WorldWideScience

Sample records for insufficient background knowledge

  1. The Importance of Background Culture Knowledge in Reading

    Institute of Scientific and Technical Information of China (English)

    王蓁

    2012-01-01

    As achieving cross-culture communication is the final aim of learning English,it turns out to be inefficient to attach more importance on the ability of listening,speaking,reading,writing and knowledge system.Background culture knowledge is supposed to be an important way to reach the aim of language teaching,and help readers understand articles.Considering the effects of background culture knowledge and its importance,this article will do a research on it and try to help both readers and teachers aware of the importance of background culture knowledge and take note of it.

  2. Using background knowledge for picture organization and retrieval

    Science.gov (United States)

    Quintana, Yuri

    1997-01-01

    A picture knowledge base management system is described that is used to represent, organize and retrieve pictures from a frame knowledge base. Experiments with human test subjects were conducted to obtain further descriptions of pictures from news magazines. These descriptions were used to represent the semantic content of pictures in frame representations. A conceptual clustering algorithm is described which organizes pictures not only on the observable features, but also on implicit properties derived from the frame representations. The algorithm uses inheritance reasoning to take into account background knowledge in the clustering. The algorithm creates clusters of pictures using a group similarity function that is based on the gestalt theory of picture perception. For each cluster created, a frame is generated which describes the semantic content of pictures in the cluster. Clustering and retrieval experiments were conducted with and without background knowledge. The paper shows how the use of background knowledge and semantic similarity heuristics improves the speed, precision, and recall of queries processed. The paper concludes with a discussion of how natural language processing of can be used to assist in the development of knowledge bases and the processing of user queries.

  3. The Effect of Cultural Background Knowledge on Learning English Language

    Directory of Open Access Journals (Sweden)

    Dr. Ibrahim

    2013-12-01

    Full Text Available This study aims to investigate the effect of cultural background knowledge on learning English Language. It also aims to investigate if there are significant differences between subjects' performance in reading comprehension according to sex and general ability in English (GAE. The study aims at answering the following questions: 1 . To what extent is the effect of cultural background knowledge on subjects' performance in reading comprehension? 2 . What is the difference in performance in reading comprehension between male and female subjects who have cultural background knowledge and those who do not have any knowledge? 3. What is the differenc e between subjects' performance in reading comprehension texts which are loaded with American culture and their general ability in English. ? The population of th is study consisted of all first - year students majoring in English at Hebron University in th e first semester of the academic year 2011/2012. They were 600. The sample of the study consisted of 60 subjects, males and females divided into four groups, two experimental and two controlled. The researcher followed the experimental method. Means, stand ard deviations and Pearson Product Moment Correlation were calculated by using SPSS program. The study revealed the following results: 1. There are statistically significant differences in performance in reading comprehension between subjects who have cu ltural background knowledge and those who do not have any knowledge . 2 . There are no statistically significant differences in performance in reading comprehension between male and female subjects who have cultural background knowledge and those who do not have any knowledge. 3. Subjects' GAE revealed that there are significant differences in performance in reading comprehension between subjects who have cultural background knowledge and those who do not have any knowledge. In the light of the results of th e study, the researcher recommends the

  4. Socio-demographic factors affecting knowledge level of ...

    African Journals Online (AJOL)

    Background: The Tuberculosis (TB) control program in Bangladesh is still unsatisfactory due to insufficient knowledge and stigma about TB. Patients with low knowledge may be at higher risk of experiencing delays in diagnosis and appropriate treatment. Objectives: The aims of this study were to identify the knowledge ...

  5. Building and Activating Students' Background Knowledge: It's What They Already Know That Counts

    Science.gov (United States)

    Fisher, Douglas; Frey, Nancy; Lapp, Diane

    2012-01-01

    Students enter the middle grades with varying amounts of background knowledge. Teachers must assess student background knowledge for gaps or misconceptions and then provide instruction to build on that base. This article discusses effective strategies for assessing and developing students' background knowledge so they can become independent…

  6. Insufficiency fracture after radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Dong Ryul; Huh, Seung Jae [Dept.of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2014-12-15

    Insufficiency fracture occurs when normal or physiological stress applied to weakened bone with demineralization and decreased elastic resistance. Recently, many studies reported the development of IF after radiation therapy (RT) in gynecological cancer, prostate cancer, anal cancer and rectal cancer. The RT-induced insufficiency fracture is a common complication during the follow-up using modern imaging studies. The clinical suspicion and knowledge the characteristic imaging patterns of insufficiency fracture is essential to differentiate it from metastatic bone lesions, because it sometimes cause severe pain, and it may be confused with bone metastasis.

  7. Knowledge of sexually transmitted diseases among secondary ...

    African Journals Online (AJOL)

    Background: Sexually Transmitted Diseases (STDs) are a major health problem affecting mostly young people in both developed and developing countries. Insufficient knowledge about STDs is a major impediment to successfully prevent the diseases among adolescent populations in developing countries. Objective: To ...

  8. Comparison of maintenance worker's human error events occurred at United States and domestic nuclear power plants. The proposal of the classification method with insufficient knowledge and experience and the classification result of its application

    International Nuclear Information System (INIS)

    Takagawa, Kenichi

    2008-01-01

    Human errors by maintenance workers in U.S. nuclear power plants were compared with those in Japanese nuclear power plants for the same period in order to identify the characteristics of such errors. As for U.S. events, cases which occurred during 2006 were selected from the Nuclear Information Database of the Institute to Nuclear Safety System while Japanese cases that occurred during the same period, were extracted from the Nuclear Information Archives (NUCIA) owned by JANTI. The most common cause of human errors was insufficient knowledge or experience' accounting for about 40% for U.S. cases and 50% or more of cases in Japan. To break down 'insufficient knowledge', we classified the contents of knowledge into five categories; method', 'nature', 'reason', 'scope' and 'goal', and classified the level of knowledge into four categories: 'known', 'comprehended', 'applied' and analytic'. By using this classification, the patterns of combination of each item of the content and the level of knowledge were compared. In the U.S. cases, errors due to 'insufficient knowledge of nature and insufficient knowledge of method' were prevalent while three other items', 'reason', scope' and 'goal' which involve work conditions among the contents of knowledge rarely occurred. In Japan, errors arising from 'nature not being comprehended' were rather prevalent while other cases were distributed evenly for all categories including the work conditions. For addressing insufficient knowledge or experience', we consider that the following approaches are valid: according to the knowledge level which is required for the work, the reflection of knowledge on the procedure or education materials, training and confirmation of understanding level, virtual practice and instruction of experience should be implemented. As for the knowledge on the work conditions, it is necessary to enter the work conditions in the procedure and education materials while conducting training or education. (author)

  9. Reexamining the Relationship between Verbal Knowledge Background and Keyword Training for Vocabulary Acquisition

    Science.gov (United States)

    Hogben; Lawson

    1997-07-01

    The literature on keyword training presents a confusing picture of the usefulness of the keyword method for foreign language vocabulary learning by students with strong verbal knowledge backgrounds. This paper reviews research which notes the existence of conflicting sets of findings concerning the verbal background-keyword training relationship and presents the results of analyses which argue against the assertion made by McDaniel and Pressley (1984) that keyword training will have minimal effect on students with high verbal ability. Findings from regression analyses of data from two studies did not show that the relationship between keyword training and immediate recall performance was moderated by verbal knowledge background. The disparate sets of findings related to the keyword training-verbal knowledge relationship and themes emerging from other research suggest that this relationship requires further examination.

  10. RECOMMENDATIONS ON THE DEVELOPMENT OF KNOWLEDGE MANAGEMENT IN ROMANIAN SMES

    OpenAIRE

    Sebastian Ion CEPTUREANU

    2014-01-01

    Knowledge management is a relatively new related to theoretical background and arise controversies regarding theories, concepts, tools used, and insufficient crystallization of concepts regarding to it. Developed due to changes in social, economic, technical, technological, etc., knowledge management requires a systematic approach to overcome the classical approach. This paper aims to formulate a series of proposals for development of the notions of knowledge management in SME sector, represe...

  11. The Effects of Lesson Screen Background Color on Declarative and Structural Knowledge

    Science.gov (United States)

    Clariana, Roy B.; Prestera, Gustavo E.

    2009-01-01

    This experimental investigation replicates previous investigations of the effects of left margin screen background color hue to signal lesson sections on declarative knowledge and extends those investigations by adding a measure of structural knowledge. Participants (N = 80) were randomly assigned to receive 1 of 4 computer-based lesson treatments…

  12. Privacy-Preserving Matching of Spatial Datasets with Protection against Background Knowledge

    DEFF Research Database (Denmark)

    Ghinita, Gabriel; Vicente, Carmen Ruiz; Shang, Ning

    2010-01-01

    should be disclosed. Previous research efforts focused on private matching for relational data, and rely either on spaceembedding or on SMC techniques. Space-embedding transforms data points to hide their exact attribute values before matching is performed, whereas SMC protocols simulate complex digital...... circuits that evaluate the matching condition without revealing anything else other than the matching outcome. However, existing solutions have at least one of the following drawbacks: (i) they fail to protect against adversaries with background knowledge on data distribution, (ii) they compromise privacy...... by returning large amounts of false positives and (iii) they rely on complex and expensive SMC protocols. In this paper, we introduce a novel geometric transformation to perform private matching on spatial datasets. Our method is efficient and it is not vulnerable to background knowledge attacks. We consider...

  13. Both Low Blood Glucose and Insufficient Treatment Confer Risk of Neurodevelopmental Impairment in Congenital Hyperinsulinism

    DEFF Research Database (Denmark)

    Rasmussen, Annett Helleskov; Melikyan, Maria; Globa, Evgenia

    2017-01-01

    BACKGROUND/AIMS: Congenital hyperinsulinism (CHI) is a heterogeneous disease most frequently caused by KATP-channel (ABCC8 and KCNJ11) mutations, with neonatal or later onset, variable severity, and with focal or diffuse pancreatic involvement as the two major histological types. CHI confers a high...... seen in uni- or multivariate analysis. CONCLUSION: Not only very low blood glucose, but also insufficient treatment as expressed by delay until expert center hospitalization, increased the risk of neurodevelopmental impairment. This novel finding calls for improvements in spread of knowledge about CHI...

  14. Combining Task Execution and Background Knowledge for the Verification of Medical Guidelines

    Science.gov (United States)

    Hommersom, Arjen; Groot, Perry; Lucas, Peter; Balser, Michael; Schmitt, Jonathan

    The use of a medical guideline can be seen as the execution of computational tasks, sequentially or in parallel, in the face of patient data. It has been shown that many of such guidelines can be represented as a 'network of tasks', i.e., as a number of steps that have a specific function or goal. To investigate the quality of such guidelines we propose a formalization of criteria for good practice medicine a guideline should comply to. We use this theory in conjunction with medical background knowledge to verify the quality of a guideline dealing with diabetes mellitus type 2 using the interactive theorem prover KIV. Verification using task execution and background knowledge is a novel approach to quality checking of medical guidelines.

  15. Effects of Classical Background Music on Stress, Anxiety, and Knowledge of Filipino Baccalaureate Nursing Students.

    Science.gov (United States)

    Evangelista, Kevin; Macabasag, Romeo Luis A; Capili, Brylle; Castro, Timothy; Danque, Marilee; Evangelista, Hanzel; Rivero, Jenica Ana; Gonong, Michell Katrina; Diño, Michael Joseph; Cajayon, Sharon

    2017-10-28

    Previous work on the use of background music suggests conflicting results in various psychological, behavioral, and educational measures. This quasi-experiment examined the effect of integrating classical background music during a lecture on stress, anxiety, and knowledge. A total of 42 nursing students participated this study. We utilized independent sample t-test and multivariate analysis of variance to examine the effect of classical background music. Our findings suggest that the presence or absence of classical background music do not affect stress, anxiety, and knowledge scores (Λ = 0.999 F(3, 78) = 0.029, p = 0.993). We provided literature to explain the non-significant result. Although classical music failed to establish a significant influence on the dependent variables, classical background music during lecture hours can be considered a non-threatening stimulus. We recommend follow up studies regarding the role of classical background music in regulating attention control of nursing students during lecture hours.

  16. Some Aspects of Developing Background Knowledge in Second Language Acquisition Revisited

    Science.gov (United States)

    Zashchitina, Galina; Moysyak, Natalia

    2017-01-01

    The article focuses on defining how background knowledge impacts on second-language acquisition by giving a brief overview of schema theory, the interaction of the basic modes of information processing. A challenge of dealing with culturally specific texts in second language acquisition is also touched upon. Different research-supported views on…

  17. Aortic insufficiency

    Science.gov (United States)

    ... page, please enable JavaScript. Aortic insufficiency is a heart valve disease in which the aortic valve does not close ... aortic insufficiency Images Aortic insufficiency References Carabello BA. Valvular heart disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil ...

  18. MRI of occult sacral insufficiency fractures following radiotherapy

    International Nuclear Information System (INIS)

    Mammone, J.F.; Schweitzer, M.E.

    1995-01-01

    Following radiation therapy, marrow abnormalities noted on magnetic resonance imaging (MRI) are frequent and may mimic metastases. Specific radiotherapy changes are usually easily identifiable; however, traumatic lesions cause more interpretive difficulties. We assessed the incidence and MRI characteristics of insufficiency fractures in this population. During a 5-year span (1987-1991), 546 patients received pelvic radiotherapy for primary malignancies. MRI was performed in 25 of these patients at least 3 months after treatment. The mean dose in this group was 53 Gy. These MRI scans were retrospectively reviewed for the appearance of the sacrum with particular attention to the presence of insufficiency fractures. This was correlated with clinical course and scintigraphic findings. Presumed insufficiency fractures on MRI paralleled the sacral side of the sacroiliac joint, enhanced with Gd-DTPA, were most prominent or initially seen anteriorly, and had ill-defined margins on all imaging sequences. The incidence of occult sacral insufficiency fractures was at least 20%. Insufficiency fractures of the sacrum in the post-radiotherapy patient are a relatively frequent occurrence which can mimic metastases. Consideration of this phenomenon and knowledge of differential features may avoid overdiagnosis of osseous metastases. (orig.)

  19. Patients with psoriasis have insufficient knowledge of their risk of atherothrombotic disease and metabolic syndrome

    DEFF Research Database (Denmark)

    Skiveren, J; Philipsen, P; Therming, Gitte

    2015-01-01

    BACKGROUND: Knowledge is crucial to allow patients to increase their level of self-care. OBJECTIVES: To examine the extent to which patients with moderate to severe psoriasis feel informed about their disease, to investigate their level of knowledge about psoriasis and the associated risk...... to a questionnaire. RESULTS: Patients were well informed about their skin disease, but were less well informed about their risk of atherothrombotic disease/metabolic syndrome (visual analogue scale values of 6.91 and 5.15, respectively). Patients' knowledge of the disease was reflected by 74.2-99.1% correct answers...... (CA). The risk of arthritis elicited 88% CA and of depression 41.7% CA, while the risk of atherothrombotic disease and metabolic syndrome produced only 11.9-15.3% CA. Patients treated with biological drugs had a significantly stronger sense of being more well informed about the risk of disease (P = 0...

  20. Recurrent Tricuspid Insufficiency

    Science.gov (United States)

    Kara, Ibrahim; Koksal, Cengiz; Cakalagaoglu, Canturk; Sahin, Muslum; Yanartas, Mehmet; Ay, Yasin; Demir, Serdar

    2013-01-01

    This study compares the medium-term results of De Vega, modified De Vega, and ring annuloplasty techniques for the correction of tricuspid insufficiency and investigates the risk factors for recurrent grades 3 and 4 tricuspid insufficiency after repair. In our clinic, 93 patients with functional tricuspid insufficiency underwent surgical tricuspid repair from May 2007 through October 2010. The study was retrospective, and all the data pertaining to the patients were retrieved from hospital records. Functional capacity, recurrent tricuspid insufficiency, and risk factors aggravating the insufficiency were analyzed for each patient. In the medium term (25.4 ± 10.3 mo), the rates of grades 3 and 4 tricuspid insufficiency in the De Vega, modified De Vega, and ring annuloplasty groups were 31%, 23.1%, and 6.1%, respectively. Logistic regression analysis revealed that chronic obstructive pulmonary disease, left ventricular dysfunction (ejection fraction, tricuspid insufficiency. Medium-term survival was 90.6% for the De Vega group, 96.3% for the modified De Vega group, and 97.1% for the ring annuloplasty group. Ring annuloplasty provided the best relief from recurrent tricuspid insufficiency when compared with DeVega annuloplasty. Modified De Vega annuloplasty might be a suitable alternative to ring annuloplasty when rings are not available. PMID:23466680

  1. Adrenal insufficiency in pakistani hiv infected patients

    International Nuclear Information System (INIS)

    Afreen, B.; Khan, K.A.; Riaz, A.

    2017-01-01

    Background: Adrenal insufficiency (AI) is the most common endocrine complication among patients with AIDS/HIV infection and there are number of causes of AI in HIV patients. Human immunodeficiency virus directly as well as indirectly destroys adrenal glands. The estimates of its prevalence and severity vary. AI is the most life threatening but readily correctable endocrine complication that occurs in persons with HIV infection. This study was carried out to determine the frequency of Adrenal Insufficiency in HIV patients and their clinical features as proper diagnosis and timely treatment have been shown to improve quality of life and long-term mortality in AIDS patients. Methods: It was a cross sectional survey conducted at HIV clinic and Jinnah Allama Iqbal Institute of Diabetes and Endocrinology, Jinnah Hospital Lahore. Sixty-four HIV positive patients, both male and female, aged above 15 years were included in the study. HIV patients who had recently taken steroids, ketoconazole or rifampicin, determined on history, were excluded from the study. The data was collected on a structured proforma and analysis was performed in SPSS-21.0. Frequency and percentages for adrenal insufficiency and its characteristics were calculated. Chi-square test was used with p<0.05 as statistically significant. Results: In this study, 9 (14.06%) HIV patients were diagnosed with adrenal insufficiency, male to female ratio was 3.5:1 and AI was found statistically significantly associated with fatigue (p<0.008) and weight loss (p<0.001). Conclusion: Adrenal insufficiency was high among the patients with HIV, it was not gender specific but it was found to be associated with fatigue and weight loss. (author)

  2. Portuguese Coaches' Perceptions of and Preferences for Knowledge Sources Related to their Professional Background.

    Science.gov (United States)

    Mesquita, Isabel; Isidro, Sofia; Rosado, António

    2010-01-01

    The purpose of this study was to analyse Portuguese coaches' perceptions of, and preferences for, knowledge sources as related to professional background; namely academic education level, coach education level and coaching experience. The study's participants comprised 336 Portuguese coaches from twenty-two sports. A questionnaire was used to identify coaches' demographic characteristics and representations about their preferred sources of coaching knowledge. MANOVA using Tukey's HSD test was used to compare groups. The results highlighted that coaches perceived that coaching knowledge is built from a broad range of sources from personal coaching and playing experiences to more explicit formal, informal and non-formal learning situations. Results indicated that the coaches ascribed more importance to experiential sources such as working with experts, learning by doing, interacting with peer coaches and attending informal seminars and clinics, than to the formal learning situations provided by the national coaching certification programs. Differences, however, were found in that coaches who had a greater background within higher education (physical) and sport valued informal and non-formal learning sources more than did coaches who were defined as not coming from an academic background. The findings point to the importance of developing new learning, experientially-based, opportunities within the Portuguese context, where curricula content continues to be delivered via didactic means. Key pointsCoaches recognized that learning is obtained from a broad range of sources of coaching knowledge and each source has a particular role in the development of a coach.Experiential guided sources reached more importance to coaches as working with experts, learning by doing, attending seminars/clinics outside of the formal system and interaction with peers were the most acknowledged.The only source that is related to formal learning, national certification programs, was

  3. Portuguese Coaches’ Perceptions of and Preferences for Knowledge Sources Related to their Professional Background

    Science.gov (United States)

    Mesquita, Isabel; Isidro, Sofia; Rosado, António

    2010-01-01

    The purpose of this study was to analyse Portuguese coaches’ perceptions of, and preferences for, knowledge sources as related to professional background; namely academic education level, coach education level and coaching experience. The study’s participants comprised 336 Portuguese coaches from twenty-two sports. A questionnaire was used to identify coaches’ demographic characteristics and representations about their preferred sources of coaching knowledge. MANOVA using Tukey’s HSD test was used to compare groups. The results highlighted that coaches perceived that coaching knowledge is built from a broad range of sources from personal coaching and playing experiences to more explicit formal, informal and non-formal learning situations. Results indicated that the coaches ascribed more importance to experiential sources such as working with experts, learning by doing, interacting with peer coaches and attending informal seminars and clinics, than to the formal learning situations provided by the national coaching certification programs. Differences, however, were found in that coaches who had a greater background within higher education (physical) and sport valued informal and non-formal learning sources more than did coaches who were defined as not coming from an academic background. The findings point to the importance of developing new learning, experientially-based, opportunities within the Portuguese context, where curricula content continues to be delivered via didactic means. Key points Coaches recognized that learning is obtained from a broad range of sources of coaching knowledge and each source has a particular role in the development of a coach. Experiential guided sources reached more importance to coaches as working with experts, learning by doing, attending seminars/clinics outside of the formal system and interaction with peers were the most acknowledged. The only source that is related to formal learning, national certification programs

  4. Subject Knowledge Enhancement Courses for Creating New Chemistry and Physics Teachers: The Students' Perceptions

    Science.gov (United States)

    Tynan, Richard; Jones, Robert Bryn; Mallaburn, Andrea; Clays, Ken

    2016-01-01

    Subject knowledge enhancement (SKE) courses are one option open in England to graduates with a science background whose first degree content is judged to be insufficient to train to become chemistry or physics teachers. Previous articles in "School Science Review" have discussed the structure of one type of extended SKE course offered at…

  5. Combining rules, background knowledge and change patterns to maintain semantic annotations.

    Science.gov (United States)

    Cardoso, Silvio Domingos; Chantal, Reynaud-Delaître; Da Silveira, Marcos; Pruski, Cédric

    2017-01-01

    Knowledge Organization Systems (KOS) play a key role in enriching biomedical information in order to make it machine-understandable and shareable. This is done by annotating medical documents, or more specifically, associating concept labels from KOS with pieces of digital information, e.g., images or texts. However, the dynamic nature of KOS may impact the annotations, thus creating a mismatch between the evolved concept and the associated information. To solve this problem, methods to maintain the quality of the annotations are required. In this paper, we define a framework based on rules, background knowledge and change patterns to drive the annotation adaption process. We evaluate experimentally the proposed approach in realistic cases-studies and demonstrate the overall performance of our approach in different KOS considering the precision, recall, F1-score and AUC value of the system.

  6. Imaging of insufficiency fractures

    Energy Technology Data Exchange (ETDEWEB)

    Krestan, Christian [Department of Radiology, Medical University of Vienna, Vienna General Hospital, Waehringerstr. 18-20, 1090 Vienna (Austria)], E-mail: christian.krestan@meduniwien.ac.at; Hojreh, Azadeh [Department of Radiology, Medical University of Vienna, Vienna General Hospital, Waehringerstr. 18-20, 1090 Vienna (Austria)

    2009-09-15

    This review focuses on the occurrence, imaging and differential diagnosis of insufficiency fractures. Prevalence, the most common sites of insufficiency fractures and their clinical implications are discussed. Insufficiency fractures occur with normal stress exerted on weakened bone. Postmenopausal osteoporosis is the most common cause of insufficiency fractures. Other conditions which affect bone turnover include osteomalacia, hyperparathyroidism, chronic renal failure and high-dose glucocorticoid therapy. It is a challenge for the radiologist to detect and diagnose insufficiency fractures, and to differentiate them from other bone lesions. Radiographs are still the most widely used imaging method for identification of insufficiency fractures, but sensitivity is limited, depending on the location of the fractures. Magnetic resonance imaging (MRI) is a very sensitive tool to visualize bone marrow abnormalities associated with insufficiency fractures. Thin section, multi-detector computed tomography (MDCT) depicts subtle fracture lines allowing direct visualization of cortical and trabecular bone. Bone scintigraphy still plays a role in detecting fractures, with good sensitivity but limited specificity. The most important differential diagnosis is underlying malignant disease leading to pathologic fractures. Bone densitometry and clinical history may also be helpful in confirming the diagnosis of insufficiency fractures.

  7. [Membranous nephropathy associated to autoimmune thyroiditis, chronic pancreatitis and suprarrenal insufficiency].

    Science.gov (United States)

    Merino, J L; Fernández Lucas, M; Teruel, J L; Valer, P; Moreira, V; Arambarri, M; Ortuño, J

    2004-01-01

    A 33 year old female was admitted to the hospital to study aedema and bocio, A nephrotic syndrome was diagnosed and the renal biopsy demonstrated membranous glomerulonephritis, stage II. She was also diagnosed of Hashimoto's autoinmmune thyroiditis: TSH (41.5 uUl/ml), T4 (0.07 ng/dl), antithyroglobuline (1/2560) and antimicrosome (1/6400). Four year latter she was diagnosed of autoinmmune pancreatitis, without evidence of diabetes mellitus or exocrine pancreatic insufficiency. Eight years latter she was diagnosed of primary autoimmune suprarrenal insufficiency: basal cortisol: 2.7 mcg/dl, post ACTH estimulated cortisol: 5.6 mcg/dl, antinuclear antibody (1/160) and antiparietal (1/320). We present a pluriglandular autoimmune syndrome with membranous glomerulonephritis, thyroiditis, pancreatitis and suprarrenal insufficiency. To the best of our knowledge this complex syndrome has not been previously described.

  8. Study of acute renal insufficiency and chronic renal insufficiency using radioisotopes

    International Nuclear Information System (INIS)

    Raynaud, C.

    1976-01-01

    Radioisotopic renal function tests are of assistance to diagnose and follow-up the course of renal insufficiency. The radioisotopic renogram is useful in assessing the response to therapy of child obstructive uropathies and evaluating renal transplant function. The renal scan is helpful, in an emergency service, to differenciate chronic renal insufficiency from acute renal insufficiency. Hg renal uptake test provides informations on physiopathological problems. Among them, the following problems are emphasized: evolution of a nonfunctioning kidney, control of the success of a reparative surgery and of bilateral obstructive uropathies with unilateral symptoms [fr

  9. Students' Knowledge Sources and Knowledge Sharing in the Design Studio--An Exploratory Study

    Science.gov (United States)

    Chiu, Sheng-Hsiao

    2010-01-01

    Architectural design is a knowledge-intensive activity; however, students frequently lack sufficient knowledge when they practice design. Collaborative learning can supplement the students' insufficient expertise. Successful collaborative learning relies on knowledge sharing between students. This implies that the peers are a considerable design…

  10. [Addison's disease : Primary adrenal insufficiency].

    Science.gov (United States)

    Pulzer, A; Burger-Stritt, S; Hahner, S

    2016-05-01

    Adrenal insufficiency, a rare disorder which is characterized by the inadequate production or absence of adrenal hormones, may be classified as primary adrenal insufficiency in case of direct affection of the adrenal glands or secondary adrenal insufficiency, which is mostly due to pituitary or hypothalamic disease. Primary adrenal insufficiency affects 11 of 100,000 individuals. Clinical symptoms are mainly nonspecific and include fatigue, weight loss, and hypotension. The diagnostic test of choice is dynamic testing with synthetic ACTH. Patients suffering from chronic adrenal insufficiency require lifelong hormone supplementation. Education in dose adaption during physical and mental stress or emergency situations is essential to prevent life-threatening adrenal crises. Patients with adrenal insufficiency should carry an emergency card and emergency kit with them.

  11. Increased Risk for School Violence-Related Behaviors among Adolescents with Insufficient Sleep

    Science.gov (United States)

    Hildenbrand, Aimee K.; Daly, Brian P.; Nicholls, Elizabeth; Brooks-Holliday, Stephanie; Kloss, Jacqueline D.

    2013-01-01

    Background: School violence is associated with significant acute and long-term negative health outcomes. Previous investigations have largely neglected the role of pertinent health behaviors in school violence, including sleep. Insufficient sleep is associated with adverse physical, behavioral, and psychosocial consequences among adolescents, many…

  12. Is knowing believing? The role of event plausibility and background knowledge in planting false beliefs about the personal past.

    Science.gov (United States)

    Pezdek, Kathy; Blandon-Gitlin, Iris; Lam, Shirley; Hart, Rhiannon Ellis; Schooler, Jonathan W

    2006-12-01

    False memories are more likely to be planted for plausible than for implausible events, but does just knowing about an implausible event make individuals more likely to think that the event happened to them? Two experiments assessed the independent contributions o f plausibility a nd background knowledge to planting false beliefs. In Experiment 1, subjects rated 20 childhood events as to the likelihood of each event having happened to them. The list included the implausible target event "received an enema," a critical target event of Pezdek, Finger, and Hodge (1997). Two weeks later, subjects were presented with (1) information regarding the high prevalence rate of enemas; (2) background information on how to administer an enema; (3) neither type of information; or (4) both. Immediately or 2 weeks later, they rated the 20 childhood events again. Only plausibility significantly increased occurrence ratings. In Experiment 2, the target event was changed from "barium enema administered in a hospital" to "home enema for constipation"; significant effects of both plausibility and background knowledge resulted. The results suggest that providing background knowledge can increase beliefs about personal events, but that its impact is limited by the extent of the individual's familiarity with the context of the suggested target event.

  13. Adrenal Insufficiency as a Cause of Acute Liver Failure: A Case Report

    Directory of Open Access Journals (Sweden)

    Jamshid Vafaeimanesh

    2013-01-01

    Full Text Available Introduction. Many diseases and conditions can contribute to elevated liver enzymes. Common causes include viral and autoimmune hepatitis, fatty liver, and bile duct diseases, but, in uncommon cases like liver involvement in endocrine disorders, liver failure is also seen. Adrenal insufficiency is the rarest endocrine disorder complicating the liver. In the previously reported cases of adrenal insufficiency, mild liver enzymes elevation was seen but we report a case with severe elevated liver enzymes and liver failure due to adrenal insufficiency. Based on our knowledge, this is the first report in this field. Case Report. A 39-year-old woman was referred to emergency ward due to drowsiness and severe fatigue. Her laboratory tests revealed prothrombin time: 21 sec, alanine aminotransferase (ALT: 2339 IU/L, aspartate aminotransferase (AST: 2002 IU/L, and ALP: 90 IU/L. No common cause of liver involvement was discovered, and eventually, with diagnosis of adrenal insufficiency and corticosteroid therapy, liver enzymes and function became normal. Finally, the patient was discharged with good general condition. Conclusion. With this report, we emphasize adrenal insufficiency (primary or secondary as a reason of liver involvement in unexplainable cases and recommend that any increase in the liver enzymes, even liver failure, in these patients should be observed.

  14. [Knowledge and beliefs of professional workers in education, health and social services towards ADHD].

    Science.gov (United States)

    Massé, Line; Couture, Caroline; Anciaux, Valentine

    2010-01-01

    This study aims at better understanding the knowledge and beliefs of professional workers in school, health and social service settings in Quebec regarding ADHD. The authors examine the important discrepancies identified by Cohen (1999) between identified standard practices in treating ADHD patients and practices used in Quebec. This situation could be linked to insufficient knowledge of workers or certain of their beliefs that oppose these practices and their reluctance to implement them in their environment. Two measurement scales were utilised : the Attention Deficit Hyperactivity Disorder Orientation Scale (ADHDOS, Couture, 2002) and the Survey of ADHD of Jerome and al. (1994). Results show among other things, that knowledge and beliefs vary according to professionals'background and training.

  15. Improving Oncology Nurses' Knowledge About Nutrition and Physical Activity for Cancer Survivors.

    Science.gov (United States)

    van Veen, Merel R; Hoedjes, Meeke; Versteegen, Joline J; van de Meulengraaf-Wilhelm, Nienke; Kampman, Ellen; Beijer, Sandra

    2017-07-01

    To assess what percentage of oncology nurses perceived themselves as having insufficient knowledge to provide advice on nutrition and/or physical activity (PA), which characteristics were associated with nurses' perception, and whether the content and information sources differed among those nurses.
. A cross-sectional study.
. A web-based survey among oncology nurses in the Netherlands.
. 355 oncology nurses provided advice on nutrition; of these, 327 provided advice on PA.
. From May to July 2013, oncology nurses were invited to complete an online questionnaire. Pearson's chi-squared tests and uni- and multivariate logistic regression analyses were conducted.
. Oncology nurses' perception of having sufficient or insufficient knowledge to be able to provide advice on nutrition and PA, the content of the advice, and the information sources on which the advice was based.
. 43% of oncology nurses perceived themselves as having insufficient knowledge to provide advice on nutrition, and 46% perceived insufficient knowledge to provide advice on PA. Factors associated with perceiving insufficient knowledge on nutrition were being aged younger, having lower education, and providing counseling during treatment only. Those nurses were more likely to suggest taking oral nutritional supplements or visiting a dietitian and were less likely to provide information on fluid intake. Nurses perceiving insufficient knowledge about PA used oncology guidelines less often.
. Almost half of the oncology nurses providing advice on nutrition and PA perceived themselves as having insufficient knowledge to be able to provide such advice. In particular, younger oncology nurses and oncology nurses with an intermediate vocational education may benefit most from education about these topics. 
. Educational training for oncology nurses should include nutrition and PA. Oncology nurses should collaborate with dietitians to discuss what information should be provided to patients by

  16. The contribution of phonological knowledge, memory, and language background to reading comprehension in deaf populations

    Directory of Open Access Journals (Sweden)

    Elizabeth Ann Hirshorn

    2015-08-01

    Full Text Available While reading is challenging for many deaf individuals, some become proficient readers. Yet we do not know the component processes that support reading comprehension in these individuals. Speech-based phonological knowledge is one of the strongest predictors of reading comprehension in hearing individuals, yet its role in deaf readers is controversial. This could reflect the highly varied language backgrounds among deaf readers as well as the difficulty of disentangling the relative contribution of phonological versus orthographic knowledge of spoken language, in our case ‘English’, in this population. Here we assessed the impact of language experience on reading comprehension in deaf readers by recruiting oral deaf individuals, who use spoken English as their primary mode of communication, and deaf native signers of American Sign Language. First, to address the contribution of spoken English phonological knowledge in deaf readers, we present novel tasks that evaluate phonological versus orthographic knowledge. Second, the impact of this knowledge, as well as verbal short-term memory and long-term memory skills, on reading comprehension was evaluated. The best predictor of reading comprehension differed as a function of language experience, with long-term memory, as measured by free recall, being a better predictor in deaf native signers than in oral deaf. In contrast, the measures of English phonological knowledge, independent of orthographic knowledge, best predicted reading comprehension in oral deaf individuals. These results suggest successful reading strategies differ across deaf readers as a function of their language experience, and highlight a possible alternative route to literacy in deaf native signers.

  17. Outcomes of Pulmonary Valve Replacement for Correction Pulmonary Insufficiency after Primary Repair of Tetralogy of Fallot (TOF)

    OpenAIRE

    Mohammad Abbassi Teshnisi; Aliasghar Moeinipour; Hamid Hoseinikhah; Seyedeh Zahra Aemmi; Shahla Shirin Bahador; Nahid Zirak

    2016-01-01

    Background Total correction of Tetralogy of Fallot (TOF) anomaly in early childhood has been practiced in many centers with good results, but in some of patients after few years sever Pulmonary valve insufficiency occurred. Materials and Methods At a cross- sectional study from January 2015 to January 2016, 10 patients who had history of primary repair of TOF with free pulmonary insufficiency (PI) that underwent of pulmonary valve replacement (PVR) with bioprosthetic valves were evaluated. Re...

