, protection discourse and pain discourse, the notion of identity itself will be critically examined and the girls' agency in destabilizing heteronormativity will be discussed. This study also deals with the appropriation of popular culture by the girls, suggesting...

  15. Radiation protection in medicine

    International Nuclear Information System (INIS)

    Frischauf, H.; Kletter, H.; Dudczak, R.

    1983-01-01

    Radiation burden of medical personnel is low in trained medical staff. Higher doses can occur with therapeutic application of unsealed or sealed sources, if adequate shielding is not possible or not cared for or if radiation protection measures are not observed in work with higher activities of radionuclides. More important than immoderate structural alterations for shielding purposes is individual inspection with advice on the working place and optimisation of working methods, also in regard to the radiation protection. This is possible only by cooperation and by discussing risks and problems between the radiation protection officer and the working personnel in an overt manner, assuring the mutual understanding. Radiation protection concerning medical uses of radiation in the whole population and in patients especially is determined by the necessity of indication for the medical application of radiation, by quality control and lastly by the correct interpretation of results or consequences. The latter necessitates a good collaboration between nuclear medicine specialists and clinicians because of the individual particularity of the patient which must be considered in the evaluation of results. (Author)

  16. Radiation protection in Qatar

    International Nuclear Information System (INIS)

    Al Maadheed, Khalid; Al Khatibeh, Ahmad

    2008-01-01

    Full text: The State of Qatar has become a member State of IAEA since 1974. Later the Department of Industrial Development (DID) beam the focal point and the competent authority regarding all aspects of the peaceful application of Nuclear Technology. In July, 2000 the Supreme Council was established and charged with all matters related to environmental protection. The Supreme Council joined the IAEA Projects on upgrading protection infrastructure in West Asia region. A preliminary research was initiated to discover where radiation sources are being used, and the legal framework, if any, to regulate their use. The research indicated that radiation sources were being used in the industrial practices (well logging, industrial radiography and nuclear gauges) and in medical practices (mainly diagnostic radiology). The research also indicated that there was virtually no legal framework to regulate them. In less than five years, the State of Qatar was able to issue the radiation protection law, three sets of regulations, namely: Radiation Protection Regulations, Radioactive Waste Management Regulations and the Safe Transport of Radioactive Materials Regulations. In addition, several specific regulation work, dose limits and radiation protection officers were issued. A radiation Protection Department, comprising three sections was established. We are providing individual exposure monitoring for most of the radiation workers in the public sector and some in the private sector. We have set up a proper licensing and inspections procedures, where our inspectors are enforcing the law. More recently, we established an early warning network for nuclear of radiological emergencies, consisting of 6 transplantable stations, five mobile stations and two navigating stations. This year, the network was augmented with five fixed station and an advanced early warning centre, which provides early warning via multiple means (MMS, Fax, E-mail and audio alarms). Last year we signed a nuclear

  17. Foundations for radiation protection

    International Nuclear Information System (INIS)

    2006-01-01

    Full text; In 1996, the IAEA published the latest edition of the International Basic Safety Standards for Protection Against Ionizing Radiation and for the Safety of Radiation Sources (Basic Safety Standards or BSS) comprising basic requirements to be filled in all activities involving radiation exposure. The standards define internationally harmonized requirements and provide practical guidance for public authorities and services, employers and workers, specialized radiation protection bodies, enterprises and health and safety communities. In the same year, the IAEA, through the technical cooperation programme, launched the Model Project on Upgrading Radiation Protection Infrastructure, a global initiative designed to help Member States establish the infrastructure needed to adhere to the BSS. To address the complexity of this task, the radiation protection team identified key elements, known as Thematic Safety Areas. These are: 1. Legislative Framework and Regulatory Infrastructure, Draft and put into effect radiation protection laws and regulations and establish and empower a national regulatory authority. 2. Occupational Exposure Control Protect the health and safety of each individual who faces the risk of radiation exposure in the workplace through individual and workplace monitoring programmes, including dose assessment, record keeping of doses and quality management. 3. Medical Exposure Control: Develop procedures and activities to control the exposure of patients undergoing diagnosis and/or treatment via diagnostic and interventional radiology, nuclear medicine or radiotherapy through staff training, provision of basic quality control equipment, and the establishment of quality assurance programmes. 4. Public and Environmental Exposure Control: Develop means to protect both the public and the environment including: a) programmes to register, inventory and provide safe storage of unused radioactive sources and material; b) procedures to control and safely

  18. BGS Radon Protective Measures GIS

    International Nuclear Information System (INIS)

    Appleton, D.; Adlam, K.

    2000-01-01

    The British Geological Survey Radon Protective Measures Geographical Information System is described. The following issues are highlighted: Identification of development sites where radon protection is required in new dwellings; Mapping radon potential on the basis of house radon and geology; Radon Protective Measures GIS; Radon site reports; and Follow-up radon protective measures sire reports

  19. Enhancing radiation protection

    International Nuclear Information System (INIS)

    2006-01-01

    When a new radiotherapy center in Gezira, Sudan, delivers its first therapeutic dose to a cancer patient, two things happen: A young man begins to regain his health and looks forward to being better able to support his family and contribute to his community; and a developing nation realizes an important step toward deriving the social and economic benefits of nuclear science. The strategic application of nuclear technology in particular fields- human health, industry, food and agriculture, energy, water resources and environmental protection - has enormous potential to help shape the future of developing countries. But past radiological incidents, several of which involved high levels of exposure or death (Bolivia, Brazil, Cost Rica, Georgia, Ghana, Morocco, Panama and Thailand), underscore the inherent and very serious risks. For this reason, the IAEA's Departments of Technical Cooperation and Nuclear Safety and Security partner closely, particularly in the area of radiation protection. They strive to consider every minute detail in the equation that brings together radiation sources, modern technologies, people and the environment. Launched in 1996, the Model Project on Upgrading Radiation Protection Infrastructure (the Model Project) aimed to help Member States: achieve capacities that underpin the safe and secure application of nuclear technologies; establish a legislative framework and regulatory infrastructure; develop exposure control mechanisms to protect workers, medical patients, the public and the environment; and achieve preparedness and planned response to radiological emergencies. In fact, the hospital scenario above typically marks several years of intense collaboration amongst scientists, legislators, regulators, politicians and administrators from both Member States and the IAEA, orchestrated and aided by regional managers and technical experts from the IAEA. As radiation protection team members can attest, every application of nuclear technology

  20. 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

  1. [Separation of functions in the System of Social Protection in Health, Mexico 2009: progress and challenges].

