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Sample records for inadequate anaesthesiological protection

  1. The future of anaesthesiology

    Directory of Open Access Journals (Sweden)

    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 Ether, after reigning the kingdom of anaesthesiology for more than a century, came to be superseded by newer and newer agents.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.

  2. Bridge Failure Due to Inadequate Design of Bed Protection

    Science.gov (United States)

    Gupta, Yogita; Kaur, Suneet; Dindorkar, Nitin

    2017-12-01

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

  3. Determinants of inadequate parental sun protection behaviour in their children--results of a cross-sectional study in Germany.

    Science.gov (United States)

    Klostermann, Swaantje; Bolte, Gabriele

    2014-03-01

    Unprotected sun exposure especially during childhood is a risk factor for skin cancer. A combined use of sun protection measures is recommended to protect children. However, the prevalence and determinants for combined use have been scarcely studied in children. The objective of this study was to identify determinants of parental sun protection behaviour. A cross-sectional survey was performed in five regions in Bavaria (Germany) during school entrance health examination (2010/2011). Parents of 4579 children (47% female, aged 5-6 years) completed a self-administered questionnaire (response 61%). Most children were regularly protected with single measures (shade (69%), clothes (80%), hat (83%), sunscreen (89%), sunglasses (20%)). However, regarding regular and combined use, >50% of children were inadequately protected. Larger family size, lower household equivalent income, darker skin and sunburn history were associated with inadequate use of different sun protection measures. The less frequent use of one sun protection measure was associated with less frequent use of the others. Child's sex, migration background, parental education and sun exposure showed inconsistent results regarding the different sun protection outcomes. Based on our results a regular, combined and correct use of multiple sun protection for children should be promoted independent of sociodemographic characteristics. Priority of shade, clothes and hat before sunscreen should be clarified. Copyright © 2013 Elsevier GmbH. All rights reserved.

  4. 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.

  5. 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.

    2014-01-01

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

  6. Behaviorally inadequate

    DEFF Research Database (Denmark)

    Kasperbauer, Tyler Joshua

    2014-01-01

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

  7. Mobbing Exposure of Anaesthesiology Residents in Turkey.

    Science.gov (United States)

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

    2016-08-01

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

  8. Education for leadership in anaesthesiology. The sixteenth Husfeldt lecture, Copenhagen, 11 May, 1984.

    Science.gov (United States)

    Papper, E M

    1985-01-01

    A description of the genesis of the Anaesthesiology Centre in Copenhagen after World War II is presented. The major contribution of Professor Husfeldt in organizing is described. The need for leadership in anaesthesiology is discussed in detail. The characteristics of leadership and leaders are presented, and their importance in the future development of anaesthesiology is pointed out.

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

    Directory of Open Access Journals (Sweden)

    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.

  10. 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.

  11. 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.

  12. Scientific publications in international anaesthesiology journals: a 10-year survey.

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    Li, Z; Qiu, L-X; Wu, F-X; Yang, L-Q; Sun, S; Yu, W F

    2011-03-01

    Significant growth has been seen in the field of anaesthesiology in recent decades. The current geographic distribution of the publications on anaesthesia research may be different from ten years ago. We performed this literature survey to examine the national origin of articles published in international anaesthesiology journals and to evaluate their contribution to anaesthesia research. Articles published in 18 major anaesthesiology journals from 2000 to 2009 were identified from the PubMed database and the Science Citation Index. A total of 30,191 articles were published in the selected 18 journals from 2000 to 2009. The country responsible for the largest number of articles was the United States of America (29.4%), followed by the United Kingdom, Germany, Japan, Canada, Australia and France. Denmark, Switzerland and Finland had the largest number of articles per capita. Anesthesia & Analgesia published the most number of articles from 2000 to 2009, followed by Anesthesiology, Pain and the British Journal of Anaesthesia. The numbers of clinical studies and randomised controlled trials decreased markedly from 2000 to 2009.

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

    DEFF Research Database (Denmark)

    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...

  14. Inadequate housing in Ghana

    Directory of Open Access Journals (Sweden)

    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.

  15. Validation of core competencies during residency training in anaesthesiology

    Directory of Open Access Journals (Sweden)

    Spies, Claudia

    2011-01-01

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

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

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    Jordan, Silvia; Brauner, Elisabeth

    2008-04-01

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

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

    Science.gov (United States)

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

    2003-01-01

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

  18. 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

    BACKGROUND: A new reform on postgraduate education in Denmark requires a formal in-training assessment in all specialties. The aim of this study was to survey the implementation and acceptability of the first example of a nation-wide in-training assessment programme for first-year trainees...... 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...

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

    Directory of Open Access Journals (Sweden)

    Daphne Demetriou

    2015-09-01

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

  20. [Shortage of physicians in anaesthesiology and intensive care medicine - Causes, consequences and solutions].

    Science.gov (United States)

    Papenfuß, Tim; Roch, Carmen

    2012-05-01

    74% of all hospitals had vacant positions in 2011, also departments of anaesthesiology and intensive care medicine. More than 50% of these departments work with locums. There are couple of reasons for the shortage of physicians. The consequences in anaesthesiology and intensive care medicine can result in qualitative and financial loss. To solve the shortage of physicians one has to solve the reasons. Main reasons are increasing feminization of medical profession and part-time-work, work-life-balance and a poor specialised education. © Georg Thieme Verlag Stuttgart · New York.

  1. 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.

  2. Perceptions of house officers working in hospitals of Lahore about joining the field of anaesthesiology as a career.

    Science.gov (United States)

    Anjum, Sohail; Mahboob, Usman

    2016-10-01

    To determine the perceptions of house officers working in hospitals about joining anaesthesiology as a career. This quantitative, descriptive questionnaire-based study was carried out from September 2014 to February 2015 in 26 teaching hospitals of Lahore, Pakistan, and comprised house officers. Those with at least three months of working experience in anaesthesiology were included. They were approached in their respective departments and a validated self-reporting questionnaire was delivered to them and received back by hand. SPSS 16 was used for data analysis. Of the 73 house officers approached, 53(72.6%) responded; 35(66%) men and 18(33%) women. Overall, 25(47.16%) respondents refused to join anaesthesiology as a career and 27(50.94%) included it in their first three career choices. Moreover, 25(47.16%) cited minimal interaction with patient as a reason for not taking anaesthesia as a career choice; 29(56.6%) of the respondents believed an anaesthetist had no or little role in surgery. Change in attitude about anaesthesiology as a specialty after having an anaesthesia rotation was mentioned by 26(49.05%) respondents. House officers had reservations about joining anaesthesiology as a career. The findings are suggestive of a positive effect of anaesthesiology house job on house officers attitude about the specialty.

  3. 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.

  4. 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.)

  5. Anaesthesiological strategies in elective craniotomy: randomized, equivalence, open trial--the NeuroMorfeo trial.

    Science.gov (United States)

    Citerio, Giuseppe; Franzosi, Maria Grazia; Latini, Roberto; Masson, Serge; Barlera, Simona; Guzzetti, Stefano; Pesenti, Antonio

    2009-04-06

    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 anaesthesiological 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. 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 > or = 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 during anaesthesia; intraoperative

  6. [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.

  7. 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.

  8. 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

    for first-year residency in anaesthesiology appears to be appropriate regarding the range of competencies assessed, the appropriateness as a basis for pass/fail decisions, and regarding the content of the tests used for pass/fail decisions. Further studies are needed to assess the feasibility...

  9. 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

  10. 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....

  11. Comparison of Patient Costs in Internal Medicine and Anaesthesiology Intensive Care Units in a Tertiary University Hospital.

    Science.gov (United States)

    Kara, İskender; Yıldırım, Fatma; Başak, Dilek Yumuş; Küçük, Hamit; Türkoğlu, Melda; Aygencel, Gülbin; Katı, İsmail; Karabıyık, Lale

    2015-06-01

    The allocation of the Gross Domestic Product (GDP) to health is limited, therefore it has made a need for professional management of health business. Hospital managers as well as employees are required to have sufficient knowledge about the hospital costs. Hospital facilities like intensive care units that require specialization and advanced technology have an important part in costs. For this purpose, cost analysis studies should be done in the general health business and special units separately. In this study we aimed to compare the costs of anaesthesiology and internal medicine intensive care units (ICU) roughly. After approval of this study by Gazi University Faculty of Medicine Ethics Committee, the costs of 855 patients that were hospitalized, examined and treated for at least 24 hours in internal medicine and anaesthesiology ICUs between January 2012-August 2013 (20 months period) were taken and analyzed from chief staff of the Department of Information Technology, Gazi University Hospital. At the end of the study, we observed clear differences between internal medicine and anaesthesiology ICUs arising from transactions and patient characteristics of units. We stated that these differences should be considered by Social Security Institution (SSI) for the reimbursement of the services. Further, we revealed that SSI payments do not meet the intensive care expenditure.

  12. 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

  13. 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....

  14. 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

  15. 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.)

  16. 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

  17. 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…

  18. Descriptive analysis of work and trends in anaesthesiology from 2005 to 2006: Quantitative and qualitative aspects of effects and evaluation of anaesthesia

    Directory of Open Access Journals (Sweden)

    Aleksić Valentina V.

    2010-01-01

    Full Text Available Introduction. In anaesthesiology, economic aspects have been insufficiently studied. Objective. The aim of this paper was the assessment of rational choice of the anaesthesiological services based on the analysis of the scope, distribution, trend and cost. Methods. The costs of anaesthesiological services were counted based on “unit” prices from the Republic Health Insurance Fund. Data were analysed by methods of descriptive statistics and statistical significance was tested by Student’s t-test and χ2-test. Results. The number of general anaesthesia was higher and average time of general anaesthesia was shorter, without statistical significance (t-test, p=0.436 during 2006 compared to the previous year. Local anaesthesia was significantly higher (χ2-test, p=0.001 in relation to planned operation in emergency surgery. The analysis of total anaesthesiological procedures revealed that a number of procedures significantly increased in ENT and MFH surgery, and ophthalmology, while some reduction was observed in general surgery, orthopaedics and trauma surgery and cardiovascular surgery (χ2-test, p=0.000. The number of analgesia was higher than other procedures (χ2-test, p=0.000. The structure of the cost was 24% in neurosurgery, 16% in digestive (general surgery,14% in gynaecology and obstetrics,13% in cardiovascular surgery and 9% in emergency room. Anaesthesiological services costs were the highest in neurosurgery, due to the length anaesthesia, and digestive surgery due to the total number of general anaesthesia performed. Conclusion. It is important to implement pharmacoeconomic studies in all departments, and to separate the anaesthesia services for emergency and planned operations. Disproportions between the number of anaesthesia, surgery interventions and the number of patients in surgical departments gives reason to design relation database.

  19. 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.

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

    Science.gov (United States)

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

    2015-05-01

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

  1. 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.

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

    Science.gov (United States)

    Kerwat, Klaus; Wulf, Hinnerk

    2013-11-01

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

  3. 9 CFR 417.6 - Inadequate HACCP Systems.

    Science.gov (United States)

    2010-01-01

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

  4. 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.

  5. Wind energy: Overcoming inadequate wind and modeling uncertainties

    Energy Technology Data Exchange (ETDEWEB)

    Kane, Vivek

    2010-09-15

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

  6. Clinical significance of inadequate endometrial biopsies prior to hysterectomy.

    Science.gov (United States)

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

    2012-01-01

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

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

    African Journals Online (AJOL)

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

  8. Determinants of inadequate fruit and vegetable consumption amongst Portuguese adults.

    Science.gov (United States)

    Oliveira, A; Maia, B; Lopes, C

    2014-04-01

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

  9. 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.

  10. Inadequate exercise as a risk factor for sepsis mortality.

    Science.gov (United States)

    Williams, Paul T

    2013-01-01

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

  11. 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.

  12. 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.

  13. 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.

  14. 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 ...

  15. Protective Health Education

    Science.gov (United States)

    Aydin, Ganime

    2016-01-01

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

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

    Science.gov (United States)

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

  17. Post-implementation review of inadequate core cooling instrumentation

    International Nuclear Information System (INIS)

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

    1988-01-01

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

  18. 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

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

    International Nuclear Information System (INIS)

    Jordan, E.L.

    1992-01-01

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

  20. 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.

  1. Inadequate Brain Glycogen or Sleep Increases Spreading Depression Susceptibility

    KAUST Repository

    Kilic, Kivilcim; Karatas, Hulya; Donmez-Demir, Buket; Eren-Kocak, Emine; Gursoy-Ozdemir, Yasemin; Can, Alp; Petit, Jean-Marie; Magistretti, Pierre J.; Dalkara, Turgay

    2017-01-01

    Glycogen in astrocyte endfeet contributes to maintenance of low extracellular glutamate and K+ concentrations around synapses. Sleep deprivation (SD), a common migraine trigger induces transcriptional changes in astrocytes reducing glycogen breakdown. We hypothesize that when glycogen utilization cannot match synaptic energy demand, extracellular K+ can rise to levels that activate neuronal pannexin-1 channels and downstream inflammatory pathway, which might be one of the mechanisms initiating migraine headaches.We suppressed glycogen breakdown by inhibiting glycogen phosphorylation with 1,4-dideoxy-1,4-imino-D-arabinitol (DAB) and by SD.DAB caused neuronal pannexin-1 large-pore opening and activation of the downstream inflammatory pathway as shown by procaspase-1 cleavage and HMGB1 release from neurons. Six-hour SD induced pannexin-1 mRNA. DAB and SD also lowered the cortical spreading depression (CSD) induction threshold, which was reversed by glucose or lactate supplement, suggesting that glycogen-derived energy substrates are needed to prevent CSD generation. Supporting this, knocking-down neuronal lactate transporter, MCT2 with an anti-sense oligonucleotide or inhibiting glucose transport from vessels to astrocytes with intracerebroventricularly given phloretin reduced the CSD threshold. In vivo recordings with a K+ -sensitive/selective fluoroprobe, APG-4 disclosed that DAB treatment or SD caused significant rise in extracellular K+ during whisker-stimulation, illustrating the critical role of glycogen in extracellular K+ clearance.Synaptic metabolic stress caused by insufficient glycogen-derived energy substrate supply can activate neuronal pannexin-1 channels as well as lowering the CSD threshold. Therefore, conditions that limit energy supply to synapse (e.g. SD) may predispose to migraine attacks as suggested by genetic studies associating glucose or lactate transporter deficiency with migraine. This article is protected by copyright. All rights reserved.

  2. 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.

  3. 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

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

    Science.gov (United States)

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

    2014-01-01

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

  5. 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.

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

    OpenAIRE

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

    2014-01-01

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

  7. 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

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

    International Nuclear Information System (INIS)

    Sardanelli, Francesco; Aliprandi, Alberto; Fausto, Alfonso

    2005-01-01

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

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

    Science.gov (United States)

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

    2018-05-01

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

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

    Science.gov (United States)

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

    1999-01-01

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

  11. 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.

  12. 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.

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

    Science.gov (United States)

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

    2015-06-01

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

  14. 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

  15. 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...

  16. 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.

  17. 25 CFR 170.811 - What happens if lack of funds results in inadequate maintenance?

    Science.gov (United States)

    2010-04-01

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

  18. 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.

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

    Science.gov (United States)

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

    2010-01-01

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

  20. 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...