  18. Optimal glucocorticoid replacement in adrenal insufficiency.

    Science.gov (United States)

    Øksnes, Marianne; Ross, Richard; Løvås, Kristian

    2015-01-01

    Adrenal insufficiency (glucocorticoid deficiency) comprises a group of rare diseases, including primary adrenal insufficiency, secondary adrenal insufficiency and congenital adrenal hyperplasia. Lifesaving glucocorticoid therapy was introduced over 60 years ago, but since then a number of advances in treatment have taken place. Specifically, little is known about short- and long-term treatment effects, and morbidity and mortality. Over the past decade, systematic cohort and registry studies have described reduced health-related quality of life, an unfavourable metabolic profile and increased mortality in patients with adrenal insufficiency, which may relate to unphysiological glucocorticoid replacement. This has led to the development of new modes of replacement that aim to mimic normal glucocorticoid physiology. Here, evidence for the inadequacy of conventional glucocorticoid therapy and recent developments in treatment are reviewed, with an emphasis on primary adrenal insufficiency. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Inflammatory manifestations of experimental lymphatic insufficiency.

    Directory of Open Access Journals (Sweden)

    Raymond Tabibiazar

    2006-07-01

    Full Text Available BACKGROUND: Sustained lymph stagnation engenders a pathological response that is complex and not well characterized. Tissue inflammation in lymphedema may reflect either an active or passive consequence of impaired immune traffic. METHODS AND FINDINGS: We studied an experimental model of acute post-surgical lymphedema in the tails of female hairless, immunocompetent SKH-1 mice. We performed in vivo imaging of impaired immune traffic in experimental, murine acquired lymphatic insufficiency. We demonstrated impaired mobilization of immunocompetent cells from the lymphedematous region. These findings correlated with histopathological alterations and large-scale transcriptional profiling results. We found intense inflammatory changes in the dermis and the subdermis. The molecular pattern in the RNA extracted from the whole tissue was dominated by the upregulation of genes related to acute inflammation, immune response, complement activation, wound healing, fibrosis, and oxidative stress response. CONCLUSIONS: We have characterized a mouse model of acute, acquired lymphedema using in vivo functional imaging and histopathological correlation. The model closely simulates the volume response, histopathology, and lymphoscintigraphic characteristics of human acquired lymphedema, and the response is accompanied by an increase in the number and size of microlymphatic structures in the lymphedematous cutaneous tissues. Molecular characterization through clustering of genes with known functions provides insights into processes and signaling pathways that compose the acute tissue response to lymph stagnation. Further study of genes identified through this effort will continue to elucidate the molecular mechanisms and lead to potential therapeutic strategies for lymphatic vascular insufficiency.

  20. Enhancing Knowledge Sharing and Research Collaboration among Academics: The Role of Knowledge Management

    Science.gov (United States)

    Tan, Christine Nya-Ling

    2016-01-01

    Although knowledge sharing (KS) has been acknowledged as important, universities face issues that may hinder active sharing among its faculty members such as the absence of trust among its members or insufficient incentives rewarded to those who deserved it. The aim of this research is to focus on the impact of knowledge management (KM) factors in…

  1. Food insufficiency is associated with high-risk sexual behavior among women in Botswana and Swaziland.

    Directory of Open Access Journals (Sweden)

    Sheri D Weiser

    2007-10-01

    Full Text Available Both food insufficiency and HIV infection are major public health problems in sub-Saharan Africa, yet the impact of food insufficiency on HIV risk behavior has not been systematically investigated. We tested the hypothesis that food insufficiency is associated with HIV transmission behavior.We studied the association between food insufficiency (not having enough food to eat over the previous 12 months and inconsistent condom use, sex exchange, and other measures of risky sex in a cross-sectional population-based study of 1,255 adults in Botswana and 796 adults in Swaziland using a stratified two-stage probability design. Associations were examined using multivariable logistic regression analyses, clustered by country and stratified by gender. Food insufficiency was reported by 32% of women and 22% of men over the previous 12 months. Among 1,050 women in both countries, after controlling for respondent characteristics including income and education, HIV knowledge, and alcohol use, food insufficiency was associated with inconsistent condom use with a nonprimary partner (adjusted odds ratio [AOR] 1.73, 95% confidence interval [CI] 1.27-2.36, sex exchange (AOR 1.84, 95% CI 1.74-1.93, intergenerational sexual relationships (AOR 1.46, 95% CI 1.03-2.08, and lack of control in sexual relationships (AOR 1.68, 95% CI 1.24-2.28. Associations between food insufficiency and risky sex were much attenuated among men.Food insufficiency is an important risk factor for increased sexual risk-taking among women in Botswana and Swaziland. Targeted food assistance and income generation programs in conjunction with efforts to enhance women's legal and social rights may play an important role in decreasing HIV transmission risk for women.

  2. Vocabulary Knowledge Predicts Lexical Processing: Evidence from a Group of Participants with Diverse Educational Backgrounds

    Directory of Open Access Journals (Sweden)

    Nina Mainz

    2017-07-01

    Full Text Available Vocabulary knowledge is central to a speaker's command of their language. In previous research, greater vocabulary knowledge has been associated with advantages in language processing. In this study, we examined the relationship between individual differences in vocabulary and language processing performance more closely by (i using a battery of vocabulary tests instead of just one test, and (ii testing not only university students (Experiment 1 but young adults from a broader range of educational backgrounds (Experiment 2. Five vocabulary tests were developed, including multiple-choice and open antonym and synonym tests and a definition test, and administered together with two established measures of vocabulary. Language processing performance was measured using a lexical decision task. In Experiment 1, vocabulary and word frequency were found to predict word recognition speed while we did not observe an interaction between the effects. In Experiment 2, word recognition performance was predicted by word frequency and the interaction between word frequency and vocabulary, with high-vocabulary individuals showing smaller frequency effects. While overall the individual vocabulary tests were correlated and showed similar relationships with language processing as compared to a composite measure of all tests, they appeared to share less variance in Experiment 2 than in Experiment 1. Implications of our findings concerning the assessment of vocabulary size in individual differences studies and the investigation of individuals from more varied backgrounds are discussed.

  3. Vocabulary Knowledge Predicts Lexical Processing: Evidence from a Group of Participants with Diverse Educational Backgrounds

    Science.gov (United States)

    Mainz, Nina; Shao, Zeshu; Brysbaert, Marc; Meyer, Antje S.

    2017-01-01

    Vocabulary knowledge is central to a speaker's command of their language. In previous research, greater vocabulary knowledge has been associated with advantages in language processing. In this study, we examined the relationship between individual differences in vocabulary and language processing performance more closely by (i) using a battery of vocabulary tests instead of just one test, and (ii) testing not only university students (Experiment 1) but young adults from a broader range of educational backgrounds (Experiment 2). Five vocabulary tests were developed, including multiple-choice and open antonym and synonym tests and a definition test, and administered together with two established measures of vocabulary. Language processing performance was measured using a lexical decision task. In Experiment 1, vocabulary and word frequency were found to predict word recognition speed while we did not observe an interaction between the effects. In Experiment 2, word recognition performance was predicted by word frequency and the interaction between word frequency and vocabulary, with high-vocabulary individuals showing smaller frequency effects. While overall the individual vocabulary tests were correlated and showed similar relationships with language processing as compared to a composite measure of all tests, they appeared to share less variance in Experiment 2 than in Experiment 1. Implications of our findings concerning the assessment of vocabulary size in individual differences studies and the investigation of individuals from more varied backgrounds are discussed. PMID:28751871

  4. Knowledge insufficient: the management of haemoglobin SC disease.

    Science.gov (United States)

    Pecker, Lydia H; Schaefer, Beverly A; Luchtman-Jones, Lori

    2017-02-01

    Although haemoglobin SC (HbSC) accounts for 30% of sickle cell disease (SCD) in the United States and United Kingdom, evidence-based guidelines for genotype specific management are lacking. The unique pathology of HbSC disease is complex, characterized by erythrocyte dehydration, intracellular sickling and increased blood viscosity. The evaluation and treatment of patients with HbSC is largely inferred from studies of SCD consisting mostly of haemoglobin SS (HbSS) patients. These studies are underpowered to allow definitive conclusions about HbSC. We review the pathophysiology of HbSC disease, including known and potential differences between HbSS and HbSC, and highlight knowledge gaps in HbSC disease management. Clinical and translational research is needed to develop targeted treatments and to validate management recommendations for efficacy, safety and impact on quality of life for people with HbSC. © 2016 John Wiley & Sons Ltd.

  5. METONYMY BASED ON CULTURAL BACKGROUND KNOWLEDGE AND PRAGMATIC INFERENCING: EVIDENCE FROM SPOKEN DISCOURSE

    Directory of Open Access Journals (Sweden)

    Arijana Krišković

    2009-01-01

    Full Text Available Th e characterization of metonymy as a conceptual tool for guiding inferencing in language has opened a new fi eld of study in cognitive linguistics and pragmatics. To appreciate the value of metonymy for pragmatic inferencing, metonymy should not be viewed as performing only its prototypical referential function. Metonymic mappings are operative in speech acts at the level of reference, predication, proposition and illocution. Th e aim of this paper is to study the role of metonymy in pragmatic inferencing in spoken discourse in televison interviews. Case analyses of authentic utterances classifi ed as illocutionary metonymies following the pragmatic typology of metonymic functions are presented. Th e inferencing processes are facilitated by metonymic connections existing between domains or subdomains in the same functional domain. It has been widely accepted by cognitive linguists that universal human knowledge and embodiment are essential for the interpretation of metonymy. Th is analysis points to the role of cultural background knowledge in understanding target meanings. All these aspects of metonymic connections are exploited in complex inferential processes in spoken discourse. In most cases, metaphoric mappings are also a part of utterance interpretation.

  6. The contribution of phonological knowledge, memory, and language background to reading comprehension in deaf populations

    Science.gov (United States)

    Hirshorn, Elizabeth A.; Dye, Matthew W. G.; Hauser, Peter; Supalla, Ted R.; Bavelier, Daphne

    2015-01-01

    While reading is challenging for many deaf individuals, some become proficient readers. Little is known about the component processes that support reading comprehension in these individuals. Speech-based phonological knowledge is one of the strongest predictors of reading comprehension in hearing individuals, yet its role in deaf readers is controversial. This could reflect the highly varied language backgrounds among deaf readers as well as the difficulty of disentangling the relative contribution of phonological versus orthographic knowledge of spoken language, in our case ‘English,’ in this population. Here we assessed the impact of language experience on reading comprehension in deaf readers by recruiting oral deaf individuals, who use spoken English as their primary mode of communication, and deaf native signers of American Sign Language. First, to address the contribution of spoken English phonological knowledge in deaf readers, we present novel tasks that evaluate phonological versus orthographic knowledge. Second, the impact of this knowledge, as well as memory measures that rely differentially on phonological (serial recall) and semantic (free recall) processing, on reading comprehension was evaluated. The best predictor of reading comprehension differed as a function of language experience, with free recall being a better predictor in deaf native signers than in oral deaf. In contrast, the measures of English phonological knowledge, independent of orthographic knowledge, best predicted reading comprehension in oral deaf individuals. These results suggest successful reading strategies differ across deaf readers as a function of their language experience, and highlight a possible alternative route to literacy in deaf native signers. Highlights: 1. Deaf individuals vary in their orthographic and phonological knowledge of English as a function of their language experience. 2. Reading comprehension was best predicted by different factors in oral deaf and

  7. Introduction of a Successful Pregnancy in a Patient with Advanced Chronic Renal Insufficiency

    Directory of Open Access Journals (Sweden)

    H. Saghafi

    2008-04-01

    Full Text Available Background and ObjectiveIn the women with chronic renal insufficiency ovulation is suppressed therefore they rarely become pregnant. If pregnancy occurs, they might encounter many conflictions. It may lead to death (fetus or mother. The aim of this study was reporting a successful pregnancy in a patient with advanced chronic renal insufficiency.Case reportThe patient was a 32 years old woman with long period of infertility (8 years. The first main clinical symptom was abdominal pain especially in hypogastric area as well as hyperuremia, elevated levels of creatinine (2.9 mg/dl, mild proteinuria and hematuria. The urine specific gravity was 1010. Sonography data showed asymmetrical small kidneys. Other complaints were pruritus and flank pain during urination. The primary diagnosis was chronic renal failure due to probable chronic pyelonephritis. After an interval she returned with positive pregnancy test. She decided to continue the pregnancy in despite of obstetrician belief for aborting. During pregnancy, proteinuria reached to two plus, hemoglobin fell to 9.7, creatinine levels reached to 3.7 mg/dl and blood pressure was fluctuating between 110/80 and 130/85 mmHg. She admitted in the hospital in third trimester of pregnancy because of preterm labor. However the pain was suppressed after starting magnesium sulfate infusion. Keywords: Renal Insufficiency, Chronic Renal Insufficiency, Pregnancy

  8. Insufficient time for leisure and perceived health and stress in working parents with small children.

    Science.gov (United States)

    Håkansson, Carita; Axmon, Anna; Eek, Frida

    2016-10-17

    More knowledge about how recovery may promote health among parents with small children is needed. To explore whether insufficient time for leisure was associated with poorer perceived health and higher stress in working parents. A further aim was to explore potential gender differences in the association between insufficient time for leisure and poor perceived health. A postal survey including the perceived stress scale and three measures of subjective health - self-rated health (SF-36), work-related fatigue (Swedish occupational fatigue questionnaire), and Lund subjective health complaints - as well as questions about time for leisure was completed by 965 women and 597 men. Risk ratios for poor perceived health and stress were estimated using Poisson regression, in which also gender interaction was analysed. The results showed higher risk for perceived stress among parents reporting insufficient time for relaxation, and more subjective health complaints among those reporting insufficient time to spend with their children. Overall, effects were larger among women than among men. A good balance between work and leisure seems to be of importance for working parents' perceived health and stress.

  9. Knowledge fusion: Time series modeling followed by pattern recognition applied to unusual sections of background data

    International Nuclear Information System (INIS)

    Burr, T.; Doak, J.; Howell, J.A.; Martinez, D.; Strittmatter, R.

    1996-03-01

    This report describes work performed during FY 95 for the Knowledge Fusion Project, which by the Department of Energy, Office of Nonproliferation and National Security. The project team selected satellite sensor data as the one main example to which its analysis algorithms would be applied. The specific sensor-fusion problem has many generic features that make it a worthwhile problem to attempt to solve in a general way. The generic problem is to recognize events of interest from multiple time series in a possibly noisy background. By implementing a suite of time series modeling and forecasting methods and using well-chosen alarm criteria, we reduce the number of false alarms. We then further reduce the number of false alarms by analyzing all suspicious sections of data, as judged by the alarm criteria, with pattern recognition methods. This report describes the implementation and application of this two-step process for separating events from unusual background. As a fortunate by-product of this activity, it is possible to gain a better understanding of the natural background

  10. Knowledge fusion: Time series modeling followed by pattern recognition applied to unusual sections of background data

    Energy Technology Data Exchange (ETDEWEB)

    Burr, T.; Doak, J.; Howell, J.A.; Martinez, D.; Strittmatter, R.

    1996-03-01

    This report describes work performed during FY 95 for the Knowledge Fusion Project, which by the Department of Energy, Office of Nonproliferation and National Security. The project team selected satellite sensor data as the one main example to which its analysis algorithms would be applied. The specific sensor-fusion problem has many generic features that make it a worthwhile problem to attempt to solve in a general way. The generic problem is to recognize events of interest from multiple time series in a possibly noisy background. By implementing a suite of time series modeling and forecasting methods and using well-chosen alarm criteria, we reduce the number of false alarms. We then further reduce the number of false alarms by analyzing all suspicious sections of data, as judged by the alarm criteria, with pattern recognition methods. This report describes the implementation and application of this two-step process for separating events from unusual background. As a fortunate by-product of this activity, it is possible to gain a better understanding of the natural background.

  11. Association between vitamin D insufficiency and elevated serum uric acid among middle-aged and elderly Chinese Han women.

    Directory of Open Access Journals (Sweden)

    Hao Peng

    Full Text Available BACKGROUND: Association between vitamin D insufficiency and hyperuricemia has not been reported so far. We aimed to study the association of vitamin D insufficiency with elevated serum uric acid among middle-aged and elderly Chinese Han women. METHODS: We collected data from participants residing in Jinchang district of Suzhou from January to May, 2010. Serum uric acid, 25-hydroxy vitamin D and other traditional biomarkers including fasting plasma glucose and blood lipids were determined in 1726 women aged above 30 years. Association between vitamin D insufficiency and elevated uric acid was analyzed in premenopausal and postmenopausal women, respectively. RESULTS: Among postmenopausal women, 25-hydroxy vitamin D level of participants with elevated uric acid was lower than that of those with normal uric acid (median [interquartile range]: 35[28-57] vs 40[32-58], µg/L; P = 0.006. Elevated uric acid was more prevalent in participants with vitamin D insufficiency compared to those without vitamin D insufficiency (16.50% vs 8.08%; P<0.001. Association between vitamin D insufficiency and elevated uric acid was not significant among premenopausal women. However, participants with vitamin D insufficiency were more likely to have elevated uric acid compared with those without vitamin D insufficiency among postmenopausal women (OR, 95% CI: 2.38, 1.47-3.87. Moreover, after excluding individuals with diabetes and/or hypertension, the association of vitamin D insufficiency with elevated uric acid was still significant (OR, 95% CI: 2.48, 1.17-5.44. CONCLUSIONS: Vitamin D insufficiency was significantly associated with elevated uric acid among postmenopausal Chinese Han women. This study suggested that a clinical trial should be conducted to confirm the association of vitamin D insufficiency with hyperuricemia.

  12. Knowledge gain and behavioral change in citizen-science programs.

    Science.gov (United States)

    Jordan, Rebecca C; Gray, Steven A; Howe, David V; Brooks, Wesley R; Ehrenfeld, Joan G

    2011-12-01

    Citizen-science programs are often touted as useful for advancing conservation literacy, scientific knowledge, and increasing scientific-reasoning skills among the public. Guidelines for collaboration among scientists and the public are lacking and the extent to which these citizen-science initiatives change behavior is relatively unstudied. Over two years, we studied 82 participants in a three-day program that included education about non-native invasive plants and collection of data on the occurrence of those plants. Volunteers were given background knowledge about invasive plant ecology and trained on a specific protocol for collecting invasive plant data. They then collected data and later gathered as a group to analyze data and discuss responsible environmental behavior with respect to invasive plants. We tested whether participants without experience in plant identification and with little knowledge of invasive plants increased their knowledge of invasive species ecology, participation increased knowledge of scientific methods, and participation affected behavior. Knowledge of invasive plants increased on average 24%, but participation was insufficient to increase understanding of how scientific research is conducted. Participants reported increased ability to recognize invasive plants and increased awareness of effects of invasive plants on the environment, but this translated into little change in behavior regarding invasive plants. Potential conflicts between scientific goals, educational goals, and the motivation of participants must be considered during program design. ©2011 Society for Conservation Biology.

  13. An evaluation of clinical treatment of convergence insufficiency for children with reading difficulties

    Directory of Open Access Journals (Sweden)

    Dusek Wolfgang A

    2011-08-01

    Full Text Available Abstract Background The present study investigates two different treatment options for convergence insufficiency CI for a group of children with reading difficulties referred by educational institutes to a specialist eye clinic in Vienna. Methods One hundred and thirty four subjects (aged 7-14 years with reading difficulties were referred from an educational institute in Vienna, Austria for visual assessment. Each child was given either 8Δ base-in reading spectacles (n = 51 or computerised home vision therapy (HTS (n = 51. Thirty two participants refused all treatment offered (clinical control group. A full visual assessment including reading speed and accuracy were conducted pre- and post-treatment. Results Factorial analyses demonstrated statistically significant changes between results obtained for visits 1 and 2 for total reading time, reading error score, amplitude of accommodation and binocular accommodative facility (within subjects effects (p Conclusions Reading difficulties with no apparent intellectual or psychological foundation may be due to a binocular vision anomaly such as convergence insufficiency. Both the HTS and prismatic correction are highly effective treatment options for convergence insufficiency. Prismatic correction can be considered an effective alternative to HTS.

  14. Glottal insufficiency with aspiration risk in dysphagia.

    Science.gov (United States)

    Giraldez-Rodriguez, Laureano A; Johns, Michael

    2013-12-01

    Glottal closure is an important part of the mechanism that protects the airway during the normal swallow. Glottal insufficiency disrupts glottal closure and therefore puts patients at risk of aspiration. Treatment of glottal insufficiency can be classified as surgical or nonsurgical. The objective of treating glottal insufficiency is to avoid aspiration or penetration of secretions or food into the airway. Nonsurgical treatment consists of swallowing maneuvers and other measures. Surgical treatment of glottal insufficiency includes injection laryngoplasty, medialization thyroplasty with or without arytenoid adduction or with arytenopexy and cricothyroid subluxation, hypopharyngoplasty, cricopharynx muscle dilation, and cricopharynx myotomy. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Predictive factors of adrenal insufficiency in patients admitted to acute medical wards: a case control study

    Directory of Open Access Journals (Sweden)

    Oboni Jean-Baptiste

    2013-01-01

    Full Text Available Abstract Background Adrenal insufficiency is a rare and potentially lethal disease if untreated. Several clinical signs and biological markers are associated with glucocorticoid failure but the importance of these factors for diagnosing adrenal insufficiency is not known. In this study, we aimed to assess the prevalence of and the factors associated with adrenal insufficiency among patients admitted to an acute internal medicine ward. Methods Retrospective, case-control study including all patients with high-dose (250 μg ACTH-stimulation tests for suspected adrenal insufficiency performed between 2008 and 2010 in an acute internal medicine ward (n = 281. Cortisol values Results 32 patients (11.4% presented adrenal insufficiency; the others served as controls. Among all clinical and biological parameters studied, history of glucocorticoid withdrawal was the only independent factor significantly associated with patients with adrenal insufficiency (Odds Ratio: 6.71, 95% CI: 3.08 –14.62. Using a logistic regression, a model with four significant and independent variable was obtained, regrouping history of glucocorticoid withdrawal (OR 7.38, 95% CI [3.18 ; 17.11], p-value p-value 0.044, eosinophilia (OR 17.6, 95% CI [1.02; 302.3], p-value 0.048 and hyperkalemia (OR 2.41, 95% CI [0.87; 6.69], p-value 0.092. The AROC (95% CI was 0.75 (0.70; 0.80 for this model, with 6.3 (0.8 – 20.8 for sensitivity and 99.2 (97.1 – 99.9 for specificity. Conclusions 11.4% of patients with suspected adrenal insufficient admitted to acute medical ward actually do present with adrenal insufficiency, defined by an abnormal response to high-dose (250 μg ACTH-stimulation test. A history of glucocorticoid withdrawal was the strongest factor predicting the potential adrenal failure. The combination of a history of glucocorticoid withdrawal, nausea, eosinophilia and hyperkaliemia might be of interest to suspect adrenal insufficiency.

  16. The Use of Canine Stifle Orthotics for Cranial Cruciate Ligament Insufficiency

    Directory of Open Access Journals (Sweden)

    Brittany Jean Carr

    2016-01-01

    Full Text Available Objective: To assess weight bearing of dogs treated for unilateral cranial cruciate ligament insufficiency with a custom stifle orthotic.Background: Cranial cruciate ligament (CCL insufficiency is the most common cause of hind limb lameness in dogs. While there are numerous options for surgical management, surgery is not always an option. Recently, the use of canine stifle orthotics has also emerged as a means to non-surgically manage patients with cranial cruciate ligament insufficiency.  Evidentiary value:  This is a retrospective study of ten dogs treated for unilateral cranial cruciate ligament rupture with a stifle orthotic.Methods: Medical records (January 2005- December 2012 of ten dogs treated for unilateral cranial cruciate ligament rupture with a stifle orthotic were reviewed.  Temporospatial gait analysis was performed using a pressure sensing walkway at baseline and 90 days or greater post orthotic placement to identify weight bearing with total pressure index % (TPI%.Results: TPI% improved significantly by 5.1% in the affected limb when compared to baseline (p = 0.0020. At final gait analysis, TPI% significantly improved by 3% in the affected limb with the orthotic off when compared to the unaffected limb (p = 0.0020.Conclusion: Custom canine stifle orthotics allow for improved weight bearing in the affected limb.Application: Custom canine stifle orthotics should be considered for cases with concurrent medical conditions or financial constraints that do not allow for surgical intervention.

  17. Forensic nursing science knowledge and competency: the use of simulation.

    Science.gov (United States)

    Drake, Stacy A; Langford, Rae; Young, Anne; Ayers, Constance

    2015-01-01

    Forensic nursing is a nursing specialty that provides services to a variety of patient populations who have experienced violence, including interpersonal violence, sudden or unexpected death, and motor vehicle collisions. However, many critical care nurses have received the background knowledge or practical skills required to provide the level of care required by many forensic patients. The purpose of this study was to determine whether differences in knowledge or practical competence exist between participants using 2 different learning modalities: medium fidelity simulation versus face-to-face lecture. Participants who were enrolled in an elective online forensic nursing science course were randomly assigned to an intervention or control group. The 18 intervention group participants were given three 2-hour forensic simulation sessions in the laboratory. The 17 control group participants attended 3 face-to-face lectures covering forensic science topics. All study participants also received the same forensic course content via the online Blackboard platform. No significant differences were found between the 2 groups in either knowledge or practical competency. The lack of results may have been heavily influenced by the small sample size, which resulted in insufficient power to detect possible differences.

  18. Hypothalamic functions in patients with pituitary insufficiency

    NARCIS (Netherlands)

    Borgers, A.J.F.

    2013-01-01

    The main objective of this thesis is to increase our understanding of hypothalamic (dys)function in patients with pituitary insufficiency. This goal is driven by the clinical experience of persisting symptoms in patients adequately treated for pituitary insufficiency. We focus primarily on patients

  19. Adrenal insufficiency in critical patients: New ethiopathogenic concepts and therapeutic implications.

    Science.gov (United States)

    Mateos Moreno, Laura; Palacios García, Nuria; Estrada García, Francisco Javier

    2017-12-01

    Recently, there have been advances in understanding of the changes that occur in the hypothalamic-pituitary-adrenal axis during the different stages of critical disease. Such advances have led to a paradigm change, so that the aforementioned adaptations are no longer considered the result of adrenal axis activation, but a consequence of decreased cortisol metabolism illness. Knowledge of this new pathophysiological bases should lead to reconsider the diagnosis and treatment of adrenal insufficiency in critically ill patients, a condition poorly understood to date. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Convergence Insufficiency, Accommodative Insufficiency, Visual Symptoms, and Astigmatism in Tohono O'odham Students.

    Science.gov (United States)

    Davis, Amy L; Harvey, Erin M; Twelker, J Daniel; Miller, Joseph M; Leonard-Green, Tina; Campus, Irene

    2016-01-01

    Purpose. To determine rate of convergence insufficiency (CI) and accommodative insufficiency (AI) and assess the relation between CI, AI, visual symptoms, and astigmatism in school-age children. Methods. 3rd-8th-grade students completed the Convergence Insufficiency Symptom Survey (CISS) and binocular vision testing with correction if prescribed. Students were categorized by astigmatism magnitude (no/low: <1.00 D, moderate: 1.00 D to <3.00 D, and high: ≥3.00 D), presence/absence of clinical signs of CI and AI, and presence of symptoms. Analyses determine rate of clinical CI and AI and symptomatic CI and AI and assessed the relation between CI, AI, visual symptoms, and astigmatism. Results. In the sample of 484 students (11.67 ± 1.81 years of age), rate of symptomatic CI was 6.2% and symptomatic AI 18.2%. AI was more common in students with CI than without CI. Students with AI only (p = 0.02) and with CI and AI (p = 0.001) had higher symptom scores than students with neither CI nor AI. Moderate and high astigmats were not at increased risk for CI or AI. Conclusions. With-the-rule astigmats are not at increased risk for CI or AI. High comorbidity rates of CI and AI and higher symptoms scores with AI suggest that research is needed to determine symptomatology specific to CI.

  1. Teachers' Knowledge and Views on the Use of Learners' Socio-Cultural Background in Teaching Natural Sciences in Grade 9 Township Classes

    Science.gov (United States)

    Mavuru, Lydia; Ramnarain, Umesh

    2017-01-01

    This article explores teachers' knowledge and views on the role of learners' socio-cultural background when teaching Natural Sciences to Grade 9 learners at three South African township schools. Within a socio-cultural framework, the research investigated how teachers accommodate learners' cultural norms and values, religion and beliefs,…

  2. Adverse childhood experiences and frequent insufficient sleep in 5 U.S. States, 2009: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Chapman Daniel P

    2013-01-01

    Full Text Available Abstract Background Although adverse childhood experiences (ACEs have previously been demonstrated to be adversely associated with a variety of health outcomes in adulthood, their specific association with sleep among adults has not been examined. To better address this issue, this study examines the relationship between eight self-reported ACEs and frequent insufficient sleep among community-dwelling adults residing in 5 U.S. states in 2009. Methods To assess whether ACEs were associated with frequent insufficient sleep (respondent did not get sufficient rest or sleep ≥14 days in past 30 days in adulthood, we analyzed ACE data collected in the 2009 Behavioral Risk Factor Surveillance System, a random-digit-dialed telephone survey in Arkansas, Louisiana, New Mexico, Tennessee, and Washington. ACEs included physical abuse, sexual abuse, verbal abuse, household mental illness, incarcerated household members, household substance abuse, parental separation/divorce, and witnessing domestic violence before age 18. Smoking status and frequent mental distress (FMD (≥14 days in past 30 days when self-perceived mental health was not good were assessed as potential mediators in multivariate logistic regression analyses of frequent insufficient sleep by ACEs adjusted for race/ethnicity, gender, education, and body mass index. Results Overall, 28.8% of 25,810 respondents reported frequent insufficient sleep, 18.8% were current smokers, 10.8% reported frequent mental distress, 59.5% percent reported ≥1 ACE, and 8.7% reported ≥ 5 ACEs. Each ACE was associated with frequent insufficient sleep in multivariate analyses. Odds of frequent insufficient sleep were 2.5 (95% CI, 2.1-3.1 times higher in persons with ≥5 ACEs compared to those with no ACEs. Most relationships were modestly attenuated by smoking and FMD, but remained significant. Conclusions Childhood exposures to eight indicators of child maltreatment and household dysfunction were significantly

  3. Probabilistic Model-based Background Subtraction

    DEFF Research Database (Denmark)

    Krüger, Volker; Anderson, Jakob; Prehn, Thomas

    2005-01-01

    is the correlation between pixels. In this paper we introduce a model-based background subtraction approach which facilitates prior knowledge of pixel correlations for clearer and better results. Model knowledge is being learned from good training video data, the data is stored for fast access in a hierarchical...

  4. The Effect of “Insufficient Milk Supply” Concept Intervention on Mother's Perception of Breast Milk Production

    Directory of Open Access Journals (Sweden)

    Mekar Dwi Anggraeni

    2016-09-01

    Full Text Available Background: World Health Organisation (WHO recommends every mother to provide exclusive breastfeeding for their infants because of its benefits. However the exclusive breastfeeding rate in Indonesia was only 35%in 2013. One of the main factors affecting low exclusive breastfeeding rate was maternal perception of having low breastmilk supply. There were no previous studies examining the effect of "Insufficient Milk Supply" concept intervention on mother’s perception of low breastmilk production. This research was an innovation in nursing. Aim: To investigate the effect of intervention program based on “Insufficient Milk Supply” concept on mother’s perception of low breastmilk supply. Methods: This study was a quasy experiment pretest-posttest. Postpartum mothers were provided an intervention using a module based on the concept of "Insufficient Milk Supply". The perception of breastmilk production was measured using the Nine-items of Lactation Scale. Data were analyzed using independent t test and paired t test. Results: The t test assumptions were examined and yielded that the data were normally distributed and the variances were homogeneous. The results showed there were significant differences between the scores of pre- and post-test in the intervention group (t = -9,03, p < 0.001. Conclusion: This study offers evidence that Insufficient Milk Supply can be used in nursing practice as a concept to improve the perception of the mother's breastmilk supply.

  5. Haplo-insufficiency of both BubR1 and SGO1 accelerates cellular senescence

    Directory of Open Access Journals (Sweden)

    Sung-Hyun Park

    2016-02-01

    Full Text Available Abstract Background Spindle assembly checkpoint components BubR1 and Sgo1 play a key role in the maintenance of chromosomal instability during cell division. These proteins function to block the anaphase entry until all condensed chromosomes have been attached by the microtubules emanating from both spindle poles. Haplo-insufficiency of either BubR1 or SGO1 results in enhanced chromosomal instability and tumor development in the intestine. Recent studies show that spindle checkpoint proteins also have a role in slowing down the ageing process. Therefore, we want to study whether haplo-insufficiency of both BubR1 and SGO1 accelerates cellular senescence in mice. Methods We took advantage of the availability of BubR1 and SGO1 knockout mice and generated primary murine embryonic fibroblasts (MEFs with mutations in either BubR1, SGO1, or both and analyzed cellular senescence of the MEFs of various genetic backgrounds. Results We observed that BubR1 +/− SGO +/− MEFs had an accelerated cellular senescence characterized by morphological changes and expressed senescence-associated β-galactosidase. In addition, compared with wild-type MEFs or MEFs with a single gene deficiency, BubR1 +/− SGO1 +/− MEFs expressed enhanced levels of p21 but not p16. Conclusions Taken together, our observations suggest that combined deficiency of BubR1 and Sgo1 accelerates cellular senescence.

  6. Beta activity measurements in high, variable gamma backgrounds

    International Nuclear Information System (INIS)

    Stanga, D.; Sandu, E.; Craciun, L.

    1997-01-01

    In many cases beta activity measurements must be performed in high and variable gamma backgrounds. In such instances it is necessary to use well-shielded detectors but this technique is limited to laboratory equipment and frequently insufficient. In order to perform in a simple manner beta activity measurements in high and variable backgrounds a software-aided counting technique have been developed and a counting system have been constructed. This technique combines the different counting techniques with traditional method of successive measurement of the sample and background. The counting system is based on a programmable multi-scaler which is endowed with appropriate software and allow all operations to be performed via keyboard in an interactive fashion. Two large - area proportional detectors were selected in order to have the same background and the same gamma response within 5%. A program has been developed for the counting data analysis and beta activity computing. The software-aided counting technique has been implemented for beta activity measurement in high and variable backgrounds. (authors)

  7. Treatment results of combined platelet-rich plasma and fat injection in patients with velopharyngeal insufficiency

    OpenAIRE

    Hamid Reza Fathi; Farid Fereyduni

    2013-01-01

    Background: Velopharyngeal insufficiency causes hypernasal vocal quality and can also result in audible nasal air emission and difficulty in producing pressure consonants. The resulting speech is often socially unacceptable and can be difficult to understand. Platelet-rich plasma is an autologous derivative of whole blood. Today, the importance of clinical use of Platelet-rich plasma in the plastic surgery is considered. This study was designed to evaluate the effectiveness of combined Platel...