    Science.gov (United States)

    González-Robledo, Luz María; Nigenda, Gustavo; González-Robledo, María Cecilia; Reich, Michael

    2011-01-01

    To evaluate advancements and challenges in the separation of functions within Mexico's System of Social Protection in Health. A 2009 evaluation study involving nine states and the National Commission for Social Protection in Health was carried out via semi-structured interviews with key actors and literature analysis. The main advancement has been the creation of the State Regimens for Social Protection in Health (REPSS in Spanish) which act as intermediaries between users and health service providers, making these state-level entities responsible for both managing financial resources and shaping and coordinating the health care delivery network. However, most of the REPSS studied were found to be in a state of inertia, leading to inadequate compliance with legally mandated functions. Normative, technical, political and managerial obstacles persist, impeding the successful separation of functions.

  2. 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.

  3. 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)

  4. Protecting the anaesthetised brain

    Directory of Open Access Journals (Sweden)

    Mary Abraham

    2014-01-01

    Full Text Available The anaesthetized brain is vulnerable to ischaemic insults, which could result in neurological deficits ranging from neuropsychological disturbances to stroke and even death. The risk of perioperative brain injury is relatively high in cardiac, neurosurgical and major vascular surgery, although it has also rarely been reported in noncardiac nonneurosurgical operations. Besides underlying risk factors such as cerebrovascular disease, advanced age, and cardiovascular disease, anaesthesia and surgery per se could also be a contributory factor. The anaesthesiologist plays a pivotal role in protecting the anaesthetized brain, both by taking preventive measures and instituting brain protection strategies. Despite advances and breakthroughs in pharmacological neuroprotection in the laboratory, currently there is no drug, anaesthetic or non-anaesthetic, which is available for clinical use. The anaesthesiologist has to rely on non-pharmacological modalities and neuromonitoring to prevent intraoperative brain injury

  5. EMP protection technology interchange

    International Nuclear Information System (INIS)

    Martin, L.C.

    1977-01-01

    Investigation and assessment of the potential degrading and destructive effects associated with the nuclear electromagnetic (EMP) phenomena has created a large technological base. This base is indeed quite broad owing to the unique and system-pervasive character of the EMP. One of the aims of an emerging discipline, such as that associated with EMP, is to provide for adequate transfer and integration of the developing technology into the overall engineering community. The needs of the community and how EMP hardening and protection information can be transferred or exchanged are reviewed. Many of the current and generally available sources of information are listed, examples of interchange methods are provided, and problems of developing specifications, standards, and suitable guidelines for design and incorporation of protection are also discussed

  6. Airway protective mechanisms.

    Science.gov (United States)

    Pitts, Teresa

    2014-02-01

    Cough and swallow are highly coordinated reflex behaviors whose common purpose is to protect the airway. The pharynx is the common tube for air and food/liquid movement from the mouth into the thorax, has been largely overlooked, and is potentially seen as just a passive space. The thyropharyngeus muscle responds to cough inducing stimuli to prepare a transient holding area for material that has been removed from the subglottic airway. The cricopharyngeus muscle participates with the larynx to ensure regulation of pressure when a bolus/air is moving from the upper airway through to the thorax (i.e., inspiration or swallow) or the reverse (i.e., expiration reflex or vomiting). These vital mechanisms have not been evaluated in clinical conditions but could be impaired in many neurodegenerative diseases, leading to aspiration pneumonia. These newly described airway protective mechanisms need further study, especially in healthy and pathologic human populations.

  7. Lectures on radiation protection

    International Nuclear Information System (INIS)

    Wachsmann, F.; Consentius, K.

    1981-01-01

    All important subjects of radiation protection are presented in concise form; the explanations may serve as lecture manuscripts. The lectures are divided into 16 to 19 teaching units. Each teaching unit is supplemented by a slide to be projected on a screen while the text is read. This method of visual teaching has already been tried with good results in medicine and medical engineering. Pictures of the slides are given in the text so that the book may also be used for self-studies. The main facts are summarized at the end of each lesson. The finished book will consist of 8 lessons; the first three of these discuss 1. Radiation effects and hazards 2. Dose definitions and units and their role in radiology and radiation protection 3. Dose limits and legal specifications. (orig.) [de

  8. Superconducting coil protection

    International Nuclear Information System (INIS)

    Woods, E.L.

    1975-01-01

    The protection system is based on a two-phase construction program. Phase I is the development of a reliable hardwired relay control system with a digital loop utilizing firmware and a microprocessor controller. Phase II is an expansion of the digital loop to include many heretofore unmonitored coil variables. These new monitored variables will be utilized to establish early quench detection and to formulate confirmation techniques of the quench detection mechanism. Established quench detection methods are discussed and a new approach to quench detection is presented. The new circuit is insensitive to external pulsed magnetic fields and the associated induced voltages. Reliability aspects of the coil protection system are discussed with respect to shutdowns of superconducting coil systems. Redundance and digital system methods are presented as related topics

  9. Overvoltage protection network

    Science.gov (United States)

    Cambra, J. M. (Inventor)

    1974-01-01

    Electrical equipment to be protected from overvoltage is connected with a possible source of overvoltage via an input conductor. A fuse is connected in series with the input conductor. A spark gap is connected between the input conductor and ground for conducting the overvoltage current to ground and for blowing the fuse to open the circuit to the electrical equipment. A pulse attenuator network is provided between the spark gap and the electrical equipment to be protected for attenuating the pulse of energy passing through the fuse and spark gap prior to blowing of the fuse. The pulse attenuator network includes additional shunt spark gaps, series inductance, and a series connection of a twisted shielded pair of conductors having low-voltage insulation.

  10. Challenges of protection

    Directory of Open Access Journals (Sweden)

    Emma Fanning

    2010-11-01

    Full Text Available Local protection committees in North and South Kivu are tackling – with some success – a range of protection challenges.Since June 2010, Mukungu1 village in Kalehe, South Kivu, has welcomed 1,150 displaced households fleeing FDLR2 attacks during military operations in the area. A battalion of the national army arrived recently; they have set up checkpoints demanding a fee, do not speak any local language and have moved in with local families unasked. Forced labour and arbitrary arrests are widespread. Meanwhile, locals cannot farm fields near the forest as FDLR soldiers rape women who try – and have killed men who accompany them. The local community takes in IDPs but they warn that resources are limited.

  11. The potential role of the educational system in addressing the effect of inadequate knowledge of mosquitoes on use of insecticide-treated nets in Ghana.