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

    Directory of Open Access Journals (Sweden)

    Cristiane M. Silva

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

  2. 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…

  3. 76 FR 33780 - Assessments for Mismatched Payments or Inadequate Payment Information for Geothermal, Solid...

    Science.gov (United States)

    2011-06-09

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Vidhya Venugopal

    2016-09-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

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

    Science.gov (United States)

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

    2010-09-21

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

  9. 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...

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

    Science.gov (United States)

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

    2017-02-01

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

  11. 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.

  12. 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...

  13. 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.

  14. 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...

  15. 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.

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

    Science.gov (United States)

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

    2017-09-01

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

  17. 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.

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

    Science.gov (United States)

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

    2018-01-01

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

  19. 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.

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    Satheesh B Haralur

    2018-01-01

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

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

    Science.gov (United States)

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

    2010-05-01

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

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

    Science.gov (United States)

    2017-08-20

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

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

    International Nuclear Information System (INIS)

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

    1977-01-01

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

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

    Science.gov (United States)

    Vanwoerden, Salome; Kalpakci, Allison; Sharp, Carla

    2017-11-01

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

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

    Science.gov (United States)

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

    2010-05-01

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

  7. 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.

  8. 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.

  9. 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.

  10. 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.

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

    Science.gov (United States)

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

    2017-04-29

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

  12. 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.

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

    DEFF Research Database (Denmark)

    Kristiansen, Bettina Kjær

    2014-01-01

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

  14. 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.

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

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

    International Nuclear Information System (INIS)

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

    2017-01-01

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

  17. Advanced worker protection system

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-10-01

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

  18. 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

  19. 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

  20. [Liability in Anaesthesiology: theory of disproportionate damage].

    Science.gov (United States)

    Galán Gutiérrez, J C; Galán Cortés, J C

    2013-10-01

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

  1. 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 ...

  2. 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

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

    Science.gov (United States)

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

    2017-10-19

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

  4. 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.

  5. 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.

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

    Science.gov (United States)

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

    2015-04-01

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

  7. 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.

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

    Directory of Open Access Journals (Sweden)

    Leonardo Carvalho da Fonseca

    2012-04-01

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

  9. 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

  10. 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.

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

    Science.gov (United States)

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

    1999-06-01

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

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

    Science.gov (United States)

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

    2017-06-22

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

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

    Science.gov (United States)

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

    2018-05-01

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

  14. 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.

  15. 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

  16. Advanced worker protection system

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-12-01

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

  17. 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.

  18. 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

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

    African Journals Online (AJOL)

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

  20. Comparison of Vildagliptin and Pioglitazone in Korean Patients with Type 2 Diabetes Inadequately Controlled with Metformin.

    Science.gov (United States)

    Kim, Jong Ho; Kim, Sang Soo; Baek, Hong Sun; Lee, In Kyu; Chung, Dong Jin; Sohn, Ho Sang; Bae, Hak Yeon; Kim, Mi Kyung; Park, Jeong Hyun; Choi, Young Sik; Kim, Young Il; Hahm, Jong Ryeal; Lee, Chang Won; Jo, Sung Rae; Park, Mi Kyung; Lee, Kwang Jae; Kim, In Joo

    2016-06-01

    We compared the efficacies of vildagliptin (50 mg twice daily) relative to pioglitazone (15 mg once daily) as an add-on treatment to metformin for reducing glycosylated hemoglobin (HbA1c) levels in Korean patients with type 2 diabetes. The present study was a multicenter, randomized, active-controlled investigation comparing the effects of vildagliptin and pioglitazone in Korean patients receiving a stable dose of metformin but exhibiting inadequate glycemic control. Each patient underwent a 16-week treatment period with either vildagliptin or pioglitazone as an add-on treatment to metformin. The mean changes in HbA1c levels from baseline were -0.94% in the vildagliptin group and -0.6% in the pioglitazone group and the difference between the treatments was below the non-inferiority margin of 0.3%. The mean changes in postprandial plasma glucose (PPG) levels were -60.2 mg/dL in the vildagliptin group and -38.2 mg/dL in the pioglitazone group and these values significantly differed (P=0.040). There were significant decreases in the levels of total, low density lipoprotein, high density lipoprotein (HDL), and non-HDL cholesterol in the vildagliptin group but increases in the pioglitazone group. The mean change in body weight was -0.07 kg in the vildagliptin group and 0.69 kg in the pioglitazone group, which were also significantly different (P=0.002). As an add-on to metformin, the efficacy of vildagliptin for the improvement of glycemic control is not inferior to that of pioglitazone in Korean patients with type 2 diabetes. In addition, add-on treatment with vildagliptin had beneficial effects on PPG levels, lipid profiles, and body weight compared to pioglitazone.

  1. 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.

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

    Science.gov (United States)

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

    2016-09-01

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

  3. 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.

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

    Science.gov (United States)

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

    2018-02-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1994-12-31

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

  6. 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

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

    Science.gov (United States)

    Ogbu, James E.

    2015-01-01

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

  8. 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

  9. 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

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

    Science.gov (United States)

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

    2007-03-01

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

  11. 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.

  12. 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.

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

    Science.gov (United States)

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

    2018-01-01

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

  14. Whistleblower Protection

    Science.gov (United States)

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

  15. 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

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

    Directory of Open Access Journals (Sweden)

    Maria Cristina Triguero Veloz Teixeira

    2015-01-01

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

  17. 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)

  18. Diplomatic Protection

    OpenAIRE

    Režná, Jana

    2006-01-01

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

  19. New drugs and indications in 2010: inadequate assessment; patients at risk.

    Science.gov (United States)

    2011-04-01

    In 2010, we rated 97 new drugs or new indications in our French edition la revue Prescrire, only 4 of which provided a therapeutic advantage. However, 19 others (1 in 5) were approved despite having more harms than benefits. More paediatric products were released in 2010 than in previous years, but few of them made any real difference and many had not been properly evaluated. Drug regulatory agencies can protect patients from exposure to dangerous drugs by refusing to grant market approval or by demanding their market withdrawal.Yet they are failing to fulfil this responsibility: so-called risk management plans and modifications to the wording in the SPC are only half-measures. Too often the authorities put companies' short-term financial interests above patients' well-being by granting premature marketing authorisation, by agreeing to high levels of reimbursement that fail to take added therapeutic value into account, and by allowing the development of "umbrella" ranges. The European authorities' questionable plans for pharmacovigilance and advertising of prescription-only drugs were restricted after public mobilisation, but they are still likely to undermine healthcare quality. Decision-makers must make patients' well-being their top priority.

  20. NRC Information No. 88-60: Inadequate design and installation of watertight penetration seals

    International Nuclear Information System (INIS)

    Rossi, C.E.

    1992-01-01

    On June 3, 1988, with Vogtle Unit 1 at 100 percent power, an inadvertent pressurization of the fire protection system caused 1/4 to 1/2 inch of water to accumulate around cable penetrations on the B train cable spreading room floor. The water then seeped through the floor into the control room below. The water entered various process panel cabinets causing a spurious pressurizer high level signal and alarm. The spurious signal also resulted in a pressurizer level deviation signal that caused the pressurizer backup heaters to cycle on and off. In addition, the water caused a pressurizer power-operated relief valve to open. During the review of this event, the licensee identified an unanalyzed condition in which a postulated fire in the B train cable spreading room, with either actuation of the sprinkler system and/or manual fire suppression activities, could result in a loss of functions required for safe shutdown as follows: loss of control room train B and auxiliary shutdown panel via the fire, and loss of control room train A via water leaking into control room panels. A second auxiliary shutdown panel (not required by the NRC) would still be available; however, no indication would be available since the indication circuits on that panel are not isolated from the control room. The licensee found through additional testing that there was a second leak path within the cable bundles penetrating the foam sealant material. If a large number of cables are so tightly massed that foam does not completely surround the individual cables, leakage can occur along the cables

  1. 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.

  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. 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.

  4. 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

  5. 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.

  6. Protective relay

    International Nuclear Information System (INIS)

    Lim, Mu Ji; Jung, Hae Sang

    1974-10-01

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

  7. 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....

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

    Science.gov (United States)

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

    1997-09-01

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

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

    Science.gov (United States)

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

    2014-03-22

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

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

    OpenAIRE

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

    2007-01-01

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

  11. 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.

  12. 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.

  13. The importance of verifiable fire protection design

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-07-01

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

  14. Radiation Protection

    International Nuclear Information System (INIS)

    Loos, M.

    2002-01-01

    Major achievements of SCK-CEN's Radiation Protection Department in 2001 are described. The main areas for R and D of the department are enviromnental remediation, emergency planning, radiation protection research, low-level radioactvity measurements, safeguards and physics measurements, decision strategy research and policy support and social sciences in nuclear research. Main achievements for 2001 in these areas are reported

  15. Sun protection

    Science.gov (United States)

    ... sun exposure. The start of summer is when UV rays can cause the most skin damage. Use sun protection, even on cloudy days. Clouds and haze don't protect you from the sun. Avoid surfaces that reflect light, such as water, sand, concrete, snow, and areas ...

  16. 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)

  17. Hand protection from ultraviolet exposure

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-07-01

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

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

    Science.gov (United States)

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

    2013-02-01

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

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

    Science.gov (United States)

    Raghunath, Rajat; Varghese, Gigi; Simon, Betty

    2014-01-01

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

  20. 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...

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

    Science.gov (United States)

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

    2014-07-14

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

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

    Science.gov (United States)

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

    2012-01-01

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

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

    International Nuclear Information System (INIS)

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

    2000-01-01

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

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

    Science.gov (United States)

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

    2012-08-15

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

  5. 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)

  6. Protected Areas

    Data.gov (United States)

    Kansas Data Access and Support Center — This dataset shows the boundaries of properties in Kansas in public or institutional ownership that contain ecological resources that merit some level of protection....

  7. 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)

  8. 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

  9. Employment protection

    OpenAIRE

    Stefano Scarpetta

    2014-01-01

    Laws on hiring and firing are intended to protect workers from unfair behavior by employers, to counter imperfections in financial markets that limit workers’ ability to insure themselves against job loss, and to preserve firm-specific human capital. But by imposing costs on firms’ adaptation to changes in demand and technology, employment protection legislation may reduce not only job destruction but also job creation, hindering the efficient allocation of labor and productivity growth....

  10. 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

  11. 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

  12. Copyright protection

    OpenAIRE

    Plchotová, Gabriela

    2011-01-01

    The aim of this thesis is to offer a straightforward manual to anyone who authors their own original work or who utilises the original work of other creators. As such, it is necessary to briefly and clearly explain the historical development and essential terms of authorship as a concept and the origin of the need for copyright protection. Furthermore, this thesis includes chapters on copyright protection development specifically in the Czech Republic and the current definition of related law...

  13. Radiological protection

    International Nuclear Information System (INIS)

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

    2010-01-01

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

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

    Science.gov (United States)

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

    2017-08-01

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

  15. 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

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

    Science.gov (United States)

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

    2018-02-12

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

  17. 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.

  18. Radiation protection

    International Nuclear Information System (INIS)

    Jain, Aman; Sharma, Shivam; Parasher, Abhishek

    2014-01-01

    Radiation dose measurement, field of radiobiology, is considered to be critical factor for optimizing radiation protection to the health care practitioners, patients and the public. This lead to equipment that has dose - area product meters permanently installed. In many countries and even institution, the range of equipment is vast and with the opportunity for radiation protection and dose recording varies considerably. Practitioners must move with the changed demands of radiation protection but in many cases without assistance of modern advancements in technology Keeping the three basic safety measures Time, Dose and Shielding we can say 'Optimum dose is safe dose' instead of 'No dose is safe dose'. The purpose enclosed within the title 'Radiation Protection'. The use of radiation is expanding widely everyday around the world and crossing boundaries of medical imaging, diagnostic and. The way to get the ''As low as reasonably achievable' is only achievable by using methodology of radiation protection and to bring the concern of general public and practitioners over the hazards of un-necessary radiation dose. Three basic principles of radiation protection are time, distance and shielding. By minimizing the exposure time increasing the distance and including the shielding we can reduce the optimum range of dose. The ability of shielding material to attenuate radiation is generally given as half value layer. This is the thickness of the material which will reduce the amount of radiation by 50%. Lab coat and gloves must be worn when handling radioactive material or when working in a labeled radiation work area. Safety glasses or other appropriate splash shields should be used when handling radioactive material. 1. Reached to low dose level to occupational workers, public as per prescribed dose limit. 2. By mean of ALARA principle we achieved the protection from radiation besides us using the radiation for our benefit

  19. Machine Protection

    International Nuclear Information System (INIS)

    Schmidt, R

    2014-01-01

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

  20. 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 ...

  1. 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.

  2. 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.

  3. 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.

  4. 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

  5. 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.

  6. Machine Protection

    International Nuclear Information System (INIS)

    Zerlauth, Markus; Schmidt, Rüdiger; Wenninger, Jörg

    2012-01-01

    The present architecture of the machine protection system is being recalled and the performance of the associated systems during the 2011 run will be briefly summarized. An analysis of the causes of beam dumps as well as an assessment of the dependability of the machine protection systems (MPS) itself is being presented. Emphasis will be given to events that risked exposing parts of the machine to damage. Further improvements and mitigations of potential holes in the protection systems will be evaluated along with their impact on the 2012 run. The role of rMPP during the various operational phases (commissioning, intensity ramp up, MDs...) will be discussed along with a proposal for the intensity ramp up for the start of beam operation in 2012

  7. 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.

  8. Machine Protection

    Energy Technology Data Exchange (ETDEWEB)

    Zerlauth, Markus; Schmidt, Rüdiger; Wenninger, Jörg [European Organization for Nuclear Research, Geneva (Switzerland)

    2012-07-01

    The present architecture of the machine protection system is being recalled and the performance of the associated systems during the 2011 run will be briefly summarized. An analysis of the causes of beam dumps as well as an assessment of the dependability of the machine protection systems (MPS) itself is being presented. Emphasis will be given to events that risked exposing parts of the machine to damage. Further improvements and mitigations of potential holes in the protection systems will be evaluated along with their impact on the 2012 run. The role of rMPP during the various operational phases (commissioning, intensity ramp up, MDs...) will be discussed along with a proposal for the intensity ramp up for the start of beam operation in 2012.

  9. Physical protection

    International Nuclear Information System (INIS)

    Myre, W.C.; DeMontmollin, J.M.

    1989-01-01

    Serious concern about physical protection of nuclear facilities began around 1972. R and D was initiated at Sandia National Laboratories which had developed techniques to protect weapons for many years. Special vehicles, convoy procedures, and a communications system previously developed for weapons shipments were improved and extended for shipments of other sensitive materials. Barriers, perimeter alarms, portal and internal control systems were developed, tested, and published in handbooks and presented at symposia. Training programs were initiated for U.S. and foreign personnel. Containment and surveillance techniques were developed for the IAEA. Presently emphasis is on computer security, active barriers, and techniques to prevent theft or sabotage by ''insiders''

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

    OpenAIRE

    Eichner Maxine

    2008-01-01

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

  11. Negotiating Protection

    DEFF Research Database (Denmark)

    Bille, Mikkel

    efficacy. Some informants, for example, adopt an orthodox scriptural Islamic approach to protection and denounce certain material registers as un-Islamic and materialistic leftovers from an ignorant past, and rather prescribe Qur'anic remembrance. For other informants the very physicality of such contested...