  8. MR imaging appearance of insufficiency fractures of the medial tibial plateau

    International Nuclear Information System (INIS)

    Laredo, J.D.; Savy, J.M.; Oreel, P.; Liote, F.; Kuntz, D.; Kaplan, G.

    1990-01-01

    This paper reports on the etiology of a painful syndrome of the medial tibial plateau (MTP) in elderly patients. Findings include acute pain of the medial aspect of the knee, normal plain radiographs, and increased uptake of the MTP on bone scans. It has been related to osteonecrosis in most cases and, more rarely, to an insufficiency fracture. To our knowledge, no MR studies of patients with this syndrome have been previously reported. Five patients presenting with this syndrome (age > 59 years) were studied with MR imaging. In all five cases, initial plain radiographs were normal and increased uptake of the MTP was found on bone scans

  9. Knowledge representation within information systems in manufacturing environments

    OpenAIRE

    Sharif, Amir M

    2004-01-01

    This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University. Representing knowledge as information content alone is insufficient in providing us with an understanding of the world around us. A combination of context as well as reasoning of the information content is fundamental to representing knowledge in an information system. Knowledge Representation is typically concerned with providing structures and theories that are used as a basis for intellige...

  10. Pancreatic Exocrine Insufficiency in Pancreatic Cancer

    Directory of Open Access Journals (Sweden)

    Miroslav Vujasinovic

    2017-02-01

    Full Text Available Abstract: Cancer patients experience weight loss for a variety of reasons, commencing with the tumor’s metabolism (Warburg effect and proceeding via cachexia to loss of appetite. In pancreatic cancer, several other factors are involved, including a loss of appetite with a particular aversion to meat and the incapacity of the pancreatic gland to function normally when a tumor is present in the pancreatic head. Pancreatic exocrine insufficiency is characterized by a deficiency of the enzymes secreted from the pancreas due to the obstructive tumor, resulting in maldigestion. This, in turn, contributes to malnutrition, specifically a lack of fat-soluble vitamins, antioxidants, and other micronutrients. Patients with pancreatic cancer and pancreatic exocrine insufficiency have, overall, an extremely poor prognosis with regard to surgical outcome and overall survival. Therefore, it is crucial to be aware of the mechanisms involved in the disease, to be able to diagnose pancreatic exocrine insufficiency early on, and to treat malnutrition appropriately, for example, with pancreatic enzymes.

  11. Pancreatic Exocrine Insufficiency in Pancreatic Cancer.

    Science.gov (United States)

    Vujasinovic, Miroslav; Valente, Roberto; Del Chiaro, Marco; Permert, Johan; Löhr, J-Matthias

    2017-02-23

    Abstract : Cancer patients experience weight loss for a variety of reasons, commencing with the tumor's metabolism (Warburg effect) and proceeding via cachexia to loss of appetite. In pancreatic cancer, several other factors are involved, including a loss of appetite with a particular aversion to meat and the incapacity of the pancreatic gland to function normally when a tumor is present in the pancreatic head. Pancreatic exocrine insufficiency is characterized by a deficiency of the enzymes secreted from the pancreas due to the obstructive tumor, resulting in maldigestion. This, in turn, contributes to malnutrition, specifically a lack of fat-soluble vitamins, antioxidants, and other micronutrients. Patients with pancreatic cancer and pancreatic exocrine insufficiency have, overall, an extremely poor prognosis with regard to surgical outcome and overall survival. Therefore, it is crucial to be aware of the mechanisms involved in the disease, to be able to diagnose pancreatic exocrine insufficiency early on, and to treat malnutrition appropriately, for example, with pancreatic enzymes.

  12. Thirty-day outcomes underestimate endocrine and exocrine insufficiency after pancreatic resection.

    Science.gov (United States)

    Lim, Pei-Wen; Dinh, Kate H; Sullivan, Mary; Wassef, Wahid Y; Zivny, Jaroslav; Whalen, Giles F; LaFemina, Jennifer

    2016-04-01

    Long-term incidence of endocrine and exocrine insufficiency after pancreatectomy is poorly described. We analyze the long-term risks of pancreatic insufficiency after pancreatectomy. Subjects who underwent pancreatectomy from 2002 to 2012 were identified from a prospective database (n = 227). Subjects who underwent total pancreatectomy or pancreatitis surgery were excluded. New post-operative endocrine and exocrine insufficiency was defined as the need for new pharmacologic intervention within 1000 days from resection. 28 (16%) of 178 subjects without pre-existing endocrine insufficiency developed post-operative endocrine insufficiency: 7 (25%) did so within 30 days, 8 (29%) between 30 and 90 days, and 13 (46%) after 90 days. 94 (43%) of 214 subjects without pre-operative exocrine insufficiency developed exocrine insufficiency: 20 (21%) did so within 30 days, 29 (31%) between 30 and 90 days, and 45 (48%) after 90 days. Adjuvant radiation was associated with new endocrine insufficiency. On multivariate regression, pancreaticoduodenectomy and chemotherapy were associated with a greater risk of exocrine insufficiency. Reporting 30-day functional outcomes for pancreatic resection is insufficient, as nearly 45% of subjects who develop disease do so after 90 days. Reporting of at least 90-day outcomes may more reliably assess risk for post-operative endocrine and exocrine insufficiency. Copyright © 2016 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

  13. Sexual knowledge, attitudes and activity of men conscripted into the military

    Directory of Open Access Journals (Sweden)

    Ku Yanchiou

    2010-09-01

    Full Text Available Abstract Background Military conscripts may experience a change in their attitude towards sex at times when sexual urges are at their peak during their physical growth. This study examines the experience, understanding, knowledge and attitudes regarding sexual activity of the military conscripts. Methods Data was obtained from a cross-sectional survey of 1127 young adult military conscripts, and were evaluated in Southern Taiwan from January to July 2009, their demographic data, sexual knowledge, attitudes and activities were assessed. Results Nearly 43% of the participants had performed penetrative vaginal intercourse at least once; 34% of the participants performed heterosexual oral sex at least once; almost 7% of participants had had homosexual intercourse, and 7.5% of participants had experienced homosexual oral sex in the past year. The mean sexual knowledge score based on 30 questions was 23.2 ± 4.0. The higher the educational level of the participants, the greater sexual knowledge they had obtained. Conclusion This study found that 43% of unmarried young recruits had experienced premarital sexual activity. However, their sexual knowledge was insufficient and should be strengthened by sex education from an earlier age. College aged and adult learners also have sex education needs, especially with regard to integrating sexuality and life, being able to relate responsibly as sexual beings to others, the use of contraception, and about sexually transmitted disease. Keywords Young recruits, Sexual behavior, Sexual knowledge, Sex education

  14. A Structural Knowledge Representation Approach in Emergency Knowledge Reorganization

    OpenAIRE

    Wang, Qingquan; Rong, Lili

    2007-01-01

    Facing complicate problems in emergency responses, decision makers should acquire sufficient background knowledge for efficient decision-making. Emergency knowledge acquired can be a kind of special product that is transferred among emergency decision makers and functional departments. The processing of knowledge product motivates the emergency knowledge decomposition and event-oriented knowledge integration, i.e. knowledge reorganization. Supported by the semantic power of category theory, t...

  15. Association of STAT4 polymorphism with severe renal insufficiency in lupus nephritis.

    Directory of Open Access Journals (Sweden)

    Karin Bolin

    Full Text Available Lupus nephritis is a cause of significant morbidity in systemic lupus erythematosus (SLE and its genetic background has not been completely clarified. The aim of this investigation was to analyze single nucleotide polymorphisms (SNPs for association with lupus nephritis, its severe form proliferative nephritis and renal outcome, in two Swedish cohorts. Cohort I (n = 567 SLE cases, n = 512 controls was previously genotyped for 5676 SNPs and cohort II (n = 145 SLE cases, n = 619 controls was genotyped for SNPs in STAT4, IRF5, TNIP1 and BLK. Case-control and case-only association analyses for patients with lupus nephritis, proliferative nephritis and severe renal insufficiency were performed. In the case-control analysis of cohort I, four highly linked SNPs in STAT4 were associated with lupus nephritis with genome wide significance with p = 3.7 × 10(-9, OR 2.20 for the best SNP rs11889341. Strong signals of association between IRF5 and an HLA-DR3 SNP marker were also detected in the lupus nephritis case versus healthy control analysis (p <0.0001. An additional six genes showed an association with lupus nephritis with p <0.001 (PMS2, TNIP1, CARD11, ITGAM, BLK and IRAK1. In the case-only meta-analysis of the two cohorts, the STAT4 SNP rs7582694 was associated with severe renal insufficiency with p = 1.6 × 10(-3 and OR 2.22. We conclude that genetic variations in STAT4 predispose to lupus nephritis and a worse outcome with severe renal insufficiency.

  16. Sources of the Radio Background Considered

    Energy Technology Data Exchange (ETDEWEB)

    Singal, J.; /KIPAC, Menlo Park /Stanford U.; Stawarz, L.; /KIPAC, Menlo Park /Stanford U. /Jagiellonian U., Astron. Observ.; Lawrence, A.; /Edinburgh U., Inst. Astron. /KIPAC, Menlo Park /Stanford U.; Petrosian, V.; /KIPAC, Menlo Park /Stanford U., Phys. Dept. /Stanford U., Appl. Phys. Dept.

    2011-08-22

    We investigate possible origins of the extragalactic radio background reported by the ARCADE 2 collaboration. The surface brightness of the background is several times higher than that which would result from currently observed radio sources. We consider contributions to the background from diffuse synchrotron emission from clusters and the intergalactic medium, previously unrecognized flux from low surface brightness regions of radio sources, and faint point sources below the flux limit of existing surveys. By examining radio source counts available in the literature, we conclude that most of the radio background is produced by radio point sources that dominate at sub {mu}Jy fluxes. We show that a truly diffuse background produced by elections far from galaxies is ruled out because such energetic electrons would overproduce the observed X-ray/{gamma}-ray background through inverse Compton scattering of the other photon fields. Unrecognized flux from low surface brightness regions of extended radio sources, or moderate flux sources missed entirely by radio source count surveys, cannot explain the bulk of the observed background, but may contribute as much as 10%. We consider both radio supernovae and radio quiet quasars as candidate sources for the background, and show that both fail to produce it at the observed level because of insufficient number of objects and total flux, although radio quiet quasars contribute at the level of at least a few percent. We conclude that the most important population for production of the background is likely ordinary starforming galaxies above redshift 1 characterized by an evolving radio far-infrared correlation, which increases toward the radio loud with redshift.

  17. Language-Related Values, Reading Amount, and Reading Comprehension in Students with Migration Backgrounds

    Science.gov (United States)

    El-Khechen, Wahiba; Ferdinand, Hanna D.; Steinmayr, Ricarda; McElvany, Nele

    2016-01-01

    Background: Although various studies on general language performance have investigated determinants of students' reading comprehension (e.g., reading amount), they have paid insufficient attention to how students perceive parental values influence their language-related values and behaviour--and, as a consequence, their performance. This is…

  18. Knowledge foundations for beginning reading teachers in EFL.

    Science.gov (United States)

    Goldfus, Carol

    2012-10-01

    This study examined the knowledge that teachers need in order to become successful early reading teachers in English as a foreign language. The findings showed that in-service teachers had better content knowledge than pre-service teachers, although the results indicated overall low performance and insufficiently developed concepts about the structure of language, spelling rules, and academic terminology in both groups.

  19. Insufficiency Fractures After Pelvic Radiotherapy in Patients With Prostate Cancer

    International Nuclear Information System (INIS)

    Igdem, Sefik; Alco, Guel; Ercan, Tuelay; Barlan, Metin; Ganiyusufoglu, Kuersat; Unalan, Buelent; Turkan, Sedat; Okkan, Sait

    2010-01-01

    Purpose: To assess the incidence, predisposing factors, and clinical characteristics of insufficiency fractures (IF) in patients with prostate cancer, who received pelvic radiotherapy as part of their definitive treatment. Methods and Materials: The charts of 134 prostate cancer patients, who were treated with pelvic radiotherapy between 1998 and 2007 were retrospectively reviewed. IF was diagnosed by bone scan and/or CT and/or MRI. The cumulative incidence of symptomatic IF was estimated by actuarial methods. Results: Eight patients were identified with symptomatic IF after a median follow-up period of 68 months (range, 12-116 months). The 5-year cumulative incidence of symptomatic IF was 6.8%. All patients presented with lower back pain. Insufficiency fracture developed at a median time of 20 months after the end of radiotherapy and was managed conservatively without any need for hospitalization. Three patients were thought to have metastatic disease because of increased uptake in their bone scans. However, subsequent CT and MR imaging revealed characteristic changes of IF, avoiding any further intervention. No predisposing factors for development of IF could be identified. Conclusions: Pelvic IF is a rare complication of pelvic radiotherapy in prostate cancer. Knowledge of pelvic IF is essential to rule out metastatic disease and prevent unnecessary treatment, especially in a patient cohort with high-risk features for distant spread.

  20. Loyalty Programmes : Current Knowledge and Research Directions

    NARCIS (Netherlands)

    Dorotic, Matilda; Bijmolt, Tammo H. A.; Verhoef, Peter C.

    Loyalty programmes (LPs) have increased in number and popularity, but their effects on customer behaviour remain equivocal, due to a lack of understanding of the drivers of LP effectiveness and insufficient generalizable conclusions across prior studies. This paper synthesizes current knowledge

  1. Nurses’ Knowledge Levels of Chest Drain Management: A Descriptive Study

    Directory of Open Access Journals (Sweden)

    Merve Tarhan

    2016-12-01

    Full Text Available Objective: The physician is responsible for inserting one or more chest tubes into the pleural space or the mediastinal space and connecting them to an appropriate drainage system. When the general principles about care of patients with chest drains were implemented correctly and effectively by nurses, nurse will contribute to accelerate the healing process of patients. In this context, the aim of this study was to determine the nurses’ level of knowledge regarding the care of patients with chest drains. Methods: The study was conducted with 153 nurses who worked in a chest diseases and thoracic surgery hospital in July 2014. Questionnaire form of 35 questions prepared by investigators was used to collect data. For the analysis of results, frequency tests, independent sample t-test and oneway ANOVA test were used. Results: 69.3% of nurses stated that they had obtained information from colleguages. 35.3% considered their knowledge about chest drain management to be inadequate. 55.6% scored 13 points and above from knowledge questionnaire about chest drain management. There were statistically significant difference between knowledge level and educational background, clinic work type, working unit, years of professional experience and institutional experience, frequency of contact patients with chest drain and perception of knowledge level (p<0.05. Conclusion: Results of this study indicate that lack of evidence-based nursing care and insufficient training has resulted in uncertainty and knowledge deficit in important aspects of chest drain care. It can be concluded that nurses receive training needs and training protocols are about chest drain management.

  2. Residents' Attitude, Knowledge, and Perceived Preparedness Toward Caring for Patients from Diverse Sociocultural Backgrounds.

    Science.gov (United States)

    Marshall, Jessie Kimbrough; Cooper, Lisa A; Green, Alexander R; Bertram, Amanda; Wright, Letitia; Matusko, Niki; McCullough, Wayne; Sisson, Stephen D

    2017-01-01

    Purpose: Training residents to deliver care to increasingly diverse patients in the United States is an important strategy to help alleviate racial and ethnic disparities in health outcomes. Cross-cultural care training of residents continues to present challenges. This study sought to explore the associations among residents' cross-cultural attitudes, preparedness, and knowledge about disparities to better elucidate possible training needs. Methods: This cross-sectional study used web-based questionnaires from 2013 to 2014. Eighty-four internal medicine residency programs with 954 residents across the United States participated. The main outcome was perceived preparedness to care for sociocultural diverse patients. Key Results: Regression analysis showed attitude toward cross-cultural care (beta coefficient [β]=0.57, 95% confidence interval [CI]: 0.49-0.64, p attitude toward cross-cultural care and their level of exposure to patients from diverse sociocultural backgrounds. Future studies should examine the role of residents' cross-cultural care-related attitudes on their ability to care for diverse patients.

  3. Long-term follow-up of acute isolated accommodation insufficiency.

    Science.gov (United States)

    Lee, Jung Jin; Baek, Seung-Hee; Kim, Ungsoo Samuel

    2013-04-01

    To define the long-term results of accommodation insufficiency and to investigate the correlation between accommodation insufficiency and other factors including near point of convergence (NPC), age, and refractive errors. From January 2008 to December 2009, 11 patients with acute near vision disturbance and remote near point of accommodation (NPA) were evaluated. Full ophthalmologic examinations, including best corrected visual acuity, manifest refraction and prism cover tests were performed. Accommodation ability was measured by NPA using the push-up method. We compared accommodation insufficiency and factors including age, refractive errors and NPC. We also investigated the recovery from loss of accommodation in patients. Mean age of patients was 20 years (range, 9 to 34 years). Five of the 11 patients were female. Mean refractive error was -0.6 diopters (range, -3.5 to +0.25 diopters) and 8 of 11 patients (73%) had emmetropia (+0.50 to -0.50 diopters). No abnormalities were found in brain imaging tests. Refractive errors were not correlated with NPA or NPC (rho = 0.148, p = 0.511; rho = 0.319, p = 0.339; respectively). The correlation between age and NPA was not significant (rho = -395, p = 0.069). However, the correlation between age and NPC was negative (rho = -0.508, p = 0.016). Three of 11 patients were lost to follow-up, and 6 of 8 patients had permanent insufficiency of accommodation. Accommodation insufficiency is most common in emmetropia, however, refractive errors and age are not correlated with accommodation insufficiency. Dysfunction of accommodation can be permanent in the isolated accommodation insufficiency.

  4. Assessing the effectiveness of combining evaluation methods for the early identification of students with inadequate knowledge during a clerkship.

    Science.gov (United States)

    Hemmer, Paul A.; Grau, Thomas; Pangaro, Louis N.

    2001-10-01

    This study examined the predictive validity of in-clerkship evaluation methods to identify medical students who have insufficient knowledge. Study subjects were 124 third-year medical students at the Uniformed Services University. Insufficient knowledge was defined by: (1) a clerkship 'pre-test' score one standard deviation below the mean or lower; or (2) any teacher verbally rating a student's general knowledge as 'marginal' or less; or (3) a student did not pass Step One of the United States Medical Licensing Examination (USMLE). We determined sensitivity and specificity using a standard score of variable. Sixteen students scored 90%. Using USMLE Step One pass-fail performance did not improve sensitivity. Combining a 'pre-test' and instructors' formal evaluation session comments improves the early identification of students with insufficient knowledge, allowing for formative feedback and remediation during the clerkship.

  5. PENGARUH BACKGROUND MAHASISWA TERHADAP KINERJA AKADEMIK

    Directory of Open Access Journals (Sweden)

    Trianasari Angkawijaya

    2014-09-01

    Full Text Available Abstract: The Effect of Students’ Background on Academic Performance. This study examines the effect of background variables on the academic performance of accounting students in a private university in Surabaya. The background variables under study included previous academic performance, prior knowledge on accounting, sex, motivation, preparedness, and expectations. The results show that previous academic performance, motivation, and expectations have positive and significant effects on the students’ overall academic performance in accounting, while preparedness affects only the students’ performance in management accounting. In contrast, prior knowledge on accounting and sex do not give significant impacts to the students’ overall academic performance.These findings indicate the importance of previous aca­demic performance as well as motivation and expectations as background variables in current academic performance. Keywords: students’ background, academic performance, accounting Abstrak: Pengaruh Background Mahasiswa terhadap Kinerja Akademik. Penelitian ini mengkaji pengaruh variabel background terhadap kinerja akademik mahasiswa akuntansi di Universitas Surabaya. Lima variabel background utama dipergunakan, yaitu kinerja akademik sebelumnya, pengetahuan akun­tansi sebelumnya, jenis kelamin, motivasi, kesiapan, dan ekspektasi. Hipotesis diuji menggunakan model regresi linier berganda OLS dan Robust Standar Error. Hasil penelitian memerlihatkan bahwa kinerja akademik sebelumnya, motivasi, dan ekspektasi memiliki pengaruh positif signifikan terhadap kinerja akademik keseluruhan, sementara kesiapan memberikan pengaruh positif hanya pada kinerja akademik akuntansi manajemen. Sebaliknya, pengetahuan akuntansi sebelumnya dan jenis kelamin tidak memberi­kan pengaruh signifikan terhadap kinerja akademik keseluruhan. Temuan ini mengindikasikan bahwa kinerja akademik sebelumnya beserta motivasi dan ekspektasi adalah variabel background

  6. Subchondral insufficiency fractures of the femoral head

    Energy Technology Data Exchange (ETDEWEB)

    Davies, M.; Cassar-Pullicino, V.N. [Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, SY10 7AG, Shropshire (United Kingdom); Darby, A.J. [Department of Pathology, Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, SY10 7AG, Shropshire (United Kingdom)

    2004-02-01

    The aim of this study was to increase awareness of, and to show the variable clinical and radiological features of, subchondral insufficiency fractures of the femoral head. The clinical and radiological findings in 7 patients with subchondral insufficiency fractures of the femoral head were reviewed retrospectively. The diagnosis was confirmed histologically in 4 patients. Radiographs were performed in all patients, MRI in 5 and scintigraphy in 4 patients. Radiographs showed varying degrees of femoral head collapse in 4 patients. In the remaining 3 patients radiographs showed a normal femoral head, regional osteoporosis and focal sclerosis, respectively. Magnetic resonance imaging showed a low-signal band on T1- and T2-weighted images in the subchondral bone adjacent or parallel to the articular surface associated with bone marrow oedema. Scintigraphy showed increased uptake in the femoral head. Insufficiency fractures of the femoral head are easily overlooked or confused with avascular necrosis and, when there is significant joint destruction, osteoarthritis. Unsuspected insufficiency fracture of the femoral head can lead to significant and rapid loss of bone stock in osteoporotic patients waiting for arthroplasty for osteoarthritis. Increased awareness of this condition will hopefully lead to earlier diagnosis and a successful outcome of conservative treatment. (orig.)

  7. Primary Adrenal Insufficiency (Addison's Disease) Associated with Systemic Lupus Erythematosus: A Rare Occurrence.

    Science.gov (United States)

    Godswill, Okwuonu Chimezie; Odigie, Ojeh-Oziegbe

    2014-10-01

    Coexistence of Addison's disease and systemic lupus erythematosus (SLE) is a rare occurrence with only few reported cases in the literature. We describe a 29-year-old woman who presented to us with clinical features of acute Addisonian crisis and SLE. Laboratory investigations were confirmatory of Addison's disease in a background of SLE. The patient made remarkable improvement on administration of steroids as replacement therapy for adrenal insufficiency and treatment of SLE. Clinicians need to have a high-index of suspicion of this possible coexistence in order to avoid the associated deleterious hemodynamic and metabolic consequences.

  8. Re-valuing Women's Knowledge

    Directory of Open Access Journals (Sweden)

    Hilary Yerbury

    2013-11-01

    Full Text Available Women’s knowledge has often been seen as “a whole set of knowledges that have been disqualified as inadequate to their task or insufficiently elaborated: naive knowledges, located low down on the hierarchy, beneath the required level of cognition or scientificity." (Foucault 1980, p. 82. In this description, scientific knowledges are seen to be hierarchically more important, with traditional knowledges ranged beneath them. In this hierarchy, women’s knowledges are found wanting. The purpose of this paper is to explore the assertion that women’s knowledges are inadequate and to document ways in which they are marginalised. Revaluing women’s knowledge is recognised as one of the most direct methods of changing the way a society works. A vast literature has argued that is a key factor in development and has been shown to lead to poverty alleviation, to the development of active citizens and to the creation of a more open and democratic society. Possibilities for the revaluing of women’s knowledge using information and communication technologies are considered, focussing on the concepts of open access and the information commons. DOI: http://dx.doi.org/10.5130/ccs.v5i3.3381

  9. Adrenal Insufficiency and Addison's Disease

    Science.gov (United States)

    ... These conditions can lead to an adrenal crisis. Pregnancy Women with adrenal insufficiency who become pregnant are ... can benefit from following a diet rich in sodium. A health care provider or a dietitian can ...

  10. Household food insufficiency is associated with dietary intake in Korean adults.

    Science.gov (United States)

    Lee, Sang Eun; Song, Yoon Ju; Kim, Young; Choe, Jeongsook; Paik, Hee-Young

    2016-04-01

    To examine the association of food insufficiency with dietary intake and eating and health behaviours. A cross-sectional study. Data were obtained from a secondary source, the Fifth Korea National Health and Nutrition Examination Survey (2010-2012). The sample size consisted of 15 603 adults over 19 years of age (8898 households). Significant differences in socio-economic factors were observed according to food insufficiency level (Pfood-insufficient group, but we found no association with fat intake. Regarding micronutrients, Ca, Fe, vitamin A, thiamin, riboflavin niacin and vitamin C intakes were negatively associated with food insufficiency level (P trendfood groups, such as meat, fish, eggs and beans, vegetables and fruits, was significantly lower as food insufficiency level decreased after controlling for all possible variables; food group consumption also differed by sex. Overall eating and health behaviours were poorer in the mildly and severely food-insufficient groups, who received more food assistance but less nutritional education. Our results showed that dietary intake as well as eating and health behaviours are adversely associated with food insufficiency. These findings suggest that specific strategies to help food-insufficient individuals should be developed in order to improve their dietary quality and health status.

  11. Primary ovarian insufficiency: an update

    Directory of Open Access Journals (Sweden)

    Cox L

    2014-02-01

    Full Text Available Leticia Cox, James H LiuUH Case Medical Center, MacDonald Women's Hospital, Department of Obstetrics and Gynecology, Case Western Reserve University School of Medicine, Department of Reproductive Biology, Cleveland, OH, USAAbstract: Primary ovarian insufficiency is a condition that represents impaired ovarian function on a continuum with intermittent ovulation. This condition commonly leads to premature menopause, defined as cessation of ovulation prior to the age of 40 years. Because there are potential immediate and long-term consequences of hypoestrogenism, a timely diagnosis is invaluable. This comprehensive review will discuss identifiable causes for primary ovarian insufficiency, including genetic disorders and metabolic abnormalities, as well as review current strategies for diagnosis, evaluation, and management of women with this condition.Keywords: premature ovarian failure, premature menopause, ovarian dysfunction

  12. [Adrenal insufficiency of the adult].

    Science.gov (United States)

    Jublanc, C; Bruckert, E

    2016-12-01

    Adrenal insufficiency is a rare but life-threatening disorder. Clinical manifestations include fatigue, weight loss, gastrointestinal manifestations and skin hyperpigmentation, the latter being specific of primary adrenal failure. Because of non-specific clinical features of this rare disorder, diagnosis can be delayed and adrenal failure be revealed by an acute crisis. Adrenal insufficiency can be primary (Addison disease), most frequently autoimmune, or secondary, resulting from long term administration of exogenous glucocorticoids or more rarely from pituitary disorders. Monitoring of substitutive treatment is now well codified. Patient education is very important in this chronic disease that remains associated with a persistent high risk of adrenal crisis. Copyright © 2016 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  13. Plasma B-type natriuretic peptide concentration for diagnosis of acute heart failure with renal insufficiency

    Directory of Open Access Journals (Sweden)

    Naila Atik Khan

    2016-07-01

    Full Text Available Background : Plasma B-type natriuretic peptide (BNP is the diagnostic tool for acute heart failure (AHF.This natriu­retic peptide level depends on renal function, through renal metabolism and excretion. Therefore we examined the effect ofrenal impairment on plasma BNP level during diagnosis of AHF.Objective: The objective of the study was to assess the effect of renal dysfunction on plasma BNP level and to determine appropriate cutoff value of plasma BNP to diagnose the patients of AHF with renal insufficiency.Methods: This cross sectional analytical study was conducted in the Depart­ment of Biochemistry Bangabandhu Sheikh Mujib Medical University (BSMMU. The study was done among 90 AHF patients selected from cardiology emergency department during the period of July 2012 to June 2013. After enrollment plasma BNP concentration was measured and eGFR was estimated from serum creatinine by the four parameter Modifica­tion of Diet and Renal Disease (MORD equation and then grouped into two groups on the basis of empirical cut off value of eGFR 60 ml/min/1.73 m2Results: In this study a significant negative correlation was found between plasma BNP evel and eGFR (P<0.001 , with higher BNP levels observed as eGFR declined. The optimal BNP cutoff value for diagno­sis of AHF patients with renal insufficiency was 824 pg/ml. At this cutoff level AHF with renal insufficiency could be diagnosed with sensitivity and specificity of 84% and 71 %, respectively.Conclusions: By adjusting the cutoff value, plasma BNP can be used to diagnose AHF with renal insufficiency with an acceptable sensitivity and specificity.

  14. Genetics Home Reference: fragile X-associated primary ovarian insufficiency

    Science.gov (United States)

    ... Share: Email Facebook Twitter Home Health Conditions FXPOI Fragile X-associated primary ovarian insufficiency Printable PDF Open All ... Javascript to view the expand/collapse boxes. Description Fragile X-associated primary ovarian insufficiency ( FXPOI ) is a condition ...

  15. [Attrition and poor performance in general practice training: age, competence and knowledge play a role].

    Science.gov (United States)

    Vermeulen, Margit I; Kuyvenhoven, Marijke M; Zuithoff, N P A Peter; van der Graaf, Yolanda; Pieters, H M Ron

    2011-01-01

    To investigate which determinants are related to poor performance and forced attrition in the first year residency in general practice (GP). Observational retrospective cohort study. We collected data relating to personal characteristics such as age, sex and clinical experience from residents who started the GP training in Utrecht, the Netherlands, in the period March 2005-August 2007. We also collected competence scores from the domains 'medical expertise', 'doctor-patient communication' and 'professionalism', as well as scores on a national GP knowledge test. The outcome measures were 'poor performance' and 'forced attrition'. Multivariate logistic regression was used to analyse correlations between personal characteristics, competence scores on the 3 domains and knowledge scores in the first trimester on the one hand and poor performance or forced attrition on the other. 215 residents started the GP training. In the first trimester a quarter of the residents had an insufficient score in 1 or more of the domains. Competence scores were mutually correlated, but did not correlate with the knowledge score. 18 residents showed poor performance and 3 were forced to stop their training. Poor performance and forced attrition were correlated with age (adjusted odds ratio (OR): 1.1; 95% CI: 1.0-1.3), insufficient knowledge (adjusted OR: 8.9; 3.0-26.3) and medical expertise (adjusted OR: 2.1; 1.1-4.0) at the beginning of the training. Age, insufficient knowledge of general practice, and insufficient competence in the domain of 'medical expertise' at the beginning of the training are risk factors for poor performance by residents and attrition from their GP training.

  16. Recurrent tricuspid insufficiency: is the surgical repair technique a risk factor?

    Science.gov (United States)

    Kara, Ibrahim; Koksal, Cengiz; Cakalagaoglu, Canturk; Sahin, Muslum; Yanartas, Mehmet; Ay, Yasin; Demir, Serdar

    2013-01-01

    This study compares the medium-term results of De Vega, modified De Vega, and ring annuloplasty techniques for the correction of tricuspid insufficiency and investigates the risk factors for recurrent grades 3 and 4 tricuspid insufficiency after repair. In our clinic, 93 patients with functional tricuspid insufficiency underwent surgical tricuspid repair from May 2007 through October 2010. The study was retrospective, and all the data pertaining to the patients were retrieved from hospital records. Functional capacity, recurrent tricuspid insufficiency, and risk factors aggravating the insufficiency were analyzed for each patient. In the medium term (25.4 ± 10.3 mo), the rates of grades 3 and 4 tricuspid insufficiency in the De Vega, modified De Vega, and ring annuloplasty groups were 31%, 23.1%, and 6.1%, respectively. Logistic regression analysis revealed that chronic obstructive pulmonary disease, left ventricular dysfunction (ejection fraction, tricuspid insufficiency. Medium-term survival was 90.6% for the De Vega group, 96.3% for the modified De Vega group, and 97.1% for the ring annuloplasty group. Ring annuloplasty provided the best relief from recurrent tricuspid insufficiency when compared with DeVega annuloplasty. Modified De Vega annuloplasty might be a suitable alternative to ring annuloplasty when rings are not available.

  17. Pubic insufficiency fracture: MRI findings

    International Nuclear Information System (INIS)

    Min, Tae Kyu; Lee, Yeon Soo; Park, Jeong Mi; Kim, Jee Young; Chung, Hong Jun; Lee, Eun Hee; Lee, Eun Ja; Kang, So Won; Han Tae Il

    2000-01-01

    To evaluate the characteristic MRI findings of pubic insufficiency fracture. In nine cases of pubic insufficiency fracture, the findings of plain radiography (n=9), MRI (n=9), and bone scintigraphy (n=8) were reviewed. We retrospectively analyzed, with regard to fracture site, the destructive pattern revealed by plain radiography, and uptake by other pelvic bones, as demonstrated by RI bone scanning. The MR findings evaluated were the fracture gap and its signal intensity, the site and signal intensity of the soft tissue mass, and other pelvic bone fractures. Plain radiography revealed osteolysis and sclerosis of pubic bone in eight of nine cases (89%), and parasymphyseal fractures in seven (78%). RI indicated uptake by the sacrum in six cases (66%), and by the ilium in three (33%). MR findings of fracture gap (seven cases, 78%) were hypo to isointensity on T1WI, hyper intensity on T2WI and the absence of contrast enhancement. Soft tissue masses were found in seven cases (78%); in four of these the location was parasymphyseal, and in three, surrounding muscle was involved. Hypo to isointensity was revealed by T1WI, hyperintensity by T2WI, and there was peripheral enhancement. Other associated pelvic bone fractures involved the sacrum in seven cases and the ilium in four. The characteristic MR findings of pubic insufficiency fracture were parasymphyseal location, fracture gap, peripherally enhanced soft tissue mass formation, and fractures of other pelvic bones, namely the sacrum and ilium

  18. [Association between Williams syndrome and adrenal insufficiency].

    Science.gov (United States)

    Rchachi, Meryem; Larwanou, Maazou Mahamane; El Ouahabi, Hanan; Ajdi, Farida

    2017-01-01

    Williams syndrome is a developmental disorder including dysmorphia, cardiovascular malformations and a specific neuropsychological profile together with other associated disorders. We report the case of a 17-year old girl, born of a non-inbred marriage, with Williams syndrome discovered during an assessment of degree of failure to thrive. Its association with primary adrenal insufficiency makes it unique. Diagnosis is confirmed by cytogenetic and molecular analysis. Its management consists of the implementation of treatment for adrenal insufficiency associated with a clinico-biological monitoring.