    Science.gov (United States)

    Kudom, Andreas A; Mensah, Ben A

    2010-09-15

    Since 2001, there has been a tremendous increase in number of households protected by ITN and IRS in Ghana. However, there has not been evidence of a reduction in malaria cases as expected and reported deaths have rather increased since 2007. As a result, this study was undertaken to get a better understanding of perceptions of malaria, knowledge on mosquitoes and the value attached to ITNs among secondary and tertiary students in Cape Coast. Structured questionnaires were administered randomly to gather data on demographic characteristics of students, knowledge of mosquitoes and ITNs and attitude towards the use of ITN in seven public high schools and four tertiary institutions in Cape Coast metropolis. In addition, curriculums of science courses common to all students from junior high school to the university were carefully examined. A total of 492 students took part in this study and more than 90% of them had high knowledge of malaria transmission and ITN, but little knowledge of mosquito life history. Only 1% in secondary and 2.1% in tertiary institutions had seen or knew about all the development stages of mosquitoes. In high school and tertiary institutions, 24.2% and 10.8% of respondents, respectively, were able to mention other genera of mosquitoes, apart from Anopheles. Though 93.9% in senior high school and 86.7% in the tertiary institutions knew that ITNs are either used to protect oneself from mosquito bites or to prevent malaria, 32.7% of the respondents in secondary and 21.9% in tertiary institutions who owned ITN did not use them. The study reveals that respondents did not have adequate knowledge on the biology and behaviour of mosquitoes. This appears to weaken their knowledge of the link between the use of ITN and malaria control; the effect of this is that a significant number owned ITNs but did not use them. The implication is that if people will really accept and use ITN or other mosquito control interventions, then just creating awareness of

  12. Airway Protective Mechanisms

    OpenAIRE

    Pitts, Teresa

    2013-01-01

    Cough and swallow are highly coordinated reflex behaviors whose common purpose is to protect the airway. The pharynx is the common tube for air and food/liquid movement from the mouth into the thorax, has been largely overlooked, and is potentially seen as just a passive space. The thyropharyngeus muscle responds to cough inducing stimuli to prepare a transient holding area for material that has been removed from the subglottic airway. The cricopharyngeus muscle participates with the larynx t...

  13. Protective garment ventilation system

    Science.gov (United States)

    Lang, R. (Inventor)

    1970-01-01

    A method and apparatus for ventilating a protective garment, space suit system, and/or pressure suits to maintain a comfortable and nontoxic atmosphere within is described. The direction of flow of a ventilating and purging gas in portions of the garment may be reversed in order to compensate for changes in environment and activity of the wearer. The entire flow of the ventilating gas can also be directed first to the helmet associated with the garment.

  14. Fundamentals of radiological protection

    International Nuclear Information System (INIS)

    Wells, J.; Mill, A.J.; Charles, M.W.

    1978-05-01

    The basic processes of living cells which are relevant to an understanding of the interaction of ionizing radiation with man are described. Particular reference is made to cell death, cancer induction and genetic effects. This is the second of a series of reports which present the fundamentals necessary for an understanding of the bases of regulatory criteria such as those recommended by the International Commision on Radiological Protection (ICRP). Others consider basic radiation physics and the biological effects of ionizing radiation. (author)

  15. Radiation protection and society

    International Nuclear Information System (INIS)

    Skryabin, A.M.

    1997-01-01

    The radiological protection of population, living on the contaminated territories, is actual 10 years after the Chernobyl accident. Eventually, the whole system of countermeasures application is aimed to protect society as a complex community of individuals . The variety of levels of society, i.e. family, settlement on the whole, can be considered as certain harmonic systems differing in their public consciousness levels and lifestyles, this explain the difference in their 'behaviour' in terms of radiation protection and attitude to the information obtained. Each level of society possesses a certain degree of liberty of choice, that finally influence the magnitude and the character of dose distribution within certain population groups. In general, the dose distribution in the settlement can be explained only on the bases of 'family' analysis. This concerns the rural settlement as a society too. All rural settlement can be divided into two or three classes: with low, high and intermediate social features. Small settlements (< 100 persons), where the advanced in age persons with low material income and high degree of natural economy are applied to the first class. This results in higher doses (2-3 fold), than in the settlements with higher social level. The analysis shows that in socially 'waning' settlements the countermeasures are less efficient and the term of their action is shorter. (this class is the largest, About 50% among all the rural settlements). Due to the deterioration of the economic situation in the Republic of Belarus after 1991-1992 resulted in the increase of doses mainly in the habitants first of all of this class of settlements. It seems problematic to increase countermeasures efficiency in this class of settlements without the refuse of the accustomed lifestyle and radical improvement of social-demographic and economic conditions. The present material shows the necessity of the differential approach based on 'society-analysis' in the

  16. Ceramic protective coating

    International Nuclear Information System (INIS)

    Harbach, F.; Nicoll, A.

    1987-01-01

    The basic material of the above-mentioned layer consists of pure aluminium oxide or essentially aluminium oxide. To improve this protective layer metal oxides from the groups IIA, IIIA, IIIB, VB, VIB, VIIB or VIII of the periodic system are added to its basic material before the said protective coating is applied. In this way a corundum structure is formed in the case of aluminium oxide. Gallium oxide, vanadium oxide, chromium oxide or iron oxide are particularly suited for the correlation of such a corundum structure. The formation of the corundum structure increases the resistance of the protective coating to the corrosive effects of vanadium pentoxide and sodium sulfate. By the addition of a specific quantity of magnesium oxide it is possible not only to stimulate the formation of corundum but also to reduce the increase in grain size in the case of the aluminium oxide. The other metallic oxides are especially favorable to the formation of the corundum structure, so that preferably magnesium oxide is to be added to these metallic oxides in order to reduce the increase in grain size. (author)

  17. Radiation Protection: Introduction

    International Nuclear Information System (INIS)

    Loos, M.

    2007-01-01

    As a federal research Centre, SCK-CEN has the statutory assignment to give priority to research related to safety, radioactive waste management, protection of man and environment, management of fissile and other strategic materials and social implications as part of the pursuit of sustainable development and to develop and gather the necessary knowledge and spread this knowledge through formation and communication. At the Division of Radiation Protection at SCK-CEN we are therefore active to maintain and enhance knowledge and expertise in each aspect of radiation protection: we study the risk of exposure - the way that radioactive materials spread in the environment and the potential for human contact - and the risk from exposure - how radiation affects human health; we perform health physics measurements; we are involved in emergency planning and preparedness and support to risk governance and decision taking. These activities are supported by radiation specific analysis and measurement techniques. These activities are not performed in isolation but in context of national and international collaborations or demands

  18. Principles of radiation protection

    International Nuclear Information System (INIS)

    Karamourtzounis, J.N.