  12. 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...

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

    Science.gov (United States)

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

    2017-07-01

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

  14. Inadequate vitamin D levels are associated with culture positive sepsis and poor outcomes in paediatric intensive care.

    Science.gov (United States)

    Onwuneme, Chike; Carroll, Aoife; Doherty, Dermot; Bruell, Heike; Segurado, Ricardo; Kilbane, Mark; Murphy, Nuala; McKenna, Malachi J; Molloy, Eleanor J

    2015-10-01

    This study aimed to assess vitamin D status, and its determinants, in paediatric patients with suspected sepsis who were admitted to a paediatric intensive care unit (PICU). We also investigated the association between vitamin D status and clinical outcomes. Serum 25-hydroxy vitamin D (25OHD) and clinical determinants were prospectively assessed in children with suspected sepsis (<12 years old) admitted to the PICU. The relationship between 25OHD and clinical outcomes was evaluated. Vitamin D status was also assessed in control children of a similar age. We enrolled 120 children with suspected sepsis admitted to the PICU and 30 paediatric controls. 25OHD was <50 nmol/L in 59% of the children admitted to the PICU and 25OHD was lower than in the controls (47 ± 29 vs 66 ± 26 nmol/L, p < 0.001). After adjusting for potential confounders, 25OHD was strongly associated with culture positive sepsis (p < 0.001), the paediatric index of mortality (p = 0.026) and the duration of mechanical ventilation (p = 0.008). There was a negative correlation between 25OHD and C-reactive protein (CRP): each 0.1% decrease in 25OHD increased CRP (p = 0.04). Children admitted to the PICU with suspected sepsis had lower 25OHD than controls and inadequate 25OHD status was associated with confirmed sepsis and poor outcomes. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  15. 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.

  16. Associations between inadequate knee function detected by KOOS and prospective graft failure in an anterior cruciate ligament-reconstructed knee.

    Science.gov (United States)

    Granan, Lars-Petter; Baste, Valborg; Engebretsen, Lars; Inacio, Maria C S

    2015-04-01

    First, to evaluate whether the 2 year post-operative Knee injury and Osteoarthritis Outcome Score (KOOS) in primary anterior cruciate ligament reconstructions (ACLRs) was significantly different between patients that did not go on to have a subsequent revision after the 2 year post-operative control and the ones that did. Second, to test whether the "clinically failure" value of KOOS quality of life (QoL) < 44 was indicative of a clinically relevant difference in the risk of subsequent revision ACLR. ACLRs reported to the Norwegian Knee Ligament Registry between June 2004 and December 2009. 5,517 primary ACLRs with at least 2-year follow-up with KOOS QoL before revision surgery. There were clinically significant differences, adjusted and unadjusted, in both the KOOS Sport and Recreation and QoL subscales in patients with a later revision surgery compared to those that did not have a revision surgery. In adjusted models, the risk of later ACLR revision was 3.7 (95 % CI 2.2-6.0) higher in patients with a 2-year KOOS QoL < 44 compared to patients with a KOOS QoL ≥ 44. For every 10-point reduction in the KOOS QoL, a 33.6 % (95 % CI 21.2-47.5 %) higher risk for later ACLR revision was observed. This study reveals an association between inadequate knee function, as measured by KOOS, and a prospective ACL-reconstructed graft failure. Prognostic study (prospective cohort study), Level II.

  17. 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 (Pachievement of Japanese 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

  18. Improving access to shared decision-making for Hispanics/Latinos with inadequately controlled type 2 diabetes mellitus.

    Science.gov (United States)

    Davidson, Jaime A; Rosales, Aracely; Shillington, Alicia C; Bailey, Robert A; Kabir, Chris; Umpierrez, Guillermo E

    2015-01-01

    To describe the cultural and linguistic adaptation and Spanish translation of an English-language patient decision aid (PDA) for use in supporting shared decision-making in Hispanics/Latinos with type 2 diabetes mellitus (T2DM), a group at a high risk for complications. A steering committee of endocrinologists, a primary care physician, a certified diabetes educator, and a dietician, each with extensive experience in providing care to Hispanics/Latinos was convened to assess a PDA developed for English-speaking patients with T2DM. English content was reviewed for cultural sensitivity and appropriateness for a Hispanic/Latino population. A consensus-building process and iterative version edits incorporated clinician perspectives. The content was adapted to be consistent with traditional Hispanic/Latino cultural communication precepts (eg, avoidance of hostile confrontation; value for warm interaction; respect for authority; value of family support for decisions). The PDA was translated by native-speaking individuals with diabetes expertise. The PDA underwent testing during cognitive interviews with ten Spanish-speaking Hispanics/Latinos with T2DM to ensure that the content is reflective of the experience, understanding, and language Hispanic/Latino patients use to describe diabetes and treatment. Content edits were made to assure a literacy level appropriate to the audience, and the PDA was produced for online video dissemination. High-quality, well-developed tools to facilitate shared decision-making in populations with limited access to culturally sensitive information can narrow gaps and align care with individual patient preferences. A newly developed PDA is available for shared decision-making that provides culturally appropriate treatment information for inadequately controlled Hispanics/Latinos with T2DM. The impact on the overall health of patients and care management of T2DM requires further study.

  19. Low vitamin D deficiency in Irish toddlers despite northerly latitude and a high prevalence of inadequate intakes.

    Science.gov (United States)

    Ní Chaoimh, Carol; McCarthy, Elaine K; Hourihane, Jonathan O'B; Kenny, Louise C; Irvine, Alan D; Murray, Deirdre M; Kiely, Mairead E

    2018-03-01

    While reports of inadequate vitamin D intakes among young children are widespread, data on the prevalence of vitamin D deficiency are inconsistent. We aimed to quantify vitamin D intake and serum 25-hydroxyvitamin D [25(OH)D] concentrations in children aged 2 years in the prospective Cork BASELINE Birth Cohort Study. Serum 25(OH)D was analysed using UPLC-MS/MS in 741 children living in Cork, Ireland (51°N). Two-day weighed food diaries were collected in 467 children, and 294 provided both a blood sample and a food diary. Mean (SD) 25(OH)D concentrations were 63.4 (20.4) nmol/L [winter: 54.5 (19.9), summer: 71.2 (17.5)]. The prevalence of vitamin D deficiency (D intake of 3.5 (3.1) µg/day, 96% had intakes below 10 µg/day, the current IOM estimated average requirement and the SACN safe intake value for this age group. After adjustment for season, vitamin D intake (µg/day) was associated with higher 25(OH)D concentrations [adjusted estimate (95% CI) 2.5 (1.9, 3.1) nmol/L]. Children who did not consume vitamin D-fortified foods or supplements had very low vitamin D intakes (1.2 (0.9) µg/day), and during winter, 12 and 77% were D status during winter, especially among children who did not consume fortified foods or nutritional supplements. Our data indicate the need for dietary strategies to increase vitamin D intakes in this age group. This report provides further evidence that DRVs for vitamin D should be based on experimental data in specific population groups and indicates the need for dose-response RCTs in young children.

  20. Current V3 genotyping algorithms are inadequate for predicting X4 co-receptor usage in clinical isolates.

    Science.gov (United States)

    Low, Andrew J; Dong, Winnie; Chan, Dennison; Sing, Tobias; Swanstrom, Ronald; Jensen, Mark; Pillai, Satish; Good, Benjamin; Harrigan, P Richard

    2007-09-12

    Integrating CCR5 antagonists into clinical practice would benefit from accurate assays of co-receptor usage (CCR5 versus CXCR4) with fast turnaround and low cost. Published HIV V3-loop based predictors of co-receptor usage were compared with actual phenotypic tropism results in a large cohort of antiretroviral naive individuals to determine accuracy on clinical samples and identify areas for improvement. Aligned HIV envelope V3 loop sequences (n = 977), derived by bulk sequencing were analyzed by six methods: the 11/25 rule; a neural network (NN), two support vector machines, and two subtype-B position specific scoring matrices (PSSM). Co-receptor phenotype results (Trofile Co-receptor Phenotype Assay; Monogram Biosciences) were stratified by CXCR4 relative light unit (RLU) readout and CD4 cell count. Co-receptor phenotype was available for 920 clinical samples with V3 genotypes having fewer than seven amino acid mixtures (n = 769 R5; n = 151 X4-capable). Sensitivity and specificity for predicting X4 capacity were evaluated for the 11/25 rule (30% sensitivity/93% specificity), NN (44%/88%), PSSM(sinsi) (34%/96%), PSSM(x4r5) (24%/97%), SVMgenomiac (22%/90%) and SVMgeno2pheno (50%/89%). Quantitative increases in sensitivity could be obtained by optimizing the cut-off for methods with continuous output (PSSM methods), and/or integrating clinical data (CD4%). Sensitivity was directly proportional to strength of X4 signal in the phenotype assay (P < 0.05). Current default implementations of co-receptor prediction algorithms are inadequate for predicting HIV X4 co-receptor usage in clinical samples, particularly those X4 phenotypes with low CXCR4 RLU signals. Significant improvements can be made to genotypic predictors, including training on clinical samples, using additional data to improve predictions and optimizing cutoffs and increasing genotype sensitivity.

  1. 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.

  2. 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

  3. 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)

  4. Eye Protection

    OpenAIRE

    Pashby, Tom

    1986-01-01

    Eye injuries frequently occur in the home, at work and at play. Many result in legally blind eyes, and most are preventable. Awareness of potential hazards is essential to preventing eye injuries, particularly in children. In addition, protective devices must be used appropriately. We have developed eye protectors that have proved effective in reducing both the overall incidence and the severity of sports eye injuries.

  5. [Cerebral protection].

    Science.gov (United States)

    Cattaneo, A D

    1993-09-01

    Cerebral protection means prevention of cerebral neuronal damage. Severe brain damage extinguishes the very "human" functions such as speech, consciousness, intellectual capacity, and emotional integrity. Many pathologic conditions may inflict injuries to the brain, therefore the protection and salvage of cerebral neuronal function must be the top priorities in the care of critically ill patients. Brain tissue has unusually high energy requirements, its stores of energy metabolites are small and, as a result, the brain is totally dependent on a continuous supply of substrates and oxygen, via the circulation. In complete global ischemia (cardiac arrest) reperfusion is characterized by an immediate reactive hyperemia followed within 20-30 min by a delayed hypoperfusion state. It has been postulated that the latter contributes to the ultimate neurologic outcome. In focal ischemia (stroke) the primary focus of necrosis is encircled by an area (ischemic penumbra) that is underperfused and contains neurotoxic substances such as free radicals, prostaglandins, calcium, and excitatory neurotransmitters. The variety of therapeutic effort that have addressed the question of protecting the brain reflects their limited success. 1) Barbiturates. After an initial enthusiastic endorsement by many clinicians and years of vigorous controversy, it can now be unequivocally stated that there is no place for barbiturate therapy following resuscitation from cardiac arrest. One presumed explanation for this negative statement is that cerebral metabolic suppression by barbiturates (and other anesthetics) is impossible in the absence of an active EEG. Conversely, in the event of incomplete ischemia EEG activity in usually present (albeit altered) and metabolic suppression and hence possibly protection can be induced with barbiturates. Indeed, most of the animal studies led to a number of recommendations for barbiturate therapy in man for incomplete ischemia. 2) Isoflurane. From a cerebral

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

    Science.gov (United States)

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

    2016-01-01

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

  7. 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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  10. 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.

  11. Improving access to shared decision-making for Hispanics/Latinos with inadequately controlled type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Davidson JA

    2015-04-01

    -quality, well-developed tools to facilitate shared decision-making in populations with limited access to culturally sensitive information can narrow gaps and align care with individual patient preferences. A newly developed PDA is available for shared decision-making that provides culturally appropriate treatment information for inadequately controlled Hispanics/Latinos with T2DM. The impact on the overall health of patients and care management of T2DM requires further study.Keywords: patient decision aid, language adaptation, Hispanic, decision making, type 2 diabetes

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

    Science.gov (United States)

    Girma, Meseret; Yaya, Yaliso; Gebrehanna, Ewenat; Berhane, Yemane; Lindtjørn, Bernt

    2013-11-04

    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.

  13. Efficacy and safety of tofacitinib following inadequate response to conventional synthetic or biological disease-modifying antirheumatic drugs.

    Science.gov (United States)

    Charles-Schoeman, Christina; Burmester, Gerd; Nash, Peter; Zerbini, Cristiano A F; Soma, Koshika; Kwok, Kenneth; Hendrikx, Thijs; Bananis, Eustratios; Fleischmann, Roy

    2016-07-01

    Biological disease-modifying antirheumatic drugs (bDMARDs) have shown diminished clinical response following an inadequate response (IR) to ≥1 previous bDMARD. Here, tofacitinib was compared with placebo in patients with an IR to conventional synthetic DMARDs (csDMARDs; bDMARD-naive) and in patients with an IR to bDMARDs (bDMARD-IR). Data were taken from phase II and phase III studies of tofacitinib in patients with rheumatoid arthritis (RA). Patients received tofacitinib 5 or 10 mg twice daily, or placebo, as monotherapy or with background methotrexate or other csDMARDs. Efficacy endpoints and incidence rates of adverse events (AEs) of special interest were assessed. 2812 bDMARD-naive and 705 bDMARD-IR patients were analysed. Baseline demographics and disease characteristics were generally similar between treatment groups within subpopulations. Across subpopulations, improvements in efficacy parameters at month 3 were generally significantly greater for both tofacitinib doses versus placebo. Clinical response was numerically greater with bDMARD-naive versus bDMARD-IR patients (overlapping 95% CIs). Rates of safety events of special interest were generally similar between tofacitinib doses and subpopulations; however, patients receiving glucocorticoids had more serious AEs, discontinuations due to AEs, serious infection events and herpes zoster. Numerically greater clinical responses and incidence rates of AEs of special interest were generally reported for tofacitinib 10 mg twice daily versus tofacitinib 5 mg twice daily (overlapping 95% CIs). Tofacitinib demonstrated efficacy in both bDMARD-naive and bDMARD-IR patients with RA. Clinical response to tofacitinib was generally numerically greater in bDMARD-naive than bDMARD-IR patients. The safety profile appeared similar between subpopulations. (NCT00413660, NCT00550446, NCT00603512, NCT00687193, NCT00960440, NCT00847613, NCT00814307, NCT00856544, NCT00853385). Published by the BMJ Publishing Group Limited

  14. Patient- and population-level health consequences of discontinuing antiretroviral therapy in settings with inadequate HIV treatment availability

    Directory of Open Access Journals (Sweden)

    Kimmel April D

    2012-09-01

    stable. Conclusions In settings with inadequate HIV treatment availability, trade-offs emerge between maximizing outcomes for individual patients already on treatment and ensuring access to treatment for all people who may benefit. While individuals may derive some benefit from ART even after virologic failure, the aggregate public health benefit is maximized by providing effective therapy to the greatest number of people. These trade-offs should be explicit and transparent in antiretroviral policy decisions.

  15. 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

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

    Science.gov (United States)

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

    2014-01-01

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

  17. 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.

  18. 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

  19. Radiation protection

    International Nuclear Information System (INIS)

    Kamalaksh Shenoy, K.