  19. Magnetic resonance imaging in osteomalacic insufficiency fractures of the pelvis

    Energy Technology Data Exchange (ETDEWEB)

    Kanberoglu, K. [Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul (Turkey)]. E-mail: zkanber@istanbul.edu.tr; Kantarci, F. [Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul (Turkey); Cebi, D. [Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul (Turkey); Yilmaz, M.H. [Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul (Turkey); Kurugoglu, S. [Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul (Turkey); Bilici, A. [Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University, Istanbul (Turkey); Koyuncu, H. [Department of Physical Medicine and Rehabilitation, Cerrahpasa Medical Faculty, Istanbul University, Istanbul (Turkey)

    2005-01-01

    AIMS: To report the magnetic resonance imaging (MRI) findings of osteomalacic insufficiency fractures of the pelvis. MATERIALS AND METHODS: In all, 12 persons presenting with chronic pelvic pain and with a definitive diagnosis of osteomalacia (OM) were enrolled in this study. Radiological work-up included direct radiographs (n=12), computed tomography (n=5), scintigraphy n=12) and MRI (n=12). The location of the insufficiency fractures and corresponding MRI appearances were evaluated. Depending on the presence or absence of signal intensity around the fractures, the lesions were grouped into active and chronic forms. RESULTS: A total of 34 insufficiency fractures were depicted on imaging studies. MRI demonstrated 33 of the lesions. All the insufficiency fractures were seen as a hypointense lines or fissures on T1- and T2-weighted and STIR MR images. There was a high frequency of insufficiency fractures at the sacrum and iliac bone (16/34, 47%). Overall, 11 chronic-type (no abnormal signal intensity around the fissure) and 22 active-type (abnormal signal intensity around the fissure) insufficiency fractures were detected by MRI. Follow-up MR examinations of 2 subjects showed that abnormal signal intensity had disappeared after appropriate treatment. CONCLUSION: The results of this study showed that the iliac and sacral bones are frequently involved in patients with OM. MRI can determine the clinical activity of the disease, and can monitor the response to treatment of the active type of insufficiency fractures.

  20. Magnetic resonance imaging in osteomalacic insufficiency fractures of the pelvis

    International Nuclear Information System (INIS)

    Kanberoglu, K.; Kantarci, F.; Cebi, D.; Yilmaz, M.H.; Kurugoglu, S.; Bilici, A.; Koyuncu, H.

    2005-01-01

    AIMS: To report the magnetic resonance imaging (MRI) findings of osteomalacic insufficiency fractures of the pelvis. MATERIALS AND METHODS: In all, 12 persons presenting with chronic pelvic pain and with a definitive diagnosis of osteomalacia (OM) were enrolled in this study. Radiological work-up included direct radiographs (n=12), computed tomography (n=5), scintigraphy n=12) and MRI (n=12). The location of the insufficiency fractures and corresponding MRI appearances were evaluated. Depending on the presence or absence of signal intensity around the fractures, the lesions were grouped into active and chronic forms. RESULTS: A total of 34 insufficiency fractures were depicted on imaging studies. MRI demonstrated 33 of the lesions. All the insufficiency fractures were seen as a hypointense lines or fissures on T1- and T2-weighted and STIR MR images. There was a high frequency of insufficiency fractures at the sacrum and iliac bone (16/34, 47%). Overall, 11 chronic-type (no abnormal signal intensity around the fissure) and 22 active-type (abnormal signal intensity around the fissure) insufficiency fractures were detected by MRI. Follow-up MR examinations of 2 subjects showed that abnormal signal intensity had disappeared after appropriate treatment. CONCLUSION: The results of this study showed that the iliac and sacral bones are frequently involved in patients with OM. MRI can determine the clinical activity of the disease, and can monitor the response to treatment of the active type of insufficiency fractures

  1. Nuclear knowledge management

    International Nuclear Information System (INIS)

    Constantin, Marin; Ghitescu, Petre

    2007-01-01

    Nuclear knowledge is characterized by high-complexity and variety of the component topics and long duration required by the build-up of individual competence. At organizational level, these characteristics made the power of an organization or institution to be determined by the capital accumulated of existing knowledge. Furthermore, the capacity of an organization to re-generate and raise the knowledge capital according to the specific processes it is running according to the existing demand decides its position/ranking in the economy of nuclear field. Knowledge management emphasizes re-utilization of existing practice and experience, upgrade, enrich and re-value of accumulated knowledge. The present paper identifies and classifies the nuclear knowledge steps, namely: tacit knowledge, explicit knowledge, preserving, transfer, knowledge capture etc. On this basis there are identified the existing problems of nuclear knowledge management in Romania such as: difficulties to keep within the country the existing expertise, lack of interest in nuclear education, low level of organization of existing knowledge due to a small number of data bases, an insufficient integration of existing knowledge in IT systems, lack of ontology and taxonomy or an average structuralism. Nuclear knowledge in Romania is facing a major challenge which is generated by the future development of nuclear facilities. It is related to the rising demand of expertise and experts. This challenge is better solved by partnership between end users and institutions of Research and Development and university organization as well which could ensure the generation, transfer and preservation of nuclear knowledge. (authors)

  2. Predictive factors for exocrine pancreatic insufficiency after pancreatoduodenectomy with pancreaticogastrostomy.

    Science.gov (United States)

    Nakamura, Hiroyuki; Murakami, Yoshiaki; Uemura, Kenichiro; Hayashidani, Yasuo; Sudo, Takeshi; Ohge, Hiroki; Sueda, Taijiro

    2009-07-01

    The aim of this study was to determine risk factors for exocrine pancreatic insufficiency after pancreatoduodenectomy (PD) with pancreaticogastrostomy (PG). A (13)C-labeled mixed triglyceride breath test was performed in 61 patients after PD to assess exocrine pancreatic function. Percent (13)CO(2) cumulative dose at 7 h pancreatic insufficiency. Abdominal computed tomography scans were utilized to assess the dilatation of the main pancreatic duct (MPD dilatation) in the remnant. Thirty-eight of 61 patients (62.3%) were diagnosed with exocrine pancreatic insufficiency. Univariate analysis identified significant associations between two preoperative factors (preoperative impaired endocrine function and a hard pancreatic texture induced by preexisting obstructive pancreatitis), plus one postoperative factor (MPD dilatation caused by PG stricture) and exocrine pancreatic insufficiency (P pancreatic insufficiency after PD may be partly explainable by preexisting obstructive pancreatitis prior to surgery, surgeons desiring to obtain better postoperative exocrine pancreatic function after PD would be well-advised to devote considerable attention to preventing PG stricture.

  3. Pancreatic insufficiency after different resections for benign tumours.

    Science.gov (United States)

    Falconi, M; Mantovani, W; Crippa, S; Mascetta, G; Salvia, R; Pederzoli, P

    2008-01-01

    Pancreatic resections for benign diseases may lead to long-term endocrine/exocrine impairment. The aim of this study was to compare postoperative and long-term results after different pancreatic resections for benign disease. Between 1990 and 1999, 62 patients underwent pancreaticoduodenectomy (PD), 36 atypical resection (AR) and 64 left pancreatectomy (LP) for benign tumours. Exocrine and endocrine pancreatic function was evaluated by 72-h faecal chymotrypsin and oral glucose tolerance test. The incidence of pancreatic fistula was significantly higher after AR than after LP (11 of 36 versus seven of 64; P = 0.028). The long-term incidence of endocrine pancreatic insufficiency was significantly lower after AR than after PD (P insufficiency was more common after PD (P endocrine and exocrine insufficiency was higher for PD and LP than for AR (32, 27 and 3 per cent respectively at 1 year; 58, 29 and 3 per cent at 5 years; P pancreatic resections are associated with different risks of developing long-term pancreatic insufficiency. AR represents the best option in terms of long-term endocrine and exocrine function, although it is associated with more postoperative complications. Copyright (c) 2007 British Journal of Surgery Society Ltd.

  4. Renal tubular acidosis complicated with hyponatremia due to cortisol insufficiency

    OpenAIRE

    Izumi, Yuichiro; Nakayama, Yushi; Onoue, Tomoaki; Inoue, Hideki; Mukoyama, Masashi

    2015-01-01

    Adrenocortical insufficiency such as occurs in Addison's disease causes hyponatremia and renal tubular acidosis (RTA). Hyponatremia results from both aldosterone and cortisol insufficiency. RTA is due to aldosterone insufficiency. The involvement of cortisol in RTA is unclear. Here, we report a woman in her 70s who was admitted to our hospital with severe hyponatremia (106 mEq/l) and RTA. The patient exhibited low plasma cortisol levels with little response to rapid adrenocorticotropic hormon...

  5. Insufficient self-shielding correction in VITAMIN-B6

    International Nuclear Information System (INIS)

    Konno, Chikara; Ochiai, Kentaro; Ohnishi, Seiki

    2011-01-01

    We carried out a simple benchmark calculation test with a multigroup cross-section library VITAMIN-B6 generated from ENDF/B-VI. The model of this test consisted of an iron sphere of 1 m in radius with an isotropic 20 MeV neutron source in the center. Neutron spectra in the sphere were calculated with an Sn code ANISN and VITAMIN-B6 or FENDL/MG-1.1. A calculation with MCNP and ENDF/B-VI was carried out as a reference. The neutron spectra with ANISN and FENDL/MG-1.1 agreed with those with MCNP, while those with ANISN and VITAMIN-B6 were at most 50% different from those with MCNP. We uncovered that the discrepancy came from insufficient self-shielding correction due to the followings; 1) The smallest background cross section of 56 Fe in VITAMIN-B6 is 1. 2) The weighting flux used in generating VITAMIN-B6 is not adequate. VITAMIN-B6 should be revised for adequate self-shielding correction. (author)

  6. Treatment results of combined platelet-rich plasma and fat injection in patients with velopharyngeal insufficiency

    Directory of Open Access Journals (Sweden)

    Hamid Reza Fathi

    2013-10-01

    Full Text Available Background: Velopharyngeal insufficiency causes hypernasal vocal quality and can also result in audible nasal air emission and difficulty in producing pressure consonants. The resulting speech is often socially unacceptable and can be difficult to understand. Platelet-rich plasma is an autologous derivative of whole blood. Today, the importance of clinical use of Platelet-rich plasma in the plastic surgery is considered. This study was designed to evaluate the effectiveness of combined Platelet-rich plasma and fat injection in the treatment of velopharyngeal insufficiency. Methods: In this prospective clinicaltrial study, of 15 patients including 9 males and 6 females and aged 15-20 years with mild/ moderate velopharyngeal insufficiency who were injected with 5 mL of combined Platelet-rich plasma (1 mL and fat (4 mL in the front volume in the posterior pharyngeal wall in the pre-vertebral fascia under sedation. Speech samples were recorded by nasoendoscopy before the injection, and at 6 weeks and 6 months after the injection. Assessment of pathologic speech was done by speech therapist. Results: Velar displacement showed significantly increased at 6 weeks after the injection (P=0.049. Velopharyngeal gap disappeared in 60% of patients at 6 weeks after the injection (P=0.019. Lateral pharyngeal wall movement showed significantly increased in 73.3% of the patients at 6 months after the injection (P=0.04. After the treatment, aerodynamic assessment showed significantly decreased in nasal air escape during phonation and repeat the words (P<0.05. Assessment speech therapist showed significantly improve quality of phonation in these patients (P<0.05. Conclusion: It seems that, combined Platelet-rich plasma and fat injection lead to improve voice resonance and reduce nasal air escape in all treated cases. It can be a promising alternative to major procedures, such as velopharyngoplasties, for the treatment of mild/ moderate velopharyngeal insufficiency.

  7. How does the knowledge environment shape procurement practices for orthopaedic medical devices in Mexico?

    Science.gov (United States)

    Lingg, Myriam; Wyss, Kaspar; Durán-Arenas, Luis

    2016-07-08

    In organisational theory there is an assumption that knowledge is used effectively in healthcare systems that perform well. Actors in healthcare systems focus on managing knowledge of clinical processes like, for example, clinical decision-making to improve patient care. We know little about connecting that knowledge to administrative processes like high-risk medical device procurement. We analysed knowledge-related factors that influence procurement and clinical procedures for orthopaedic medical devices in Mexico. We based our qualitative study on 48 semi-structured interviews with various stakeholders in Mexico: orthopaedic specialists, government officials, and social security system managers or administrators. We took a knowledge-management related perspective (i) to analyse factors of managing knowledge of clinical procedures, (ii) to assess the role of this knowledge and in relation to procurement of orthopaedic medical devices, and (iii) to determine how to improve the situation. The results of this study are primarily relevant for Mexico but may also give impulsion to other health systems with highly standardized procurement practices. We found that knowledge of clinical procedures in orthopaedics is generated inconsistently and not always efficiently managed. Its support for procuring orthopaedic medical devices is insufficient. Identified deficiencies: leaders who lack guidance and direction and thus use knowledge poorly; failure to share knowledge; insufficiently defined formal structures and processes for collecting information and making it available to actors of health system; lack of strategies to benefit from synergies created by information and knowledge exchange. Many factors are related directly or indirectly to technological aspects, which are insufficiently developed. The content of this manuscript is novel as it analyses knowledge-related factors that influence procurement of orthopaedic medical devices in Mexico. Based on our results we

  8. Skin cancer knowledge and sun protection behavior among nursing students.

    Science.gov (United States)

    Yilmaz, Medine; Yavuz, Betul; Subasi, Media; Kartal, Asiye; Celebioglu, Aysun; Kacar, Halime; Adana, Filiz; Ozyurek, Pakize; Altiparmak, Saliha

    2015-01-01

    The objective of this study was to determine skin cancer knowledge and sun protection behavior among nursing students. A total of 1178 nursing students in the Aegean Region of Turkey took part in this descriptive study. A score for knowledge on protection against skin cancer and a score for protective behavior against skin cancer were calculated. In this study, first year students sunbathed more in the middle of the day than fourth year students, and their knowledge of skin cancer was lower. No statistical difference was determined for protective behavior between the two groups. The knowledge levels and protective behavior of first year students were alarmingly low, but the average scores for knowledge and behavior of the fourth year university students were higher. The knowledge levels of the fourth year students were average but their protective behavior was insufficient. It was found that the knowledge levels and the levels of protective behavior of light-skinned students were higher. This study revealed that the knowledge levels and protective behavior of first year nursing students against the harmful effects of the sun and for protection against skin cancer were alarmingly low. It also showed that the knowledge levels of the fourth year nursing students were average, but that their protective behavior was very insufficient. These findings suggest that it is of extreme importance to acquire knowledge and behavior for protection against skin cancers in the education of nursing students. © 2014 The Authors. Japan Journal of Nursing Science © 2014 Japan Academy of Nursing Science.

  9. Evaluation of HACCP knowledge of the catering staff

    Directory of Open Access Journals (Sweden)

    Ewa Cieślik

    2013-03-01

    Full Text Available This paper presents the results of a study on HACCP knowledge among catering staff. The study involved 100 people working in catering establishments randomly selected, such as restaurants, bars and cafes. The research tool was a survey questionnaire. The results indicate an insufficient level of knowledge of the respondents and indicate the need for training in the principles and significance of the HACCP system among people working in the catering industry. Since their knowledge is highly dependent, functioning of the HACCP system in the catering establishment seriously depends on their knowledge which is reflected in the quality and safety of food produced.

  10. Adrenal Insufficiency Caused by Locally Applied Glucocorticoids-Myth or Fact?

    DEFF Research Database (Denmark)

    Dinsen, Stina; Klose, Marianne; Rasmussen, Åse Krogh

    2015-01-01

    Case-reports have made it evident that both inhaled, percutaneous, intranasal, intraarticular and ophthalmic administered glucocorticoids have the potential to cause life threatening adrenal insufficiency. With few and sometimes conflicting data and study methodology the prevalence of adrenal...... insufficiency secondary to locally applied glucocorticoids is not clear. Adrenal insufficiency can only be correctly evaluated by a stimulation test, and has by this procedure been reported in up to 40-50% of patients treated with high-dose inhaled glucocorticoids. Medium- to low-dose inhaled glucocorticoids...... have been shown to cause adrenal suppression in 0-16% of patients. Glucocorticoid creams and nasal glucocorticoids can cause adrenal insufficiency, also when used within prescribed doses, but the frequency seems to be less than with inhaled glucocorticoids. Intraarticularly administered glucocorticoids...

  11. Pancreatic insufficiency secondary to abdominal radiotherapy

    International Nuclear Information System (INIS)

    Dookeran, K.A.; Thompson, M.M.; Allum, W.H.

    1993-01-01

    Delayed post-irradiation steatorrhoea secondary to acute pancreatic insufficiency is rare. The authors describe a case occurring in a patient 23 years following radical abdominal radiotherapy for testicular seminoma. (Author)

  12. Pancreatic insufficiency secondary to abdominal radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Dookeran, K.A.; Thompson, M.M.; Allum, W.H. (Leicester Royal Infirmary (United Kingdom). Dept. of Surgery)

    1993-02-01

    Delayed post-irradiation steatorrhoea secondary to acute pancreatic insufficiency is rare. The authors describe a case occurring in a patient 23 years following radical abdominal radiotherapy for testicular seminoma. (Author).

  13. Knowledge and practice of universal precautions against blood ...

    African Journals Online (AJOL)

    ... lack of display of universal precautions guidelines; emergency nature of the procedure; insufficient water supply; patient perceived to be at low risk of blood borne pathogens; pressure of time; and universal precautions equipments interferingwith technical skills. Although knowledge of universal precautions is high for both ...

  14. Experts' views regarding Australian school-leavers' knowledge of nutrition and food systems.

    Science.gov (United States)

    Sadegholvad, Sanaz; Yeatman, Heather; Parrish, Anne-Maree; Worsley, Anthony

    2017-10-01

    To explore Australian experts' views regarding strengths and gaps in school-leavers' knowledge of nutrition and food systems ( N&FS) and factors that influence that knowledge. Semi-structured interviews were conducted with 21 highly experienced food-related experts in Australia. Qualitative data were analysed thematically using Attride-Stirling's thematic network framework. Two global themes and several organising themes were identified. The first global theme, 'structural curriculum-based problems', emerged from three organising themes of: inconsistencies in provided food education programs at schools in Australia; insufficient coverage of food-related skills and food systems topics in school curricula; and the lack of trained school teachers. The second global theme, 'insufficient levels of school-leavers knowledge of N&FS ', was generated from four organising themes, which together described Australian school-leavers' poor knowledge of N&FS more broadly and knowledge translation problem for everyday practices. Study findings identified key problems relating to current school-based N&FS education programs in Australia and reported knowledge gaps in relation to N&FS among Australian school-leavers. These findings provide important guidance for N&FS curriculum development, to clearly articulate broadly-based N&FS knowledge acquisition in curriculum policy and education documents for Australian schools. © 2017 The Authors.

  15. Antineoplastic treatment of patients with renal insufficiency

    International Nuclear Information System (INIS)

    Rajec, J.; Mego, M.; Rajec, J.

    2011-01-01

    Kidneys are the main route of elimination for many antineoplastic drugs and their metabolites. The kidney dysfunction may lead to the drug cumulation in organism with the resulting increased systemic toxicity. A lot of used cytostatics requires a dose modification at different levels of renal insufficiency. Due to the lack of data from clinical trials, the limiting of systemic toxicity is difficult especially in patients with severe renal impairment or patients undergoing chronic hemodialysis. The following article is focused on the preventive strategies dealing with recommended dosing modification of various antineoplastic agents in patients with renal insufficiency. (author)

  16. Efficacy and tolerability of a high loading dose (25,000 IU weekly) vitamin D3 supplementation in obese children with vitamin D insufficiency/deficiency

    NARCIS (Netherlands)

    Radhakishun, Nalini N E; van Vliet, Mariska; Poland, Dennis C W; Weijer, Olivier; Beijnen, Jos H; Brandjes, Dees P M; Diamant, Michaela; von Rosenstiel, Ines A

    2014-01-01

    BACKGROUND: The recommended dose of vitamin D supplementation of 400 IU/day might be inadequate to treat obese children with vitamin D insufficiency. Therefore, we tested the efficacy and tolerability of a high loading dose vitamin D3 supplementation of 25,000 IU weekly in multiethnic obese

  17. Chronic workplace stress and insufficient physical activity: a cohort study.

    Science.gov (United States)

    Kouvonen, Anne; Vahtera, Jussi; Oksanen, Tuula; Pentti, Jaana; Väänänen, Ari K P; Heponiemi, Tarja; Salo, Paula; Virtanen, Marianna; Kivimäki, Mika

    2013-01-01

    To examine whether exposure to workplace stressors predicts changes in physical activity and the risk of insufficient physical activity. Prospective data from the Finnish Public Sector Study. Repeated exposure to low job control, high job demands, low effort, low rewards and compositions of these (job strain and effort-reward imbalance) were assessed at Time 1 (2000-2002) and Time 2 (2004). Insufficient physical activity (workplace stressors on change in physical activity was examined using fixed-effects (within-subject) logistic regression models (N=6665). In addition, logistic regression analysis was applied to examine the associations between repeated exposure to workplace stressors and insufficient physical activity (N=13 976). In these analyses, coworker assessed workplace stressor scores were used in addition to individual level scores. The proportion of participants with insufficient physical activity was 24% at baseline and 26% at follow-up. 19% of the participants who were sufficiently active at baseline became insufficiently active at follow-up. In the fixed-effect analysis, an increase in workplace stress was weakly related to an increase in physical inactivity within an individual. In between-subjects analysis, employees with repeated exposure to low job control and low rewards were more likely to be insufficiently active at follow-up than those with no reports of these stressors; fully adjusted ORs ranged from 1.11 (95% CI 1.00 to 1.24) to 1.21 (95% CI 1.05 to 1.39). Workplace stress is associated with a slightly increased risk of physical inactivity.

  18. Knowledge uptake by technical professionals and decision-makers ...

    African Journals Online (AJOL)

    While significant knowledge appears to be available on developmental water services (a term for service provision, to meet developmental objectives, with an emphasis on poor communities, in which a range of factors other than purely technical factors are addressed), there appears to be insufficient uptake of this ...

  19. Protocol for the realization of venous mapping by chronic venous insufficiency in lower limbs under sonographic guide

    International Nuclear Information System (INIS)

    Blanco Rojas, Diego Jose

    2013-01-01

    The current state of knowledge is reviewed with respect to the realization of lower limbs venous mapping. Venous mapping is obtained by the use of color and spectral Doppler ultrasound. Doppler ultrasound has provided a precise graphical representation of the superficial and deep venous systems. The performance of the venous mapping is considered essential for the correct handling of venous diseases. The anatomical and pathophysiological basic concepts are defined to realize the sonographic assessment of the veins of the lower limbs. The required technical aspects are revised for the realization of sonographic exploration of the patient with venous insufficiency. Sonographic findings are characterized to support the diagnostic of venous insufficiency of the lower limbs. The CEAP (clinical-etiologic-anatomic-pathophysiologic) classification is utilized to differentiate forms and degrees of severity of the disorder, and has allowed an interinstitutional comparison in clinical studies, the evaluation of treatment and monitoring of patients. A proposal is designed to perform reports that have served of guide surgical to vascular surgeons [es

  20. Why Sleep Matters—The Economic Costs of Insufficient Sleep

    Science.gov (United States)

    Hafner, Marco; Stepanek, Martin; Taylor, Jirka; Troxel, Wendy M.; van Stolk, Christian

    2017-01-01

    Abstract The Centers for Disease Control and Prevention (CDC) in the United States has declared insufficient sleep a “public health problem.” Indeed, according to a recent CDC study, more than a third of American adults are not getting enough sleep on a regular basis. However, insufficient sleep is not exclusively a US problem, and equally concerns other industrialised countries such as the United Kingdom, Japan, Germany, or Canada. According to some evidence, the proportion of people sleeping less than the recommended hours of sleep is rising and associated with lifestyle factors related to a modern 24/7 society, such as psychosocial stress, alcohol consumption, smoking, lack of physical activity and excessive electronic media use, among others. This is alarming as insufficient sleep has been found to be associated with a range of negative health and social outcomes, including success at school and in the labour market. Over the last few decades, for example, there has been growing evidence suggesting a strong association between short sleep duration and elevated mortality risks. Given the potential adverse effects of insufficient sleep on health, well-being and productivity, the consequences of sleep-deprivation have far-reaching economic consequences. Hence, in order to raise awareness of the scale of insufficient sleep as a public-health issue, comparative quantitative figures need to be provided for policy- and decision-makers, as well as recommendations and potential solutions that can help tackling the problem. PMID:28983434

  1. Physiologic AV valvular insufficiency in cine MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Yoon Hyung; Kang, Eun Joo; Baik, Seung Kug; Ahn, Woo Hyun; Choi, Han Yong; Kim, Bong Gi [Wallace Memorial Baptist Hospital, Pusan (Korea, Republic of)

    1994-05-15

    To give a help in the interpretation of cardiac cine-MR examination, the extent, shape, and timing of appearance of signal void regions near atrioventricular(A-V) valve prospectively evaluate in the healthy population. Using an axial gradient-echo technique with small flip angle, repetition time(TR) of 36 msec and echo time(TE) of 22 msec, 20 volunteers without known valvular abnormalities undertook cardiac cine-MR imaging including atrioventricular valve areas. Transient signal void was observed within the near the tricuspid(13/20 = 65%) and mitral valves(9/20 = 45%), respectively, which is so called {sup p}hysioloic atrioventricular valvular insufficiency{sup .} Eight subjects revealed the signal void areas near both tricuspid and mitral valves but, 5 subjects did not show any evidence of physiologic insufficiency. This physiologic condition does not extend more than 1 cm proximal to A-V valve plane and is generally observed only during early systole. Its morphology is semilunar or triangular configuration with the base to the valve plane in most cases of normal tricuspid insufficiency and small globular appearance in most cases of normal mitral insufficiency. Awareness of normal signal void areas near the A-V valve and their characteristics is critical in the interpretation of cardiac cine MR examinations and maybe helpful in the study of the normal cardiac physiology.

  2. Physiologic AV valvular insufficiency in cine MR imaging

    International Nuclear Information System (INIS)

    Jang, Yoon Hyung; Kang, Eun Joo; Baik, Seung Kug; Ahn, Woo Hyun; Choi, Han Yong; Kim, Bong Gi

    1994-01-01

    To give a help in the interpretation of cardiac cine-MR examination, the extent, shape, and timing of appearance of signal void regions near atrioventricular(A-V) valve prospectively evaluate in the healthy population. Using an axial gradient-echo technique with small flip angle, repetition time(TR) of 36 msec and echo time(TE) of 22 msec, 20 volunteers without known valvular abnormalities undertook cardiac cine-MR imaging including atrioventricular valve areas. Transient signal void was observed within the near the tricuspid(13/20 = 65%) and mitral valves(9/20 = 45%), respectively, which is so called p hysioloic atrioventricular valvular insufficiency . Eight subjects revealed the signal void areas near both tricuspid and mitral valves but, 5 subjects did not show any evidence of physiologic insufficiency. This physiologic condition does not extend more than 1 cm proximal to A-V valve plane and is generally observed only during early systole. Its morphology is semilunar or triangular configuration with the base to the valve plane in most cases of normal tricuspid insufficiency and small globular appearance in most cases of normal mitral insufficiency. Awareness of normal signal void areas near the A-V valve and their characteristics is critical in the interpretation of cardiac cine MR examinations and maybe helpful in the study of the normal cardiac physiology

  3. Endovenous Laser Ablation as a Treatment for Postsurgical Recurrent Saphenous Insufficiency

    International Nuclear Information System (INIS)

    Anchala, Praveen R.; Wickman, Christopher; Chen, Richard; Faundeen, Tonya; Pearce, William; Narducy, Lisa; Resnick, Scott A.

    2010-01-01

    The purpose of this study was to investigate the safety and efficacy of endovenous laser ablation as a treatment for recurrent symptomatic saphenous insufficiency occurring after saphenous vein ligation and stripping. A single-center retrospective review of patients who received endovenous laser ablation as a treatment for recurrent symptomatic saphenous insufficiency after ligation and stripping between November 2003 and October 2006 was performed. Fifty-six insufficient saphenous systems were identified in 38 patients. Follow-up consisted of a clinical examination in all patients as well as selective lower-extremity duplex ultrasound as clinically indicated. All 38 patients demonstrated complete closure of the insufficient saphenous vein by clinical examination and/or duplex ultrasound evaluation. Preoperative symptoms resolved after treatment in all 38 patients. No major complications were identified. Endovenous laser ablation of recurrent symptomatic saphenous venous insufficiency is a safe and effective treatment in patients who develop recurrent symptoms after saphenous vein ligation and stripping.

  4. Public Knowledge and Attitude toward Crimean Congo Hemorrhagic Fever in Tokat Turkey

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    R Yilmaz

    2009-12-01

    Full Text Available Background: The World health Organization (WHO declares Crimean Congo hemorrhagic fe­ver (CCHF endemic in Turkey. Despite the magnitude of problem, no documented evi­dence exists in Turkey, which reveals the aware­ness and practices of the country's adult popula­tion regarding CCHF, its spread, symptoms, treatment, and preven­tion. This study was conducted to assess the level of knowledge, attitudes, and practices regarding CCHF in people visit­ing terti­ary care hospital in Tokat, Turkey.Methods: This questionnaire based cross-sectional survey was conducted among patients' rela­tives or guardians who ad­mitted pediatric outpatient clinics during May-July 2008. The question­naire was composed of 25 questions.Results: A total of 1034 respondents participated in the survey. Sufficient knowledge about CCHF was not found in 28.9% of the sample. Literate individuals were relatively better informed about CCHF as compared to the illiterate peo­ple. Television and radio were con­sidered as the most important and useful source of information on the disease.Conclusion: We have found insufficient knowledge on CCHF in our population. It is thought to have no chance of suc­cess against a fatal disease such as CCHF, which has serious consequences, without the contribution of commu­nity. It is clear that there are important tasks for health, agri­culture, and media sectors to improve public knowledge and awareness about CCHF.

  5. Public Knowledge and Attitude toward Crimean Congo Hemorrhagic Fever in Tokat Turkey

    Directory of Open Access Journals (Sweden)

    R Yilmaz

    2009-12-01

    Full Text Available "nBackground: The World health Organization (WHO declares Crimean Congo hemorrhagic fe­ver (CCHF endemic in Turkey. Despite the magnitude of problem, no documented evi­dence exists in Turkey, which reveals the aware­ness and practices of the country's adult popula­tion regarding CCHF, its spread, symptoms, treatment, and preven­tion. This study was conducted to assess the level of knowledge, attitudes, and practices regarding CCHF in people visit­ing terti­ary care hospital in Tokat, Turkey."nMethods: This questionnaire based cross-sectional survey was conducted among patients' rela­tives or guardians who ad­mitted pediatric outpatient clinics during May-July 2008. The question­naire was composed of 25 questions."nResults: A total of 1034 respondents participated in the survey. Sufficient knowledge about CCHF was not found in 28.9% of the sample. Literate individuals were relatively better informed about CCHF as compared to the illiterate peo­ple. Television and radio were con­sidered as the most important and useful source of information on the disease."nConclusion: We have found insufficient knowledge on CCHF in our population. It is thought to have no chance of suc­cess against a fatal disease such as CCHF, which has serious consequences, without the contribution of commu­nity. It is clear that there are important tasks for health, agri­culture, and media sectors to improve public knowledge and awareness about CCHF. "n Keywords: Crimean Congo hemorrhagic fever, Public knowledge, Survey, Turkey

  6. Sources of Knowledge and Barriers of Implementing Evidence-Based Practice Among Mental Health Nurses in Saudi Arabia.

    Science.gov (United States)

    Hamaideh, Shaher H

    2017-07-01

    The purposes of this study were to identify the sources of knowledge for nursing practices and to identify the barriers of using "evidence-based practice" (EBP). Descriptive cross-sectional design was used to collect data from 164 Saudi mental health nurses by completing the Development of Evidence-Based Practice Questionnaire. The most frequently used sources of knowledge were relied on social interactions and the nurses' own experiences, while the least frequently used sources were external sources of knowledge and research evidences. Insufficient time to find research reports, difficulty in understanding research reports, and insufficient resources for evidences were the barriers of using EBP. The organizations should encourage using EBP by providing adequate time, resources, knowledge, and skills for mental health nurses through conducting workshops and mentoring. © 2016 Wiley Periodicals, Inc.

  7. Career development of South African knowledge workers

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    Adeline Du Toit

    2011-03-01

    Full Text Available The demand for knowledge workers is on the increase, yet little is known about their career perceptions and attitudes. The objective of this article is to determine the factors affecting the career development of knowledge workers in South Africa. Part-time learners of a postgraduate course were used as a purposive sample and 82 completed questionnaires were received. The results of the online survey provide an interesting look at the unique career issues knowledge workers experience from a South African perspective. Issues identified dealt with the lack of importance placed upon organisational training, the lack of interest in temporary work assignments and the low importance placed on learning from mentors. Organisations need to take note of their reward structures as knowledge workers have indicated that promotions and rewards based on their knowledge is insufficient.

  8. Hereditary myopathies with early respiratory insufficiency in adults.

    Science.gov (United States)

    Naddaf, Elie; Milone, Margherita

    2017-11-01

    Hereditary myopathies with early respiratory insufficiency as a predominant feature of the clinical phenotype are uncommon and underestimated in adults. We reviewed the clinical and laboratory data of patients with hereditary myopathies who demonstrated early respiratory insufficiency before the need for ambulatory assistance. Only patients with disease-causing mutations or a specific histopathological diagnosis were included. Patients with cardiomyopathy were excluded. We identified 22 patients; half had isolated respiratory symptoms at onset. The diagnosis of the myopathy was often delayed, resulting in delayed ventilatory support. The most common myopathies were adult-onset Pompe disease, myofibrillar myopathy, multi-minicore disease, and myotonic dystrophy type 1. Single cases of laminopathy, MELAS (mitochondrial encephalomyopathy with lactic acidosis and strokelike events), centronuclear myopathy, and cytoplasmic body myopathy were identified. We highlighted the most common hereditary myopathies associated with early respiratory insufficiency as the predominant clinical feature, and underscored the importance of a timely diagnosis for patient care. Muscle Nerve 56: 881-886, 2017. © 2017 Wiley Periodicals, Inc.

  9. Observational aspects of the microwave cosmic background spectrum

    International Nuclear Information System (INIS)

    Martin, D.H.

    1982-01-01

    The discovery of the isotropic microwave background, in 1964, was followed by a decade of careful measurements of the background flux throughout the centimetric and millimetric ranges of wavelength. The results of these measurements are not inconsistent with a Planckian spectrum but the absolute precision of the measurements is not as high as is frequently assumed. More recently attention has turned to searches for variations in the flux density with direction in the sky, while preparations are made in laboratories around the world for a second wave of measurements of the spectrum which are to have a much higher absolute precision. The author points out the limitations in present knowledge of the microwave background, identifies the observational difficulties in improving that knowledge and reports on some of the plans for future measurements. (Auth.)