    1969-01-01

    In the rapidly developing areas of occupational and public health devoted to the protection of people from both immediate and delayed harmful (and sometimes Irreversible) effects of radiation exposure, industrial hygienists, radiological physicists and radiologists must now assume the additional responsibility of protection against radiation. Everyone during his life will have had one or more X-rays taken for diagnostic purposes. The doses received, depending upon the site, are not harmful to the individual, from the genetic aspect, however, the increasing use of X-ray examinations does present a danger,since almost the whole population is involved. Rapid progress in the development of nuclear energy and the practical extension of its use in medicine, agriculture and industry are steadily increasing the potential danger of large groups of the population being exposed to radiation, and radiation hazards are becoming an important aspect of industrial and public hygiene. WHO is concerned with the overall evaluation of population exposure from peaceful uses of atomic energy and through medical practice, the evaluation of radiation risks,and the control of medical radiation exposure. WHO stimulates and provides technical assistance for the development of appropriate programs of radiation protection with respect to the agricultural, industrial and medical applications of radioisotopes. X-rays and radium. (author)

  19. Radiation protection and monitoring

    International Nuclear Information System (INIS)

    Bruecher, L.; Langmueller, G.; Tuerschmann, G.

    1997-01-01

    The safety, the quality and efficiency of the radiological monitoring systems for block one and two of the NPP Mochovce, designed and delivered by the general designer, should be increased by EUCOM Siemens. Modern, accident resistant and/or more powerful monitoring systems have been designed by Siemens will be added to the existing systems. To achieve this radiation measuring units will be installed inside the hermetic zone, in the reactor hall, at the stack, at the release water system and in the environment in the vicinity of the NPP. The presentation, the storage distribution and the processing of all measuring results also will be optimised by installing a modern high-performance computer system, the so-called Central Radiological Computer System 'CRCS', featuring a high availability. The components will be installed in the relevant control rooms all over the plant. With this computer system it is easy to control the radiation level inside and outside the NPP during normal operation and during and after an accident. Special programs, developed by Siemens support the staff by interpreting the consequences of radioactive releases into the environment and by initiating protection procedures during and after an accident. All functions of the system are available for emergency protection drills and training the staff interruption of the normal control procedure. For the personal protection a digital personal dosimetry system completely considering with the requirements of ICRP 60 and several contamination monitors will be installed. (authors)

  20. Child Protection and Vulnerable Families: Trends and Issues in the Australian Context

    Directory of Open Access Journals (Sweden)

    Elizabeth Fernandez

    2014-10-01

    Full Text Available This paper will provide an overview and analysis of developments in child protection and out of home care in Australia. It will outline early responses to perceived inadequate parenting to provide the historical and policy contexts of contemporary debates on, and responses to, the care and protection of children and young people. Child maltreatment affects a large number of children across Australia. The statistics of reported maltreatment reflect striking increases over time. Over the last decade, several public inquiries into the operation of child protection have been undertaken in a number of state jurisdictions following which some states have embarked on large scale reform of legislation and policy, to either strengthen the child protection mandate, or refocus services. Some exemplars of significant reform in selected states will be cited. Some of the themes that will be explored in the paper will include the impact of major state based public inquiries, overseas reviews and research on child protection policy and practice; the changing balance between orientations to child protection and family support, the parameters of out of home care, the high levels of governmental intervention experienced by Aboriginal and Torres Strait Islander families, and a critical appraisal of major transformations in protective care.

  1. 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)

  2. Protective orders: questions and conundrums.

    Science.gov (United States)

    Logan, T K; Shannon, Lisa; Walker, Robert; Faragher, Teri Marie

    2006-07-01

    Current media portrayal of protective orders is often negative, focusing on weaknesses in how protective orders are obtained and enforced. This review of research findings on protective orders examines issues and suggests areas in need of future research to clarify and improve public policy. More specifically, this review has five main objectives: (a) to provide background information about partner violence and the need for protective orders; (b) to describe what protective orders are, how many women obtain them, and the advantages and disadvantages of obtaining protective orders; (c) to examine characteristics of women who seek protective orders; (d) to explore research on whether protective orders actually increase women's safety; and (e) to highlight opportunities and gaps in the practice and research literature regarding the use of protective orders for women with violent partners or ex-partners.

  3. 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.

  4. 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.

  5. Protecting the child.

    Science.gov (United States)

    Okwudili, O

    1993-01-01

    The 1991 African charter and the 1990 UN convention on the rights of the child have had an impact on efforts by Nigeria to legally protect the welfare of children. The African Charter and the international community are particularly concerned about legally protecting the best interests of children accused or found guilty of breaking the law: recognizing a legal age of responsibility for infringements of the penal code, separating a child, deprived of liberty from imprisoned adults when it is in the child's interests, and applying separate laws, procedures, authorities, and institutions for children. The African charter also seeks to shield children from environmental adversity and exploitation in employment or jobs that interfere with health and formal education. It is illegal to use children for begging, to abduct children, or to traffic in the sale of children by any person, including parents or legal guardians. Children are to be protected from sexual exploitation and sexual abuse in prostitution, pornographic activities, and coercion to perform sexual acts. Declines in infant mortality, elimination of diseases and malnutrition, and provision of education, particularly for female children and the gifted and the disadvantaged, are recommended. Pregnant adolescents should have access to education during and after the pregnancy. Protection is also sought from narcotic drug production, use, and trafficking, child marriage, and child abuse and torture, and participation in armed conflicts. Children are to be protected upon dissolution of marriage and in adoption. Children need to be assured the right to play and recreation. Nigeria has taken steps to implement fully the provisions of the convention, and to integrate the provisions within the existing Children and Young Persons Laws. The provisions will be integrated by the Department of Social Welfare of the Federal Ministry of Health and Social Services. More punitive enforcement measures will be included in the new

  6. 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

    Full Text Available Welding is associated with several ocular and systemic hazards especially where adequate protective measures are not taken.  The purpose of this project was to study the eye protection practices and symptoms among welders in the Capricorn District of Limpopo Province, South Africa. Questionnaires designed to investigate eye protection practices and symptoms experienced were completed byone hundred and fifty (150 welders. The types of welding done were shielded metal arc (84%, oxyacetylene gas (4% and silver brazing (12%. The number of years spent in the welding industry ranged from one to 10 years with a mean of 5 ± 3.1 years and the number of hours of welding per day ranged from one to 10 hours with a mean of 6 ± 2.1 hours. A large percentage of the welders (89% reported wearing protective devices when welding and the most common protective devices used by the welders were: helmets (57%, goggles(22%, and face shields (15%. Six percent used inefficient protective devices such as sunglasses.  Sixty one percent reported occasional exposure to welding flashes when not wearing any eye protection. Welding-related eye symptoms reported included foreign body sensation (18%, persistent after-images (31%, and watery eyes (50%.  Al-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. 