    2013-01-01

    Three main pillars underpin the IAEA's mission: Safety and Security - The IAEA helps countries to upgrade their infrastructure for nuclear and radiation safety and security, and to prepare for and respond to emergencies. Work is keyed to international conventions, the development of international standards and the application of these standards. The aim is to protect people and the environment from the harmful effects of exposure to ionizing radiation. Science and Technology - The IAEA is the world's focal point for mobilizing peaceful applications of nuclear science and technology for critical needs in developing countries. The work contributes to alleviating poverty, combating disease and pollution of the environment and to other goals of sustainable development. Safeguards and Verification - The IAEA is the nuclear inspectorate, with more than four decades of verification experience. Inspectors work to verify that nuclear material and activities are not diverted towards military purposes. Quantities and Units: Dose equivalent is the product of absorbed dose of radiation and quality factor (Q). For absorbed dose in rads, dose equivalent is in rems. If absorbed dose is in gray, the dose equivalent is in sievert. Quality factor is defined without reference to any particular biological end point. Quality factors are recommended by committees such as the International Commission on Radiological Protection (ICRP) or the National Council on Radiation Protection and Measurements (NCRP), based on experimental RBE values but with some judgment exercised. Effective Dose Equivalent: It is the sum of the weighted dose equivalents for all irradiated tissues, in which the weighting factors represent the different risks of each tissue to mortality from cancer and hereditary effects. Committed dose equivalent: It is the integral over 50 years of dose equivalent following the intake of a radionuclide. Collective effective dose equivalent: It is a quantity for a population and is

  20. 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.

  1. Food protection

    International Nuclear Information System (INIS)

    Gummer, Selwyn; Campbell-Savours, D.N.; Maxwell-Hyslop, R.

    1987-01-01

    The motion is to consolidate the Food Protection (Emergency Prohibitions) (England) (No 2) Order 1987 and seven subsequent amendment orders, into one order. The orders are those under which restrictions on the movement of sheep as a result of the Chernobyl accident are carried out. A debate lasting more than two hours followed and this is reported verbatim. Much of the early part of the debate concerns a telex message allegedly from the chief scientist of the radiochemical institute saying that meat contaminated by radiation after Chernobyl was sold in Britain. Both the source and the content of the telex were found not to be as alleged. In particular, the allegation that 10kg lambs had gone to market. The minister pointed out that these lambs were not big enough to be sold. The debate broadened into a more general discussion as to levels of contamination in sheep and the government diligence or otherwise in protecting the public. The motion was agreed to. (U.K.)

  2. Radiation protection and environmental protection

    International Nuclear Information System (INIS)

    Xie Zi; Dong Liucan; Zhang Yongxing

    1994-01-01

    A collection of short papers is presented which review aspects of research in radiation and environmental protection carried out by the Chinese Institute of Atomic Energy in 1991. The topics covered are: the analysis of Po 210 in the gaseous effluent of coal-fired boilers; the determination of natural radionuclide levels in various industrial waste slags and management countermeasures; assessment of the collective radiation dose from natural sources for the Chinese population travelling by water; the preliminary environmental impact report for the multipurpose heavy water research reactor constructed by China for the Islamic Republic of Algeria. (UK)

  3. 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)

  4. 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)

  5. Protecting Democracy

    DEFF Research Database (Denmark)

    Galster, Kjeld

    2007-01-01

    of a democratic state as defence per se is to its government. Democratic governance rests on the mutual dependence and influence of leadership and led, and the practical function subsumes professional bureaucracies. Thus, defence debate is the exchange of views on matters important to national security amongst...... the democratically elected leadership, the public, and the defence bureaucracy’s professional experts. Defence debate is a decisive contributor to defence policy and it normally includes quantitative issues like the size of military forces and the proportion of the state’s resources devoted to the armed forces......ABSTRACT Galster, Kjeld Hald. Doctoral Student (History). Saxo Institute. May 2007. Protecting Democracy: Danish Defence Debate in Times of Change. Supervisor: Professor, Dr. Gunner Lind. Democratic debate on defence and democratic organisation of the forces are as central to the life...

  6. 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.

  7. 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.

  8. Cathodic protection for the bottoms of above ground storage tanks

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-07-01

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

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

    African Journals Online (AJOL)

    2013-03-04

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

  10. 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 ...

  11. What should I tell my patient? Disclosure in anaesthesiology ...

    African Journals Online (AJOL)

    information that is highly technical and difficult to understand, ... sense thereof by relating new information to their unique frames of .... e.g. when discussing repairs to a motor car or appliance. ..... read-the-journal/all-issues/2010-2019/2015/.

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

    African Journals Online (AJOL)

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

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

    Science.gov (United States)

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

    2018-01-01

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

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

    Science.gov (United States)

    2012-01-01

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

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Yamaguchi Rin

    2012-05-01

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

  18. 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

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

    Directory of Open Access Journals (Sweden)

    H. L. Sithole

    2009-12-01

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

  20. 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

  1. 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.

  2. 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

  3. Radiation protection principles

    International Nuclear Information System (INIS)

    Ismail Bahari

    2007-01-01

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

  4. 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.

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

    Science.gov (United States)

    Umpierrez, Guillermo; Issa, Maher; Vlajnic, Aleksandra

    2006-04-01

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

  6. [Light protection: principles of UV protection].

    Science.gov (United States)

    Stege, H; Mang, R

    2006-05-01

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

  7. 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...

  8. 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…

  9. 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

  10. 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.

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

    Science.gov (United States)

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

    2017-09-01

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

  12. Environmental protection economically viable

    International Nuclear Information System (INIS)

    Dartsch, B.; Hildebrandt, T.

    1994-01-01

    The Environmental Technology Forum for Industry and Research (Utech) was held for the fifth time this year at the International Congress Centre in Berlin. The main themes of this year's Utech were additive environmental protection, production-integrated environmental protection, management and economic aspects of environmental protection, research and development in environmental protection as well as environmental information legislation. (orig.) [de

  13. 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

  14. Operational radiation protection and radiation protection training

    International Nuclear Information System (INIS)

    Kraus, W.

    1989-01-01

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

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

    OpenAIRE

    NIKOLIĆ N.; GAJOVIĆ A.; PAUNOVIĆ V.

    2015-01-01

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

  16. 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.

  17. 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.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  19. Radiation. Protection. Health. Proceedings

    International Nuclear Information System (INIS)

    Hajek, Michael; Maringer, Franz Josef; Steurer, Andreas; Schwaiger, Martina; Timal, Guenter

    2015-01-01

    The topics of the meeting are the diagnostic and therapeutic application of ionizing radiations, the application of radiation in research, industry and engineering and radiation protection. The volume includes the following chapters: Radiation protection and society, radiation protection infrastructure, population and environment, metrology and measuring techniques, 1. Workshop on population and environment, NORM and radon, 2. Update: dose - extent of damage - limiting value definition, radiation protection for personnel (except medicine), radiation protection in medicine.

  20. Loft fire protection

    International Nuclear Information System (INIS)

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

    1980-01-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Science.gov (United States)

    Forst, Thomas; Koch, Cornelia; Dworak, Markus

    2015-06-01

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

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

    Science.gov (United States)

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

    2014-05-01

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

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  6. 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.

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

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

    2016-08-12

    Aug 12, 2016 ... The issue LSLAs raise a number of concerns regarding compensation, including ... at a meeting with traders in Lamu, Kenya, where a new port is planned. ... compensation and a fair share of benefits and risks in land deals.

  8. 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.

  9. 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.

  10. Solving the Upper Valley's housing needs: how a coalition of public and private organizations joined forces to develop housing in a region with inadequate stock and prohibitive prices

    OpenAIRE

    Dan French

    2004-01-01

    Like many communities, New Hampshire and Vermont's Upper Valley region is facing a serious housing shortage. Dan French reveals how an innovative housing coalition is working to find solutions that provide housing and protect the area's quality of life.

  11. 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...

  12. 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 ...

  13. 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)

  14. Cathodic protection -- Rectifier 46

    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 on the Hanford Reservation. The tank farms store radioactive waste

  15. Healthy Watersheds Protection

    Science.gov (United States)

    ... for restoring areas with degraded water quality, as well as protecting healthy waters from emerging problems before expensive damages occur. ... exclusively on restoring impaired waters, EPA created the Healthy ... more emphasis to proactively protecting high quality waters, following the ...

  16. 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

  17. 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.

  18. Effects of vildagliptin versus saxagliptin on daily acute glucose fluctuations in Chinese patients with T2DM inadequately controlled with a combination of metformin and sulfonylurea.

    Science.gov (United States)

    Xiaoyan, Chen; Jing, Wang; Xiaochun, Huang; Yuyu, Tan; Shunyou, Deng; Yingyu, Fu

    2016-06-01

    Objective The present study aimed to compare the effects of the dipeptidyl peptidase-4 (DPP-4) inhibitors vildagliptin and saxagliptin on 24 hour acute glucose fluctuations in Chinese patients with type 2 diabetes mellitus (T2DM) inadequately controlled with a combination of metformin and sulfonylurea. Research design and methods This was a 24 week, prospective, randomized, open-label, active-controlled study. Patients (N = 73) with T2DM who had inadequate glycemic control (HbA1c 7.0%-10.0%) with a stable dosage of metformin plus gliclazide for more than 3 months were randomized to receive either vildagliptin 50 mg twice daily (BID, n = 37) or saxagliptin 5 mg once daily (QD, n = 36). Change in mean amplitude of glycemic excursions (MAGE) was assessed at the end of 24 weeks. Results At baseline, the mean (±SD) age was 62.9 ± 6.55 years, disease duration was 7.0 ± 2.33 years, and HbA1c was 8.4 ± 0.68%. After 24 weeks of treatment, the MAGE decreased from 5.81 ± 1.16 mmol/L to 4.06 ± 0.86 mmol/L (pvildagliptin group and from 5.66 ± 1.14 mmol/L to 4.79 ± 1.25 mmol/L (p = 0.003) in the saxagliptin group. The mean change in MAGE in the vildagliptin group was significantly greater than that in the saxagliptin group (1.74 ± 0.48 mmol/L vs. 0.87 ± 0.40 mmol/L, pvildagliptin and saxagliptin groups, was 1.22 ± 0.40% and 1.07 ± 0.36%, respectively, with no significant difference between the groups (p = 0.091). The overall safety and tolerability of vildagliptin and saxagliptin were similar. The limitations of the study were a small number of patients and open-label administration of the study drug. Conclusion Vildagliptin produced a significantly greater reduction in acute glucose fluctuations compared with saxagliptin when added to a dual combination of metformin and sulfonylurea in Chinese patients with T2DM. Chinese clinical trial registration number ChiCTR-TRC-13003858.

  19. Tofacitinib 5 mg Twice Daily in Patients with Rheumatoid Arthritis and Inadequate Response to Disease-Modifying Antirheumatic Drugs: A Comprehensive Review of Phase 3 Efficacy and Safety.

    Science.gov (United States)

    Bird, Paul; Bensen, William; El-Zorkany, Bassel; Kaine, Jeffrey; Manapat-Reyes, Bernadette Heizel; Pascual-Ramos, Virginia; Witcombe, David; Soma, Koshika; Zhang, Richard; Thirunavukkarasu, Krishan

    2018-05-24

    Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). We performed a comprehensive review of phase 3 studies of tofacitinib 5 mg twice daily (BID) (approved dose in many countries) in patients with moderate to severe RA and inadequate response to prior disease-modifying antirheumatic drugs. A search of PubMed and ClinicalTrials.gov identified 5 studies: ORAL Solo (NCT00814307), ORAL Sync (NCT00856544), ORAL Standard (included adalimumab 40 mg once every 2 weeks; NCT00853385), ORAL Scan (NCT00847613), and ORAL Step (NCT00960440). Efficacy and safety data for tofacitinib 5 mg BID, placebo, and adalimumab were analyzed. Across the 5 studies, 1216 patients received tofacitinib 5 mg BID, 681 received placebo, and 204 received adalimumab. At month 3, tofacitinib demonstrated significantly higher 20%, 50%, and 70% improvement in American College of Rheumatology response criteria (ACR20, ACR50, and ACR70, respectively) response rates, greater improvement in Health Assessment Questionnaire-Disability Index, and a higher proportion of Disease Activity Score-defined remission than placebo. Frequencies of adverse events (AEs), serious AEs, and discontinuations due to AEs were similar for tofacitinib and placebo at month 3; serious infection events were more frequent for tofacitinib. In ORAL Standard, although not powered for formal comparisons, tofacitinib and adalimumab had numerically similar efficacy and AEs; serious AEs and serious infection events were more frequent with tofacitinib. Tofacitinib 5 mg BID reduced RA signs and symptoms and improved physical function versus placebo in patients with inadequate response to prior disease-modifying antirheumatic drugs. Tofacitinib 5 mg BID had a consistent, manageable safety profile across studies, with no new safety signals identified.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where

  20. 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

  1. Machine protection systems

    CERN Document Server

    Macpherson, A L

    2010-01-01

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

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

    Science.gov (United States)

    ... and Research Centers 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 ...

  3. Protective Behavior in Games

    OpenAIRE

    Fiestras-Janeiro, G.; Borm, P.E.M.; van Megen, F.J.C.

    1996-01-01

    This paper introduces the notion of protective equilibrium in the context of fin ite games in strategic form.It shows that for matrix games the set of protective equilibria equals the set of proper equilibria.Moreover, in the context of bima trix games, the notion of protective behaviour is used as a refinement tool.

  4. Protective Behavior in Games

    NARCIS (Netherlands)

    Fiestras-Janeiro, G.; Borm, P.E.M.; van Megen, F.J.C.

    1996-01-01

    This paper introduces the notion of protective equilibrium in the context of fin ite games in strategic form.It shows that for matrix games the set of protective equilibria equals the set of proper equilibria.Moreover, in the context of bima trix games, the notion of protective behaviour is used as

  5. 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.

  6. Ozone Layer Protection

    Science.gov (United States)

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

  7. Designing physical protection technology for insider protection

    International Nuclear Information System (INIS)

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

    1986-01-01

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

  8. 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.

  9. 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.

  10. Effects of Pathologic Stage on the Learning Curve for Radical Prostatectomy: Evidence That Recurrence in Organ-Confined Cancer Is Largely Related to Inadequate Surgical Technique

    Science.gov (United States)

    Vickers, Andrew J.; Bianco, Fernando J.; Gonen, Mithat; Cronin, Angel M.; Eastham, James A.; Schrag, Deborah; Klein, Eric A.; Reuther, Alwyn M.; Kattan, Michael W.; Pontes, J. Edson; Scardino, Peter T.

    2008-01-01

    Objectives We previously demonstrated that there is a learning curve for open radical prostatectomy. We sought to determine whether the effects of the learning curve are modified by pathologic stage. Methods The study included 7765 eligible prostate cancer patients treated with open radical prostatectomy by one of 72 surgeons. Surgeon experience was coded as the total number of radical prostatectomies conducted by the surgeon prior to a patient’s surgery. Multivariable regression models of survival time were used to evaluate the association between surgeon experience and biochemical recurrence, with adjustment for PSA, stage, and grade. Analyses were conducted separately for patients with organ-confined and locally advanced disease. Results Five-year recurrence-free probability for patients with organ-confined disease approached 100% for the most experienced surgeons. Conversely, the learning curve for patients with locally advanced disease reached a plateau at approximately 70%, suggesting that about a third of these patients cannot be cured by surgery alone. Conclusions Excellent rates of cancer control for patients with organ-confined disease treated by the most experienced surgeons suggest that the primary reason such patients recur is inadequate surgical technique. PMID:18207316

  11. 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.