  10. Insufficient quality of sputum submitted for tuberculosis diagnosis and associated factors, in Klaten district, Indonesia

    Science.gov (United States)

    Sakundarno, Mateus; Nurjazuli, Nurjazuli; Jati, Sutopo Patria; Sariningdyah, Retna; Purwadi, Sumarsono; Alisjahbana, Bachti; van der Werf, Marieke J

    2009-01-01

    Background Sputum smear microscopy is the standard diagnostic method for detection of smear positive pulmonary tuberculosis (TB). Insufficient quality of sputum might result in missing cases. In this study we aimed at assessing the quality of sputum in a district in Central Java and determining patient and health worker factors associated with submission of three good quality sputum samples. Methods In 16 health centers information was collected on the quality of sputum submitted by TB suspects, i.e. volume, color, and viscosity. TB suspects were interviewed to assess their knowledge of TB, motivation to provide sputum and whether they were informed why and how to produce a sputum sample. Health workers were interviewed to assess what information they provided to TB suspects about the reason for sputum examination, methods to produce sputum and characteristics of a good quality sputum sample. All health worker and patient factors were evaluated for association with sputum quality. Results Of 387 TB suspects, 294 (76.0%) could be traced and interviewed, and of 272 (70.3%) information about sputum quality was available. Of those 203 (74.6%) submitted three samples, 90 (33.1%) provided at least one good sample, and 37 (13.6%) provided three good quality sputum samples. Of the 272 TB suspects, 168 (61.8%) mentioned that information on the reason for sputum examination was provided, 66 (24.3%) remembered that they were informed about how to produce sputum and 40 (14.7%) recalled being informed about the characteristics of good quality sputum. Paramedics reported to provide often/always information on the importance of sputum examination, and when to produce sputum. Information on how to produce sputum and characteristics of a good sputum sample was less often provided. None of the studied patient characteristics or health worker factors was associated with providing good quality sputum. Conclusion A considerable number of TB suspects did not provide three sputum samples

  11. Insufficient quality of sputum submitted for tuberculosis diagnosis and associated factors, in Klaten district, Indonesia

    Directory of Open Access Journals (Sweden)

    Purwadi Sumarsono

    2009-05-01

    Full Text Available Abstract Background Sputum smear microscopy is the standard diagnostic method for detection of smear positive pulmonary tuberculosis (TB. Insufficient quality of sputum might result in missing cases. In this study we aimed at assessing the quality of sputum in a district in Central Java and determining patient and health worker factors associated with submission of three good quality sputum samples. Methods In 16 health centers information was collected on the quality of sputum submitted by TB suspects, i.e. volume, color, and viscosity. TB suspects were interviewed to assess their knowledge of TB, motivation to provide sputum and whether they were informed why and how to produce a sputum sample. Health workers were interviewed to assess what information they provided to TB suspects about the reason for sputum examination, methods to produce sputum and characteristics of a good quality sputum sample. All health worker and patient factors were evaluated for association with sputum quality. Results Of 387 TB suspects, 294 (76.0% could be traced and interviewed, and of 272 (70.3% information about sputum quality was available. Of those 203 (74.6% submitted three samples, 90 (33.1% provided at least one good sample, and 37 (13.6% provided three good quality sputum samples. Of the 272 TB suspects, 168 (61.8% mentioned that information on the reason for sputum examination was provided, 66 (24.3% remembered that they were informed about how to produce sputum and 40 (14.7% recalled being informed about the characteristics of good quality sputum. Paramedics reported to provide often/always information on the importance of sputum examination, and when to produce sputum. Information on how to produce sputum and characteristics of a good sputum sample was less often provided. None of the studied patient characteristics or health worker factors was associated with providing good quality sputum. Conclusion A considerable number of TB suspects did not provide

  12. Ping-pong champion with adrenal insufficiency

    Science.gov (United States)

    Arima, Hiroshi; Imamine, Rui; Oiso, Yutaka

    2009-01-01

    A 62-year-old Japanese man, a bronze medal winner in the World Championship of table tennis when in his 20s, was diagnosed with secondary adrenocortical insufficiency due to isolated adrenocorticotropic hormone (ACTH) deficiency, and steroid administration was started. About 1 year after the diagnosis, he took part in a table tennis championship which was open to those 40 years or older. He took 10 mg hydrocortisone after breakfast as usual, played 10 matches, each of which took 20–30 min, and won the championship in about 8 h. Since the man could not always win the gruelling competition even when in his 50s, it is suggested that extra steroid hormone is not necessary for patients with adrenocortical insufficiency due to ACTH deficiency in order to successfully engage in sports requiring such intensity and endurance. PMID:21686433

  13. [Traumatic tricuspid insufficiency].

    Science.gov (United States)

    Vayre, F; Richard, P; Ollivier, J P

    1996-04-01

    Traumatic tricuspid insufficiency is a rare condition. The diagnosis is difficult because of the slow progression of this pathology and the presence of more clinically acute lesions. Non-penetrating chest trauma is responsible for 90% of cases. Echocardiography is the investigation of choice for assessing the mechanism of the tricuspid regurgitation and for diagnosing associated lesions. It should be performed systematically in patients with multiple trauma. The surgical indications are difficult to determine and depend on the patients' symptoms and the type of anatomical lesions. It should be undertaken before right ventricular myocardial dysfunction. Several techniques may be used from valvuloplasty to valve replacement mainly with bioprostheses in symptomatic patients.

  14. Multidrug-Resistant Tuberculosis and Its Association with Adrenal Insufficiency: Assessment with the Low-Dose ACTH Stimulation Test

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    René Rodríguez-Gutiérrez

    2016-01-01

    Full Text Available Background. Multidrug-resistant tuberculosis (MDR-TB is a major public health care concern that affects the life of millions of people around the world. The association of tuberculosis and adrenal insufficiency is well known; however, it is thought to be less prevalent every time. A spike in TB incidence and a lack of evidence of this association in patients with MDR-TB call for reassessment of an illness (adrenal dysfunction that if not diagnosed could seriously jeopardize patients’ health. Objective. To determine the prevalence of adrenocortical insufficiency in patients with MDR-TB using the low-dose (1 μg ACTH stimulation test at baseline and at 6–12 months of follow-up after antituberculosis treatment and culture conversion. Methods. A total of 48 men or women, aged ≥18 years (HIV-negative patients diagnosed with pulmonary MDR-TB were included in this prospective observational study. Blood samples for serum cortisol were taken at baseline and 30 and 60 minutes after 1 μg ACTH stimulation at our tertiary level university hospital before and after antituberculosis treatment. Results. Forty-seven percent of subjects had primary MDR-TB; 43.8% had type 2 diabetes; none were HIV-positive. We found at enrollment 2 cases (4.2% of adrenal insufficiency taking 500 nmol/L as the standard cutoff point value and 4 cases (8.3% alternatively, using 550 nmol/L. After antituberculosis intensive phase drug-treatment and a negative mycobacterial culture (10.2±3.6 months adrenocortical function was restored in all cases. Conclusions. In patients with MDR-TB, using the low-dose ACTH stimulation test, a low prevalence of mild adrenal insufficiency was observed. After antituberculosis treatment adrenal function was restored in all cases. Given the increasing and worrying epidemic of MDR-TB these findings have important clinical implications that may help clinicians and patients make better decisions when deciding to test for adrenocortical

  15. Low Prevalence of Vitamin D Insufficiency among Nepalese Infants Despite High Prevalence of Vitamin D Insufficiency among Their Mothers

    Directory of Open Access Journals (Sweden)

    Johanne Haugen

    2016-12-01

    Full Text Available Background: Describing vitamin D status and its predictors in various populations is important in order to target public health measures. Objectives: To describe the status and predictors of vitamin D status in healthy Nepalese mothers and infants. Methods: 500 randomly selected Nepalese mother and infant pairs were included in a cross-sectional study. Plasma 25(OHD concentrations were measured by LC-MS/MS and multiple linear regression analyses were used to identify predictors of vitamin D status. Results: Among the infants, the prevalence of vitamin D insufficiency (25(OHD <50 nmol/L and deficiency (<30 nmol/L were 3.6% and 0.6%, respectively, in contrast to 59.8% and 14.0% among their mothers. Infant 25(OHD concentrations were negatively associated with infant age and positively associated with maternal vitamin D status and body mass index (BMI, explaining 22% of the variability in 25(OHD concentration. Global solar radiation, maternal age and BMI predicted maternal 25(OHD concentration, explaining 9.7% of its variability. Conclusion: Age and maternal vitamin D status are the main predictors of vitamin D status in infants in Bhaktapur, Nepal, who have adequate vitamin D status despite poor vitamin D status in their mothers.

  16. Pancreatic fibrosis correlates with exocrine pancreatic insufficiency after pancreatoduodenectomy.

    Science.gov (United States)

    Tran, T C K; van 't Hof, G; Kazemier, G; Hop, W C; Pek, C; van Toorenenbergen, A W; van Dekken, H; van Eijck, C H J

    2008-01-01

    Obstruction of the pancreatic duct can lead to pancreatic fibrosis. We investigated the correlation between the extent of pancreatic fibrosis and the postoperative exocrine and endocrine pancreatic function. Fifty-five patients who were treated for pancreatic and periampullary carcinoma and 19 patients with chronic pancreatitis were evaluated. Exocrine pancreatic function was evaluated by fecal elastase-1 test, while endocrine pancreatic function was assessed by plasma glucose level. The extent of fibrosis, duct dilation and endocrine tissue loss was examined histopathologically. A strong correlation was found between pancreatic fibrosis and elastase-1 level less than 100 microg/g (p pancreatic insufficiency. A strong correlation was found between pancreatic fibrosis and endocrine tissue loss (p pancreatic fibrosis nor endocrine tissue loss were correlated with the development of postoperative diabetes mellitus. Duct dilation alone was neither correlated with exocrine nor with endocrine function loss. The majority of patients develop severe exocrine pancreatic insufficiency after pancreatoduodenectomy. The extent of exocrine pancreatic insufficiency is strongly correlated with preoperative fibrosis. The loss of endocrine tissue does not correlate with postoperative diabetes mellitus. Preoperative dilation of the pancreatic duct per se does not predict exocrine or endocrine pancreatic insufficiency postoperatively. Copyright 2008 S. Karger AG, Basel.

  17. High prevalence of vitamin D insufficiency and its association with obesity and metabolic syndrome among Malay adults in Kuala Lumpur, Malaysia

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    Bulgiba Awang

    2011-09-01

    Full Text Available Abstract Background Vitamin D status, as indicated by 25-hydroxyvitamin D is inversely associated with adiposity, glucose homeostasis, lipid profiles, and blood pressure along with its classic role in calcium homeostasis and bone metabolism. It is also shown to be inversely associated with metabolic syndrome and cardiovascular diseases in western populations. However, evidence from the Asian population is limited. Therefore, we aim to study the prevalence of vitamin D insufficiency ( Methods This is an analytical cross sectional study. A total of 380 subjects were sampled and their vitamins D status (25-hydroxyvitamin D, fasting blood glucose, full lipid profile were assessed using venous blood. Systolic and diastolic blood pressure, weight, height and waist circumference were measured following standard protocols. Socio-demographic data such as sex, age, smoking status etc were also collected. Data was analysed using t-test, chi-square test, General Linear Model and multiple logistic regression. Results Females made up 58% of the sample. The mean age of respondents was 48.5 (SD 5.2 years. Females had significantly lower mean Vitamin D levels (36.2; 95% CI: 34.5, 38.0 nmol/L compared to males (56.2; 95% CI: 53.2, 59.2 nmol/L. Approximately 41% and 87% of males and females respectively had insufficient ( Conclusions Our results highlight the high prevalence of vitamin D insufficiency among Malay adults in Kuala Lumpur. Vitamin D insufficiency is independently associated with younger age, female sex and greater abdominal obesity. Vitamin D insufficiency is also associated with Metabolic Syndrome.

  18. Diagnosis and management of pancreatic exocrine insufficiency.

    Science.gov (United States)

    Nikfarjam, Mehrdad; Wilson, Jeremy S; Smith, Ross C

    2017-08-21

    In 2015, the Australasian Pancreatic Club (APC) published the Australasian guidelines for the management of pancreatic exocrine insufficiency (http://pancreas.org.au/2016/01/pancreatic-exocrine-insufficiency-guidelines). Pancreatic exocrine insufficiency (PEI) occurs when normal digestion cannot be sustained due to insufficient pancreatic digestive enzyme activity. This may be related to a breakdown, at any point, in the pancreatic digestive chain: pancreatic stimulation; synthesis, release or transportation of pancreatic enzymes; or synchronisation of secretions to mix with ingested food. Main recommendations: The guidelines provide advice on diagnosis and management of PEI, noting the following: A high prevalence of PEI is seen in certain diseases and conditions, such as cystic fibrosis, acute and chronic pancreatitis, pancreatic cancer and pancreatic surgery. The main symptoms of PEI are steatorrhoea or diarrhoea, abdominal pain, bloating and weight loss. These symptoms are non-specific and often go undetected and untreated. PEI diagnosis is predominantly based on clinical findings and the presence of underlying disease. The likelihood of PEI in suspected patients has been categorised into three groups: definite, possible and unlikely. If left untreated, PEI may lead to complications related to fat malabsorption and malnutrition, and have an impact on quality of life. Pancreatic enzyme replacement therapy (PERT) remains the mainstay of PEI treatment with the recommended adult initial enzyme dose being 25 000-40 000 units of lipase per meal, titrating up to a maximum of 75 000-80 000 units of lipase per meal. Adjunct acid-suppressing therapy may be useful when patients still experience symptoms of PEI on high dose PERT. Nutritional management by an experienced dietitian is essential. Changes in management as a result of these guidelines: These are the first guidelines to classify PEI as being definite, possible or unlikely, and provide a diagnostic algorithm to

  19. Health consequences of shift work and insufficient sleep.

    Science.gov (United States)

    Kecklund, Göran; Axelsson, John

    2016-11-01

    This review summarises the literature on shift work and its relation to insufficient sleep, chronic diseases, and accidents. It is based on 38 meta-analyses and 24 systematic reviews, with additional narrative reviews and articles used for outlining possible mechanisms by which shift work may cause accidents and adverse health. Evidence shows that the effect of shift work on sleep mainly concerns acute sleep loss in connection with night shifts and early morning shifts. A link also exists between shift work and accidents, type 2 diabetes (relative risk range 1.09-1.40), weight gain, coronary heart disease (relative risk 1.23), stroke (relative risk 1.05), and cancer (relative risk range 1.01-1.32), although the original studies showed mixed results. The relations of shift work to cardiometabolic diseases and accidents mimic those with insufficient sleep. Laboratory studies indicate that cardiometabolic stress and cognitive impairments are increased by shift work, as well as by sleep loss. Given that the health and safety consequences of shift work and insufficient sleep are very similar, they are likely to share common mechanisms. However, additional research is needed to determine whether insufficient sleep is a causal pathway for the adverse health effects associated with shift work. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. Association between perceived insufficient sleep, frequent mental distress, obesity and chronic diseases among US adults, 2009 behavioral risk factor surveillance system

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    Liu Yong

    2013-01-01

    Full Text Available Abstract Background Although evidence suggests that poor sleep is associated with chronic disease, little research has been conducted to assess the relationships between insufficient sleep, frequent mental distress (FMD ≥14 days during the past 30 days, obesity, and chronic disease including diabetes mellitus, coronary heart disease, stroke, high blood pressure, asthma, and arthritis. Methods Data from 375,653 US adults aged ≥ 18 years in the 2009 Behavioral Risk Factor Surveillance System were used to assess the relationships between insufficient sleep and chronic disease. The relationships were further examined using a multivariate logistic regression model after controlling for age, sex, race/ethnicity, education, and potential mediators (FMD and obesity. Results The overall prevalence of insufficient sleep during the past 30 days was 10.4% for all 30 days, 17.0% for 14–29 days, 42.0% for 1–13 days, and 30.6% for zero day. The positive relationships between insufficient sleep and each of the six chronic disease were significant (p  Conclusions Assessment of sleep quantity and quality and additional efforts to encourage optimal sleep and sleep health should be considered in routine medical examinations. Ongoing research designed to test treatments for obesity, mental distress, or various chronic diseases should also consider assessing the impact of these treatments on sleep health.

  1. The knowledge about cervical cancer among female students of Lublin universities

    Directory of Open Access Journals (Sweden)

    Agata Żminda

    2017-08-01

    The level of knowledge of female students in Lublin about cervical cancer seems to be insufficient. There is a need to educate women in the prevention and diagnosis of this cancer. The most commonly pointed source of knowledge about cervical cancer was the Internet. This makes it possible to improve young women's knowledge by conducting large-scale information campaigns on social networking sites or on websites concerning health. Doctors should pay particular attention to the educational aspect of patient care.

  2. Clinic Predictive Factors for Insufficient Myocardial Reperfusion in ST-Segment Elevation Myocardial Infarction Patients Treated with Selective Aspiration Thrombectomy during Primary Percutaneous Coronary Intervention

    Directory of Open Access Journals (Sweden)

    Jinfan Tian

    2016-01-01

    Full Text Available Background. Insufficient data are available on the potential benefit of selective aspiration and clinical predictors for no-reflow in STEMI patients undergoing primary percutaneous coronary intervention (PPCI adjunct with aspiration thrombectomy. Objective. The aim of our study was to investigate clinical predictors for insufficient reperfusion in patients with high thrombus burden treated with PPCI and manual aspiration thrombectomy. Methods. From January 2011 till December 2015, 277 STEMI patients undergoing manual aspiration thrombectomy and PPCI were selected and 202 patients with a Thrombolysis in Myocardial Infarction (TIMI thrombus grade 4~5 were eventually involved in our study. According to a cTFC value, patients were divided into Group I (cTFC > 40, namely, insufficient reperfusion group; Group II (cTFC ≤ 40, namely, sufficient reperfusion group. Results. Univariate analysis showed that hypertension, multivessel disease, time from symptom to PCI (≧4.8 hours, and postaspiration cTFC > 40 were negative predictors for insufficient reperfusion. After multivariate adjustment, age ≧ 60 years, hypertension, time from symptom to PCI (≧4.8 hours, and postaspiration cTFC > 40 were independently associated with insufficient reperfusion in STEMI patients treated with manual aspiration thrombectomy. Upfront intracoronary GP IIb/IIIa inhibitor (Tirofiban was positively associated with improved myocardial reperfusion. Conclusion. Fully identifying risk factors will help to improve the effectiveness of selective thrombus aspiration.

  3. Association Between Vitamin D Insufficiency and Metabolic Syndrome in Patients With Psychotic Disorders.

    Science.gov (United States)

    Yoo, Taeyoung; Choi, Wonsuk; Hong, Jin-Hee; Lee, Ju-Yeon; Kim, Jae-Min; Shin, Il-Seon; Yang, Soo Jin; Amminger, Paul; Berk, Michael; Yoon, Jin-Sang; Kim, Sung-Wan

    2018-04-01

    This study examined the association between vitamin D and metabolic syndrome in patients with psychotic disorders. The study enrolled 302 community-dwelling patients with psychotic disorders. Sociodemographic and clinical characteristics, including blood pressure, physical activity, and dietary habit were gathered. Laboratory examinations included vitamin D, lipid profile, fasting plasma glucose, HbA1c, liver function, and renal function. Vitamin D insufficiency was defined as vitamin D insufficiency were identified. Among the 302 participants, 236 patients (78.1%) had a vitamin D insufficiency and 97 (32.1%) had metabolic syndrome. Vitamin D insufficiency was significantly associated with the presence of metabolic syndrome (p=0.006) and hypertension (p=0.017). Significant increases in triglycerides and alanine transaminase were observed in the group with a vitamin D insufficiency (p=0.002 and 0.011, respectively). After adjusting for physical activity and dietary habit scores, vitamin D insufficiency remained significantly associated with metabolic syndrome and hypertension. Vitamin D insufficiency was associated with metabolic syndrome and was particularly associated with high blood pressure, although the nature, direction and implications of this association are unclear.

  4. Background enhancement in breast MR: Correlation with breast density in mammography and background echotexture in ultrasound

    International Nuclear Information System (INIS)

    Ko, Eun Sook; Lee, Byung Hee; Choi, Hye Young; Kim, Rock Bum; Noh, Woo-Chul

    2011-01-01

    Objective: This study aimed to determine whether background enhancement on MR was related to mammographic breast density or ultrasonographic background echotexture in premenopausal and postmenopausal women. Materials and methods: We studied 142 patients (79 premenopausal, 63 postmenopausal) who underwent mammography, ultrasonography, and breast MR. We reviewed the mammography for overall breast density of the contralateral normal breast according to the four-point scale of the BI-RADS classification. Ultrasound findings were classified as homogeneous or heterogeneous background echotexture according to the BI-RADS lexicon. We rated background enhancement on a contralateral breast MR into four categories based on subtraction images: absent, mild, moderate, and marked. All imaging findings were interpreted independently by two readers without knowledge of menstrual status, imaging findings of other modalities. Results: There were significant differences between the premenopausal and postmenopausal group in distribution of mammographic breast density, ultrasonographic background echotexture, and degree of background enhancement. Regarding the relationship between mammographic density and background enhancement, there was no significant correlation. There was significant relationship between ultrasonographic background echotexture and background enhancement in both premenopausal and postmenopausal groups. Conclusion: There is a significant correlation between ultrasonographic background echotexture and background enhancement in MR regardless of menopausal status. Interpreting breast MR, or scheduling for breast MR of women showing heterogeneous background echotexture needs more caution.

  5. Effectiveness of vision therapy in school children with symptomatic convergence insufficiency

    Directory of Open Access Journals (Sweden)

    Jung Un Jang

    2017-01-01

    Conclusion: Among convergence insufficiency symptoms, the following improved in particular: near point of convergence, exophoria, and near positive fusional vergence. These findings suggest that vision therapy is very effective to recover from symptomatic convergence insufficiency.

  6. Leptomeningeal dissemination of an astrocytoma causing hypophyseal insufficiency

    International Nuclear Information System (INIS)

    Suzan, S.; Cigdem, O.; Furkan, U.; Baki, A.

    2012-01-01

    Full text: Introduction: Hypophyseal insufficiency is an unusual clinical presentation of metastatic disease. Objectives: In this report, a case of leptomeningeal metastasis of an astrocytoma to the infundibular recess, causing hypophyseal insufficiency is presented with its magnetic resonance imaging (MRI) findings. Materials and methods: A 27-year-old woman presented with nausea, vomiting and generalized weakness. Her laboratory results were consistent with hypopituitarism. She had an operation history for astrocytoma. She was referred to radiology department for brain MRI study. Contrast-enhanced MRI scan showed extensive wall enhancement of ventricles consistent with leptomeningeal metastases. A nodular mass with pronounced contrast enhancement was also detected at the infundibular stalk. Results: Because suprasellar cistern was normal and extensive leptomeningeal metastases was detected, the nodular mass at the infundibular stalk thought to be secondary to leptomeningeal involvement of the infundibular recess. Conclusion: When a patient with a known malignancy presented with hypophyseal insufficiency, it should be thought that leptomeningeal metastases to the infundibular recess may also be a cause. The neuroimaging, especially contrast-enhanced studies, is necessary for the confirmation

  7. RHSEG and Subdue: Background and Preliminary Approach for Combining these Technologies for Enhanced Image Data Analysis, Mining and Knowledge Discovery

    Science.gov (United States)

    Tilton, James C.; Cook, Diane J.

    2008-01-01

    Under a project recently selected for funding by NASA's Science Mission Directorate under the Applied Information Systems Research (AISR) program, Tilton and Cook will design and implement the integration of the Subdue graph based knowledge discovery system, developed at the University of Texas Arlington and Washington State University, with image segmentation hierarchies produced by the RHSEG software, developed at NASA GSFC, and perform pilot demonstration studies of data analysis, mining and knowledge discovery on NASA data. Subdue represents a method for discovering substructures in structural databases. Subdue is devised for general-purpose automated discovery, concept learning, and hierarchical clustering, with or without domain knowledge. Subdue was developed by Cook and her colleague, Lawrence B. Holder. For Subdue to be effective in finding patterns in imagery data, the data must be abstracted up from the pixel domain. An appropriate abstraction of imagery data is a segmentation hierarchy: a set of several segmentations of the same image at different levels of detail in which the segmentations at coarser levels of detail can be produced from simple merges of regions at finer levels of detail. The RHSEG program, a recursive approximation to a Hierarchical Segmentation approach (HSEG), can produce segmentation hierarchies quickly and effectively for a wide variety of images. RHSEG and HSEG were developed at NASA GSFC by Tilton. In this presentation we provide background on the RHSEG and Subdue technologies and present a preliminary analysis on how RHSEG and Subdue may be combined to enhance image data analysis, mining and knowledge discovery.

  8. Visualization of traumatic tricuspid insufficiency by three-dimensional echocardiography.

    Science.gov (United States)

    Nishimura, Kazuhisa; Okayama, Hideki; Inoue, Katsuji; Saito, Makoto; Nagai, Takayuki; Suzuki, Jun; Ogimoto, Akiyoshi; Ohtsuka, Tomoaki; Higaki, Jitsuo

    2010-01-01

    A 19-year-old male was admitted to the emergency room of our hospital after a motor vehicle accident. During his first physical examination, a holosystolic murmur was heard at the fourth left parasternal border. Transthoracic echocardiography showed severe tricuspid insufficiency, but the cause of tricuspid insufficiency was unclear. Therefore, three-dimensional echocardiography was performed and demonstrated flail anterior, posterior and septal leaflets of the tricuspid valve. The diagnosis was tricuspid insufficiency due to papillary muscle rupture secondary to chest blunt trauma. Surgical repair of the tricuspid valve was performed in this patient. After surgery, the signs and symptoms of right ventricular heart failure were relieved. In this case, three-dimensional echocardiography was very useful for the evaluation of spatial destruction of the tricuspid valve and papillary muscle. 2009 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  9. Children of ethnic minority backgrounds

    DEFF Research Database (Denmark)

    Johansen, Stine Liv

    2010-01-01

    media products and toys just as they will have knowledge of different media texts, play genres, rhymes etc. This has consequences for their ability to access social settings, for instance in play. New research in this field will focus on how children themselves make sense of this balancing of cultures......Children of ethnic minority background balance their everyday life between a cultural background rooted in their ethnic origin and a daily life in day care, schools and with peers that is founded in a majority culture. This means, among other things, that they often will have access to different...

  10. Insufficiency fracture of the pelvis after the radiotherapy for carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    Nishimura, Tetsuo; Shimizu, Teppei; Sugiyama, Akira; Ichinohe, Kenji; Teshima, Takeshi; Takahashi, Motoichiro; Takai, Michikatsu; Kaneko, Masao

    1990-01-01

    Bone injury after radiotherapy for carcinoma of the uterine cervix has been reported since early days of this century. Recently, the concept of insufficiency fracture has been confirmed. Insufficiency fracture is one of the stress fractures and occurs when the elastic resistance of bone is inadequate to withstand normal or physiological stress. In the American and European studies, radiotherapy is known as a cause of insufficiency fracture. There are no reports on insufficiency fracture in the Japanese literatures. Four cases of carcinomas of the uterine cervix presented pelvic insufficiency fractures following radiotherapy. In the pubic bone, a vertical parasymphyseal fracture with mixed lytic and sclerotic changes of surrounding tissue is characteristic. Sacral insufficiency fracture shows a vertical or horizontal line with lytic and sclerotic appearance. Bone scintigraphy is a sensitive modality for the early detection. H-shaped configuration is diagnostic for sacral insufficiency fracture. CT is an accurate technique demonstrating a vertical fracture and excluding the malignant bony lesion. Although radiological findings of insufficiency fracture are similar to bone malignancy, differential diagnosis from malignant lesions is possible. Bony symptoms of all patients disappeared without specific treatments. In the follow-up study of patients with carcinomas of the uterine cervix after radiotherapy, it is important to have the consideration on insufficiency fracture. (author)

  11. Recurrent Tricuspid Insufficiency: Is the Surgical Repair Technique a Risk Factor?

    OpenAIRE

    Kara, Ibrahim; Koksal, Cengiz; Cakalagaoglu, Canturk; Sahin, Muslum; Yanartas, Mehmet; Ay, Yasin; Demir, Serdar

    2013-01-01

    This study compares the medium-term results of De Vega, modified De Vega, and ring annuloplasty techniques for the correction of tricuspid insufficiency and investigates the risk factors for recurrent grades 3 and 4 tricuspid insufficiency after repair.

  12. Knowledge, Attitude and Performance of Shiraz General Dentists about Infection Control Principles during Preparing Intraoral Radiographies

    Directory of Open Access Journals (Sweden)

    Abdolaziz Hagh Negahdar

    2017-02-01

    Full Text Available Background & Objective: Infection control in dental centers is affected by the persons’ attitude and knowledge about mechanisms of infection transmission. This study was designed to evaluate the knowledge and the attitude of Shiraz dentists about infection control during intraoral radiographies preparation. Materials & Methods: In this cross-sectional, and analytical research, the attitude and the knowledge of 45 male and 25 female, randomly selected dentists, were obtained through completion of a researcher- planed questioner which its validity and reliability had been confirmed. Data were analyzed using Cronbach`s alpha, one-way ANOVA, student’s t-test, and Pearson’s correlation coefficient in SPSS (V.21. Results: The average of the dentists’ age was 40.59±10.72 and their average occupational experience was 13.49±9.75 years. The mean score obtained for knowledge about infection control during intraoral radiographic procedures was less than fifty percent of total obtainable score, and was assessed as weak knowledge. There was no significant difference in the level of knowledge between studied male and female dentists (P>0.05. In addition, no significant relationship was detected between level, age/experience, and the university of education (P>0.05. The attitude of the dentists about infection control during intraoral radiography preparation assessed as moderate to good level. Conclusions: The results showed that the main reason for the present problems is insufficient knowledge of the dentists in related subjects. Therefore, the solution, which is recommended among dentists, is to raise their awareness and to change their attitudes and culture in order to improve their performance.

  13. Outcomes of Pulmonary Valve Replacement for Correction Pulmonary Insufficiency after Primary Repair of Tetralogy of Fallot (TOF

    Directory of Open Access Journals (Sweden)

    Mohammad Abbassi Teshnisi

    2016-09-01

    Full Text Available Background Total correction of Tetralogy of Fallot (TOF anomaly in early childhood has been practiced in many centers with good results, but in some of patients after few years sever Pulmonary valve insufficiency occurred. Materials and Methods At a cross- sectional study from January 2015 to January 2016, 10 patients who had history of primary repair of TOF with free pulmonary insufficiency (PI that underwent of pulmonary valve replacement (PVR with bioprosthetic valves were evaluated. Results Themean age of patients was 6.5 + 0.753 years old (ranged 8-12 years old and male to female ratio was 6/4. The mean of Intensive care unit (ICU stay and Hospital stay was 4.5+ 0.712 days (ranged 3-8 and 11.5+ 0.357 days (ranged 9- 16. Mean of cardiopulmonary bypass time and operation time was 45 + 0.684 min (ranged 32-60 and 83 + 0.317 min (ranged 65-112. In this study we did not find any mortality and ventricular arrhythmia and Heart block. There was only one case (10% with superficial wound infection that was controlled. At 6 months follow up, all of patients were alive, but Echocardiography sign of Right Ventricular (RV failure was present in 2 patients (20% recently. Conclusion Although for Pulmonary insufficiency after primary TOF repair there is controversial in studies, but we had good results of PVR with Bioprosthesis in TOF patients.

  14. Diagnosis of tricuspid insufficiency by Doppler flowmetry in the inferior vena cava

    International Nuclear Information System (INIS)

    Smith, H.J.

    1986-01-01

    Eighty-five patients subjected to routine heart catheterization were examined with duplex scanning of the inferior vena cava. Adequate Doppler recordings and a right ventricular angiography were obtained in 79 of them. Tricuspid insufficiency was found to be present in 34 patients at angiography and in 24 at duplex examination. No false positive Doppler diagnoses of tricuspid insufficiency occurred. The possibility of false positive angiographic diagnoses is discussed. A high correlation was found between percentage reversed flow in the inferior vena cava during ventricular systole and degree of angiographic tricuspid insufficiency. It is concluded that duplex scanning of the inferior vena cava seems to be a good alternative to angiography in the diagnosis and quantification of tricuspid insufficiency. (orig.)

  15. Anti-nuclear behavioral intentions: The role of perceived knowledge, information processing, and risk perception

    International Nuclear Information System (INIS)

    Zhu, Weiwei; Wei, Jiuchang; Zhao, Dingtao

    2016-01-01

    This study explored the key factors underlying people's anti-nuclear behavioral intentions. The protective action decision model and the heuristic–systematic model were integrated and adapted from a risk information perspective to construct a hypothetical model. A questionnaire study was conducted on a sample of residents near the Haiyang Nuclear Power Plant, which is under construction in Shandong Province, China (N=487). Results show that, as expected, perceived knowledge is vital in predicting people's information insufficiency, information seeking, systematic processing, and risk perception. Moreover, the inverted U relationship between perceived knowledge and anti-nuclear behavioral intentions is indicated in the study. Information insufficiency and information seeking also significantly predict systematic processing. Furthermore, people's behavioral intentions are motivated by risk perception but fail to be stimulated by systematic processing. Implications and recommendations for future research are discussed. - Highlights: • The study explores anti-nuclear behavior from a risk information perspective. • Risk perception and knowledge matter to anti-nuclear behavioral intentions. • Inverted U relationship between knowledge and behavioral intentions is indicated. • More understanding of nuclear power could reduce public opposition.

  16. Research on the relativity between gene polymorphism and children cardiac insufficiency.

    Science.gov (United States)

    He, X-H; Li, C-L; Ling, N; Wang, Q-W; Wang, Z-Z; An, X-J

    2017-08-01

    We analyzed the relationship between Mink-S27 gene polymorphism and children with cardiac insufficiency. From April 2013 to April 2015, we enrolled 73 cases of children with cardiac insufficiency for this study, and all 73 were placed in the observation group. 76 normal cases were selected for the control group. Restriction fragment length polymorphism (RFLP) was used to make polymorphism analysis of the Mink-S27. Our results showed no significant differences in Mink-S27 genotype and allele distribution in both observation and control groups (p>0.05). In lesion samples collected from children with cardiac insufficiency, we detected significant difference in AA, CC genotype frequency and allele frequency between the observation group and the control group (prelatively high. GNAS2 gene polymorphism was associated with the prevalence of cardiac insufficiency in children. And also the patients' condition was correlated to the frequency of different genotypes and alleles.

  17. Knowledge Management Technology for Decision Support: an empirical examination

    Directory of Open Access Journals (Sweden)

    Meliha Handzic

    2001-11-01

    Full Text Available This paper reports the results of an empirical examination of the effectiveness of one type of knowledge management technology, namely 'contextual knowledge repository', for supporting individual decision makers in a predictive judgement task context. 31 volunteer subjects participated in the study. The results indicate that a given technology was fairly useful, but insufficient to maximally enhance individual decision making. On one hand, subjects were found to extract more knowledge and make significantly smaller decision errors than their notional naive counterparts. On the other hand, subjects tended to extract less knowledge and make significantly larger decision errors compared to notional optimal counterparts. These findings suggest that individuals could potentially benefit from those knowledge management technologies that would provide additional explicit analytical and procedural knowledge, or those that would facilitate sharing of tacit knowledge through interaction with others. Future research is necessary to address these issues.

  18. Experimental study on acquisition of knowledge through repeated education and training

    International Nuclear Information System (INIS)

    Sasou, Kunihide; Suzuki, Tomohiro; Yoshimura, Seiichi; Kitamura, Masaharu.