  7. 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

  8. Protection of plants against air pollutants: Role of chemical protectants

    International Nuclear Information System (INIS)

    Pandey, J.; Agrawal, M.

    1993-01-01

    The protection of plants against air pollution damage can best be achieved either by developing pollution-tolerant cultivars or by using chemical protectants. Use of chemical protectants such as pesticides, growth regulators, anti-oxidants, fertilizers, etc. is a short-term solution to reduce the risk of air pollution damage. In addition, these protectants help in understanding the mechanism of air pollution toxicity and provide a scientific basis for assessing crop losses in field conditions. 95 refs

  9. 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.

  10. 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.)

  11. Radiological protection report 2010

    International Nuclear Information System (INIS)

    2011-01-01

    This is the 7 th Annual Report of the Swiss Federal Nuclear Safety Inspectorate (ENSI) on radiological protection in Swiss nuclear facilities. Section A deals with doses for staff and individual jobs and Section B covers releases from nuclear facilities and the monitoring of environmental radioactivity in their immediate vicinity. The year under review was again marked by an event classified by ENSI as Level 2 on the INES Scale. During maintenance work in the fuel-assembly transfer system at the Leibstadt nuclear power station, a diver recovered a pipe-like object. The object, which was highly radioactive, was the end piece from a jacketed pipe previously removed from the in-core instrumentation. Subsequent investigations showed that the diver had been exposed to a hand dose of 7.5 Sv and a complete-body dose of 28 mSv, both in excess of the annual limits specified in the Swiss Radiological Protection Ordinance. As with the INES-2 event in 2009, this event showed that particular attention is required when working with high and variable radiation fields. In terms of radiological protection, a range of measures must be introduced as a matter of urgency, including for example, measures to ensure that acoustic alarms and warnings from electronic dosimeters are audible immediately even under difficult working conditions. In addition, there needs to be a systematic identification of radiation fields and this information must be made available to all concerned. Neither collective nor average individual doses have changed significantly in recent years. The average individual dose for personnel in nuclear facilities is now 0.7 mSv. This is significantly lower than both the maximum annual limit for persons exposed to radiation in the course of their work and the average annual rate of exposure to radon for the population in Switzerland as a whole (3.2 mSv). The maximum individual dose in the Leibstadt nuclear power plant was 28 mSv. The maximum dose rate at the Goesgen

  12. Training in radiological protection

    International Nuclear Information System (INIS)

    Medina G, E.

    2014-08-01

    In the Peru, according to the current regulations, people that work with ionizing radiations should have an authorization (individual license), which is granted by the Technical Office of the National Authority that is the technical body of the Instituto Peruano de Energia Nuclear (IPEN) manager of the control of ionizing radiations in the country. The individual license is obtained after the applicant fulfills the requested requirements, as having safety knowledge and radiological protection. Since its founding in 1972, the Centro Superior de Estudios Nucleares (CSEN) of the IPEN has carried out diverse training courses in order to that people can work in a safe way with ionizing radiations in medicine, industry and research, until the year 2013 have been organized 2231 courses that have allowed the training of 26213 people. The courses are organized according to the specific work that is carried out with radiations (medical radio-diagnostic, dental radiology, nuclear medicine, radiotherapy, industrial radiography, nuclear meters, logging while drilling, etc.). In their majority the courses are directed to people that will make use of radiations for first time, but refresher courses are also granted in the topic. The CSEN also carries out the Master degree programs highlighting the Second Professional Specialization in Radiological Protection carried out from the year 2004 with the support of the National University of Engineering. To the present has been carried out 2 programs and there is other being developed. In this work is shown the historical evolution of the radiological protection courses as well as the important thing that they are to work in a safe way in the country. (Author)

  13. Radiological Protection in Medicine

    International Nuclear Information System (INIS)

    Valetin, J.

    2011-01-01

    This report was prepared to underpin the Commission's 2007 Recommendations with regard to the medical exposure of patients, including their comforters and carers, and volunteers in biomedical research. It addresses the proper application of the fundamental principles (justification, optimisation of protection, and application of dose limits) of the Commission's 2007 Recommendations to these individuals. With regard to medical exposure of patients, it is not appropriate to apply dose limits or dose constraints, because such limits would often do more harm than good. Often, there are concurrent chronic, severe, or even life-threatening medical conditions that are more critical than the radiation exposure. The emphasis is then on justification of the medical procedures and on the optimisation of radiological protection. In diagnostic and interventional procedures, justification of procedures (for a defined purpose and for an individual patient), and management of the patient dose commensurate with the medical task, are the appropriate mechanisms to avoid unnecessary or unproductive radiation exposure. Equipment features that facilitate patient dose management, and diagnostic reference levels derived at the appropriate national, regional, or local level, are likely to be the most effective approaches. In radiation therapy, the avoidance of accidents is a predominant issue. With regard to comforters and carers, and volunteers in biomedical research, dose constraints are appropriate. Over the last decade, the Commission has published a number of documents that provided detailed advice related to radiological protection and safety in the medical applications of ionising radiation. Each of the publications addressed a specific topic defined by the type of radiation source and the medical discipline in which the source is applied, and was written with the intent of communicating directly with the relevant medical practitioners and supporting medical staff. This report

  14. Download this PDF file

    African Journals Online (AJOL)

    Knowledge in selection and administration of antibiotics is inadequate and should be incorporated during the training. WAJM 2013; 32(1): 3–7. Keywords: Perioperative antibiotics, Anaesthetist, Selection,. Administration, Training. Department of Anaesthesiology, University of Port Harcourt Teaching Hospital, PMB 6173 Port ...

  15. Fundamentals of radiological protection

    International Nuclear Information System (INIS)

    Charles, M.W.; Wells, J.; Mill, A.J.