  12. 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

  13. 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

  14. 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)

  15. 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.

  16. 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

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

    Science.gov (United States)

    Siewiera, Jacek; Trnka, Jakub; Kübler, Andrzej

    2014-01-01

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

  18. 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

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

    Science.gov (United States)

    Eichner, Maxine

    2008-08-04

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

  20. 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.

  1. 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.

  2. 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...

  3. Protection of hydrological heritage sites of Serbia: Problems and perspectives

    Directory of Open Access Journals (Sweden)

    Simić Sava

    2012-01-01

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

  4. Resilience from coastal protection.

    Science.gov (United States)

    Ewing, Lesley C

    2015-10-28

    Coastal areas are important residential, commercial and industrial areas; but coastal hazards can pose significant threats to these areas. Shoreline/coastal protection elements, both built structures such as breakwaters, seawalls and revetments, as well as natural features such as beaches, reefs and wetlands, are regular features of a coastal community and are important for community safety and development. These protection structures provide a range of resilience to coastal communities. During and after disasters, they help to minimize damages and support recovery; during non-disaster times, the values from shoreline elements shift from the narrow focus on protection. Most coastal communities have limited land and resources and few can dedicate scarce resources solely for protection. Values from shore protection can and should expand to include environmental, economic and social/cultural values. This paper discusses the key aspects of shoreline protection that influence effective community resilience and protection from disasters. This paper also presents ways that the economic, environmental and social/cultural values of shore protection can be evaluated and quantified. It presents the Coastal Community Hazard Protection Resilience (CCHPR) Index for evaluating the resilience capacity to coastal communities from various protection schemes and demonstrates the use of this Index for an urban beach in San Francisco, CA, USA. © 2015 The Author(s).

  5. Certolizumab Pegol for Treating Rheumatoid Arthritis Following Inadequate Response to a TNF-α Inhibitor: An Evidence Review Group Perspective of a NICE Single Technology Appraisal.

    Science.gov (United States)

    Bermejo, Iñigo; Stevenson, Matt; Archer, Rachel; Stevens, John W; Goka, Edward; Clowes, Mark; Scott, David L; Young, Adam

    2017-11-01

    As part of its single technology appraisal (STA) process, the National Institute for Health and Care Excellence (NICE) invited the manufacturer (UCB Pharma) of certolizumab pegol (CZP; Cimzia ® ) to submit evidence of its clinical and cost effectiveness for the treatment of rheumatoid arthritis (RA) following inadequate response to a tumour necrosis factor-α inhibitor (TNFi). The School of Health and Related Research Technology Appraisal Group at the University of Sheffield was commissioned to act as the independent Evidence Review Group (ERG). The ERG produced a detailed review of the evidence for the clinical and cost effectiveness of the technology, based upon the company's submission to NICE. The clinical effectiveness evidence in the company's submission for CZP was based predominantly on six randomised controlled trials (RCTs) comparing the efficacy of CZP against placebo. The clinical effectiveness review identified no head-to-head evidence on the efficacy of CZP against the comparators within the scope; therefore, the company performed a network meta-analysis (NMA). The company's NMA concluded that CZP had a similar efficacy to that of its comparators. The company submitted a Markov model that assessed the incremental cost effectiveness of CZP versus comparator biologic disease-modifying antirheumatic drugs (bDMARDs) for the treatment of RA from the perspective of the National Health Service for three decision problems, each of which followed an inadequate response to a TNFi. These were (1) a comparison against rituximab (RTX) in combination with methotrexate (MTX); (2) a comparison against bDMARDs when RTX was contraindicated or withdrawn due to an adverse event; and (3) a comparison against bDMARDs when MTX was contraindicated or withdrawn due to an adverse event. Results from the company's economic evaluation showed that CZP resulted in a similar number of quality-adjusted life years (QALYs) produced at similar or lower costs compared with comparator b

  6. 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

  7. 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.

  8. 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.

  9. Baricitinib in Patients with Rheumatoid Arthritis and an Inadequate Response to Conventional Disease-Modifying Antirheumatic Drugs in United States and Rest of World: A Subset Analysis.

    Science.gov (United States)

    Wells, Alvin F; Greenwald, Maria; Bradley, John D; Alam, Jahangir; Arora, Vipin; Kartman, Cynthia E

    2018-06-01

    This article evaluates the efficacy and safety of baricitinib 4 mg versus placebo in United States including Puerto Rico (US) and rest of the world (ROW) subpopulations using data pooled from RA-BEAM and RA-BUILD, which enrolled patients with moderate-to-severe adult-onset rheumatoid arthritis (RA). In RA-BEAM, patients with an inadequate response (IR) to methotrexate, at least one X-ray erosion, and high sensitivity C-reactive protein (hsCRP) ≥ 6 mg/L were randomized to placebo or orally administered baricitinib 4 mg daily or subcutaneously administered adalimumab 40 mg every other week. In RA-BUILD, patients with an IR to at least one conventional synthetic disease-modifying antirheumatic drug (csDMARD) and with hsCRP ≥ 3.6 mg/L were randomized to placebo or baricitinib 2 or 4 mg daily. Patients in both trials were biologic naive. In this post hoc analysis, data from both studies were pooled (714 baricitinib 4 mg-treated, 716 placebo-treated patients). Overall, 188 US and 1242 ROW patients were included. Subgroups differed in baseline characteristics including race, weight, age, time since RA diagnosis, current corticosteroid use, and previous csDMARD use. At weeks 12 and 24, baricitinib-treated patients had larger responses compared to placebo-treated patients for multiple efficacy outcomes: American College of Rheumatology 20/50/70 response, low disease activity, remission, Disease Activity Score 28-C-reactive protein, and Health Assessment Questionnaire-Disability Index. Overall, similar efficacy was observed in US and ROW subgroups with no notable safety differences between subgroups at weeks 12 or 24. Baricitinib 4 mg was efficacious compared to placebo in US and ROW subpopulations. Safety was similar between subgroups. Eli Lilly & Company and Incyte Corporation. ClinicalTrials.gov identifiers, NCT01721057; NCT01710358.

  10. 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.

  11. 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.

  12. 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.

  13. Cystadenocarcinoma of the minor salivary gland arising in the upper lip: A surgical case of an inadequate cytology specimen hampering conclusive diagnosis

    Directory of Open Access Journals (Sweden)

    Takuya Yoshimura

    2017-09-01

    Full Text Available Cystadenocarcinoma (CAC of the salivary gland poses a diagnostic challenge to us, as this uncommon entity is extremely difficult to diagnose pre-operatively on an inadequate sample. However, markedly few papers have described the cytological features of CAC. An 82-year-old male presented with a history of a gradual increase in size and occasional mucous drainage from a swollen reddish nodule on the right upper lip. A retrospective examination of the cytological specimens from the drainage revealed a small number of clusters and scattered single cells of severely degenerated and mildly atypical epithelial cells with hyperchromatic dense nuclei and abundant clear cytoplasm, in a background of a large amount of mucinous material. We first interpreted this finding merely as the presence of atypical cells. However, a gross examination revealed a non-capsulated and relatively well-demarcated cystic lesion, grayish to whitish in color and measuring 13 × 9 mm in diameter, filled with mucin. A microscopic examination showed that the tumor had a central cystic cavity filled with mucinous material and was predominantly composed of the papillary proliferation of atypical columnar mucous epithelial cells with enlarged hyperchromatic nuclei, mixed with mitotic hot spots often projecting and melting into the mucinous cystic lumen, and focally involving the surrounding connective tissue. Therefore, we ultimately made a diagnosis of CAC of the minor salivary gland arising in the upper lip. Given the characteristic features of CAC, cytopathologists should be able to correctly diagnose this lesion based on multiple adequate fine needle aspiration samples.

  14. 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.

  15. 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.

  16. 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

  17. 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

  18. 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

  19. 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)

  20. Gonad protection in young orthopaedic patients.

    Science.gov (United States)

    Kenny, N; Hill, J

    1992-05-30

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

  1. Emergency Protection from Aerosols

    Energy Technology Data Exchange (ETDEWEB)

    Cristy, G.A.

    2001-11-13

    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.

  2. 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

  3. Protecting genetic privacy.

    Science.gov (United States)

    Roche, P A; Annas, G J

    2001-05-01

    This article outlines the arguments for and against new rules to protect genetic privacy. We explain why genetic information is different to other sensitive medical information, why researchers and biotechnology companies have opposed new rules to protect genetic privacy (and favour anti-discrimination laws instead), and discuss what can be done to protect privacy in relation to genetic-sequence information and to DNA samples themselves.

  4. 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

  5. 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)

  6. 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...

  7. DOE groundwater protection strategy

    International Nuclear Information System (INIS)

    Lichtman, S.

    1988-01-01

    EH is developing a DOE-wide Groundwater Quality Protection Strategy to express DOE's commitment to the protection of groundwater quality at or near its facilities. This strategy responds to a September 1986 recommendation of the General Accounting Office. It builds on EPA's August 1984 Ground-Water Protection Strategy, which establishes a classification system designed to protect groundwater according to its value and vulnerability. The purposes of DOE's strategy are to highlight groundwater protection as part of current DOE programs and future Departmental planning, to guide DOE managers in developing site-specific groundwater protection practices where DOE has discretion, and to guide DOE's approach to negotiations with EPA/states where regulatory processes apply to groundwater protection at Departmental facilities. The strategy calls for the prevention of groundwater contamination and the cleanup of groundwater commensurate with its usefulness. It would require long-term groundwater protection with reliance on physical rather than institutional control methods. The strategy provides guidance on providing long-term protection of groundwater resources; standards for new remedial actions;guidance on establishing points of compliance; requirements for establishing classification review area; and general guidance on obtaining variances, where applicable, from regulatory requirements. It also outlines management tools to implement this strategy

  8. 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)

  9. 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

  10. Complete rerouting protection

    DEFF Research Database (Denmark)

    Stidsen, Thomas K.; Kjærulff, Peter

    2006-01-01

    Protection of communication against network failures is becoming increasingly important and in this paper we present the most capacity efficient protection method possible, the complete rerouting protection method, when requiring that all communication should be restored in case of a single link...... network failure. We present a linear programming model of the protection method and a column generation algorithm. For 6 real world networks, the minimal restoration overbuild network capacity is between 13% and 78%. We further study the importance of the density of the network, derive analytical bounds...

  11. Techniques in cerebral protection.

    Science.gov (United States)

    Fanelli, Fabrizio; Bezzi, Mario; Boatta, Emanuele; Passariello, Roberto

    2006-10-01

    Carotid angioplasty and stenting is a valid alternative option to conventional carotid endarterectomy in the treatment of carotid artery stenosis. During the stenting process, however, distal embolization can occur with neurological consequences. To avoid this, cerebral protection devices have been introduced. Three principal types of protection system have been developed: distal balloon occlusion, distal filters and proximal protection with or without reversal of flow. As protection devices became the focus of interest by manufactures and physicians, several trials are going on worldwide to analyze the characteristics of each of them and to evaluate their efficacy to reduce the rate of distal embolization.

  12. Protection, interlocks and diagnostics

    CERN Document Server

    Griffiths, S A; White, C; Theed, J E

    2006-01-01

    When designing any power converter it is essential to assess and incorporate adequate protection. The main objective is to offer a solution which is safe, reliable and repairable and that achieves its specification within budget. The level of protection found within each converter varies widely and will depend on the topology employed, its application and rating. This document is a guide to the types of protection engineers should consider mainly when designing power converters, as protection added during construction or after installation will always be expensive.

  13. Radiation protection law

    International Nuclear Information System (INIS)

    Hebert, J.

    1981-01-01

    This article first reviews the general radiation protection law at international and national level, with particular reference to the recommendations of the International Commission on Radiological Protection (ICRP) which, although not mandatory, are nevertheless taken into consideration by international organisations establishing basic radiation protection standards such as the UN, IAEA, NEA and Euratom, at Community level, and by national legislation. These standards are therefore remarkably harmonized. Radiation protection rule applied in France for the different activities and uses of radioactive substances are then described, and finally, a description is given of the regulations governing artificial radioisotopes and radioactive effluents. (NEA) [fr

  14. Investor Protections and Economic Growth

    OpenAIRE

    Haidar, Jamal Ibrahim

    2009-01-01

    Using objective measures of investor protections in 170 countries, I establish that the level of investor protection matters for cross-country differences in GDP growth: countries with stronger protections tend to grow faster than those with poor investor protections.

  15. Protecting the Amazon with protected areas

    Science.gov (United States)

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

    2009-01-01

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

  16. 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.)

  17. Smart cathodic protection systems

    NARCIS (Netherlands)

    Polder, R.B.; Leggedoor, J.; Schuten, G.; Sajna, S.; Kranjc, A.

    2010-01-01

    Cathodic protection delivers corrosion protection in concrete structures exposed to aggressive environments, e.g. in de-icing salt and marine climates. Working lives of a large number of CP systems are at least more than 13 years and probably more than 25 years, provided a minimum level of

  18. Complete Rerouting Protection

    DEFF Research Database (Denmark)

    Stidsen, Thomas K.; Kjærulff, Peter

    2005-01-01

    In this paper we present a new protection method: Complete Rerouting. This is the most capacity e cient protection method for circuit switched networks and it is, to the best of our knowledge, the first time it has been described. We implement a column generation algorithm and test the performance...

  19. Protected urban planet

    NARCIS (Netherlands)

    Pereira Roders, A.R.; Veldpaus, L.; Verbruggen, R.C.

    2012-01-01

    PUP, abbreviation to Protected Urban Planet, is the first tool developed for visualizing, mapping and contributing to information exchange on the evolution of protected urban areas worldwide. Besides locating them, it also provides communities with means to disseminate and raise awareness for their

  20. 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.)

  1. 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.)

  2. 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

  3. The Radiation Protection Act

    International Nuclear Information System (INIS)

    Persson, L.

    1989-01-01

    The new Radiation Protection Act (1988:220) entered into force in Sweden on July 1st, 1988. This book presents the Act as well as certain regulations connected to it. As previously, the main responsibility for public radiation protection will rest with one central radiation protection authority. According to the 1988 Act, the general obligations with regard to radiation protection will place a greater responsibility than in the past on persons carrying out activities involving radiation. Under the act, it is possible to adjust the licensing and supervisory procedures to the level of danger of the radiation source and the need for adequate competence, etc. The Act recognises standardised approval procedures combined with technical regulations for areas where the risks are well known. The Act contains several rules providing for more effective supervision. The supervising authority may in particular decide on the necessary regulations and prohibitions for each individual case. The possibilities of using penal provisions have been extended and a rule on the mandatory execution of orders has been introduced. The Ordinance on Radiation Protection (1988:293) designates the National Institute of Radiation Protection (SSI) as the central authority referred to in the Radiation Protection Act. The book also gives a historic review of radiation protection laws in Sweden, lists regulations issued by SSI and presents explanations of radiation effects and international norms in the area. (author)

  4. Electroplating offers embrittlement protection

    Science.gov (United States)

    Daniels, C. M., Jr.