    1997-01-01

    Considering the educational methodology to bring up nuclear power plant operators, the experiments are conducted to discuss the relation between the educational backgrounds of subjects and the knowledge acquired through education and training and also to discuss the effects of repeated training on knowledge acquisition. The results show that the knowledge the subjects obtained through the training depends on their educational backgrounds. The subjects with the higher educational backgrounds seem to properly reorganize the knowledge for the operations with using their deep and meta knowledge. Therefore they can create anticipative responses and easily identify causes of events. The results also show that the repeated education and training given to the subjects with weaker backgrounds makes their knowledge reorganized and their ability becomes closer to the subjects' one with higher educational backgrounds. These results indicate that the knowledge acquired in the earlier stage of the education and training depends on the subjects' educational backgrounds. However, the repeated education and training compensates for the difference. It is also suggested that it will be possible to bring up operators more effectively and properly if the existence of people with different educational backgrounds is recognized and the education/training depending on the educational backgrounds are realized. (author)

  19. Prevalence of Vitamin D insufficiency and low bone mineral density in elderly Thai nursing home residents

    Directory of Open Access Journals (Sweden)

    Kruavit Anuk

    2012-09-01

    Full Text Available Abstract Background Numerous emerging data from research on osteoporosis among Asians found differences from Caucasians. Therefore, the aim of this study was to determine the prevalence of vitamin D insufficiency and osteoporosis in elderly participants from two nursing homes in Thailand, a country located near the equator. Methods The subjects of this cross-sectional study comprised 93 elderly Thai women who were living in institutional long-term nursing homes for the aged. Demographic data, daily food and calcium intake, physical activity, and sunlight exposure were measured. Lumbar spine and femoral neck bone mineral density (BMD and biochemical levels including serum 25 hydroxyvitamin D [25(OHD] and bone turnover markers were assessed. Vitamin D insufficiency was defined as 25(OHD level  Results The mean age of subjects was 75.2 ± 6.0 (SD years. Dietary calcium intake was low (322 ± 158 mg/day The mean 25(OHD level was 64.3 ± 14.9 nmol/L and the prevalence of vitamin D insufficiency was 38.7% (95% CI: 28.8%, 49.4%. There was no correlation between serum 25(OHD concentrations and age (r = −.11, p = 0.3. The mean BMD of lumbar spine and femoral neck were 0.92 ± 0.19 and 0.65 ± 0.10 g/cm2, respectively. Nearly a half of the subjects had osteopenia (44.1%, 95% CI: 33.8%, 54.8% and osteoporosis (47.3%, 95% CI: 36.9%, 57.9%. Circulating C-terminal telopeptide of type I collagen (CTx level correlated significantly with both lumbar spine (r = −0.26, p = 0.01 and femoral neck BMD (r = −0.25, p = 0.02. Conclusions More than one-third of Thai elderly women residing in nursing homes had vitamin D insufficiency. Almost all nursing home residents had osteoporosis and/or osteopenia.

  20. Traumatic Tricuspid Insufficiency Requiring Valve Repair in an Acute Setting.

    Science.gov (United States)

    Enomoto, Yoshinori; Sudo, Yoshio; Sueta, Tomonori

    2015-01-01

    Tricuspid insufficiency due to penetrating cardiac trauma is rare. Patients with tricuspid insufficiency due to trauma can tolerate this abnormality for months or even years. We report a case of a 66-year-old female with penetrating cardiac trauma on the right side of her heart that required tricuspid valve repair in an acute setting. She sustained cut and stab wounds on her bilateral forearms and in the neck and epigastric region. She had cardiac tamponade and developed pulseless electrical activity, which required emergency surgery. The right ventricle and superior vena cava were dissected approximately 5 cm and 2 cm, respectively. After these wounds had been repaired, the patient's inability to wean from cardiopulmonary bypass suggested rightsided heart failure; transesophageal echocardiography revealed tricuspid insufficiency. Right atriotomy was performed, and a detailed examination revealed that the tricuspid valve septal leaflet was split in two. There was also an atrial septal injury that created a connection with the left atrium; these injuries were not detected from the right ventricular wound. After repair, weaning from cardiopulmonary bypass with mild tricuspid insufficiency was achieved, and she recovered uneventfully. This case emphasized the importance of thoroughly investigating intracardiac injury and transesophageal echocardiography.

  1. Intraoperative Adrenal Insufficiency in a Patient with Prader-Willi Syndrome

    OpenAIRE

    Barbara, David W.; Hannon, James D.; Hartman, William R.

    2012-01-01

    Prader-Willi syndrome (PW) is a rare genetic disorder with multi-organ system involvement. These patients present many perioperative challenges including sleep-related breathing disorders, morbid obesity, thick salivary secretions, mental retardation, and difficult intravenous access. PW has been suggested to be associated with central adrenal insufficiency. We report a novel case of persistent severe hypotension from previously undiagnosed and asymptomatic adrenal insufficiency in a pediatri...

  2. Vitamin D Insufficiency among Free-Living Healthy Young Adults

    OpenAIRE

    Tangpricha, Vin; Pearce, Elizabeth N.; Chen, Tai C.; Holick, Michael F.

    2002-01-01

    Long-term vitamin D insufficiency can cause secondary hyperparathyroidism and osteomalacia (1). In addition, there is increasing evidence that vitamin D may protect against common cancers, such as cancer of the colon (2–4), prostate (5), and breast (6). Young adults aged 17 to 35 years drink inadequate amounts of milk (7) and are concerned about exposure to the sun because of the fear of developing skin cancer (8,9), which increases the risk of vitamin D insufficiency (10). We sought to exami...

  3. Improving Oncology Nurses' Knowledge About Nutrition and Physical Activity for Cancer Survivors

    NARCIS (Netherlands)

    Veen, M.R. van; Hoedjes, M.; Versteegen, J.J.; Meulengraaf-Wilhelm, N. van de; Kampman, E.; Beijer, S.

    2017-01-01

    PURPOSE/OBJECTIVES: To assess what percentage of oncology nurses perceived themselves as having insufficient knowledge to provide advice on nutrition and/or physical activity (PA), which characteristics were associated with nurses' perception, and whether the content and information sources differed

  4. Evaluation of selected dietary behaviours of students according to gender and nutritional knowledge.

    Science.gov (United States)

    Zaborowicz, Katarzyna; Czarnocińska, Jolanta; Galiński, Grzegorz; Kaźmierczak, Paulina; Górska, Karolina; Durczewski, Paweł

    2016-01-01

    Nutrition is a factor influencing physical and mental fitness. In this study we examine the lifestyle of university students and its impact on nutritional errors. To evaluate the dietary behaviours of students taking into account gender and nutritional knowledge. Using a QEB questionnaire, we were able to evaluate dietary behaviours and nutritional knowledge of respondents. Our analysis was conducted on data obtained from 456 students. We found that nutritional knowledge for women was 34.7% satisfactory and 34.7% good. In contrast, nutritional knowledge for men varied, amounting to 40.2% satisfactory and 25.1% good. The number of meals and their regular consumption did not depend on gender or the nutritional knowledge of students, however, significant differences were recorded for the types of snacks they eat. A greater number of women than men snacked on sweets and biscuits, nuts and seeds, while in the case of salty snacks an opposite trend was observed. A higher level of nutritional knowledge correlated with the number of students snacking on fruit and vegetables instead of salty snacks. Moreover, it was observed that health-promoting behaviours such as not adding sugar to beverages and not adding salt to dishes were more common with women and individuals with a higher level of nutritional knowledge. Women more frequently snack on sweets, biscuits, nuts and seeds. More men snack on salty snacks, add sugar to beverages and add salt to dishes. Individuals with insufficient nutritional knowledge more frequently snack on salty snacks rather than fruit. Students with insufficient nutritional knowledge more often commit nutritional errors.

  5. Japanese Resident Physicians' Attitudes, knowledge, and Perceived Barriers on the Practice of Evidence Based Medicine: a Survey

    Directory of Open Access Journals (Sweden)

    Emura Sei SE

    2011-09-01

    Full Text Available Abstract Background Evidence based medicine plays a crucial role as a tool that helps integrate research evidence into clinical practice. However, few reports have yet to examine its application in daily practice among resident physicians in Japan. The aim of this study was to assess the attitudes towards and knowledge of EBM among resident physicians in Japanese and determine perceived barriers to its use. Findings A cross-sectional, self-administered anonymous questionnaire was distributed to 60 resident staffs at Saga University Hospital in Japan. Forty residents completed and returned the questionnaire. Fifty four percent of respondents understood the basic terminology of EBM, 3% could explain this to others, and 41% indicated they would like to understand the terminology more. Thirteen percent admitted having a good understanding of EBM basic skills. Fifty respondents indicated having read EBM sources, but only 3% indicated that they use these sources in clinical decision making. The most prominent barriers of EBM application revealed in this study were insufficient time to access the sources, a lack of native language references, and insufficient basic EBM skills, but not scepticism about the EBM concept. Conclusions In general, respondents positively welcomed EBM, and moderately understood and knew basic EBM skill; however, barriers in its application were shown to exist.

  6. University Students' Meta-Modelling Knowledge

    Science.gov (United States)

    Krell, Moritz; Krüger, Dirk

    2017-01-01

    Background: As one part of scientific meta-knowledge, students' meta-modelling knowledge should be promoted on different educational levels such as primary school, secondary school and university. This study focuses on the assessment of university students' meta-modelling knowledge using a paper-pencil questionnaire. Purpose: The general purpose…

  7. Proposing a Knowledge Base for Teaching Academic Content to English Language Learners: Disciplinary Linguistic Knowledge

    Science.gov (United States)

    Turkan, Sultan; De Oliveira, Luciana C.; Lee, Okhee; Phelps, Geoffrey

    2014-01-01

    Background/Context: The current research on teacher knowledge and teacher accountability falls short on information about what teacher knowledge base could guide preparation and accountability of the mainstream teachers for meeting the academic needs of ELLs. Most recently, research on specialized knowledge for teaching has offered ways to…

  8. Bedtime procrastination: A self-regulation perspective on sleep insufficiency in the general population.

    Science.gov (United States)

    Kroese, Floor M; Evers, Catharine; Adriaanse, Marieke A; de Ridder, Denise T D

    2016-05-01

    Getting insufficient sleep has serious consequences in terms of mental and physical health. The current study is the first to approach insufficient sleep from a self-regulation perspective by investigating the phenomenon of bedtime procrastination: going to bed later than intended, without having external reasons for doing so. Data from a representative sample of Dutch adults (N = 2431) revealed that a large proportion of the general population experiences getting insufficient sleep and regularly goes to bed later than they would like to. Most importantly, a relationship between self-regulation and experienced insufficient sleep was found, which was mediated by bedtime procrastination. © The Author(s) 2014.

  9. Adalimumab treatment in patients with rheumatoid arthritis with renal insufficiency.

    Science.gov (United States)

    Sumida, Keiichi; Ubara, Yoshifumi; Suwabe, Tatsuya; Hayami, Noriko; Hiramatsu, Rikako; Hasegawa, Eiko; Yamanouchi, Masayuki; Hoshino, Junichi; Sawa, Naoki; Takaichi, Kenmei

    2013-03-01

    To elucidate the safety of adalimumab for rheumatoid arthritis (RA) patients with renal insufficiency, including those with end-stage renal disease undergoing hemodialysis. Sixty-five RA patients, including 2 patients undergoing hemodialysis, treated with adalimumab in our hospital from December 1, 2008 to June 30, 2011 were retrospectively analyzed. Renal function was evaluated by the estimated glomerular filtration rate (eGFR) calculated from the Cockcroft-Gault formula at the start and end of followup after adalimumab treatment. The proportion of the patients who discontinued or switched adalimumab treatment and the change of the eGFR were compared between patients with (n = 39) and without (n = 26) renal insufficiency, defined as an eGFR patients who discontinued or switched adalimumab treatment (51.3% versus 50.0%; P = 0.53). The mean ± SD changes of eGFR were from 41.6 ± 13.3 to 43.4 ± 17.9 ml/minute/1.73 m(2) in patients with renal insufficiency and from 83.6 ± 17.5 to 83.0 ± 16.8 ml/minute/1.73 m(2) in patients without renal insufficiency, and the differences in each group were not statistically significant (P = 0.92 and P = 0.78, respectively). No severe infections or other severe adverse events were observed in either group during adalimumab treatment. Our data indicate that adalimumab does not worsen renal function and has no serious adverse events even for RA patients with renal insufficiency, including those undergoing hemodialysis, and suggest that it could be a potential therapeutic option for them. Copyright © 2013 by the American College of Rheumatology.

  10. [Perinatal complications in patients with chronic renal insufficiency on hemodialysis].

    Science.gov (United States)

    Vázquez-Rodríguez, Juan Gustavo; del Angel-García, Guadalupe

    2010-09-01

    Pregnant patients with chronic renal insufficiency treated with hemodialysis experience adverse perinatal results. To compare perinatal complications of patients with chronic renal insufficiency undergoing hemodialysis who become pregnant vs. the complications of women with chronic renal insufficiency not undergoing dialysis but who then require dialysis during gestation. Transversal and retrospective study that included three patients with chronic renal insufficiency on chronic hemodialysis who became pregnant (group A) and three patients with chronic renal insufficiency without hemodialysis at the time of conception but who required dialysis during gestation (group B). Perinatal results were compared. Statistical analysis was performed with measures of central tendency and dispersion and Student t-test. Group A had 25 sessions vs. group B with 29 hemodialysis sessions (p = 0.88). Maternal complications were anemia 100% (six cases), Cesarean delivery 83.3% (group A 2 cases vs. group B 2 cases), preeclampsia 50% (group A 2 cases vs. group B 1 case), uncontrolled hypertension 50% (group A 2 cases vs. group B 1 case), preterm delivery 50% (group A 2 cases vs. group B 1 case), transfusion 33.3% (group A 2 cases), polyhydramnios 33.3% (group A 1 case vs. group B 1 case) and abortion 16.6% (group A 1 case). Fetal complications included fetal loss 16.6% (group A 1 case), neonatal mortality 33.3% (group A 1 cases vs. group B 1 case), prematurity 50% (group A2 cases vs. group B 1 case), fetal distress 50% (group A 1 case vs. group B 2 cases), respiratory failure 33.3% (group A 2 cases) and fetal growth restriction 16.6% (group A 1 case). Frequency of perinatal complications is elevated in both groups.

  11. Non-perturbative background field calculations

    International Nuclear Information System (INIS)

    Stephens, C.R.; Department of Physics, University of Utah, Salt Lake City, Utah 84112)

    1988-01-01

    New methods are developed for calculating one loop functional determinants in quantum field theory. Instead of relying on a calculation of all the eigenvalues of the small fluctuation equation, these techniques exploit the ability of the proper time formalism to reformulate an infinite dimensional field theoretic problem into a finite dimensional covariant quantum mechanical analog, thereby allowing powerful tools such as the method of Jacobi fields to be used advantageously in a field theory setting. More generally the methods developed herein should be extremely valuable when calculating quantum processes in non-constant background fields, offering a utilitarian alternative to the two standard methods of calculation: perturbation theory in the background field or taking the background field into account exactly. The formalism developed also allows for the approximate calculation of covariances of partial differential equations from a knowledge of the solutions of a homogeneous ordinary differential equation. copyright 1988 Academic Press, Inc

  12. Non-perturbative background field calculations

    Science.gov (United States)

    Stephens, C. R.

    1988-01-01

    New methods are developed for calculating one loop functional determinants in quantum field theory. Instead of relying on a calculation of all the eigenvalues of the small fluctuation equation, these techniques exploit the ability of the proper time formalism to reformulate an infinite dimensional field theoretic problem into a finite dimensional covariant quantum mechanical analog, thereby allowing powerful tools such as the method of Jacobi fields to be used advantageously in a field theory setting. More generally the methods developed herein should be extremely valuable when calculating quantum processes in non-constant background fields, offering a utilitarian alternative to the two standard methods of calculation—perturbation theory in the background field or taking the background field into account exactly. The formalism developed also allows for the approximate calculation of covariances of partial differential equations from a knowledge of the solutions of a homogeneous ordinary differential equation.

  13. AMH as Predictor of Premature Ovarian Insufficiency

    DEFF Research Database (Denmark)

    Lunding, Stine Aa; Aksglæde, Lise; Anderson, Richard A

    2015-01-01

    CONTEXT: The majority of Turner syndrome (TS) patients suffer from accelerated loss of primordial follicles. Low circulating levels of anti-Müllerian hormone (AMH) may predict the lack of spontaneous puberty in prepubertal girls and imminent premature ovarian insufficiency (POI) in TS women...

  14. Breast cancer knowledge and awareness among university students in Angola.

    Science.gov (United States)

    Sambanje, Martha Nyanungo; Mafuvadze, Benford

    2012-01-01

    The high breast cancer mortality rate in Sub-Saharan Africa has been attributed to a lack of public awareness of the disease which often leads to late diagnosis of the disease. Little is known about the level of knowledge and awareness of breast cancer in Angola. Previous studies have shown that breast cancer awareness is higher among well-educated people. The goal of this study was to assess breast cancer knowledge and awareness among university students in Angola. We conducted a cross-sectional survey of university students using a self-administered questionnaire to investigate participants' awareness and knowledge of breast cancer. A total of 595 university students in medical and non-medical programs successfully completed the survey. Our results showed insufficient knowledge of breast cancer among university students in Angola irrespective of whether they were in medical or non-medical programs. The majority of the participants were not aware of some of the early signs of breast cancer such as change in color or shape of the nipple, even though they appreciated the need for monthly breast self-examination. Overall most of the participants indicated the need for increased breast cancer awareness among university students. The study points to the insufficient knowledge of university students in Angola about breast cancer. We expect that our results may provide useful data that may be used by the department of health in Angola and other African countries to formulate health education programs aimed at increasing awareness and promote screening and early detection of breast cancer in the continent.

  15. Impact of placental insufficiency on fetal skeletal muscle growth

    Science.gov (United States)

    Hay, William W.

    2016-01-01

    Intrauterine growth restriction (IUGR) caused by placental insufficiency is one of the most common and complex problems in perinatology, with no known cure. In pregnancies affected by placental insufficiency, a poorly functioning placenta restricts nutrient supply to the fetus and prevents normal fetal growth. Among other significant deficits in organ development, the IUGR fetus characteristically has less lean body and skeletal muscle mass than their appropriately-grown counterparts. Reduced skeletal muscle growth is not fully compensated after birth, as individuals who were born small for gestational age (SGA) from IUGR have persistent reductions in muscle mass and strength into adulthood. The consequences of restricted muscle growth and accelerated postnatal “catch-up” growth in the form of adiposity may contribute to the increased later life risk for visceral adiposity, peripheral insulin resistance, diabetes, and cardiovascular disease in individuals who were formerly IUGR. This review will discuss how an insufficient placenta results in impaired fetal skeletal muscle growth and how lifelong reductions in muscle mass might contribute to increased metabolic disease risk in this vulnerable population. PMID:26994511

  16. Relationship between clinical signs and symptoms of convergence insufficiency.

    Science.gov (United States)

    Bade, Annette; Boas, Mark; Gallaway, Michael; Mitchell, G Lynn; Scheiman, Mitchell; Kulp, Marjean T; Cotter, Susan A; Rouse, Michael

    2013-09-01

    The percentage of children who are symptomatic has been shown to increase with the number of signs of convergence insufficiency (CI). Our goal was to investigate whether there is a relationship between the severity of the clinical signs of CI and symptom level reported in children with a three-sign symptomatic CI. The Convergence Insufficiency Treatment Trial enrolled 221 children with symptomatic CI from ages 9 to 17 years. Inclusion criteria included the following three signs of CI: (1) exophoria at near at least 4Δ greater than at distance, (2) insufficient positive fusional vergence (PFV) at near, and (3) a receded near point of convergence (NPC) of 6 cm break or greater. The relationships between the severity of each sign of CI (mild, moderate, and severe) and the level of symptoms as measured by the Convergence Insufficiency Symptom Survey (CISS) at baseline were evaluated. Mean CISS scores were not significantly different between mild, moderate, and severe exophoria (p = 0.60), PFV blur (p = 0.99), Sheard's criterion (p = 0.89), or NPC break (p = 0.84). There was also no difference between the frequency of subjects scoring at mild, moderate, or severe levels on the CISS and the severity of each sign of CI. Correlations between individual clinical signs and the CISS score were very low and not statistically significant. Among symptomatic children with a CISS score of 16 or higher and three clinical signs of CI, there is no further association between the severity of the clinical signs and their level of symptoms.

  17. Early intervention and management of adrenal insufficiency in children.

    LENUS (Irish Health Repository)

    Moloney, Sinéad

    2012-09-01

    The endocrine disorder adrenal insufficiency includes inadequate production of the steroid hormone cortisol. This results in poor physiological responses to illness, trauma or other stressors and risk of adrenal crisis. Management is based on administration of hydrocortisone. It is important to avoid under- or over-treatment and increase the dosage during times of physiological stress. To reduce morbidity, hospital admissions and mortality, the education and empowerment of parents and carers, and prompt intervention when necessary are essential. A steroid therapy card for adrenal insufficiency containing personal information on a patient\\'s condition was developed for use by families and their specialist centres.

  18. The role of General Practitioner in the recognition of adrenal insufficiency

    Directory of Open Access Journals (Sweden)

    Marta Dudzińska

    2017-05-01

    Full Text Available Background. Addison's disease (AD, usually caused by an autoimmune process, has non-specific symptomatology. The deficiency of cortisol is manifested by weakness, anorexia, weight loss and orthostatic hypotension.  Early recognition is crucial as acute adrenal insufficiency is a life threatening state. Objectives. Analysis of the clinical picture, occurrence of symptoms before diagnosis, and the role of General Practitioner (GP in the diagnosis of AD. Material and methods. 23 patients with primary adrenal insufficiency (18F, 5M, aged 24-80 years, with an average of 46,6 years. A method of proprietary questionnaire was used. Results. The symptoms present prior to diagnosis were as follows: weakness (100% of patients, approximately 9,2 months before the diagnosis, fatigue (100%; 8,8 months respectively, loss of appetite (95,6%; 9,1 months, skin darkening (95,6%; 10 months, orthostatic hypotension (91,3%; 10,7 months, weight loss (86,9%; 6,8 months, low blood pressure (73,9%; 11 months, stomachache (69,6%; 4,6 months, nausea (65,2%; 3,6 months, increased appetite for salt (56,5%; 6,2 months, muscle pain (52,2%; 15,5 months, hyperpigmentation of buccal mucosa and gums (47,8%; 2,7 months, vomiting (43,5%; 3,4 months. Because of these symptoms patients went to different specialists, including GPs in 78,3% of cases. Suspicion of the disease in 34.8% put GP. Conclusion. The symptoms of AD develop slowly and are present long time before the right diagnosis is established. Difficulties in early diagnosis may result from a low specificity of most of the symptoms. The role of GP in establishing the right and early diagnosis of Addison's disease is crucial.

  19. Leadership, knowledge and people in knowledge-intensive organisations : implications for HRM theory and practice

    NARCIS (Netherlands)

    Millar-Schijf, Carla C.J.M.; Chen, Stephen; Waller, Lee

    2017-01-01

    In order to offer insights into the management of HR challenges in Knowledge Intensive Firms/Organisations (KIO’s), this Special Issue explores three strands of research: International HRM, leadership and the knowledge-intensive firm/organisation. In this introduction against the background of

  20. Jump-Start Your Middle School Students' Background Knowledge and Vocabulary Skills

    Science.gov (United States)

    Ward, Elizabeth; Williams-Rossi, Dara

    2012-01-01

    One of the most challenging tasks in increasingly diverse classrooms is helping students develop the "knowledge and language of science to communicate scientific explanations and ideas" (NRC 1996, p. 144). In this article, the authors share one of their favorite methods for incorporating and reinforcing science vocabulary instruction in…

  1. MR appearance of parasymphyseal insufficiency fractures of the os pubis

    Energy Technology Data Exchange (ETDEWEB)

    Hosono, Mariko; Fujimoto, Ryota; Konishi, Junji [Department of Nuclear Medicine, Faculty of Medicine, Kyoto University, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto (Japan); Kobayashi, Hisataka [Nulcear Medicine Department, National Institutes of Health, Building 10, Room 1C-401, Bethesda, MD 20892 (United States); Tsutsui, Kazushige [Department of Radiology, Japanese Red Cross Society Wakayama Medical Center, Wakayama (Japan); Kotoura, Yoshihiko [Department of Orthopaedic Surgery, Nagahama City Hospital, Nagahama, Shiga (Japan); Tsuboyama, Tadao; Nakamura, Takashi [Department of Orthopaedic Surgery, Faculty of Medicine, Kyoto University, Kyoto (Japan); Hayashi, Hikaru [Department of Orthopaedic Surgery, Japanese Red Cross Society Wakayama Medical Center, Wakayama (Japan)

    1997-09-01

    Objective. To clarify the MRI features of parasymphyseal insufficiency fractures of the os pubis. Design and patients. MRI was performed in four postmenopausal women with parasymphyseal insufficiency fractures. The diagnosis was confirmed with plain films in every patient. T1-weighted and T2-weighted images were obtained in four patients using a 1.5-T unit. Postcontrast T1-weighted imaging was also done in three patients. Results and conclusions. MRI of pubic parasymphyseal insufficiency fracture characteristically demonstrates a hyperintense mass lesion with a hypointense rim on T2-weighted imaging, showing peripheral and septal enhancement after contrast administration. It is important to have this entity in mind in patients with osteoporosis, especially in patients with a history of pelvic irradiation for malignant disease, so as not to misinterpret it as a chondroid tumor or bone metastasis. (orig.). With 2 figs., 2 tabs.

  2. How Knowledge Powers Reading

    Science.gov (United States)

    Lemov, Doug

    2017-01-01

    Recent research shows that reading comprehension relies heavily on prior knowledge. Far more than generic "reading skills" like drawing inferences, making predictions, and knowing the function of subheads, how well students learn from a nonfiction text depends on their background knowledge of the text's subject matter. And in a cyclical…

  3. 29 CFR 541.2 - Job titles insufficient.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Job titles insufficient. 541.2 Section 541.2 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR REGULATIONS DEFINING AND DELIMITING THE EXEMPTIONS FOR EXECUTIVE, ADMINISTRATIVE, PROFESSIONAL, COMPUTER AND OUTSIDE SALES EMPLOYEES...

  4. Reproductive outcome re-evaluation for women with primary ovarian insufficiency using office

    Directory of Open Access Journals (Sweden)

    Mohamed T. Gad Al Rab

    2015-12-01

    Full Text Available Objective & Aim: The objective of this study was to analyze the usefulness of office microlaparoscopy in the re-assessment of ovarian morphological picture, relevant clinical types and future fertility prognosis of primary ovarian insufficiency (POI. Methods: Forty-five patients with POI diagnosed in a private fertility care center between October 2009 and December 2014, who gave informed consent and underwent office microlaparoscopy were studied. Pelvic ultrasound had failed to visualize and morphologically assess both ovaries in the women included. The cases were divided into four groups based on the microlaparoscopic ovarian morphology: Group N (near to normal, Group G (Gyrus shaped, Group A (atrophied, and Group S (streak shaped. These groups were analyzed with respect to patient background, blood hormone levels, the level of antinuclear antibodies measured, and their individual fertility prognosis. Result: No significant differences in patient background and serum hormone levels were observed between groups. There was complete absence of both ovaries in 5 patients included. Groups N and G had shown some improvement, such as regular spontaneous menstruation, and forthcoming pregnancy, which happened once in Group N. Many other internal genital anomalies could be diagnosed during the same office procedure. Conclusion: Office microlaparoscopy under augmented local anesthesia is a useful procedure in the definite demarcation, and the differentiation between the types of POI, regarding their menstrual regularity and future fertility prognosis.

  5. Understanding indigenous knowledge: Bridging the knowledge gap through a knowledge creation model for agricultural development

    Directory of Open Access Journals (Sweden)

    Edda T. Lwoga

    2010-12-01

    Full Text Available This article addresses the management of agricultural indigenous knowledge (IK in developing countries, with a specific focus on Tanzania. It provides background details on IK and its importance for agricultural development. It introduces various knowledge management (KM concepts and discusses their application in managing IK in the developing world by placing Nonaka’s knowledge creation theory (Nonaka 1991; Nonaka & Takeuchi 1995; Nonaka, Toyama & Konno 2000 in the context of the local communities. Data from focus groups were used to triangulate with data from interviews in order to validate, confirm and corroborate quantitative results with qualitative findings. The study findings showed that knowledge creation theory can be used to manage IK in the local communities, however, adequate and appropriate resources need to be allocated for capturing and preserving IK before it disappears altogether. For sustainable agricultural development, the communities have to be placed within a knowledge-creating setting that continuously creates, distributes and shares knowledge within and beyond the communities’ boundaries and integrates it with new agricultural technologies, innovations and knowledge.

  6. Study of Background Rejection Systems for the IXO Mission.

    Science.gov (United States)

    Laurent, Philippe; Limousin, O.; Tatischeff, V.

    2009-01-01

    The scientific performances of the IXO mission will necessitate a very low detector background level. This will imply thorough background simulations, and efficient background rejection systems. It necessitates also a very good knowledge of the detectors to be shielded. In APC, Paris, and CEA, Saclay, we got experience on these activities by conceiving and optimising in parallel the high energy detector and the active and passive background rejection system of the Simbol-X mission. Considering that this work may be naturally extended to other X-ray missions, we have initiated with CNES a R&D project on the study of background rejection systems mainly in view the IXO project. We will detail this activity in the poster.

  7. Knowledge, attitudes, and behaviours of healthcare professionals regarding child maltreatment in China.

    Science.gov (United States)

    Li, X; Yue, Q; Wang, S; Wang, H; Jiang, J; Gong, L; Liu, W; Huang, X; Xu, T

    2017-11-01

    A new, recently issued national law and regulation in China conferred the responsibility of healthcare professionals in child maltreatment intervention. However, few studies have reported on the recognition and reporting of child maltreatment by healthcare professionals in China. The aim of this study was to assess healthcare professionals' knowledge, attitudes, and self-perceived behaviour in terms of identifying, assessing, and reporting child maltreatment cases in China. A cross-sectional survey of 877 healthcare professionals from four provinces was conducted using a structured questionnaire. The respondents demonstrated insufficient knowledge on identifying potential child maltreatment cases. Over 30% of them were less than confident in the medical examination, evaluation, and treatment of child maltreatment cases, especially with regard to cases involving sexual abuse. Only 3.19% of respondents had ever received training on child maltreatment intervention, and as a result, lack of knowledge with regard to dealing with child maltreatment cases, referral procedures, and regulations was indicated to be the main cause of underreporting. Healthcare professionals in China have insufficient knowledge, skills, and confidence when it comes to dealing with all aspects of child maltreatment. Although participants reported a positive attitude towards their role in detecting and reporting child maltreatment cases, there are obstacles that hinder them from doing so. Appropriate training courses should be developed to empower professionals with knowledge and skills, as well as increase their confidence in dealing with suspected child maltreatment cases. © 2017 John Wiley & Sons Ltd.

  8. Radiological features of superomedial iliac insufficiency fractures: a possible mimicker of metastatic disease

    International Nuclear Information System (INIS)

    Donovan, Andrea; Schweitzer, Mark E.; Rafii, Mahvash; Lax, Allison

    2009-01-01

    Pelvic insufficiency fractures are common in elderly patients. Because both osteoporosis and metastatic disease occur in similar patient populations, insufficiency fractures may be mistaken for metastatic foci. Although the ilium is not an uncommon location for metastases, insufficiency fractures rarely involve the ilium. The radiological features of insufficiency fractures adjacent to the sacroiliac joint (superomedial ilium) have not been well described. We describe the computed tomography (CT), magnetic resonance (MR), and positron emission tomography (PET) imaging findings of these rare fractures. Six patients (five female, one male; mean age 66 years, age range 47-83 years) with iliac insufficiency fractures adjacent to the sacroiliac joint were identified following retrospective review of a clinical database. Imaging studies, including CT (n = 4), MR (n = 3), and PET (n = 2) were reviewed by two radiologists. Tissue biopsy result was available in one patient. CT demonstrated subtle fracture lucency (n = 2) or linear sclerosis (n = 3) adjacent to the sacroiliac joint; MR marrow changes adjacent to the sacroiliac joint demonstrated a low T1, high T2 signal intensity line (n = 2), or a low T1 and low T2 signal intensity line (n = 1). Fractures were fluorodeoxyglucose avid (n = 2) with average SUV max 2.2. Iliac fractures were bilateral in three patients; additional pelvic insufficiency fractures were present in one patient. In one patient, CT-guided biopsy showed no evidence of malignancy. Recognition of the radiological characteristics of iliac insufficiency fractures is important in order to distinguish them from malignancy. The presence of additional pelvic fractures in characteristic locations in the setting of osteoporosis may help to confirm the diagnosis. (orig.)

  9. Radiological features of superomedial iliac insufficiency fractures: a possible mimicker of metastatic disease

    Energy Technology Data Exchange (ETDEWEB)

    Donovan, Andrea; Schweitzer, Mark E. [NYU Hospital for Joint Diseases, New York, NY (United States); Rafii, Mahvash [New York, NY (United States); Lax, Allison [Georgetown University Hospital, Washington, DC (United States)

    2009-01-15

    Pelvic insufficiency fractures are common in elderly patients. Because both osteoporosis and metastatic disease occur in similar patient populations, insufficiency fractures may be mistaken for metastatic foci. Although the ilium is not an uncommon location for metastases, insufficiency fractures rarely involve the ilium. The radiological features of insufficiency fractures adjacent to the sacroiliac joint (superomedial ilium) have not been well described. We describe the computed tomography (CT), magnetic resonance (MR), and positron emission tomography (PET) imaging findings of these rare fractures. Six patients (five female, one male; mean age 66 years, age range 47-83 years) with iliac insufficiency fractures adjacent to the sacroiliac joint were identified following retrospective review of a clinical database. Imaging studies, including CT (n = 4), MR (n = 3), and PET (n = 2) were reviewed by two radiologists. Tissue biopsy result was available in one patient. CT demonstrated subtle fracture lucency (n = 2) or linear sclerosis (n = 3) adjacent to the sacroiliac joint; MR marrow changes adjacent to the sacroiliac joint demonstrated a low T1, high T2 signal intensity line (n = 2), or a low T1 and low T2 signal intensity line (n = 1). Fractures were fluorodeoxyglucose avid (n = 2) with average SUV{sub max} 2.2. Iliac fractures were bilateral in three patients; additional pelvic insufficiency fractures were present in one patient. In one patient, CT-guided biopsy showed no evidence of malignancy. Recognition of the radiological characteristics of iliac insufficiency fractures is important in order to distinguish them from malignancy. The presence of additional pelvic fractures in characteristic locations in the setting of osteoporosis may help to confirm the diagnosis. (orig.)

  10. The Influence of Prior Knowledge on the Retrieval-Directed Function of Note Taking in Prior Knowledge Activation

    Science.gov (United States)

    Wetzels, Sandra A. J.; Kester, Liesbeth; van Merrienboer, Jeroen J. G.; Broers, Nick J.