    1978-04-01

    A brief review is presented of the early and late effects of ionising radiation on man, with particular emphasis on those aspects of importance in radiological protection. The terminology and dose response curves, are explained. Early effects on cells, tissues and whole organs are discussed. Late somatic effects considered include cancer and life-span shortening. Genetic effects are examined. The review is the third of a series of reports which present the fundamentals necessary for an understanding of the basis of regulatory criteria, such as those of the ICRP. (u.K.)

  16. Designing radiation protection signs

    International Nuclear Information System (INIS)

    Rodriguez, M.A.; Richey, C.L.

    1995-01-01

    Entry into hazardous areas without the proper protective equipment is extremely dangerous and must be prevented whenever possible. Current postings of radiological hazards at the Rocky Flats Environmental Technology Site (RFETS) do not incorporate recent findings concerning effective warning presentation. Warning information should be highly visible, quickly, and easily understood. While continuing to comply with industry standards (e.g., Department of Energy (DOE) guidelines), these findings can be incorporated into existing radiological sign design, making them more effective in terms of usability and compliance. Suggestions are provided for designing more effective postings within stated guidelines

  17. RHIC prefire protection masks

    International Nuclear Information System (INIS)

    Drees, A.; Biscardi, C.; Curcio, T.; Gassner, D.; DeSanto, L.; Fu, W.; Liaw, C. J.; Montag, C.; Thieberger, P.; Yip, K.

    2015-01-01

    The protection of the RHIC experimental detectors from damage due to beam hitting close upstream elements in cases of abort kicker prefires requires some dedicated precautionary measures with two general options: to bring the beam close to a limiting aperture (i.e. the beam pipe wall), as far upstream of the detector components as possible or, alternatively, to bring a limiting aperture close to the circulating beam. Spontaneous and random prefires of abort kicker modules (Pulse Forming Network, PFN) have a history as long as RHIC is being operated. The abort system consist of 5 kickers in per ring, each of them equipped with its own dedicated PFN.

  18. Tornado protection by venting

    International Nuclear Information System (INIS)

    Cavanagh, C.A.

    1987-01-01

    The purpose of this paper is to demonstrate the ability to protect a modern nuclear power plant from the effects of a tornado by the use of a system of venting in all safety-related structures outside of the containment. The paper demonstrates this by presenting a method of analysis and of equipment selection that fully complies with the intent and the letter of applicable federal regulatory guides. A report of an actual tornado in the City of Kalamazoo, Michigan, suggests that the concept of sealing a plant during a tornado may not always be applicable

  19. Protecting yourself at work

    Directory of Open Access Journals (Sweden)

    Heather Machin

    2015-09-01

    Full Text Available You need to look after your body when you are at work. This not only prevents you from being injured but it also prevents you from living the remainder of your life with a long-term injury. If you do get injured at work, it may reduce your ability to continue to do that job – which means you might not be able to bring the same amount of money home to support your family. Therefore, anything you can do to protect yourself from injury is important and you must prioritise your health and safety at all times while at work.

  20. Epidemiology and Radiation Protection

    International Nuclear Information System (INIS)

    1987-01-01

    Epidemiology aims at providing direct evidence of the long term health effects in humans due to potentially dangerous exposures to various nuisance agents, including ionising radiation. Inappropriate interpretation and use of the results of epidemiological studies may result in inaccurate assessments of the risks associated with radiation exposure. This report presents the proceedings of a Workshop organised by the NEA to create an opportunity for epidemiologists and radiation protection specialists to exchange their experiences and views on the problems of methodology in epidemiological research and on the application of its results to the assessment of radiation risks

  1. Australia's radiation protection standards

    International Nuclear Information System (INIS)

    1989-01-01

    In Australia, public exposure to ionizing radiation above background is considered to be negligible. Average occupational exposures are about 0.5 millisievert per year, although there are some specialized industries and professions where they are much higher. The National Health and Medical Research Council has therefore adopted a position similar to that of the International Commission on Radiological Protection. For the moment, no revision of exposure limits is recommended, but users are remined of their responsibility to ensure that exposures are kept low, particularly in those workplaces where significant exposures take place

  2. Radiation protection - the employer

    International Nuclear Information System (INIS)

    Goldfinch, E.

    1983-01-01

    A brief report is given of a paper presented at the symposium on 'Radiation and the Worker - where do we go from here' in London 1983. The paper concerned the employers' viewpoint on the draft of the proposed Ionising Radiations Regulations in the Health and Safety Commission Consultative Document. It was concluded that there was already a very good standard of radiological protection in the UK and that any improvements could therefore only be fringe improvements, although the cost to the employer of introducing and implementing the new proposed Regulations was bound to be high. (U.K.)

  3. Integrating protection into food aid

    Directory of Open Access Journals (Sweden)

    Mariangela Bizzarri

    2007-01-01

    Full Text Available The World Food Programme (WFP does not have a specific protection mandate but its activities are increasingly shaped by awareness of the need to protect women and girls from sexual and gender-based violence (SGBV.

  4. Radiological protection Program of CDTN

    International Nuclear Information System (INIS)

    1983-01-01

    Radiological protection program of CDTN, its purposes and rules, responsabilities, physical control, monitoring, personnel radiation protection, radiation sources and radioactive wastes control, emergency and accidents and siting are described. (C.M.) [pt

  5. Helping Residents Protect Water Sources

    Science.gov (United States)

    Building on the successful early engagement of the Plain Sect agricultural community, the Eastern Lancaster County Source Water Protection Collaborative is expanding its efforts to involve local residents in the work of protecting drinking water sources.

  6. Lightning protection of PV systems

    OpenAIRE

    Pons, Enrico; Tommasini, Riccardo

    2013-01-01

    Lightning strikes can affect photovoltaic (PV) generators and their installations, involving also the inverter's electronics. It is therefore necessary to evaluate the risk connected to lightning strikes in order to adopt the correct protective measures for the system. The Standard IEC (EN) 62305-2 reports the procedures for the risk calculation and for the choice of proper lightning protection systems. Usually the technical guidelines suggest protecting with SPDs (surge protective devices) b...

  7. Ship impact against protection islands

    DEFF Research Database (Denmark)

    Pedersen, Preben Terndrup

    1997-01-01

    The five most exposed piers and the anchor blocks on the East Bridge shall be protected by aritificial islands. Extensive analytical and experimental investitations were carried out to verify the efficiency of how these protection works.......The five most exposed piers and the anchor blocks on the East Bridge shall be protected by aritificial islands. Extensive analytical and experimental investitations were carried out to verify the efficiency of how these protection works....