    1970-01-01

    Thin copper electrodeposited layer protects metal parts in environments with which they may be incompatible. Originally developed for main engine of Space Shuttle where high strength nickle alloy bellows must operate in high-pressure hydrogen, technique protects nickel and is unaffected by forming process or subsequent heat treatment and preinstallation processing.

  5. Practical radiation protection

    International Nuclear Information System (INIS)

    Brouwer, G.; Van den Eijnde, J.H.G.M.

    1997-01-01

    This textbook aims at providing sufficient knowledge and insight to carry out correctly radiation protection activities and operations. The subjects are appropriate for the training of radiation protection experts for the levels 5A (encapsulated sources, X rays) and 5B (open sources, laboratory activities)

  6. Consumer rights and protections

    Science.gov (United States)

    ... care consumer rights; Rights of the health care consumer ... RIGHTS AND PROTECTIONS Here are ways that the health care law protects consumers. You must be covered, even if you have a pre-existing condition. No insurance plan can reject you, ...

  7. Military radiation protection

    International Nuclear Information System (INIS)

    Harrison, J.

    1993-01-01

    The Ministry of Defence and the military in particular have a very strong commitment to radiation protection of personnel in war and peace. MOD endeavours to do better all the time because it is essential that the armed forces have the confidence to fulfil their role and this is best achieved by providing them with the best possible protection irrespective of the hazard. (author)

  8. 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.

  9. 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

  10. 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 ...

  11. Ustekinumab for patients with primary biliary cholangitis who have an inadequate response to ursodeoxycholic acid: A proof-of-concept study.

    Science.gov (United States)

    Hirschfield, Gideon M; Gershwin, M Eric; Strauss, Richard; Mayo, Marlyn J; Levy, Cynthia; Zou, Bin; Johanns, Jewel; Nnane, Ivo P; Dasgupta, Bidisha; Li, Katherine; Selmi, Carlo; Marschall, Hanns-Ulrich; Jones, David; Lindor, Keith

    2016-07-01

    The interleukin (IL)-12 signaling cascade has been associated with primary biliary cholangitis (PBC). This multicenter, open-label, proof-of-concept study evaluated the anti-IL12/23 monoclonal antibody, ustekinumab (90 mg subcutaneous at weeks 0 and 4, then every 8 weeks through week 20), in adults with PBC and an inadequate response to ursodeoxycholic acid therapy (i.e., alkaline phosphatase [ALP] >1.67× upper limit of normal [ULN] after ≥6 months). ALP response was defined as a >40% decrease from baseline and ALP remission as ALP normalization (if baseline ALP 1.67×-2.8× ULN) or 2.8× ULN). Changes in Enhanced Liver Fibrosis (ELF) scores and serum bile acids were also assessed. At baseline, patients had median disease duration of 3.2 years, median ELF score of 9.8, and highly elevated total bile acid concentration (median, 43.3 μmol/L); 13 of 20 (65%) patients had baseline ALP >3× ULN. Although steady-state serum ustekinumab concentrations were reached by week 12, no patient achieved ALP response or remission. Median percent ALP reduction from baseline to week 28 was 12.1%. ELF score decreased slightly from baseline to week 28 (median reduction: 0.173), and total serum bile acid concentrations decreased from baseline to week 28 (median reduction: 8.8 μmol/L). No serious infections or discontinuations resulting from adverse events were reported through week 28. One patient had a serious upper gastrointestinal hemorrhage considered unrelated to test agent by the investigator. Open-label ustekinumab therapy, though associated with a modest decrease in ALP after 28 weeks of therapy, did not otherwise appreciably change ALP and overt proof-of-concept was not established as per prespecified primary endpoint of proposed efficacy. No new ustekinumab safety signals were observed. (Hepatology 2016;64:189-199). © 2015 by the American Association for the Study of Liver Diseases.

  12. Tofacitinib Versus Biologic Treatments in Patients With Active Rheumatoid Arthritis Who Have Had an Inadequate Response to Tumor Necrosis Factor Inhibitors: Results From a Network Meta-analysis.

    Science.gov (United States)

    Vieira, Maria-Cecilia; Zwillich, Samuel H; Jansen, Jeroen P; Smiechowski, Brielan; Spurden, Dean; Wallenstein, Gene V

    2016-12-01

    Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). This analysis compared the efficacy and safety of tofacitinib with biologic disease-modifying antirheumatic drugs in patients with RA and a prior inadequate response (IR) to tumor necrosis factor inhibitors (TNFi). A systematic literature review identified 5 randomized placebo-controlled trials that evaluated tofacitinib or biologic disease-modifying antirheumatic drugs (bDMARDs) against placebo in patient populations with RA with a prior IR to TNFi. The definition of TNFi-IR varied across studies, and included patients with an IR or who had failed treatment with TNFi for any reason. A network meta-analysis was conducted comparing study data with regard to American College of Rheumatology response rates and Health Assessment Questionnaire-Disability Index improvement at weeks 12 and 24, rates of treatment withdrawal due to all causes; adverse events (AEs) and lack of efficacy; and rates of AEs, serious AEs, and serious infections. The 5 trials included a total of 2136 patients. Tofacitinib 5 mg twice daily combined with methotrexate was found to have relative risk estimates of American College of Rheumatology responses and change from baseline in Health Assessment Questionnaire-Disability Index score comparable with abatacept, golimumab, rituximab, and tocilizumab combined with conventional synthetic disease-modifying antirheumatic drugs. Withdrawal rates from trials due to all causes and AEs were comparable between treatments, and tofacitinib had a lower rate of withdrawals due to lack of efficacy. Rates of AEs and HAQ-DI were comparable between tofacitinib, other active treatments, and placebo. No serious infections were reported with tofacitinib during the placebo-controlled period (up to week 12) in this study population; rates of serious infection with other active treatments were generally low and similar to placebo. During a 24-week period, tofacitinib had efficacy

  13. Effects of tofacitinib monotherapy on patient-reported outcomes in a randomized phase 3 study of patients with active rheumatoid arthritis and inadequate responses to DMARDs.

    Science.gov (United States)

    Strand, Vibeke; Kremer, Joel; Wallenstein, Gene; Kanik, Keith S; Connell, Carol; Gruben, David; Zwillich, Samuel H; Fleischmann, Roy

    2015-11-04

    Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis. In this 6-month, phase 3, randomized, placebo-controlled trial, 611 patients with inadequate response to disease-modifying anti-rheumatic drugs (DMARD-IR) were randomized 4:4:1:1 to receive: tofacitinib 5 mg BID or tofacitinib 10 mg BID for the duration of the study, or placebo for 3 months followed by tofacitinib 5 mg BID or tofacitinib 10 mg BID. Patient-reported outcomes (PROs) included: Patient Global Assessment of Disease Activity (PtGA); Patient Assessment of Pain (Pain); Health Assessment Questionnaire-Disability Index (HAQ-DI); Medical Outcomes Survey (MOS) Short Form-36 (SF-36); Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F); and MOS Sleep Scale. Time-to-event data (PtGA and Pain) were collected using an interactive voice response system daily diary (baseline through day 14). At month 3, tofacitinib 5 and 10 mg BID demonstrated statistically significant improvements versus placebo in PtGA (both p tofacitinib treatment were rapid in onset and significant improvements were reported at week 2 for PtGA, Pain and HAQ-DI, and differentiation from baseline was seen as early as 3 days after treatment initiation for interactive voice response system (IVRS) PtGA and IVRS Pain. The numbers needed to treat for patients to report changes greater than or equal to the minimum clinically important difference in PtGA, Pain, HAQ-DI, SF-36 Physical Component Summary score and FACIT-F ranged between 4.0-6.1 (5 mg BID) and 3.2-5.0 (10 mg BID). Tofacitinib monotherapy in DMARD-IR patients resulted in statistically significant and clinically meaningful improvements in multiple PROs versus placebo at month 3, with sustained improvements over 6 months. Clinicaltrials.gov registration NCT00814307 , registered 22 December 2008.

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

    Science.gov (United States)

    Jones, Marian Moser; Benrubi, Isidore Daniel

    2013-05-01

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

  15. Inadequate programming, insufficient communication and non-compliance with the basic principles of maternal death audits in health districts in Burkina Faso: a qualitative study.

    Science.gov (United States)

    Congo, Boukaré; Sanon, Djénéba; Millogo, Tieba; Ouedraogo, Charlemagne Marie; Yaméogo, Wambi Maurice E; Meda, Ziemlé Clement; Kouanda, Seni

    2017-09-29

    Implementation of quality maternal death audits requires good programming, good communication and compliance with core principles. Studies on compliance with core principles in the conduct of maternal death audits (MDAs) exist but were conducted in urban areas, at the 2nd or 3rd level of the healthcare system, in experimental situations, or in a context of skills-building projects or technical platforms with an emphasis on the review of "near miss". This study aims to fill the gap of evidence on the implementation of MDAs in rural settings, at the first level of care and in the routine care situation in Burkina Faso. We conducted a multiple-case study, with seven cases (health districts) chosen by contrasted purposive sampling using four criteria: (i) the intra-hospital maternal mortality rates for 2013, (ii) rural versus urban location, (iii) proofs of regular conduct of maternal death audits (MDAs) as per routine health information system, and (iv) the use of district hospital versus regional hospital for reference when the first mentioned does not exist. A review of audit records and structured and semi-structured interviews with staff involved in MDAs were conducted. The survey was conducted from 27 April to 30 May of 2015. The results showed that maternal death audits (MDAs) were irregularly scheduled, mostly driven by critical events. Overall, preparing sessions, communication and the conduct of MDAs were most of the time inadequate. Confidentiality was globally respected during the clinical audit sessions. The principle of "no name, no shame, and no blame" was differently applied and anonymity was rarely preserved. Programming, communication, and compliance with the basic principles in the conduct of maternal death audits were inadequate as compared to the national standards. Identifying determinants of such shortcomings may help guide interventions to improve the quality of clinical audits. La mise en œuvre d'audits de décès maternels de qualité n

  16. Wake Shield Target Protection

    International Nuclear Information System (INIS)

    Valmianski, Emanuil I.; Petzoldt, Ronald W.; Alexander, Neil B.

    2003-01-01

    The heat flux from both gas convection and chamber radiation on a direct drive target must be limited to avoid target damage from excessive D-T temperature increase. One of the possibilities of protecting the target is a wake shield flying in front of the target. A shield will also reduce drag force on the target, thereby facilitating target tracking and position prediction. A Direct Simulation Monte Carlo (DSMC) code was used to calculate convection heat loads as boundary conditions input into ANSYS thermal calculations. These were used for studying the quality of target protection depending on various shapes of shields, target-shield distance, and protective properties of the shield moving relative to the target. The results show that the shield can reduce the convective heat flux by a factor of 2 to 5 depending on pressure, temperature, and velocity. The protective effect of a shield moving relative to the target is greater than the protective properties of a fixed shield. However, the protective effect of a shield moving under the drag force is not sufficient for bringing the heat load on the target down to the necessary limit. Some other ways of diminishing heat flux using a protective shield are discussed

  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. 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)

  19. 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

  20. PROTECTION OF THREATENED WITNESSES

    Directory of Open Access Journals (Sweden)

    Nadia Claudia CANTEMIR-STOICA

    2016-05-01

    Full Text Available First, I wish to make a presentation of historically institution and subsequently parallels between past and current regulators to expose whether the legislature has reached desire - namely ensuring effective protection of witnesses threatened and vulnerable. Also, I decided to analyze the topic from the perspective of the criminal procedural provisions of Law 682/2002 and witness protection, which are republished to expose the conditions and criteria by which to ensure this status. I also want to present besides theoretical and practical ways in which the National Office for Witness Protection gives effective legal provisions. Not least, I will bring criticism of current regulation and not by law ferenda proposals.

  1. Ethics and radiation protection

    Energy Technology Data Exchange (ETDEWEB)

    Hansson, Sven Ove [Department of Philosophy and the History of Technology, Royal Institute of Technology (KTH), Teknikringen 78 B, 2tr, SE-100 44 Stockholm (Sweden)

    2007-06-01

    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. Selective protection. Selektivschutz

    Energy Technology Data Exchange (ETDEWEB)

    1983-01-01

    TC 2, ''Transmission and distribution of electrical energy'', held its meeting on selective protection on 16/17 March 1983 at Nuremberg. The main reason for the development of computerized protective systems is their ability to solve a wide range of tasks using only a few, high-integrated systems, i.e. on the software side instead of the hardware side. At the meeting, experts from industrial companies and public utilities reviewed the status and trends of protective systems engineering. Scientific studies and operating experience were presented. Separate abstracts were prepared for 2 papers in this conference proceedings volume.

  3. Radiation protective clothing

    International Nuclear Information System (INIS)

    Fujinuma, Tadashi; Tamura, Shoji; Ijiri, Yasuo.

    1988-01-01

    Purpose: To obtain radiation protective clothings of excellent workability and durability. Constitution: Protective clothings of the present invention comprise shielding materials for the upper-half of the body having lead foils laminated on one surface and shielding materials for the lower-half of the body a resin sheet containing inorganic powders of high specific gravity. Such protective clothings have a frexibility capable of followings after the movement of the upper-half body and easily follow after the movement such as acute bending of the body near the waste in the lower-half body. (Kamimura, M.)

  4. 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.

  5. Protective head of sensors

    International Nuclear Information System (INIS)

    Liska, K.; Anton, P.

    1987-01-01

    The discovery concerns the protective heads of diagnostic assemblies of nuclear power plants for conductors of the sensors from the fuel and control parts of the said assemblies. A detailed description is presented of the design of the protective head which, as compared with the previous design, allows quick and simple assembly with reduced risk of damaging the sensors. The protective head may be used for diagnostic assemblies both in power and in research reactors and it will be used for WWER reactor assemblies. (A.K.). 3 figs

  6. 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.)

  7. Review of the radiation protection calculations for the encapsulation plant

    International Nuclear Information System (INIS)

    Ranta-aho, A.

    2008-09-01

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

  8. Overload protection: avoidance response to heavy plantar surface loading.

    Science.gov (United States)

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

    1988-02-01

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

  9. Radiation protection; Proteccion Radiologica

    Energy Technology Data Exchange (ETDEWEB)

    Ures Pantazi, M [Universidad de la Republica, Facultad de Quimica (Uruguay)

    1994-12-31

    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.

  10. 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.

  11. Ingredients of protection engineering

    International Nuclear Information System (INIS)

    Latorre, V.R.; Spogen, L.R. Jr.

    1974-01-01

    The protection of an electronic/electrical system from an electromagnetic environment requires a systematic approach and a clear and concise identification of the data requirements and tools (analytical and experimental) for the vulnerability assessment. In this paper, a basic protection engineering concept is developed. The concept is general and therefore applicable to many systems. It consists of five stages: (1) systems analysis, (2) subsystem degradation, (3) interaction and coupling, (4) protection trade-off analysis, and (5) fabrication and operation. A detailed discussion of all functions performed in each stage is described; the input data to these functions identified; and means (tools) by which the functional operations are satisfied are summarized. Simple examples are used throughout the paper to illustrate the definitions of various functions and to emphasize the iterative process required in arriving at a protection scheme. (U.S.)

  12. 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)

  13. 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)

  14. 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

  15. Radiation Protection: introduction

    International Nuclear Information System (INIS)

    Loos, M.