    2011-01-01

    Background: Prior knowledge activation facilitates learning. Note taking during prior knowledge activation (i.e., note taking directed at retrieving information from memory) might facilitate the activation process by enabling learners to build an external representation of their prior knowledge. However, taking notes might be less effective in…

  11. Endocrine and exocrine pancreatic insufficiency after acute pancreatitis: long-term follow-up study.

    Science.gov (United States)

    Tu, Jianfeng; Zhang, Jingzhu; Ke, Lu; Yang, Yue; Yang, Qi; Lu, Guotao; Li, Baiqiang; Tong, Zhihui; Li, Weiqin; Li, Jieshou

    2017-10-27

    Patients could develop endocrine and exocrine pancreatic insufficiency after acute pancreatitis (AP), but the morbidity, risk factors and outcome remain unclear. The aim of the present study was to evaluate the incidence of endocrine and exocrine pancreatic insufficiency after AP and the risk factors of endocrine pancreatic insufficiency through a long-term follow-up investigation. Follow-up assessment of the endocrine and exocrine function was conducted for the discharged patients with AP episodes. Oral Glucose Tolerance Test (OGTT) and faecal elastase-1(FE-1) test were used as primary parameters. Fasting blood-glucose (FBG), fasting insulin (FINS), glycosylated hemoglobin HBA1c, 2-h postprandial blood glucose (2hPG), Homa beta cell function index (HOMA-β), homeostasis model assessment of insulin resistance (HOMA-IR) and FE-1 were collected. Abdominal contrast-enhanced computed tomography (CECT) was performed to investigate the pancreatic morphology and the other related data during hospitalization was also collected. One hundred thirteen patients were included in this study and 34 of whom (30.1%) developed diabetes mellitus (DM), 33 (29.2%) suffered impaired glucose tolerance (IGT). Moreover, 33 patients (29.2%) developed mild to moderate exocrine pancreatic insufficiency with 100μg/gpancreatic insufficiency with FE-1pancreatic necrosis was significant higher than that in the non-pancreatic necrosis group (X 2  = 13.442,P = 0.001). The multiple logistic regression analysis showed that extent of pancreatic necrosisendocrine pancreatic insufficiency. HOMA-IR (P = 0.002, OR = 6.626), Wall-off necrosis (WON) (P = 0.013, OR = 184.772) were the risk factors. The integrated morbidity of DM and IGT after AP was 59.25%, which was higher than exocrine pancreatic insufficiency. 6.2% and 29.2% of patients developed severe and mild to moderate exocrine pancreatic insufficiency, respectively. The extent of pancreatic necrosis>50%, WON and insulin resistance were

  12. Knowledge brokerage - potential for increased capacities and shared power in impact assessment

    International Nuclear Information System (INIS)

    Rosario Partidario, Maria; Sheate, William R.

    2013-01-01

    Constructive and collaborative planning theory has exposed the perceived limitations of public participation in impact assessment. At strategic levels of assessment the established norm can be misleading and practice is illusive. For example, debates on SEA effectiveness recognize insufficiencies, but are often based on questionable premises. The authors of this paper argue that public participation in strategic assessment requires new forms of information and engagement, consistent with the complexity of the issues at these levels and that strategic assessments can act as knowledge brokerage instruments with the potential to generate more participative environments and attitudes. The paper explores barriers and limitations, as well as the role of knowledge brokerage in stimulating the engagement of the public, through learning-oriented processes and responsibility sharing in more participative models of governance. The paper concludes with a discussion on building and inter-change of knowledge, towards creative solutions to identified problems, stimulating learning processes, largely beyond simple information transfer mechanisms through consultative processes. The paper argues fundamentally for the need to conceive strategic assessments as learning platforms and design knowledge brokerage opportunities explicitly as a means to enhance learning processes and power sharing in IA. - Highlights: ► Debates on SEA recognize insufficiencies on public participation ► We propose new forms of engagement consistent with complex situations at strategic levels of decision-making ► Constructive and collaborative planning theories help explain how different actors acquire knowledge and the value of knowledge exchange ► Strategic assessments can act as knowledge brokerage instruments ► The paper argues for strategic assessments as learning platforms as a means to enhance learning processes and power sharing in IA.

  13. Prognostic value of relative adrenal insufficiency after out-of-hospital cardiac arrest.

    Science.gov (United States)

    Pene, Frédéric; Hyvernat, Hervé; Mallet, Vincent; Cariou, Alain; Carli, Pierre; Spaulding, Christian; Dugue, Marie-Annick; Mira, Jean-Paul

    2005-05-01

    To assess the prevalence of relative adrenal insufficiency in patients successfully resuscitated after cardiac arrest, and its prognostic role in post-resuscitation disease. A prospective observational single-center study in a medical intensive care unit. 64 patients hospitalised in the intensive care unit after successful resuscitation for out-of-hospital cardiac arrest. A corticotropin-stimulation test was performed between 12 and 24 h following admission: serum cortisol level was measured before and 60 min after administration of tetracosactide 250 microg. Patients with an incremental response less than 9 microg/dl were considered to have relative adrenal insufficiency (non-responders). Variables were expressed as medians and interquartile ranges. 33 patients (52%) had relative adrenal insufficiency. Baseline cortisol level was higher in non-responders than in responders (41 [27.2-55.5] vs. 22.8 [15.7-35.1] microg/dl respectively, P=0.001). A long interval before initiation of cardiopulmonary resuscitation was associated with relative adrenal insufficiency (5 [3-10] vs. 3 [3-5] min, P=0.03). Of the 38 patients with post-resuscitation shock, 13 died of irreversible multiorgan failure. The presence of relative adrenal insufficiency was identified as a poor prognostic factor of shock-related mortality (log-rank P=0.02). A trend towards higher mortality in non-responders was identified in a multivariate logistic regression analysis (odds ratio 6.77, CI 95% 0.94-48.99, P=0.058). Relative adrenal insufficiency occurs frequently after successful resuscitation of out-of-hospital cardiac arrest, and appears to be associated with a poor prognosis in cases of post-resuscitation shock. The role of corticosteroid supplementation should be evaluated in this setting.

  14. Cervical cerclage placement decreases local levels of proinflammatory cytokines in patients with cervical insufficiency.

    Science.gov (United States)

    Monsanto, Stephany P; Daher, Silvia; Ono, Erika; Pendeloski, Karen Priscilla Tezotto; Trainá, Évelyn; Mattar, Rosiane; Tayade, Chandrakant

    2017-10-01

    Cervical insufficiency is characterized by premature, progressive dilation and shortening of the cervix during pregnancy. If left unattended, this can lead to the prolapse and rupture of the amniotic membrane, which usually results in midtrimester pregnancy loss or preterm birth. Previous studies have shown that proinflammatory cytokines such as interleukin-1β, interleukin-6, interleukin-8, and tumor necrosis factor alpha are up-regulated in normal parturition but are also associated with preterm birth. Studies evaluating such markers in patients with cervical insufficiency have evaluated only their diagnostic potential. Even fewer studies have studied them within the context of cerclage surgery. The objective of the study was to evaluate the impact of local and systemic inflammatory markers on the pathogenesis of cervical insufficiency and the effect of cerclage surgery on the local immune microenvironment of women with cervical insufficiency. We recruited 28 pregnant women (12-20 weeks' gestation) diagnosed with insufficiency and referred for cerclage surgery and 19 gestational age-matched normal pregnant women as controls. Serum and cervicovaginal fluid samples were collected before and after cerclage surgery and during a routine checkup for normal women and analyzed using a targeted 13-plex proinflammatory cytokine assay. Before surgery, patients with cervical insufficiency had higher levels of interleukin-1β, interleukin-6, interleukin-12, monocyte chemoattractant protein-1 and tumor necrosis factor alpha in cervicovaginal fluid compared to controls, but after surgery, these differences disappeared. No differences were found in serum of insufficiency versus control women. In patients with insufficiency, the levels of interleukin-1β, interleukin-6, interleukin-8, monocyte chemoattractant protein-1, and interferon gamma in cervicovaginal fluid declined significantly after cerclage compared with before intervention, but these changes were not detected in serum

  15. Homeostatic responses to amino acid insufficiency

    Directory of Open Access Journals (Sweden)

    Tracy G. Anthony

    2015-09-01

    Full Text Available This article provides a brief overview describing how two key signaling pathways, namely the integrated stress response and the mammalian target of rapamycin complex 1, work together to facilitate cellular adaptation to dietary amino acid insufficiency. A deeper understanding of these mechanisms is leading to identification of novel targets which aid in disease treatments, improve stress recovery and increase health span through slowed aging and enhanced metabolic fitness.

  16. Subchondral insufficiency fracture of the knee: a non-traumatic injury with prolonged recovery time

    OpenAIRE

    Gourlay, Margaret L; Renner, Jordan B; Spang, Jeffrey T; Rubin, Janet E

    2015-01-01

    Subchondral insufficiency fractures are non-traumatic fractures that occur immediately below the cartilage of a joint. Although low bone density may be present concurrently, it is not the underlying cause of subchondral insufficiency fractures in the majority of patients. Patients with subchondral insufficiency fracture characteristically have unremarkable plain radiographs, while MRI examination may reveal extensive bone marrow oedema and subchondral bone collapse. This article presents a 51...

  17. A population-based approach to background discrimination in particle physics

    International Nuclear Information System (INIS)

    Colecchia, Federico

    2012-01-01

    Background properties in experimental particle physics are typically estimated from control samples corresponding to large numbers of events. This can provide precise knowledge of average background distributions, but typically does not take into account statistical fluctuations in a data set of interest. A novel approach based on mixture model decomposition is presented, as a way to extract additional information about statistical fluctuations from a given data set with a view to improving on knowledge of background distributions obtained from control samples. Events are treated as heterogeneous populations comprising particles originating from different processes, and individual particles are mapped to a process of interest on a probabilistic basis. The proposed approach makes it possible to estimate features of the background distributions from the data, and to extract information about statistical fluctuations that would otherwise be lost using traditional supervised classifiers trained on high-statistics control samples. A feasibility study on Monte Carlo is presented, together with a comparison with existing techniques. Finally, the prospects for the development of tools for intensive offline analysis of individual interesting events at the Large Hadron Collider are discussed.

  18. Pedagogical Content Knowledge of Experts and Novices--What Knowledge Do They Activate When Analyzing Science Lessons?

    Science.gov (United States)

    Krepf, Matthias; Plöger, Wilfried; Scholl, Daniel; Seifert, Andreas

    2018-01-01

    In the current debate on pedagogical content knowledge (PCK), the term is used to refer to the context-specific knowledge that teachers activate when reflecting on practice. Against the background of this debate, we conducted an empirical study and sought to answer the question of which knowledge experts and novices activated in assessing a…

  19. Knowledge Building and Mathematics: Shifting the Responsibility for Knowledge Advancement and Engagement

    Directory of Open Access Journals (Sweden)

    Joan Moss

    2010-12-01

    Full Text Available Three classrooms of Grade 4 students from different schools and diverse backgrounds collaborated in early algebra research to solve a series of linear and quadratic generalizing problems. Results revealed that high- and low-achieving students were able to solve problems of recognized difficulty. We discuss Knowledge Building principles and practices that fostered deep understanding and broad participation. Students used the online Knowledge Building environment Knowledge Forum® to conduct their work and we illustrate how Knowledge Forum supported a Knowledge Building culture for mathematical learning and problem solving. Analyses of participation patterns and note content revealed practices consistent with Knowledge Building principles, specifically democratization of knowledge, with students at all achievement levels participating, and epistemic agency, with students providing evidence and justification for conjectures and generating multiple solutions to challenging problems.

  20. Increased hallux angle in children and its association with insufficient length of footwear: A community based cross-sectional study

    Directory of Open Access Journals (Sweden)

    Kundi Michael

    2009-12-01

    Full Text Available Abstract Background Wearing shoes of insufficient length during childhood has often been cited as leading to deformities of the foot, particularly to the development of hallux valgus disorders. Until now, these assumptions have not been confirmed through scientific research. This study aims to investigate whether this association can be statistically proven, and if children who wear shoes of insufficient length actually do have a higher risk of a more pronounced lateral deviation of the hallux. Methods 858 pre-school children were included in the study. The study sample was stratified by sex, urban/rural areas and Austrian province. The hallux angle and the length of the feet were recorded. The inside length of the children's footwear (indoor shoes worn in pre-school and outdoor shoes were assessed. Personal data and different anthropometric measurements were taken. The risk of hallux valgus deviation was statistically tested by a stepwise logistic regression analysis and the relative risk (odds ratio for a hallux angle ≥ 4 degrees was calculated. Results Exact examinations of the hallux angle could be conducted on a total of 1,579 individual feet. Only 23.9% out of 1,579 feet presented a straight position of the great toe. The others were characterized by lateral deviations (valgus position at different degrees, equalling 10 degrees or greater in 14.2% of the children's feet. 88.8% of 808 children examined wore indoor footwear that was of insufficient length, and 69.4% of 812 children wore outdoor shoes that were too short. A significant relationship was observed between the lengthwise fit of the shoes and the hallux angle: the shorter the shoe, the higher the value of the hallux angle. The relative risk (odds ratio of a lateral hallux deviation of ≥ 4 degrees in children wearing shoes of insufficient length was significantly increased. Conclusions There is a significant relationship between the hallux angle in children and footwear that is

  1. Increased hallux angle in children and its association with insufficient length of footwear: A community based cross-sectional study

    Science.gov (United States)

    2009-01-01

    Background Wearing shoes of insufficient length during childhood has often been cited as leading to deformities of the foot, particularly to the development of hallux valgus disorders. Until now, these assumptions have not been confirmed through scientific research. This study aims to investigate whether this association can be statistically proven, and if children who wear shoes of insufficient length actually do have a higher risk of a more pronounced lateral deviation of the hallux. Methods 858 pre-school children were included in the study. The study sample was stratified by sex, urban/rural areas and Austrian province. The hallux angle and the length of the feet were recorded. The inside length of the children's footwear (indoor shoes worn in pre-school and outdoor shoes) were assessed. Personal data and different anthropometric measurements were taken. The risk of hallux valgus deviation was statistically tested by a stepwise logistic regression analysis and the relative risk (odds ratio) for a hallux angle ≥ 4 degrees was calculated. Results Exact examinations of the hallux angle could be conducted on a total of 1,579 individual feet. Only 23.9% out of 1,579 feet presented a straight position of the great toe. The others were characterized by lateral deviations (valgus position) at different degrees, equalling 10 degrees or greater in 14.2% of the children's feet. 88.8% of 808 children examined wore indoor footwear that was of insufficient length, and 69.4% of 812 children wore outdoor shoes that were too short. A significant relationship was observed between the lengthwise fit of the shoes and the hallux angle: the shorter the shoe, the higher the value of the hallux angle. The relative risk (odds ratio) of a lateral hallux deviation of ≥ 4 degrees in children wearing shoes of insufficient length was significantly increased. Conclusions There is a significant relationship between the hallux angle in children and footwear that is too short in length. The

  2. Bremsstrahlung background and quantitation of thin biological samples

    International Nuclear Information System (INIS)

    Khan, K.M.

    1991-02-01

    An inherent feature of all electron-excited X-ray spectra is the presence of a background upon which the characteristic peaks of interest are superimposed. To extract the x-ray intensity of the characteristics lines of interest, it is necessary to subtract this background, which may be due to both specimen generated Bremsstrahlung and extraneous sources, from a measured x-ray spectrum. Some conventional methods of background subtraction will be briefly reviewed. It has been seen that these conventional methods do not give sufficiently accurate results in biological analysis where the peaks of interest are not well-separated and most of the peaks lie in the region where the background is appreciably curved. An alternative approach of background subtraction for such samples is investigated which involves modelling the background using the currently available knowledge of x-ray physics and energy dispersive detectors. This method is particularly suitable for biological samples as well as other samples having an organic matrix. 6 figs. (author)

  3. Zinc status in chronic pancreatitis and its relationship with exocrine and endocrine insufficiency.

    Science.gov (United States)

    Girish, Banavara Narasimhamurthy; Rajesh, Gopalakrishna; Vaidyanathan, Kannan; Balakrishnan, Vallath

    2009-11-05

    A major role of the pancreas in zinc homeostasis has been suggested. To assess erythrocyte zinc status in chronic pancreatitis and to correlate it with pancreatic exocrine and endocrine insufficiency. One hundred and one patients with chronic pancreatitis (34 alcoholic chronic pancreatitis, 67 tropical chronic pancreatitis) were prospectively studied. Disease characteristics and imaging features were recorded. Erythrocyte zinc was estimated by flame atomic absorption spectrophotometry. Exocrine insufficiency was assessed using polyclonal antibody ELISA for pancreatic stool elastase1. Endocrine insufficiency was assessed by serum glucose levels and insulin requirement. Erythrocyte zinc was significantly lower in chronic pancreatitis patients than in the controls (26.5+/-9.5 microg/g Hb vs. 38.0+/-6.6 microg/g Hb; Ppancreatitis than in alcoholic chronic pancreatitis (25.0+/-10.4 microg/g Hb vs. 29.6+/-6.5 microg/g Hb, P=0.001). In chronic pancreatitis patients who had exocrine insufficiency, erythrocyte zinc positively correlated with stool elastase1 (r=0.587, Ppancreatitis patients, and that zinc deficiency correlates with exocrine and endocrine insufficiency. Further studies may clarify the possible benefits of zinc supplementation in chronic pancreatitis.

  4. EXPLORING HEALTHCARE-ASSOCIATED INFECTIONS: KNOWLEDGE, ATTITUDE, AND BEHAVIOR OF EMERGENCY NURSES WORKING IN BANDUNG, INDONESIA

    Directory of Open Access Journals (Sweden)

    Hudzaifah Al Fatih

    2016-10-01

    Full Text Available Background: Healthcare associated Infections (HAIs is considered being the most serious patient safety issue in health care settings and nurses in Emergency Department (ED face greater risk of exposure to infectious pathogens. Objective: The objectives of this study were to examine knowledge, attitude and behavior towards HAIs of Indonesian nurses working in ED and to examine the relationship among the above three variables. Method: A cross-sectional study with self-reported survey was conducted at four hospitals in Bandung, Indonesia. The Healthcare Associated Infections Survey consisting of four domains: demographic characteristics, knowledge, attitude and behavior related to HAIs was used. The participants of this study covered 115 nurses. Results: The mean of overall performance on the knowledge was good 21.23 ±5.173 (range 9-30 and 92.2% of them believed that guideline for HAIs control practice can reduced the risk of infections. The mean score for behavior when practicing infection control was 37.7±5.570 (26-50. Marital status and working hours per week, influenced nurses’ knowledge of HAIs (rs = 0.185, p = 0.048. Work experienced have negative correlation with attitude towards HAIs (rs = -0.196, p = 0.035. Furthermore, type of hospital and working hours per week have been associated with nurses’ behavior towards HAIs (r = 0.191, p = 0.04. There were no significant relationship between knowledge, attitude and behavior towards HAIs. Conclusion: Even though the majority of ED nurses in Indonesia believe that precautionary guidelines can reduce the risk of HAIs, this study has indicated that nurses’ behavior toward HAIs still insufficient.

  5. Prevalence and correlates of insufficient physical activity in school adolescents in Peru.

    Science.gov (United States)

    Sharma, Bimala; Chavez, Rosemary Cosme; Nam, Eun Woo

    2018-01-01

    OBJECTIVE To assess the prevalence and correlates of insufficient physical activity in adolescents in Peru. METHODS We used a self-administered questionnaire developed from Global school-based Student Health Survey to collect information from secondary school students in North Lima and Callao in 2015. We carried out Poisson regression with robust variance using generalized linear models to estimate the crude and adjusted prevalence ratios (APR) with 95% confidence intervals (95%CI) of insufficient physical activity for its correlates. RESULTS We have found that 78% of the adolescents did not meet the global recommendation of the World Health Organization on physical activity in the last week before the survey. Female respondents (APR = 1.13, 95%CI 1.04-1.21), respondents who perceived themselves as overweight (APR = 1.10, 95%CI 1.03-1.18), and respondents who consumed insufficient vegetables and fruits [no vegetables (APR = 1.30, 95%CI 1.06-1.59), no fruits (APR = 1.15, 95%CI 1.00-1.31) as compared to those who consumed ≥ 2 servings every day in the last seven days] were more likely to report insufficient physical activity. Adolescents who worked after school (APR = 0.92, 95%CI 0.84-0.99), had physical education classes five times per week (APR = 0.94, 95%CI 0.88-0.99), and had parental supervision (APR = 0.92, 95%CI 0.87-0.98) were less likely to report insufficient physical activity. CONCLUSIONS Sex, work after school, perceived body weight, physical education class, parental support, and healthy dietary behaviors were associated with insufficient physical activity. Attempts to improve physical activity should look for ways to enhance leisure-time physical activity, parental support, physical education classes, healthy dietary behaviors, and normal body weight maintenance in adolescents with integrated efforts from the family and school.

  6. Diabetes mellitus and exocrine pancreatic insufficiency (review of literature

    Directory of Open Access Journals (Sweden)

    L.T. Daminova

    2018-02-01

    Full Text Available Currently, an increasing importance is given to the study of the problem of exocrine pancreatic insufficiency, which is observed in a significant number of patients with diabetes mellitus (DM type 1 and 2 and can potentially affect the compensation of DM. The mechanism of reducing the external secretion of the pancreas in DM is associated with an imbalance of inhibitory and stimulating pancreatic secretion of hormones, with fibrosis of the gland as a result of diabetic angiopathy. In type 2 DM, the mechanisms that result from the metabolic syndrome are involved in the pathogenesis of exocrine pancreatic insufficiency. Enzyme replacement the­rapy should be considered as one of the promising methods of treating DM patients.

  7. Post-traumatic tricuspid valve insufficiency. 2 cases of delayed clinical manifestation.

    OpenAIRE

    Bortolotti, U; Scioti, G; Milano, A; Guglielmi, C; Benedetti, M; Tartarini, G; Balbarini, A

    1997-01-01

    We present 2 cases of tricuspid insufficiency following blunt chest trauma: 1 was diagnosed 5 months after the trauma and the other, 20 years after the trauma. In both patients, the tricuspid valve was replaced with a porcine bioprosthesis, because valve repair was not considered feasible. These cases emphasize the variability of clinical presentation of post-traumatic tricuspid valve insufficiency and indicate the need for close follow-up of patients after major thoracic trauma.

  8. Deconstructing Human Papillomavirus (HPV) Knowledge: Objective and Perceived Knowledge in Males' Intentions to Receive the HPV Vaccine

    Science.gov (United States)

    Krawczyk, Andrea; Stephenson, Ellen; Perez, Samara; Lau, Elsa; Rosberger, Zeev

    2013-01-01

    Background: The human papillomavirus (HPV) vaccine was recently approved for men. To effectively tailor HPV education efforts toward men, it is important to understand what men know about HPV and how this knowledge relates to their decision to receive the vaccine. This study examines how objective HPV knowledge, objective HPV vaccine knowledge,…

  9. Knowledge of reproductive physiology and hormone therapy in 40-60 year old women: a population-based study in Yazd, Iran.

    Science.gov (United States)

    Fallahzadeh, Hossein; Hossienzadeh, Maryam; Yazdani, Fatemeh; Javadi, Atefeh

    2012-07-01

    Background : Evidences shows that menopause affects women's health, but women's knowledge of proper care and maintenance is insufficient. To determine knowledge of hormone therapy (HT), reproductive physiology, and menopause in a population of 40-60 year old women. This cross-sectional study was conducted through a cluster sampling among 330 women in Yazd, Islamic Republic of Iran, in 2010. Data was collected using a questionnaire containing questions about reproductive physiology related to menopause and HT by interviewing. Inferential and descriptive statistics via SPSS.15 software were used for data analysis. Overall, 2.1% of women were current takers of HT, 13.4% had taken it in the past but had stopped and 84.5% had never taken hormone replacement therapy. Iranian women had low knowledge of HT, reproductive physiology, and menopause. Most of the women (85.5%) knew that hot flashes are common around menopause and only 77.2% knew decreasing estrogen production causes the menopause. They knew little about the effects of progestagens and the effects of HT on fertility. Logistic regression determined that age, educational level and BMI were the most important factors predicting use of HT after adjusting for other variables. Iranian women have a low HT usage rate and the majority of them are lacking of the knowledge about HT and menopause. Women need improved knowledge of the risks and benefits of HT as well as education about the reproductive system around menopause.

  10. Central Adrenal Insufficiency and Diabetes Insipidus Misdiagnosed as Severe Depression

    Directory of Open Access Journals (Sweden)

    Naoki Hiroi

    2010-01-01

    Full Text Available A 68 year-old Japanese man, who had been suffering from immobilization and disuse syndrome, was admitted to our hospital for evaluation of polyuria with polyposia, hyponatremia and low blood pressure. His plasma osmolality was greater than that of his urine. His endocrinological examination revealed low levels of plasma adrenocorticotropic hormone (ACTH and cortisol, and a normal response of ACTH to the corticotrophin-releasing hormone (CRH challenge. Plasma ACTH did not increase with insulin loading. A low plasma vasopressin (AVP level and no response of AVP to a 5% saline administration were observed. We diagnosed central adrenal insufficiency with central diabetes insipidus. Six months after starting administration of hydrocortisone and 1-deamino-8D-arginine vasopressin, his psychological symptoms had improved, and 1.5 years after starting treatment, he was able to walk. In conclusion, it is not particularly rare for adrenal insufficiency to be misdiagnosed as depression. However, a correct early diagnosis is necessary, because, if adrenal insufficiency is not definitively diagnosed, the patient's quality of life diminishes markedly.

  11. Bedtime procrastination: a self-regulation perspective on sleep insufficiency in the general population

    NARCIS (Netherlands)

    Kroese, Floor|info:eu-repo/dai/nl/313869871; Evers, Catharine|info:eu-repo/dai/nl/280594232; Adriaanse, Marieke|info:eu-repo/dai/nl/304823023; de Ridder, Denise|info:eu-repo/dai/nl/070706174

    2016-01-01

    Getting insufficient sleep has serious consequences in terms of mental and physical health. The current study is the first to approach insufficient sleep from a self-regulation perspective by investigating the phenomenon of bedtime procrastination: going to bed later than intended, without having

  12. Do knowledge, knowledge sources and reasoning skills affect the accuracy of nursing diagnoses? a randomised study

    NARCIS (Netherlands)

    Paans, W.; Sermeus, W.; Nieweg, R.M.; Krijnen, W.P.; van der Schans, C.P.

    2012-01-01

    ABSTRACT: BACKGROUND: This paper reports a study about the effect of knowledge sources, such as handbooks, an assessment format and a predefined record structure for diagnostic documentation, as well as the influence of knowledge, disposition toward critical thinking and reasoning skills, on the

  13. Knowledge brokerage - potential for increased capacities and shared power in impact assessment

    Energy Technology Data Exchange (ETDEWEB)

    Rosario Partidario, Maria, E-mail: mrp@civil.ist.utl.pt [Instituto Superior Tecnico, Lisbon, Portugal, Av. Rovisco Pais, 1049-001 LISBOA (Portugal); Sheate, William R., E-mail: w.sheate@imperial.ac.uk [Centre for Environmental Policy, Imperial College London, South Kensington Campus, London SW7 2AZ (United Kingdom); Collingwood Environmental Planning Ltd, London, 1E, The Chandlery, 50 Westminster Bridge Road, London SE1 7QY (United Kingdom)

    2013-02-15

    Constructive and collaborative planning theory has exposed the perceived limitations of public participation in impact assessment. At strategic levels of assessment the established norm can be misleading and practice is illusive. For example, debates on SEA effectiveness recognize insufficiencies, but are often based on questionable premises. The authors of this paper argue that public participation in strategic assessment requires new forms of information and engagement, consistent with the complexity of the issues at these levels and that strategic assessments can act as knowledge brokerage instruments with the potential to generate more participative environments and attitudes. The paper explores barriers and limitations, as well as the role of knowledge brokerage in stimulating the engagement of the public, through learning-oriented processes and responsibility sharing in more participative models of governance. The paper concludes with a discussion on building and inter-change of knowledge, towards creative solutions to identified problems, stimulating learning processes, largely beyond simple information transfer mechanisms through consultative processes. The paper argues fundamentally for the need to conceive strategic assessments as learning platforms and design knowledge brokerage opportunities explicitly as a means to enhance learning processes and power sharing in IA. - Highlights: Black-Right-Pointing-Pointer Debates on SEA recognize insufficiencies on public participation Black-Right-Pointing-Pointer We propose new forms of engagement consistent with complex situations at strategic levels of decision-making Black-Right-Pointing-Pointer Constructive and collaborative planning theories help explain how different actors acquire knowledge and the value of knowledge exchange Black-Right-Pointing-Pointer Strategic assessments can act as knowledge brokerage instruments Black-Right-Pointing-Pointer The paper argues for strategic assessments as learning

  14. Adrenal insufficiency in a child with MELAS syndrome.

    Science.gov (United States)

    Afroze, Bushra; Amjad, Nida; Ibrahim, Shahnaz H; Humayun, Khadija Nuzhat; Yakob, Yusnita

    2014-11-01

    Mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) are established subgroups of mitochondrial encephalomyopathy. m.3243A>G a common point mutation is detected in tRNA in majority of patients with MELAS phenotype whereas m.8344A>G point mutation in tRNA is observed, in MERRF phenotype. Adrenal insufficiency has not been reported in mitochondrial disease, except in Kearns-Sayre Syndrome (KSS), which is a mitochondrial deletion syndrome. We report an unusual presentation in a five year old boy who presented with clinical phenotype of MELAS and was found to have m.8344A>G mutation in tRNA. Addison disease was identified due to hyperpigmentation of lips and gums present from early childhood. This is the first report describing adrenal insufficiency in a child with MELAS phenotype. Copyright © 2014 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  15. Clinical significance of gamma camera renography in chronic renal insufficiency

    International Nuclear Information System (INIS)

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

    1980-01-01

    Gamma camera renography allows, together with renal imaging, an evaluation of individual renal function. For these examinations, I 123 orthoiodohippurate is preferred and most widely used. The results on patients with chronic renal insufficiency, including urologic and posttransplantation patients, are reported. Whereas the method is of clinical significance in evaluating posttransplantation complications and in assessing individual kidney function preoperatively in urology, as well as in monitoring therapeutic effects in the early period of renal disease, it is of limited diagnostic value in chronic renal insufficiency. In this latter regard, clinical and laboratory examinations are of primary importance. (author)

  16. The Impact of a Curriculum Course on Pre-Service Primary Teachers' Science Content Knowledge and Attitudes towards Teaching Science

    Science.gov (United States)

    Murphy, Cliona; Smith, Greg

    2012-01-01

    Many primary school teachers have insufficient content and pedagogical knowledge of science. This lack of knowledge can often lead to a lack of confidence and competence in teaching science. This article explores the impact of a year-long science methodology (curriculum science) course on second year Bachelor of Education (BEd) students'…

  17. Nutritional knowledge and eating habits of professional rugby league players: does knowledge translate into practice?

    OpenAIRE

    Alaunyte, Ieva; Perry, John L; Aubrey, Tony

    2015-01-01

    Background Adequate nutrient intake is important to support training and to optimise performance of elite athletes. Nutritional knowledge has been shown to play an important role in adopting optimal nutrition practices. The aim of the present study was to investigate the relationship between the level of nutritional knowledge and dietary habits in elite English rugby league players using the eatwell plate food categories. Method General nutritional knowledge questionnaires were collected duri...

  18. Percutaneous treatment of insufficiency fractures. Principles, technique and review of literature

    International Nuclear Information System (INIS)

    Beall, Douglas P.; Datir, Abhijit; D'Souza, Sharon L.; D'Souza, Logan S.; Gunda, Divya; Morelli, John; Johnson, Michael Brandon; Nabavizadeh, Nima

    2010-01-01

    Insufficiency fractures of the pelvis, sacrum, spine, and long bones are painful, debilitating, and are common consequences of osteoporosis. Conventional treatment for these fractures varies from conservative therapy to surgery with plate and screw fixation. The former fails to address the underlying problem of fracture and frequently does not alleviate symptoms, while the latter is invasive and not always possible in older populations with low bone density and numerous co-morbidities. Osseous augmentation with polymethylmethacrylate (PMMA) has been used for over two decades to treat fractures related to osteoporosis, but has not been commonly used to treat fractures outside of the vertebral bodies. Osseous augmentation with PMMA is an image-guided procedure and various techniques have been utilized to treat fracture in different locations. We describe various techniques for image-guided osseous augmentation and treatment of insufficiency fractures with bothPMMA and allograft bone for fractures of the pelvis including sacrum, acetabulum, pubic symphysis, pubic rami ilium; appendicular skeleton including distal radius, proximal femur, and vertebral body. We also describe the potential risks and complications associated with percutaneous treatment of insufficiency fractures and techniques to avoid the pitfalls of the various procedures. We will present the process for patient follow-up and data regarding the pre- and postprocedure pain response in patients undergoing treatment for pelvic insufficiency fractures. (orig.)

  19. Do knowledge, knowledge sources and reasoning skills affect the accuracy of nursing diagnoses? : a randomised study

    NARCIS (Netherlands)

    Paans, Wolter; Sermeus, Walter; Nieweg, Roos; Krijnen, Wim P.; van der Schans, Cees P.

    2012-01-01

    BACKGROUND: This paper reports a study about the effect of knowledge sources, such as handbooks, an assessment format and a predefined record structure for diagnostic documentation, as well as the influence of knowledge, disposition toward critical thinking and reasoning skills, on the accuracy of

  20. Prevalence and Predictors of Functional Vitamin K Insufficiency in Mothers and Newborns in Uganda

    Directory of Open Access Journals (Sweden)

    Data Santorino

    2015-10-01

    Full Text Available Vitamin K deficiency bleeding (VKDB in infancy is a serious but preventable cause of mortality or permanent disability. Lack of epidemiologic data for VKDB in sub-Saharan Africa hinders development and implementation of effective prevention strategies. We used convenience sampling to consecutively enroll mothers delivering in a southwestern Uganda Hospital. We collected socio-demographic and dietary information, and paired samples of maternal venous and neonatal cord blood for the immunoassay of undercarboxylated prothrombin (PIVKA-II, a sensitive marker of functional vitamin K (VK insufficiency. We used univariable and multivariable logistic regression models to identify predictors of VK insufficiency. We detected PIVKA-II of ≥0.2 AU (Arbitrary Units per mL/mL (indicative of VK insufficiency in 33.3% (47/141 of mothers and 66% (93/141 of newborns. Importantly, 22% of babies had PIVKA-II concentrations ≥5.0 AU/mL, likely to be associated with abnormal coagulation indices. We found no significant predictors of newborn VK insufficiency, including infant weight (AOR (adjusted odds ratio 1.85, 95% CI (confidence interval 0.15–22.49, gender (AOR 0.54, 95% CI 0.26–1.11, term birth (AOR 0.72, 95% CI 0.20–2.62, maternal VK-rich diet (AOR 1.13, 95% CI 0.55–2.35 or maternal VK insufficiency (AOR 0.99, 95% CI 0.47–2.10. VK insufficiency is common among mothers and newborn babies in southwestern Uganda, which in one fifth of babies nears overt deficiency. Lack of identifiable predictors of newborn VK insufficiency support strategies for universal VK prophylaxis to newborns to prevent VKDB.

  1. Metacognitive Knowledge in Relation to Inquiry Skills and Knowledge Acquisition Within a Computer-Supported Inquiry Learning Environment

    Directory of Open Access Journals (Sweden)

    Zrinka Ristić Dedić

    2014-04-01

    Full Text Available The study examines two components of metacognitive knowledge in the context of inquiry learning: metatask and metastrategic. Existing work on the topic has shown that adolescents often lacked metacognitive understanding necessary for optimal inquiry learning (Keselman & Kuhn, 2002; Kuhn, 2002a; Kuhn, Black, Keselman, & Kaplan, 2000, but demonstrated that engagement with inquiry tasks may improve it (Keselman, 2003; Kuhn & Pearsall, 1998.The aim of the study is to investigate the gains in metacognitive knowledge that occur as a result of repeated engagement with an inquiry learning task, and to examine the relationship between metacognitive knowledge and performance on the task.The participants were 34 eighth grade pupils, who participated in a self-directed experimentation task using the FILE programme (Hulshof, Wilhelm, Beishuizen, & van Rijn, 2005. The task required pupils to design and conduct experiments and to make inferences regarding the causal structure of a multivariable system. Pupils participated in four learning sessions over the course of one month. Metacognitive knowledge was assessed by the questionnaire before and after working in FILE.The results indicate that pupils improved in metacognitive knowledge following engagement with the task. However, many pupils showed insufficient metacognitive knowledge in the post-test and failed to apply newly achieved knowledge to the transfer task. Pupils who attained a higher level of metacognitive knowledge were more successful on the task than pupils who did not improve on metacognitive knowledge. A particular level of metacognitive understanding is a necessary, but not sufficient condition for successful performance on the task.