  8. The principles of radiation protection

    International Nuclear Information System (INIS)

    2004-01-01

    The aim of radiation protection is to avoid or to reduce the risks linked to ionizing radiation. In order to reduce these risks, the radiation protection uses three great principles: justification, optimization and limitation of radiation doses. to apply these principles, the radiation protection has regulatory and technical means adapted to three different categories of people: public, patients and workers. The nuclear safety authority elaborates the regulation, and carries out monitoring of the reliable application of radiation protection system. (N.C.)

  9. GROUNDWATER PROTECTION MANAGEMENT PROGRAM DESCRIPTION.

    Energy Technology Data Exchange (ETDEWEB)

    PAQUETTE,D.E.; BENNETT,D.B.; DORSCH,W.R.; GOODE,G.A.; LEE,R.J.; KLAUS,K.; HOWE,R.F.; GEIGER,K.

    2002-05-31

    THE DEPARTMENT OF ENERGY ORDER 5400.1, GENERAL ENVIRONMENTAL PROTECTION PROGRAM, REQUIRES THE DEVELOPMENT AND IMPLEMENTATION OF A GROUNDWATER PROTECTION PROGRAM. THE BNL GROUNDWATER PROTECTION MANAGEMENT PROGRAM DESCRIPTION PROVIDES AN OVERVIEW OF HOW THE LABORATORY ENSURES THAT PLANS FOR GROUNDWATER PROTECTION, MONITORING, AND RESTORATION ARE FULLY DEFINED, INTEGRATED, AND MANAGED IN A COST EFFECTIVE MANNER THAT IS CONSISTENT WITH FEDERAL, STATE, AND LOCAL REGULATIONS.

  10. Information booklet on personal protective equipment: protective clothing and coverall

    International Nuclear Information System (INIS)

    1992-01-01

    Personnel protective clothing are meant to provide protection to the user normally against radiant heat, flames, corrosive and other chemicals, radioactive contaminants and X-rays. Various types of leather, plastics and coated fabrics are available to fabricate these clothing. The material of the clothing should be capable of offering protection against the specific hazard involved. This information booklet covers the following four categories of protective clothing and coverall (i) flame/heat resistant suits (ii) suits for radiation protection (iii) chemical resistant suits for corrosive chemicals (iv) lead-rubber aprons for X-rays. (M.K.V.). 3 annexures, 1 appendix

  11. National congress of radiation protection

    International Nuclear Information System (INIS)

    2001-01-01

    The congress of radiation protection tackled different areas of radiation protection. The impact of ionizing radiations on environment coming from radioactive activities. The biological radiation effects, the dosimetry, the different ways of doing relative to radiation protection,the risks analysis and the communications with populations, information about accidents and the lessons learned from them are included in this congress. (N.C.)

  12. Patent protection strategies

    Directory of Open Access Journals (Sweden)

    Himanshu Gupta

    2010-01-01

    Full Text Available It is widely recognized that the pharmaceutical industry faces serious financial challenges. Large numbers of blockbuster drugs are losing patent protection and going generic. The pipeline of new drugs is too sparse to fill the gap and generate a platform for future growth. Moreover, many of the new products are biologics with much narrower target patient populations and comparatively higher prices relative to traditional pharmaceuticals. So now the time has come for pharmaceutical scientists to have a better understanding of patent fundamentals. This need is illustrated by analyses of key scientific and legal issues that arose during recent patent infringement cases involving Prozac, Prilosec, and Buspar. Facing this scenario, the pharmaceutical industry has moved to accelerate drug development process and to adopt at the same time different strategies to extend the life time of the patent monopoly to provide the economic incentives and utilizing it for drug discovery and development. This review covers the need of patent protection and various strategies to extend the patent.

  13. Protected areas in mountains

    Directory of Open Access Journals (Sweden)

    Hamilton, L. S.

    2006-12-01

    Full Text Available

    The importance of a global Protected Areas Network in sustaining appropriate mountain development is presented in this paper. Present status of the world’s “official” Protected Areas in the UN List, and the proportion that are in mountain areas, and including international designations (World Heritage and Biosphere Reserves. Current and future challenges in the management of these special areas are also commented.



    El autor destaca la importancia de una Red Mundial de Espacios Protegidos para el desarrollo sostenible de las montañas. Comenta luego el estatus actual de las Áreas Protegidas “oficiales” del Mundo en la Lista de las Naciones Unidas y qué proporción de ellas forma parte de las montañas, sin olvidar las figuras internacionales de protección como Patrimonio de la Humanidad y Reservas de Biosfera. Para terminar, se discuten los problemas de gestión actuales y futuros de estas áreas tan especiales

  14. Radiation protection primer

    International Nuclear Information System (INIS)

    Aigner, R.; Melzer, E.; Seissler, H.

    1986-01-01

    This 'radiation protection primer' does not pretend to give absolute, final answers to the many questions that have been arising after the Chernobyl accident. What it is intended to supply, as a schematic overview of problems resulting from nuclear accidents, and a likewise systematic outline of possible solutions and sensible reactions to such an event. The book takes up questions such as: What has happened to the soil. Will future harvests be 'clean' again. What does radioactivity to our drinking water and other waters. What are the effects of a radioactive fallout on food. What may we eat or drink. What happens to the human body after intake of radioactive air, or - even only slightly - contaminated food or water. What can we do to protect our health, and the health of our children. Is there anything else we can do in order to avoid such a disaster in future, except from shutting-off all reactors. The book itself presents some answers and advice, along with a list of terms and explanations, and addresses to apply to for further advice and information. (orig./HP) [de

  15. Protecting Detectors in ALICE

    CERN Document Server

    Mateusz Lechman, Mateusz; Chochula, Peter; Di Mauro, Antonio; Jirden, Lennart Stig; Schindler, Heinrich; Rosinsky, Peter; Moreno, Alberto; Kurepin, Alexander; Pinazza, Ombretta; De Cataldo, Giacinto

    2011-01-01

    ALICE (A Large Ion Collider Experiment) is one of the big LHC (Large Hadron Collider) experiments at CERN in Geneva. It is composed of many sophisticated and complex detectors mounted very compactly around the beam pipe. Each detector is a unique masterpiece of design, engineering and construction and any damage to it could stop the experiment for months or even for years. It is therefore essential that the detectors are protected from any danger and this is one very important role of the Detector Control System (DCS). One of the main dangers for the detectors is the particle beam itself. Since the detectors are designed to be extremely sensitive to particles they are also vulnerable to any excess of beam conditions provided by the LHC accelerator. The beam protection consists of a combination of hardware interlocks and control software and this paper will describe how this is implemented and handled in ALICE. Tools have also been developed to support operators and shift leaders in the decision making related...