    2005-01-01

    The abstract gives an overview and introduction to the activities of SCK-CEN's Radiation Protection department. Main strategic developments and achievements in the field of life sciences, policy supports and medical applications are summarised

  16. Radiation protection in medicine

    International Nuclear Information System (INIS)

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

    2016-01-01

    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)

  17. 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...

  18. 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)

  19. Radiation protection and monitoring

    International Nuclear Information System (INIS)

    Thomas, P.

    1982-01-01

    The present paper deals with the following topics: - Radiological quantities and units - Principles of radiological protection - Limits of doses and activity uptake - Activity discharges and monitoring - Radiation exposure and its calculation - Environmental monitoring - Personnel dosimetry. (orig./RW)

  20. 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.

  1. Personal Protective Equipment

    National Research Council Canada - National Science Library

    1998-01-01

    ... of personal protective equipment A safety program for new employees is a necessary part of any orientation program An on-going safety program should be used to motivate employees to continue to use...

  2. 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

  3. Radiation Protection Group

    CERN Document Server

    2006-01-01

    The Radioactive Waste Section of the Radiation Protection Group wishes to inform you that the Radioactive Waste Treatment Centre will be closed on the afternoon of Tuesday 19 December 2006. Thank-you for your understanding.

  4. 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 ...

  5. Software for radiation protection

    International Nuclear Information System (INIS)

    Graffunder, H.

    2002-01-01

    The software products presented are universally usable programs for radiation protection. The systems were designed in order to establish a comprehensive database specific to radiation protection and, on this basis, model in programs subjects of radiation protection. Development initially focused on the creation of the database. Each software product was to access the same nuclide-specific data; input errors and differences in spelling were to be excluded from the outset. This makes the products more compatible with each other and able to exchange data among each other. The software products are modular in design. Functions recurring in radiation protection are always treated the same way in different programs, and also represented the same way on the program surface. The recognition effect makes it easy for users to familiarize with the products quickly. All software products are written in German and are tailored to the administrative needs and codes and regulations in Germany and in Switzerland. (orig.) [de

  6. 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

  7. 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.

  8. Expeditionary Warfare- Force Protection

    National Research Council Canada - National Science Library

    Higgins, Eric

    2004-01-01

    In 2003, the Systems Engineering and Analysis students were tasked to develop a system of systems conceptual solution to provide force protection for the Sea Base conceptualized in the 2002 Expeditionary Warfare study...

  9. 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....

  10. Radiation protection housing

    Energy Technology Data Exchange (ETDEWEB)

    Maier, A

    1975-04-10

    The radiation protection housing consists of a foot rim with castor swivel wheels, a tubular frame tapering off at the top, and a crown. In the upper part of the tubular frame a lead glass window is permanently installed. The sides are covered with radiation attenuating curtains of leaded rubber. The housing has the shape of a truncated pyramid which can be dismantled into its constituent parts. It is used for protection from radiation encountered in X-ray facilities in dental radiology.

  11. 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.

  12. 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

  13. 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)

  14. 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

  15. 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)

  16. 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...

  17. Protection of Levees against Beavers

    Science.gov (United States)

    Kozłowski, Wojciech; Balawejder, Adam

    2017-10-01

    Beavers are a protected species, so the levees must be properly protected so as not to harm the beavers and protect the levees from the destruction caused by these animals. This protection requires the use of bentonite mats as shaft seals, and wire mesh. Recently, such new protection structures began to be used successfully.

  18. 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

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

    Science.gov (United States)

    Klostermann, S; Fromme, H; Bolte, G

    2015-06-01

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

  20. ETHIOPIAN WITNESS PROTECTION SYSTEM: COMPARATIVE ...

    African Journals Online (AJOL)

    witness protection involves social cohesion of the protected person. Scholars ..... interests' need to balance an accused right to know and confront prosecution ..... was reduced to 2.5 years through the fast tracking of witness protection cases.

  1. 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

  2. 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

  3. Anticorrosion protection of uranium

    Energy Technology Data Exchange (ETDEWEB)

    Goncharov, Ivan D.; Kazakovskaya, Tatiana; Tukmakov, Victor; Shapovalov, Vyacheslav [Russian Federal Nuclear Center-VNIIEF, 37, Mira Ave., RU-607190 Sarov (Nizhnii Gorod), 010450 (Russian Federation)

    2004-07-01

    Uranium in atmospheric conditions is non-stable. Sloughing products are being generated on its surface during storage or use. These corrosion products make many difficulties because of necessity to provide personnel safety. Besides, uranium corrosion may cause damage in parts. The first works devoted to uranium corrosion were performed in the framework of the USA Manhattan Project in the early forties of last century. Various methods of uranium protection were investigated, among them the galvanic one was the most studied. Later on the galvanic technology was patented. The works on this problem remains urgent up to the present time. In Russia, many methods of uranium corrosion protection, mainly against atmospheric corrosion, were tried on. In particular, such methods as diffusion zinc and paint coating were investigated. In the first case, a complex intermetallic U-Zn compound was formed but its protection was not reliable enough, this protection system was inconvenient and uncertain and that is why an additional paint coating was necessary. In the case of paint coatings another problem appeared. It was necessary to find such a coating where gas-permeability would prevail over water-permeability. Otherwise significant uranium corrosion occurs. This circumstance together with low mechanical resistance of paint coatings does not allow to use paint coating for long-term protection of uranium. Currently, there are following methods of uranium protection: ion-plasma, galvanic and thermo-vacuum annealing. These are described in this paper. In the end the issue of corrosion protection in reactor core zones is addressed. Here the greatest difficulties are caused when enriched uranium heated up to 500 deg. C needs anticorrosion protection. In this case various metal coatings are not reliable because of brittle inter-metallide formation. The reliable protection may be provided only up to the temperature plus 400 - 500 deg. C with the help of galvanic copper coating since

  4. Anticorrosion protection of uranium

    International Nuclear Information System (INIS)

    Goncharov, Ivan D.; Kazakovskaya, Tatiana; Tukmakov, Victor; Shapovalov, Vyacheslav

    2004-01-01

    Uranium in atmospheric conditions is non-stable. Sloughing products are being generated on its surface during storage or use. These corrosion products make many difficulties because of necessity to provide personnel safety. Besides, uranium corrosion may cause damage in parts. The first works devoted to uranium corrosion were performed in the framework of the USA Manhattan Project in the early forties of last century. Various methods of uranium protection were investigated, among them the galvanic one was the most studied. Later on the galvanic technology was patented. The works on this problem remains urgent up to the present time. In Russia, many methods of uranium corrosion protection, mainly against atmospheric corrosion, were tried on. In particular, such methods as diffusion zinc and paint coating were investigated. In the first case, a complex intermetallic U-Zn compound was formed but its protection was not reliable enough, this protection system was inconvenient and uncertain and that is why an additional paint coating was necessary. In the case of paint coatings another problem appeared. It was necessary to find such a coating where gas-permeability would prevail over water-permeability. Otherwise significant uranium corrosion occurs. This circumstance together with low mechanical resistance of paint coatings does not allow to use paint coating for long-term protection of uranium. Currently, there are following methods of uranium protection: ion-plasma, galvanic and thermo-vacuum annealing. These are described in this paper. In the end the issue of corrosion protection in reactor core zones is addressed. Here the greatest difficulties are caused when enriched uranium heated up to 500 deg. C needs anticorrosion protection. In this case various metal coatings are not reliable because of brittle inter-metallide formation. The reliable protection may be provided only up to the temperature plus 400 - 500 deg. C with the help of galvanic copper coating since

  5. Ethical considerations in internet use of electronic protected health information.

    Science.gov (United States)

    Polito, Jacquelyn M

    2012-03-01

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

  6. 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.

  7. 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.)

  8. 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

  9. 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...

  10. 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.

  11. 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

  12. Characteristics of protective instrumentation

    International Nuclear Information System (INIS)

    Reichart, G.

    1982-01-01

    Protective Instrumentation (PI) for Nuclear Power Plants (NPP) is a general term for an highly reliable instrumentation, which provides information for keeping the system within safe limits, for initation of countermeasures in the case of an incident or for mitigation of consequences of an accident. In German NPPs one can find a hierarchical structure of protective instrumentation, wherein the Reactor Protection System (RPS) has the highest priority. To meet the reliability requirements different design principles are used, like - redundancy - diversity - fail safe - decoupling. The presentation gives an overview about the different design principles and characterizes their reliability aspects. As an example for the technical realization the RPS of a German NPP is discussed in some detail. Furthermore some information about other type of PI is given and reliability aspects of the interaction of operating personell with these systems are mentioned. (orig.)

  13. 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.)

  14. Reactor protection system

    International Nuclear Information System (INIS)

    Fairbrother, D.B.; Lesniak, L.M.; Orgera, E.G.

    1977-10-01

    The report describes the reactor protection system (RPS-II) designed for use on Babcock and Wilcox 145-, later 177-, and 205-fuel assembly pressurized water reactors. In this system, relays in the trip logic have been replaced by solid state devices. A calculating module for the low DNBR, pump status, and offset trip functions has replaced the overpower trip (based on flow and imbalance), the power/RC pump trip, and the variable low-pressure trip. Included is a description of the changes from the present Oconee-type reactor protection system (RPS-I), a functional and hardware description of the calculating module, a description of the software programmed in the calculating module, and a discussion of the qualification program conducted to ensure that the degree of protection provided by RPS-II is not less than that provided by previously licensed systems supplied by B and W

  15. Protective and preventative measures

    International Nuclear Information System (INIS)

    Freedman, P. N

    2002-01-01

    Health care workers who come in contact with blood and other body fluids in their working environment risk being exposed to blood borne diseases such as human immunodeficiency virus (HIV), hepatitis B and C. An anti-hepatitis B vaccine is available as well as hepatitis B immunoglobulin but no vaccine is available against hepatitis C and HIV. The best way to protect against exposure to blood and body fluids is to use 'Universal Precautions' which encourage safe working methods. If an exposure does take place it should be regarded as an urgent medical problem and every facility should have a management policy to deal with this problem. The source patient's rights must also be protected. The preventative and protective measures available to health care workers as well as practical suggestions to carry out in the event of an exposure are discussed (Au)

  16. 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

  17. Advanced Worker Protection System

    International Nuclear Information System (INIS)

    1996-04-01

    The Advanced Worker Protection System (AWPS) is a liquid-air-based, self-contained breathing and cooling system with a duration of 2 hrs. AWPS employs a patented system developed by Oceaneering Space Systems (OSS), and was demonstrated at their facility in Houston, TX as well as at Kansas State University, Manhattan. The heart of the system is the life-support backpack that uses liquid air to provide cooling as well as breathing gas to the worker. The backpack is combined with advanced protective garments, an advanced liquid cooling garment (LCG), a respirator, and communications and support equipment. The prototype unit development and testing under Phase 1 has demonstrated that AWPS has the ability to meet performance criteria. These criteria were developed with an understanding of both the AWPS capabilities and the DOE decontamination and decommissioning (D and D) activities protection needs

  18. The protection of possession

    Directory of Open Access Journals (Sweden)

    Popov Danica

    2011-01-01

    Full Text Available Protection in disputes for the protection of possession can be attained through the following actions a for dispossession (interdictum recuperande possessionis and b with an action for the disturbance of possession (interdictum retinendae possessionis. The general feature of these disputes is that there is only discussion on the facts and not a legal matters. Subject matter jurisdiction for the resolution of such disputes belongs to the court of general jurisdiction, while the dispute itself is a litigation. The special rule of proceedings of action for disturbance are: provisionality of the protection of possession; urgency in proceedings; initiation of the proceedings; limiting of objection; prescribing temporary measures; rendering a ruling in the form of order; appeals which may be filed within a short deadline and which does not have suspensive effect (do not delay the execution of the order; revision is not allowed etc.

  19. 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

  20. 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)

  1. 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)

  2. New radiation protection law

    International Nuclear Information System (INIS)

    1985-01-01

    The structure of the existing legislation and its contents and aims are reconsidered. New rules which correspond to the present situation are to be established. Also the fundamental principles of the task and methods of radiation protection are to be changed. The main effort will be to create conditions so that all human beings will be protected against the harmful effects of radiation. The effects on plants, animals and on the environment should be considered as well. The legislation should include both ionizing and non-ionizing radiation. The main responsibility of protection should stay with the central authority. Licensing of apparatus, liability for medical applications and radioactive waste is discussed. Granting of permissions and control should be accomplished by the authority. Cooperation with other national and international authorities is dealt with. (G.B.)

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

    International Nuclear Information System (INIS)

    Mayoux, J.C.

    1989-01-01

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

  4. Radiation protection in the field of environmental protection

    International Nuclear Information System (INIS)

    Zhao Yamin

    2003-01-01

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

  5. Radiation protection in hospitals

    International Nuclear Information System (INIS)

    MOuld, R.F.

    1985-01-01

    A book on radiation protection in hospitals has been written to cater for readers with different backgrounds, training and needs by providing an elementary radiation physics text in Part I and an advanced, comprehensive Part II relating to specific medical applications of X-rays and of radioactivity. Part I includes information on basic radiation physics, radiation risk, radiation absorption and attenuation, radiation measurement, radiation shielding and classification of radiation workers. Part II includes information on radiation protection in external beam radiotherapy, interstitial source radiotherapy, intracavitary radiotherapy, radioactive iodine-131 radiotherapy, nuclear medicine diagnostics and diagnostic radiology. (U.K.)

  6. Radiation protection in space

    Energy Technology Data Exchange (ETDEWEB)

    Blakely, E.A. [Lawrence Berkeley Lab., CA (United States); Fry, R.J.M. [Oak Ridge National Lab., TN (United States)

    1995-02-01

    The challenge for planning radiation protection in space is to estimate the risk of events of low probability after low levels of irradiation. This work has revealed many gaps in the present state of knowledge that require further study. Despite investigations of several irradiated populations, the atomic-bomb survivors remain the primary basis for estimating the risk of ionizing radiation. Compared to previous estimates, two new independent evaluations of available information indicate a significantly greater risk of stochastic effects of radiation (cancer and genetic effects) by about a factor of three for radiation workers. This paper presents a brief historical perspective of the international effort to assure radiation protection in space.

  7. Protection from space radiation

    International Nuclear Information System (INIS)

    Tripathi, R.K.; Wilson, J.W.; Shinn, J.L.

    2000-01-01

    The exposures anticipated for astronauts in the anticipated human exploration and development of space will be significantly higher (both annual and carrier) than for any other occupational group. In addition, the exposures in deep space result largely from galactic cosmic rays for which there is as yet little experience. Some evidence exists indicating that conventional linear energy transfer defined protection quantities (quality factors) may not be appropriate. The authors evaluate their current understanding of radiation protection with laboratory and flight experimental data and discuss recent improvements in interaction models and transport methods

  8. 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.

  9. 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

  10. 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

  11. 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.

  12. 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

  13. Radiation protection in space

    International Nuclear Information System (INIS)

    Blakely, E.A.; Fry, R.J.M.