  16. Providing protection for doctors.

    Science.gov (United States)

    Hegan, T

    2003-03-01

    Over the last decade the number of negligence cases brought against doctors, dentists and other healthcare professional has increased significantly in many countries around the world. In addition, the proliferation of the pathways of accountability in many countries means that doctors are feeling undervalued and vulnerable and are therefore seeking assistance and protection more than ever. The effect of a claim or complaint on a doctor can be devastating both personally and professionally. The relationship with the patient is damaged and an increase in defensive practice ultimately causes an increase in healthcare costs. Patient expectations have increased. Patients are more knowledgeable than they were five years ago and the demands on the professions are increasing daily. Unfortunately because of the long delays that are seen between an incident and a claim it is very difficult to predict what reserves are required in the future. We have seen a number of organisations pull out of the business over the last year and it highlights the importance of having an understanding of the needs of the professions and the ability to track trends in litigation in order to set appropriate subscription rates. Doctors and other healthcare professionals require more than just financial protection. They need support from their colleagues and assistance from experienced lawyers in order to help restore their confidence and ensure that they can continue to practice for the benefit of their patients in the future.

  17. Radiological protection report 2012

    International Nuclear Information System (INIS)

    2013-06-01

    Two years after the massive release of radiation from the nuclear power plants at Fukushima Dai-ichi, the repercussions continue to preoccupy the radiological and emergency protection community, both in Switzerland and internationally. In Switzerland the Swiss Federal Nuclear Safety Inspectorate (ENSI) has initiated measures as part of the European Union Stress Tests and has its own Fukushima Action Plan. In this Annual Report, ENSI focuses on radiological protection in Swiss nuclear facilities. The average individual dose has changed little compared with previous years. At 0.7 mSv, it is significantly below the limit both for persons exposed to radiation during their work (20 mSv) and the annual average rate of exposure for the population in Switzerland as a whole (5.5 mSv). In terms of collective doses, the extensive maintenance work at the Leibstadt power plant (KKL) resulted in a doubling of rates compared with recent years. However, in the remaining nuclear facilities the rates have not changed significantly. The highest individual dose during the year under review was 13 mSv. Exposure rates in 2012 for all those exposed to radiation during work in facilities subject to ENSI surveillance were below the maximum limit. Greater attention is now being given to work in high and variable radiation fields and in difficult conditions. Swiss nuclear facilities continue to operate a consistent radiological protection approach. Measuring equipment plays an important role in radiological protection. Having conducted a range of inspections and comparative measurements of aerosol-iodine filters and waste water sampling together with measurements in the field of personal dosimetry, ENSI has concluded that the required measuring equipment for radiological protection exists, that this equipment is correctly used and provides reliable data. ENSI maintains a test laboratory that analyses samples from nuclear facilities and their immediate vicinity and also conducts field

  18. ADVANCED WORKER PROTECTION SYSTEM

    International Nuclear Information System (INIS)

    Judson Hedgehock

    2001-01-01

    From 1993 to 2000, OSS worked under a cost share contract from the Department of Energy (DOE) to develop an Advanced Worker Protection System (AWPS). The AWPS is a protective ensemble that provides the user with both breathing air and cooling for a NIOSH-rated duration of two hours. The ensemble consists of a liquid air based backpack, a Liquid Cooling Garment (LCG), and an outer protective garment. The AWPS project was divided into two phases. During Phase 1, OSS developed and tested a full-scale prototype AWPS. The testing showed that workers using the AWPS could work twice as long as workers using a standard SCBA. The testing also provided performance data on the AWPS in different environments that was used during Phase 2 to optimize the design. During Phase 1, OSS also performed a life-cycle cost analysis on a representative clean up effort. The analysis indicated that the AWPS could save the DOE millions of dollars on D and D activities and improve the health and safety of their workers. During Phase 2, OSS worked to optimize the AWPS design to increase system reliability, to improve system performance and comfort, and to reduce the backpack weight and manufacturing costs. To support this design effort, OSS developed and tested several different generations of prototype units. Two separate successful evaluations of the ensemble were performed by the International Union of Operation Engineers (IUOE). The results of these evaluations were used to drive the design. During Phase 2, OSS also pursued certifying the AWPS with the applicable government agencies. The initial intent during Phase 2 was to finalize the design and then to certify the system. OSS and Scott Health and Safety Products teamed to optimize the AWPS design and then certify the system with the National Institute of Occupational Health and Safety (NIOSH). Unfortunately, technical and programmatic difficulties prevented us from obtaining NIOSH certification. Despite the inability of NIOSH to certify

  19. ADVANCED WORKER PROTECTION SYSTEM

    Energy Technology Data Exchange (ETDEWEB)

    Judson Hedgehock

    2001-03-16

    From 1993 to 2000, OSS worked under a cost share contract from the Department of Energy (DOE) to develop an Advanced Worker Protection System (AWPS). The AWPS is a protective ensemble that provides the user with both breathing air and cooling for a NIOSH-rated duration of two hours. The ensemble consists of a liquid air based backpack, a Liquid Cooling Garment (LCG), and an outer protective garment. The AWPS project was divided into two phases. During Phase 1, OSS developed and tested a full-scale prototype AWPS. The testing showed that workers using the AWPS could work twice as long as workers using a standard SCBA. The testing also provided performance data on the AWPS in different environments that was used during Phase 2 to optimize the design. During Phase 1, OSS also performed a life-cycle cost analysis on a representative clean up effort. The analysis indicated that the AWPS could save the DOE millions of dollars on D and D activities and improve the health and safety of their workers. During Phase 2, OSS worked to optimize the AWPS design to increase system reliability, to improve system performance and comfort, and to reduce the backpack weight and manufacturing costs. To support this design effort, OSS developed and tested several different generations of prototype units. Two separate successful evaluations of the ensemble were performed by the International Union of Operation Engineers (IUOE). The results of these evaluations were used to drive the design. During Phase 2, OSS also pursued certifying the AWPS with the applicable government agencies. The initial intent during Phase 2 was to finalize the design and then to certify the system. OSS and Scott Health and Safety Products teamed to optimize the AWPS design and then certify the system with the National Institute of Occupational Health and Safety (NIOSH). Unfortunately, technical and programmatic difficulties prevented us from obtaining NIOSH certification. Despite the inability of NIOSH to certify

  20. 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.