    1995-01-01

    The challenge for planning radiation protection in space is to estimate the risk of events of low probability after low levels of irradiation. This work has revealed many gaps in the present state of knowledge that require further study. Despite investigations of several irradiated populations, the atomic-bomb survivors remain the primary basis for estimating the risk of ionizing radiation. Compared to previous estimates, two new independent evaluations of available information indicate a significantly greater risk of stochastic effects of radiation (cancer and genetic effects) by about a factor of three for radiation workers. This paper presents a brief historical perspective of the international effort to assure radiation protection in space

  14. 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.)

  15. Radiation Protection Proclamation

    International Nuclear Information System (INIS)

    1993-01-01

    A proclamation of the Government of Ethiopia, cited as the radiation protection proclamation number 79/1993 was prepared with the objective to establish a national radiation protection authority that formulates policies, controls and supervises activities involving all sources of radiation and lay down laws governing such activities in order to ensure public safety against associated hazards while allowing radiation related activities to be carried out for the benefit of the public . The Authority is guided by an inter-ministerial board and is accountable to the Ethiopian Science and Technology Commission

  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. 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

  18. Efficacy and safety of different doses and retreatment of rituximab: a randomised, placebo-controlled trial in patients who are biological naive with active rheumatoid arthritis and an inadequate response to methotrexate (Study Evaluating Rituximab's Efficacy in MTX iNadequate rEsponders (SERENE)).

    Science.gov (United States)

    Emery, P; Deodhar, A; Rigby, W F; Isaacs, J D; Combe, B; Racewicz, A J; Latinis, K; Abud-Mendoza, C; Szczepanski, L J; Roschmann, R A; Chen, A; Armstrong, G K; Douglass, W; Tyrrell, H

    2010-09-01

    This phase III study evaluated the efficacy and safety of rituximab plus methotrexate (MTX) in patients with active rheumatoid arthritis (RA) who had an inadequate response to MTX and who were naïve to prior biological treatment. Patients with active disease on stable MTX (10-25 mg/week) were randomised to rituximab 2 x 500 mg (n=168), rituximab 2 x 1000 mg (n=172), or placebo (n=172). From week 24, patients not in remission (Disease Activity Score (28 joints) > or =2.6) received a second course of rituximab; patients initially assigned to placebo switched to rituximab 2 x 500 mg. The primary end point was American College of Rheumatology 20 (ACR20) response at week 24. All patients were followed until week 48. At week 24, both doses of rituximab showed statistically superior efficacy (p<0.0001) to placebo (ACR20: 54%, 51% and 23%; rituximab (2 x 500 mg) + MTX, rituximab (2 x 1000 mg) + MTX and placebo + MTX, respectively). Secondary end points were also significantly improved for both rituximab groups compared with placebo. Further improvements in both rituximab arms were observed from week 24 to week 48. Rituximab + MTX was well tolerated, demonstrating comparable safety to placebo + MTX through to week 24, and between rituximab doses through to week 48. Rituximab (at 2 x 500 mg and 2 x 1000 mg) plus MTX significantly improved clinical outcomes at week 24, which were further improved by week 48. No significant differences in either clinical or safety outcomes were apparent between the rituximab doses.

  19. Efficacy and safety of different doses and retreatment of rituximab: a randomised, placebo-controlled trial in patients who are biological naïve with active rheumatoid arthritis and an inadequate response to methotrexate (Study Evaluating Rituximab's Efficacy in MTX iNadequate rEsponders (SERENE))

    Science.gov (United States)

    Emery, P; Deodhar, A; Rigby, W F; Isaacs, J D; Combe, B; Racewicz, A J; Latinis, K; Abud-Mendoza, C; Szczepański, L J; Roschmann, R A; Chen, A; Armstrong, G K; Douglass, W; Tyrrell, H

    2010-01-01

    Objectives This phase III study evaluated the efficacy and safety of rituximab plus methotrexate (MTX) in patients with active rheumatoid arthritis (RA) who had an inadequate response to MTX and who were naïve to prior biological treatment. Methods Patients with active disease on stable MTX (10–25 mg/week) were randomised to rituximab 2×500 mg (n=168), rituximab 2×1000 mg (n=172), or placebo (n=172). From week 24, patients not in remission (Disease Activity Score (28 joints) ≥2.6) received a second course of rituximab; patients initially assigned to placebo switched to rituximab 2×500 mg. The primary end point was American College of Rheumatology 20 (ACR20) response at week 24. All patients were followed until week 48. Results At week 24, both doses of rituximab showed statistically superior efficacy (p<0.0001) to placebo (ACR20: 54%, 51% and 23%; rituximab (2×500 mg) + MTX, rituximab (2×1000 mg) + MTX and placebo + MTX, respectively). Secondary end points were also significantly improved for both rituximab groups compared with placebo. Further improvements in both rituximab arms were observed from week 24 to week 48. Rituximab + MTX was well tolerated, demonstrating comparable safety to placebo + MTX through to week 24, and between rituximab doses through to week 48. Conclusions Rituximab (at 2×500 mg and 2×1000 mg) plus MTX significantly improved clinical outcomes at week 24, which were further improved by week 48. No significant differences in either clinical or safety outcomes were apparent between the rituximab doses. PMID:20488885

  20. Medical students' knowledge of ionizing radiation and radiation protection.

    Science.gov (United States)

    Hagi, Sarah K; Khafaji, Mawya A

    2011-05-01

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

  1. Filtration of nanoparticles - Application to respiratory protecting devices

    International Nuclear Information System (INIS)

    Brochot, C.

    2012-01-01

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

  2. 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

  3. 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)

  4. Radiation protection glossary

    International Nuclear Information System (INIS)

    Othman, Ibrahim; Abdul-Rahim, Maha

    1989-12-01

    This glossary contains the arabic equivalent of all the terms included in the IAEA Safety Series No.76 (which is a selected basic terms used in IAEA publications), thus this glossary contains English, French, Spanish, Russian, and Arabic. It is intended to facilitate the work of arabic speaking scientists involved in the field of radiation protection

  5. 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)

  6. 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,...

  7. Depth protection system

    International Nuclear Information System (INIS)

    Arita, Setsuo; Izumi, Shigeru; Suzuki, Satoru; Noguchi, Atomi.

    1988-01-01

    Purpose: To previously set a nuclear reactor toward safety side by the reactor scram if an emergency core cooling system is failed to operate. Constitution If abnormality occurs in an emergency core cooling system or an aqueous boric acid injection system, a reactor protection system is operated and, if the reactor protection system shows an abnormal state, a control rod withdrawal inhibition system is operated as a fundamental way. For instance, when the driving power source voltage for the emergency core cooling system is detected and, if it is lower than a predetermined value, the reactor protection system is operated. Alternatively, if the voltage goes lower than the predetermined value, the control rod withdrawal is inhibited. In addition, stopping for the feedwater system is inhibited. Further, integrity of the driving means for the emergency core cooling system is positively checked and the protection function is operated depending on the result of check. Since the nuclear reactor can be set toward the safety side even if the voltage for the driving power source of the aqueous boric acid injection system is lower than a predetermined value, the reactor safety can further be improved. (Horiuchi, T.)

  8. 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)

  9. Protectiveness, Persecution, and Powerlessness

    Science.gov (United States)

    Weeks, Kathleen G.

    1977-01-01

    This paper is an investigation of family pathology from a transactional viewpoint. The thesis proposed is that family pathology is a means of protecting the family and ensuring its survival. The father, mother, and child assume and exchange the roles of the Karpman drama triangle; namely, Persecutor, Victim, and Rescuer. (Author)

  10. 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...

  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. 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)

  13. Radiation protection in Switzerland

    International Nuclear Information System (INIS)

    Brunner, H.

    1990-01-01

    Switzerland's present radiation protection regulations are based on only two paragraphs of the atomic law but have been very successful in practice. A new radiation protection law, separated from nuclear legislation and valid for all application of ionizing radiation and radioctive materials, was proposed and drafted by the Federal Commission on Radiation Protection and has now been accepted by parliament with only minor modifications. The draft of the revised regulations which also will cover all applications, should be ready for consultations next year. Both the law (which contains principles but no figures such as limits) and the regulations incorporate the latest state of ICRP recommendations and are formulated in such a way as to allow application of or quick adaptation to the new basic ICRP recommendation expected for 1991. The legislation is flexible, with a relatively low regulation density and leaves sufficient room for professional judgement on a case by case basis both for authorities and for the specialists responsible for radiation protection in practice. (orig./HSCH)

  14. 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.

  15. 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 ...

  16. Applied crop protection 2016

    DEFF Research Database (Denmark)

    Jørgensen, Lise Nistrup; Nielsen, Bent Jørgen; Jensen, Peter Kryger

    This publication contains results from crop protection trials which were carried out at the Department of Agroecology within the area of agricultural crops. Most of the results come from field trials, but results from greenhouse and semi-field trials are also included. The report contains results...

  17. Consumer Protection for Educators.

    Science.gov (United States)

    Wallace, James M.

    Educational changes are examined from the perspective of consumer protection--the direct consumers are the teachers being prepared; the indirect consumers are the students and the society that supports the schools. During the colonial and early national periods of American history, there was an absence of formal and separate teacher education.…

  18. 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.

  19. Environmental radiation protection standards

    International Nuclear Information System (INIS)

    Richings, L.D.G.; Morley, F.; Kelley, G.N.

    1978-04-01

    The principles involved in the setting of radiological protection standards are reviewed, and the differences in procedures used by various countries in implementing them are outlined. Standards are taken here to mean the specific numerical limits relating to radiation doses to people or to amounts of radioactive material released into the environment. (author)

  20. 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

  1. 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.)

  2. Towards data protection compliance

    NARCIS (Netherlands)

    Zannone, N.; Petkovic, M.; Etalle, S.

    2010-01-01

    Privacy and data protection are fundamental issues nowadays for every organization. This paper calls for the development of methods, techniques and infrastructure to allow the deployment of privacy-aware IT systems, in which humans are integral part of the organizational processes and accountable

  3. Towards Data Protection Compliance

    NARCIS (Netherlands)

    Zannone, Nicola; Petkovic, M.; Etalle, Sandro

    2010-01-01

    Privacy and data protection are fundamental issues nowadays for every organization. This paper calls for the development of methods, techniques and infrastructure to allow the deployment of privacy-aware IT systems, in which humans are integral part of the organizational processes and accountable

  4. ISO radiation protection standards

    International Nuclear Information System (INIS)

    Becker, K.; West, N.

    1981-01-01

    After a brief description of the International Organization for Standardization (ISO) and its Technical Committee (TC) 85 ''Nuclear Energy'', the work of its Sub-Committee (SC) 2 ''Radiation Protection'' is described in some detail. Several international standards on subjects closely related to radiation protection have already been published, for example ISO-361 (Basic radiation protection symbol), ISO-1757 (Photographic dosimeters), ISO-1758 and 1759 (Direct and indirect-reading pocket exposure meters), ISO-2889 (Sampling of airborne radioactive materials), ISO-4037 (X and gamma reference radiations for calibration) and ISO-4071 (Testing of exposure meters and dosimeters). TC 85/SC 2 has currently eight active Working Groups (WG) dealing with 14 standards projects, mostly in advanced stages, in such fields as neutron and beta reference radiations, and X and gamma radiations of high and low dose-rates and high energies for calibration purposes, reference radiations for surface contamination apparatus, ejection systems for gamma radiography apparatus, industrial and laboratory irradiators, lead shielding units, protective clothing, thermoluminescence dosemeters, radioelement gauges, and surface contamination and decontamination. (author)

  5. 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

  6. 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

  7. Principles of Radiation Protection Concepts

    International Nuclear Information System (INIS)

    Abd Aziz Mhd Ramli

    2004-01-01

    The contents of this chapter are follows - Radiation Protection Concepts: justification, dose limitation, optimisation, potential exposures, situation requiring intervention; Special Considerations. Protection from Radiation Hazards, Remove the Hazard, Prevent the Hazard, Guard the Worker, Implementation of Radiation Protection and Safety Measures, Distance, Shielding, Time, Monitoring Programme, Safety System. Radiation Protection in Radiological Service: Specific Requirement in Diagnostic Radiological Service

  8. 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

  9. Protection of HTS magnets

    International Nuclear Information System (INIS)

    Iwasa, Yukikazu

    2005-01-01

    The paper discusses protection issues for HTS magnet. For protection, the HTS magnet must rely on an active technique. Closed-form expressions of the matrix metal operating current density based on overheating and internal voltage criteria for protection, under very simplifying assumptions, are presented. Perhaps the most important conclusions of these criteria are that: (1) HTS (and LTS) magnets must be wound with composite conductor having a significant portion of its overall cross section occupied by normal metal generally of high electrical conductivity and (2) HTS windings must possess 'high' NZP velocities to make the resistive zone occupy as large a fraction of the winding volume as possible. The paper also derives an analytical expression, under another set of simplifying assumptions, to determine the minimum resistive voltage level, dictated by the maximum hot-spot temperature set at 150 K, required to initiate an active protection process. Remarkably, this minimum detection voltage is nearly independent of the matrix metal current density, I op /A m . For a set of operating parameters used in a numerical example, a computed minimum detection voltage, at I op /A m = 5 x 10 4 A/cm 2 , is ∼30 mV, which, considering it must be discerned in the presence of extraneous voltage signals likely to be present in real world operating conditions, would be non-trivial. To satisfy the overheating criterion at a level of I op /A m , which keeps the winding overall current density 'viable' and at the same time to raise the minimum detection resistive voltage, the winding volume occupied by the resistive state must be expanded. The paper concludes with discussion of challenging new areas of research for protection of HTS magnets

  10. 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

  11. Focus radiation protection; Schwerpunkt Strahlenschutz

    Energy Technology Data Exchange (ETDEWEB)

    Ebermann, Lutz (comp.)

    2016-07-01

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

  12. 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.

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

    International Nuclear Information System (INIS)

    Townsend, K.K.

    1978-01-01

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

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

    Science.gov (United States)

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

    2006-01-01

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

  15. 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)

  16. 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)

  17. 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.

  18. 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.

  19. Temporary physical protection systems

    International Nuclear Information System (INIS)

    Williams, J.D.; Gangel, D.J.; Madsen, R.W.

    1991-01-01

    Terrorism and other aspects of world political instability have created a high demand for temporary physical protection systems within the nuclear materials management community. They can be used when vehicles carrying important assets are away from their permanent fixed site location, around areas where experiments are being temporarily conducted, around construction areas and one portions of a fixed site physical security system which is temporarily inoperable. Physical security systems can be grouped into four categories: tactical, portable, semi-permanent, and fixed. The resources and experience gained at Sandia National Laboratories in over forty years of developing and implementing security systems for protecting nuclear weapons and fixed nuclear facilities is now being applied to temporary physical security systems. This paper emphasizes temporary physical security systems and their component parts that are presently available and identify additional system-subsystem objectives, requirements, and concepts

  20. Radiation protection manual

    International Nuclear Information System (INIS)

    Spang, A.

    1983-01-01

    According to the Radiation Protection Ordinance, radiation protection experts directing or supervising the handling of radioactive materials must have expert knowledge. The concept of expert knowledge has been clearly defined by the Fachverband e.V. in a catalogue of instruction goals. The manual follows the principles of this catalogue; it presents the expert knowledge required in a total of 15 subject groups. There is an index which helps the reader to find his specific subject group and the knowledge required of him in this subject group. However, the manual gives only an outline of the subject matter in many instances and should therefore not be regarded as a textbook in the proper sense. (orig./HP) [de