  2. Knowledge About Legal Regulations Regarding Organ Transplantation Among High School and University Students in Poland.

    Science.gov (United States)

    Pawłowicz, E; Nowicki, M

    2016-06-01

    It has been reported in many studies that although young people have positive attitudes towards organ donation, their knowledge about transplantation is insufficient. This study focused on knowledge about legal regulations regarding organ transplantation in Poland. A 59-item, self-designed questionnaire was administered to 1011 young persons from Central Poland. Among the interviewees were 462 high school students, 184 students of the faculty of medicine, and 365 students from other faculties. The survey was divided into 4 parts: knowledge (basic information, maximum of 17 points; statistics, maximum of 5 points and legal regulations - maximum of 6 points), attitude, personal experience and general characteristics of the interviewees. High school and university students received 1.45 ± 1.24 and 1.54 ± 1.1 (P = .26) out of a maximal score of 6 with respect to knowledge of legal regulations. Medical students scored much higher (4.13 ± 1.23). Only 20 respondents (including 19 medical students) answered correctly all 6 questions. Those who were willing to donate their organs after death achieved better result than those who did not want to donate (1.6 ± 1.22 vs 1.34 ± 1.1; P = .002). Personal experiences did not influence knowledge about transplantation. Knowledge about legal regulations regarding organ transplantation is insufficient among young people. Structured, well-considered education programs at various levels of school and academic education are needed to improve public awareness and attitude. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Children Receiving Free or Reduced-Price School Lunch Have Higher Food Insufficiency Rates in Summer.

    Science.gov (United States)

    Huang, Jin; Barnidge, Ellen; Kim, Youngmi

    2015-09-01

    In 2012, 20% of households in the United States with children lacked consistent access to adequate food. Food insufficiency has significant implications for children, including poor physical and mental health outcomes, behavior problems, and low educational achievements. The National School Lunch Program (NSLP) is one policy solution to reduce food insufficiency among children from low-income families. The objective of this project was to evaluate the association between NSLP participation and household food insufficiency by examining trajectories of food insufficiency over 10 calendar months. The calendar months included both nonsummer months when school is in session and summer months when school is out of session. The study used the data from the Survey of Income and Program Participation and conducted linear growth curve analyses in the multilevel modeling context. Comparisons were made between the trajectories of food insufficiencies among recipients of free or reduced-price lunch and their counterparts who are eligible but choose not to participate in the program. Heads of households that included children receiving free or reduced-price lunch (n = 6867) were more likely to be female, black, unmarried, and unemployed, and have a lower educational attainment than those whose children were eligible but did not receive free or reduced-price lunch (n = 11,396). For households participating in the NSLP, the food insufficiency rate was consistent from January to May at ∼4%, and then increased in June and July to >5%. Meanwhile, food insufficiency among eligible nonrecipients was constant throughout the year at nearly 2%. The NSLP protects households from food insufficiency. Policies should be instituted to make enrollment easier for households. © 2015 American Society for Nutrition.

  4. Spontaneous osteonecrosis of the knee associated with tibial plateau and femoral condyle insufficiency stress fracture

    Energy Technology Data Exchange (ETDEWEB)

    Narvaez, J.A.; Narvaez, J.; Lama, E.De; Sanchez, A. [Department of Magnetic Resonance Imaging, IDI Hospital Duran i Reynals, Ciutat Sanitaria i Universitaria de Bellvitge, Gran Via s/n, 08907, L' Hospitalet de Llobregat (Barcelona) (Spain)

    2003-08-01

    The purpose of this article is to describe the association between spontaneous osteonecrosis and insufficiency stress fractures of the knee. To determine whether insufficiency stress fracture is associated with spontaneous osteonecrosis of the knee, we retrospectively reviewed the medical charts and imaging studies of all patients with spontaneous osteonecrosis of the knee, studied by MR imaging, seen in a tertiary hospital over an 8-year period. Four women (age range 66-84 years) presented spontaneous osteonecrosis of the knee associated with insufficiency stress fracture of the medial tibial plateau. One of these patients also presented a concomitant insufficiency stress fracture of the medial femoral condyle. Radiographs were diagnostic of spontaneous osteonecrosis of the medial femoral condyle in three cases, and insufficiency stress fracture of the medial tibial plateau was detected in one case. Magnetic resonance imaging allows the diagnosis of both conditions in all four cases. Spontaneous osteonecrosis of the knee may be associated with insufficiency stress fracture of the medial femoral condyle and the medial tibial plateau. This association provides additional arguments in favor of the traumatic etiology of spontaneous osteonecrosis of knee. (orig.)

  5. Spontaneous osteonecrosis of the knee associated with tibial plateau and femoral condyle insufficiency stress fracture

    International Nuclear Information System (INIS)

    Narvaez, J.A.; Narvaez, J.; Lama, E.De; Sanchez, A.

    2003-01-01

    The purpose of this article is to describe the association between spontaneous osteonecrosis and insufficiency stress fractures of the knee. To determine whether insufficiency stress fracture is associated with spontaneous osteonecrosis of the knee, we retrospectively reviewed the medical charts and imaging studies of all patients with spontaneous osteonecrosis of the knee, studied by MR imaging, seen in a tertiary hospital over an 8-year period. Four women (age range 66-84 years) presented spontaneous osteonecrosis of the knee associated with insufficiency stress fracture of the medial tibial plateau. One of these patients also presented a concomitant insufficiency stress fracture of the medial femoral condyle. Radiographs were diagnostic of spontaneous osteonecrosis of the medial femoral condyle in three cases, and insufficiency stress fracture of the medial tibial plateau was detected in one case. Magnetic resonance imaging allows the diagnosis of both conditions in all four cases. Spontaneous osteonecrosis of the knee may be associated with insufficiency stress fracture of the medial femoral condyle and the medial tibial plateau. This association provides additional arguments in favor of the traumatic etiology of spontaneous osteonecrosis of knee. (orig.)

  6. Pentoxifylline in the treatment of radiation-related pelvic insufficiency fractures of bone

    International Nuclear Information System (INIS)

    Bese, N.S.; Oezgueroglu, M.; Kamberoglu, K.; Karahasanoglu, T.; Oeber, A.

    2003-01-01

    The reported incidence of bone complications after radiation therapy is quite low. The most commonly seen bone complication is insufficiency fractures of the pubis and sacrum. Treatment of insufficiency fractures consists of conservative care, and mineral replacement may be useful. The resolution of symptoms takes at least one year with these treatments. Vascular damage has an important role in the etiology of late radiation injury in normal tissues. Progressive ischemic changes further weaken the bone structure, which can cause fractures, and healing is also delayed. Pentoxifylline is a methylxanthine derivative that is shown to increase tissue blood flow. Here, we present a 63-year-old male patient with pelvic insufficiency fractures due to postoperative pelvic irradiation for rectal adenocarcinoma. The patient received pelvic radiotherapy to a total dose of 50.4 Gy with concomitant 5-FU. Six months after the completion of radiotherapy, the patient presented with severe pelvic pain. Pelvic magnetic resonance imaging (MRI) demonstrated abnormal signal intensity with insufficiency fractures at the sacrum and bone marrow edema near the fractures, but not an abnormal intensity that revealed bone metastases. Neither distant nor locoregional recurrence was observed at his work-up. The final diagnosis was insufficiency fractures of the pelvic bones owing to irradiation, and pentoxifylline (400 mg, 3 times daily, peroral, 1,200 mg/day) was used for eight months as treatment. Dramatic clinical improvement was obtained in six months, and objective healing was revealed with MRI. We concluded that pentoxifylline is a cost-effective drug with minimal adverse effects in treating radiation damage of bone. (author)

  7. Female androgen insufficiency: the Princeton consensus statement on definition, classification, and assessment.

    Science.gov (United States)

    Bachmann, Gloria; Bancroft, John; Braunstein, Glenn; Burger, Henry; Davis, Susan; Dennerstein, Lorraine; Goldstein, Irwin; Guay, Andre; Leiblum, Sandra; Lobo, Rogerio; Notelovitz, Morris; Rosen, Raymond; Sarrel, Philip; Sherwin, Barbara; Simon, James; Simpson, Evan; Shifren, Jan; Spark, Richard; Traish, Abdul

    2002-04-01

    To evaluate the evidence for and against androgen insufficiency as a cause of sexual and other health-related problems in women and to make recommendations regarding definition, diagnosis, and assessment of androgen deficiency states in women. Evaluation of peer-review literature and consensus conference of international experts. Multinational conference in the United States. Premenopausal and postmenopausal women with androgen deficiency. Evaluation of peer-review literature and development of consensus panel guidelines. The term "female androgen insufficiency" was defined as consisting of a pattern of clinical symptoms in the presence of decreased bioavailable T and normal estrogen status. Currently available assays were found to be lacking in sensitivity and reliability at the lower ranges, and the need for an equilibrium dialysis measure was strongly emphasized. Causes of androgen insufficiency in women were classified as ovarian, adrenal, hypothalamic-pituitary, drug-related, and idiopathic. A simplified management algorithm and clinical guidelines were proposed to assist clinicians in diagnosis and assessment. Androgen replacement is currently available in several forms, although none has been approved for treatment of sexual dysfunction or other common symptoms of female androgen insufficiency. Potential risks associated with treatment were identified, and the need for informed consent and careful monitoring was noted. Finally, the panel identified key goals and priorities for future research. A new definition of androgen insufficiency in women has been proposed along with consensus-based guidelines for clinical assessment and diagnosis. A simplified management algorithm for women with low androgen in the presence of clinical symptoms and normal estrogen status has also been proposed.

  8. Pelvic insufficiency fractures associated with radiation atrophy: clinical recognition and diagnostic evaluation

    International Nuclear Information System (INIS)

    Mumber, M.P.; Greven, K.M.; Haygood, T.M.

    1997-01-01

    Pelvic bone injuries are infrequent complications of radiotherapy. However, insufficiency fractures in irradiated pelvic bones may be underdetected, particularly in postmenopausal women. We describe the clinical presentation, radiologic evaluation, and course of disease in three patients with postradiation pelvic insufficiency fractures. Differential diagnosis included metastatic disease, tumor recurrence, and second malignancy. Recognition of radiographic features may prevent unnecessary, possibly morbid treatments. (orig.). With 6 figs

  9. Integrating knowledge seeking into knowledge management models and frameworks

    Directory of Open Access Journals (Sweden)

    Francois Lottering

    2012-02-01

    Full Text Available Background: A striking feature of the knowledge management (KM literature is that the standard list of KM processes either subsumes or overlooks the process of knowledge seeking. Knowledge seeking is manifestly under-theorised, making the need to address this gap in KM theory and practice clear and urgent.Objectives: This article investigates the theoretical status of the knowledge-seeking process in extant KM models and frameworks. It also statistically describes knowledge seeking and knowledge sharing practices in a sample of South African companies. Using this data, it proposes a KM model based on knowledge seeking.Method: Knowledge seeking is traced in a number of KM models and frameworks with a specific focus on Han Lai and Margaret Graham’s adapted KM cycle model, which separates knowledge seeking from knowledge sharing. This empirical investigation used a questionnaire to examine knowledge seeking and knowledge sharing practices in a sample of South African companies.Results: This article critiqued and elaborated on the adapted KM cycle model of Lai and Graham. It identified some of the key features of knowledge seeking practices in the workplace. It showed that knowledge seeking and sharing are human-centric actions and that seeking knowledge uses trust and loyalty as its basis. It also showed that one cannot separate knowledge seeking from knowledge sharing.Conclusion: The knowledge seeking-based KM model elaborates on Lai and Graham’s model. It provides insight into how and where people seek and share knowledge in the workplace. The article concludes that it is necessary to cement the place of knowledge seeking in KM models as well as frameworks and suggests that organisations should apply its findings to improving their knowledge management strategies. 

  10. Vitamin D insufficiency in the elderly orthopaedic patient: an epidemic phenomenon.

    Science.gov (United States)

    Maier, Gerrit Steffen; Horas, Konstantin; Seeger, Jörn Bengt; Roth, Klaus Edgar; Kurth, Andreas Alois; Maus, Uwe

    2015-04-01

    The purpose of this observational study was to evaluate serum levels of 25-OH-D of elderly patients presenting with orthopaedic illness. Furthermore, we enquired about potential confounders and risk factors of hypovitaminosis D in comorbidities and daily medication of the elderly. Vitamin D levels in 1,083 patients aged >70 years and admitted to an orthopaedic surgery department were measured. Univariate and multivariate analyses were used to assess risk factors for insufficient vitamin D levels. Overall, 86 % of patients had insufficient serum levels of 25-OH-D and >60 % were vitamin D deficient. Serum vitamin D levels were lower during winter and months with fewer sunshine hours. Patients presenting with obesity, hypertension and osteoporosis were more likely to have low vitamin D levels. We found a high prevalence of hypovitaminosis D in elderly, nonhospitalized orthopaedic patients. Given the well-known effects of vitamin D on bone metabolism and muscle health, as well as its nonskeletal effects, vitamin D insufficiency may have a negative impact.

  11. Knowledge creation and transfer among postgraduate students

    OpenAIRE

    Kreeson Naicker; Krishna K. Govender; Karunagaran Naidoo

    2014-01-01

    Background: The skill shortages, hyper-competitive economic environments and untapped economies have created a great deal of focus on knowledge. Thus, continuously creating and transferring knowledge is critical for every organisation. Objectives: This article reports on an exploratory study undertaken to ascertain how knowledge is created and transferred amongst post-graduate (PG) students, using the knowledge (socialisation, externalisation, combination, internalisation [SECI]) spiral mo...

  12. Prevalence and effects of functional vitamin K insufficiency

    NARCIS (Netherlands)

    Riphagen, Ineke J.; Keyzer, Charlotte A.; Drummen, Nadja E.A.; Borst, de Martin H.; Beulens, Joline W.J.; Gansevoort, Ron T.; Geleijnse, Johanna M.; Muskiet, Frits A.J.; Navis, Gerjan; Visser, Sipke T.; Vermeer, Cees; Kema, Ido P.; Bakker, Stephan J.L.

    2017-01-01

    Matrix Gla Protein (MGP) is a strong vitamin K-dependent inhibitor of soft tissue calcification. We assessed the prevalence of functional vitamin K insufficiency, as derived from plasma desphospho-uncarboxylated MGP (dp-ucMGP), and investigated whether plasma dp-ucMGP is associated with all-cause

  13. Health consequences of shift work and insufficient sleep

    NARCIS (Netherlands)

    Kecklund, L.G.; Axelsson, J.

    2016-01-01

    This review summarises the literature on shift work and its relation to insufficient sleep, chronic diseases, and accidents. It is based on 38 meta-analyses and 24 systematic reviews, with additional narrative reviews and articles used for outlining possible mechanisms by which shift work may cause

  14. Vitamin D deficiency and insufficiency among patients with prostate cancer.

    Science.gov (United States)

    Trump, Donald L; Chadha, Manpreet K; Sunga, Annette Y; Fakih, Marwan G; Ashraf, Umeer; Silliman, Carrie G; Hollis, Bruce W; Nesline, Mary K; Tian, Lili; Tan, Wei; Johnson, Candace S

    2009-10-01

    To assess the frequency of vitamin D deficiency among men with prostate cancer, as considerable epidemiological, in vitro, in vivo and clinical data support an association between vitamin D deficiency and prostate cancer outcome. The study included 120 ambulatory men with recurrent prostate cancer and 50 with clinically localized prostate cancer who were evaluated and serum samples assayed for 25-OH vitamin D levels. Then 100 controls (both sexes), matched for age and season of serum sample, were chosen from a prospective serum banking protocol. The relationship between age, body mass index, disease stage, Eastern Cooperative Oncology Group performance status, season and previous therapy on vitamin D status were evaluated using univariate and multivariate analyses. The mean 25-OH vitamin D level was 25.9 ng/mL in those with recurrent disease, 27.5 ng/mL in men with clinically localized prostate cancer and 24.5 ng/mL in controls. The frequency of vitamin D deficiency (<20 ng/mL) and insufficiency (20-31 ng/mL) was 40% and 32% in men with recurrent prostate; 28% had vitamin D levels that were normal (32-100 ng/mL). Among men with localized prostate cancer, 18% were deficient, 50% were insufficient and 32% were normal. Among controls, 31% were deficient, 40% were insufficient and 29% were normal. Metastatic disease (P = 0.005) and season of blood sampling (winter/spring; P = 0.01) were associated with vitamin D deficiency in patients with prostate cancer, while age, race, performance status and body mass index were not. Vitamin D deficiency and insufficiency were common among men with prostate cancer and apparently normal controls in the western New York region.

  15. Obstructed pancreaticojejunostomy partly explains exocrine insufficiency after pancreatic head resection.

    Science.gov (United States)

    Nordback, Isto; Parviainen, Mickael; Piironen, Anneli; Räty, Sari; Sand, Juhani

    2007-02-01

    The majority of patients with long-term survival after pancreatic head resection suffer from pancreatic exocrine insufficiency. The objective of this study was to investigate whether this is due to glandular malfunction or obstructed pancreaticojejunal anastomosis. Twenty-six patients (10 M, 16 F, mean age 61 years, range 34-81 years) were re-examined a median of 52 months (range 3-76 months) after pancreatic head resection and end-to-end invaginated pancreaticojejunostomy. Pancreatic exocrine function was measured by fecal elastase-1 assay. The size of the pancreatic remnant, glandular secretion and the flow through the anastomosis were analyzed with secretin-stimulated dynamic magnetic resonance pancreatography (D-MRP). All patients had pancreatic exocrine insufficiency, 24 (92%) of them having severe insufficiency. Eighteen patients (69%) reported moderate to severe diarrhea. Lowest fecal elastase-1 concentrations were associated with the initial diagnosis of chronic pancreatitis or ductal adenocarcinoma, suggesting preoperative primary or secondary chronic pancreatitis as important determinants. The size of the remnant gland did not correlate with the fecal elastase-1 concentrations. D-MRP failed in three patients. Severe glandular malfunctions were found in 7 (30%) of the 23 successful D-MRP examinations. The anastomosis was totally obstructed in 5 patients (22%) or partially obstructed in 6 (26%) but remained perfectly open in 5 patients (22%). The five patients with perfect anastomoses had the highest measured median fecal elastase-1 activity. Although late diarrhea and pancreatic exocrine insufficiency may be partly induced already by the disease treated with resection, at least half may be explained by obstructed anastomosis. To obtain better late functional results, improvements may be required in the surgical techniques.

  16. Relative adrenal insufficiency in post-transplant lymphoproliferative disorder.

    Directory of Open Access Journals (Sweden)

    Cinclair R

    2003-01-01

    Full Text Available Post-transplant lymphoproliferative disorder is treated with rapid decrement of immunosuppressive therapy. This cannot be achieved with ease in patients on long-term glucocorticoid therapy, as chronically suppressed adrenal glands may not be capable of mounting adequate response to stress. A 52-year-old Caucasian male presented with fever, orthostatic hypotension, lymphadenopathy and hyponatraemia. Serum cortisol levels were within normal levels with a sub optimal response to stimulation by ACTH. Hyponatraemia and orthostasis responded poorly to fluid restriction, saline and salt repletion but corrected after increasing the steroid dose. The normal baseline cortisol levels represented a stimulated adrenal gland, however, the ACTH stimulation had inadequate response. This sub optimal stimulation and a good response to increased steroids suggest the presence of relative or occult adrenal insufficiency. Relative adrenal insufficiency must be considered in patients who have received prolonged glucocorticoid therapy and have symptoms such as hypotension and/or hyponatraemia.

  17. Financial Information Source, Knowledge, and Practices of College Students from Diverse Backgrounds

    Science.gov (United States)

    Mimura, Yoko; Koonce, Joan; Plunkett, Scott W.; Pleskus, Lindsey

    2015-01-01

    Using cross-sectional data, we examined the financial information sources, financial knowledge, and financial practices of young adults, many of whom are first generation college students, ethnic minorities, and immigrants or children of immigrants. Participants (n = 1,249) were undergraduate students at a large regional comprehensive university.…

  18. Recurrence rates after abdominal and vaginal cerclages in women with cervical insufficiency

    DEFF Research Database (Denmark)

    Sneider, Kirstine; Christiansen, Ole Bjarne; Sundtoft, Iben Blaabjerg

    2017-01-01

    PURPOSE: To estimate the incidence of cervical insufficiency and compare recurrence rates of second trimester miscarriage/delivery in second and third pregnancies after prophylactic vaginal cerclage, abdominal cerclage, or no cerclage. METHODS: Retrospective chart review of a representative...... register-based sample of 621 women with a spontaneous second trimester miscarriage/delivery in the first pregnancy in Denmark (1997-2012). We used strict criteria for the diagnosis of cervical insufficiency. The outcome of subsequent pregnancies was described by treatment with prophylactic vaginal cerclage......, abdominal cerclage, or no prophylactic cerclage. Women were followed until June 2015. RESULTS: Of 621 women, 149 (24%) fulfilled the strict criteria of cervical insufficiency. Prophylactic treatment with abdominal cerclage (n = 20), vaginal cerclage (n = 59), and no prophylactic cerclage (n = 61) resulted...

  19. Vocabulary knowledge predicts lexical processing: Evidence from a group of participants with diverse educational backgrounds

    NARCIS (Netherlands)

    Mainz, N.; Shao, Z.; Brysbaert, M.; Meyer, A.S.

    2017-01-01

    Vocabulary knowledge is central to a speaker's command of their language. In previous research, greater vocabulary knowledge has been associated with advantages in language processing. In this study, we examined the relationship between individual differences in vocabulary and language processing

  20. VENOUS INSUFFICIENCY AND THROMBOEMBOLIC DISEASE IN BARIATRIC SURGERY PATIENTS

    Directory of Open Access Journals (Sweden)

    Bonno van BELLEN

    2013-09-01

    Full Text Available Context Morbid obesity is associated with various co-morbidities, including chronic venous insufficiency. Bariatric surgery is the only effective treatment for morbid obesity, but with potential risks and possible complications, including venous thromboembolism. Objective To determine the prevalence of clinical and ultrasonographic signs of chronic venous insufficiency in morbid obese patients in preparation for bariatric surgery and the incidence of post-operative venous thromboembolic disease. Methods Patients on work-up for bariatric surgery of Centro Terapêutico Especializado em Fígado (CETEFI and Pro-Gastro surgical teams of the Hospital Beneficência Portuguesa de São Paulo were included. The analysed data were pre-operative findings for venous insufficiency (CEAP - clinical, etiological, anatomical, physiopathologic - classification and venous ultrassonographic findings, type of surgery (open or laparoscopic, abdominal circumference, body mass index (BMI and post-operative ultrassonography search for venous insufficiency and deep venous thrombosis. Results Between March 2007 and December 2009, 95 patients candidates for bariatric surgery had clinical and duplex scan evaluation of the lower limbs venous system. Of the 95 patients, 53 were submitted to the surgical procedure. There was a predominance of women (77.9%, the average age was 38.5 years, average preoperative weight 124.6 kg and average BMI of 45.5 kg/m2. Regarding obesity, 16.8% were obese, and 83.1% were morbidly obese. In relation to the venous findings, 86.3% of the patients did fit CEAP classification less than 3 and 13.7% greater than or equal to 3. Among the post-operative complications, there were four cases of wound infection. Three patients developed post-operative distal venous thrombosis (7.5%, but no one had clinically manifested pulmonary embolism. Conclusion No relation between BMI, CEAP classification and venous ultrassonographic findings were found. Although

  1. Density-Based Clustering with Geographical Background Constraints Using a Semantic Expression Model

    Directory of Open Access Journals (Sweden)

    Qingyun Du

    2016-05-01

    Full Text Available A semantics-based method for density-based clustering with constraints imposed by geographical background knowledge is proposed. In this paper, we apply an ontological approach to the DBSCAN (Density-Based Geospatial Clustering of Applications with Noise algorithm in the form of knowledge representation for constraint clustering. When used in the process of clustering geographic information, semantic reasoning based on a defined ontology and its relationships is primarily intended to overcome the lack of knowledge of the relevant geospatial data. Better constraints on the geographical knowledge yield more reasonable clustering results. This article uses an ontology to describe the four types of semantic constraints for geographical backgrounds: “No Constraints”, “Constraints”, “Cannot-Link Constraints”, and “Must-Link Constraints”. This paper also reports the implementation of a prototype clustering program. Based on the proposed approach, DBSCAN can be applied with both obstacle and non-obstacle constraints as a semi-supervised clustering algorithm and the clustering results are displayed on a digital map.

  2. Insufficient free-time physical activity and occupational factors in Brazilian public school teachers

    Directory of Open Access Journals (Sweden)

    Douglas Fernando Dias

    Full Text Available ABSTRACT OBJECTIVE To evaluate if perceived occupational factors are associated with insufficient free-time physical activity in Brazilian public school teachers. METHODS The relationship between insufficient physical activity (< 150 minutes/week and variables related to work was analyzed in 978 elementary and high school teachers calculating the prevalence ratio (PR and 95% confidence interval (95%CI in Poisson regression models, adjusted for sociodemographic and health variables. RESULTS The prevalence of insufficient physical activity was 71.9%, and this condition was associated independently with the perception of bad or regular balance between personal and professional life (PR = 1.09; 95%CI 1.01–1.18, perception that standing time affects the work (PR = 1.16; 95%CI 1.01–1.34, low or very low perception of current ability for the physical requirements of work (PR = 1.21; 95%CI 1.08–1.35, and temporary employment contract (PR = 1.13; 95%CI 1.03–1.25. The teaching of physical education was associated with lower prevalence of insufficient physical activity (PR = 0.78; 95%CI 0.64–0.95. CONCLUSIONS The perception of adverse working conditions is associated with increased prevalence of insufficient physical activity in teachers and should be considered for the promotion of physical activity in this population.

  3. Anaesthetists' knowledge of cardiopulmonary resuscitation | Ogboli ...

    African Journals Online (AJOL)

    Background: Cardio-Pulmonary Resuscitation (CPR) is an integral part of an anaesthetist's knowledge and practice. In Nigeria, these skills are taught mainly during medical school and postgraduate training. Objectives: The study sought to assess the knowledge of anaesthetists about CPR. Methodology: A structured ...

  4. News about the genetics of congenital primary adrenal insufficiency.

    Science.gov (United States)

    Roucher-Boulez, Florence; Mallet-Motak, Delphine; Tardy-Guidollet, Véronique; Menassa, Rita; Goursaud, Claire; Plotton, Ingrid; Morel, Yves

    2018-04-13

    Primary adrenal insufficiency (PAI) is characterized by impaired production of steroid hormones due to an adrenal cortex defect. This condition incurs a risk of acute insufficiency which may be life-threatening. Today, 80% of pediatric forms of PAI have a genetic origin but 5% have no clear genetic support. Recently discovered mutations in genes relating to oxidative stress have opened the way to research on genes unrelated to the adrenal gland. Identification of causal mutations in a gene responsible for PAI allows genetic counseling, guidance of follow-up and prevention of complications. This is particularly true for stress oxidative anomalies, as extra-adrenal manifestations may occur due to the sensitivity to oxidative stress of other organs such as the heart, thyroid, liver, kidney and pancreas. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  5. Population-Level Incidence and Predictors of Surgically Induced Diabetes and Exocrine Insufficiency after Partial Pancreatic Resection.

    Science.gov (United States)

    Elliott, Irmina A; Epelboym, Irene; Winner, Megan; Allendorf, John D; Haigh, Philip I

    2017-01-01

    Endocrine and exocrine insufficiency after partial pancreatectomy affect quality of life, cardiovascular health, and nutritional status. However, their incidence and predictors are unknown. To identify the incidence and predictors of new-onset diabetes and exocrine insufficiency after partial pancreatectomy. We retrospectively reviewed 1165 cases of partial pancreatectomy, performed from 1998 to 2010, from a large population-based database. Incidence of new onset diabetes and exocrine insufficiency RESULTS: Of 1165 patients undergoing partial pancreatectomy, 41.8% had preexisting diabetes. In the remaining 678 patients, at a median 3.6 months, diabetes developed in 274 (40.4%) and pancreatic insufficiency developed in 235 (34.7%) patients. Independent predictors of new-onset diabetes were higher Charlson Comorbidity Index (CCI; hazard ratio [HR] = 1.62 for CCI of 1, p = 0.02; HR = 1.95 for CCI ≥ 2, p pancreatitis (HR = 1.51, p = 0.03). There was no difference in diabetes after Whipple procedure vs distal pancreatic resections, or malignant vs benign pathologic findings. Independent predictors of exocrine insufficiency were female sex (HR = 1.32, p = 0.002) and higher CCI (HR = 1.85 for CCI of 1, p insufficiency (HR = 0.35, p endocrine and exocrine insufficiency were 40% and 35%, respectively. These data are critical for informing patients' and physicians' expectations.

  6. Premature ovarian insufficiency in young girls: repercussions on uterine volume and bone mineral density.

    Science.gov (United States)

    Bakhsh, Hanadi; Dei, Metella; Bucciantini, Sandra; Balzi, Daniela; Bruni, Vincenzina

    2015-01-01

    To evaluate biological differences among young subjects with premature ovarian insufficiency (POI) commencing at different stages of life. Retrospective observational study. Careggi University Hospital Participants: One hundred sixty-two females aged between 15 and 29 years with premature ovarian insufficiency. Data were collected as a retrospective chart review of baseline evaluation at diagnosis of premature ovarian insufficiency (POI). About 162 participants were divided into four groups based on gynecological age. Two primary outcome variables (uterine development and bone mineral density (BMD)) were analyzed in terms of differences among groups and in a multivariate logistic regression analysis. Uterine development was clearly jeopardized when estrogen insufficiency started at a very young age. Total body BMD showed significant differences among the four groups studied, clearly corresponding to the duration of ovarian function. Data were discussed in relation to the choice of hormone replacement therapy regimens.

  7. Altered Cyclosporine Absorption in a Patient with Ulcerative Colitis, Sclerosing Cholangitis and Pancreatic Insufficiency

    Directory of Open Access Journals (Sweden)

    Mark G Swain

    1991-01-01

    Full Text Available Pancreatic insufficiency leading to altered cyclosporine absorption is reported in a 37-year-old man with ulcerative colitis and sclerosing cholangitis. Asymptomatic chronic pancreatitis occurs frequently in patients with ulcerative colitis, and even more commonly when there is coexistent sclerosing cholangitis. However, pancreatic insufficiency has been documented in only one patient previously with ulcerative colitis and sclerosing cholangitis. Pancreatic function testing can help to identify the complex etiology of malabsorption in these patients and is recommended in patients when liver transplantation is contemplated, as pancreatic insufficiency may alter the absorption of cyclosporine.

  8. Is there any correlation between vitamin D insufficiency and diabetic retinopathy?

    Institute of Scientific and Technical Information of China (English)

    Shokoufeh; Bonakdaran; Nasser; Shoeibi

    2015-01-01

    AIM: To determine a relation between vitamin D level,which is an inhibitor of angiogenesis, and diabetic retinopathy and its risk factorsMETHODS: In a clinic-based cross sectional study two hundred and thirty-five type 2 diabetic patients older than 20 y were selected. Patients were classified according to ophthalmologic examination as following:no diabetic retinopathy(NDR)(n =153), non-proliferative diabetic retinopathy(NPDR)(n =64) and proliferative diabetic retinopathy(PDR)(n =18). Study subjects were tested for fasting blood glucose, glycated hemoglobin A1C(Hb A1C), lipid profile, microalbuminuria, Hs CRP,IGF1, insulin(in patients without history of insulin taking)and 25 hydroxy vitamin D [25(OH) D] levels. Vitamin D insufficiency was defined according to 25(OH) D level less than 30 ng/m L. The relationship between diabetic retinopathy and serum 25(OH) D insufficiency was evaluated.RESULTS: The prevalence of diabetic retinopathy was34.8% in our patients. Long duration of diabetes,hypertension, poor glycemic control, diabetic nephropathy, hyperinsulinemia and insulin resistance were risk factors for diabetic retinopathy but 25(OH) D level was not significant different between NDR, NPDR and PDR groups. Correlation between 25(OH) D level and other known risk factors of diabetic retinopathy was not significant.CONCLUSION: This study did not find any association between diabetic retinopathy and its severity and vitamin D insufficiency. Vitamin D insufficiency is not related to risk factors of diabetic retinopathy.

  9. Paraoxonase activity in patients with chronic renal failure and hepatic insufficiency

    International Nuclear Information System (INIS)

    Jamal, S.; Ishaq, M.; Hussain, S.M.W.; Alam, J.A.; Hussain, S.

    2010-01-01

    Paraoxonase (PON), a high density lipoprotein (HDL) associated enzyme, is believed to protect against the oxidation of low density lipoprotein (LDL) and hence affects the risk of vascular disease. PON is sensitive to oxidants and is inactivated by oxidized lipids, and thus it can be postulated that increased oxidative stress may decrease plasma PON activity in patients with chronic renal failure (CRF) and hepatic insufficiency (HI). Moreover, in CRF and HI patients, in contrast to normal individuals, higher levels of plasma biochemical parameters and liver enzymes had an inverse correlation with PON activity. In this study we aimed to investigate PON activity, total bilirubin, creatinine, urea and liver enzymes alanine aminotransferase and alkaline phosphatase that are the index of renal and hepatic insufficiency. We have analyzed plasma from pre-dialysis patients and compared the results with the normal individuals. We observed a positive association of PON activity with that of the disease state i.e. the activity of this enzyme was significantly lower in the patients (p < 0.001). Furthermore, the indicators of renal and hepatic insufficiency were significantly elevated as compared to the normal subjects. Based on our results we conclude that in CRF and HI, in contrast to normal individuals, higher levels of plasma biochemical parameters and liver enzymes had inverse correlation with PON activity. Collectively, these findings may add details to the understanding of the role that PON plays in chronic renal failure and hepatic insufficiency. (author)

  10. How Full Is Your Luggage? Background Knowledge of Zoo Visitors Regarding Sharks

    Science.gov (United States)

    das Neves, João Pedro Correia; Monteiro, Rute Cristina Rocha

    2013-01-01

    For the general population, sharks have a reputation that does not really fit with their biological and ecological nature. Informal surveys often classify sharks as dangerous, aggressive and/or man-eaters. This apparent common knowledge seems difficult to detach from the conscience of many worldwide zoo visitors, even with the help of…

  11. Effect of hemodialysis on the level of hormones and blood lipids in patients with chronic renal insufficiency

    Energy Technology Data Exchange (ETDEWEB)

    Dzhavad-Zade, M D; Agaev, M M; Agabalaeva, L I; Karaev, M Eh; Movla-Zade, N G; Orudzheva, A K; Shepeleva, A A; Shindyan, M A

    1987-02-01

    The task of the study was to investigate the effect of systematic hemodialysis on lipid and hormonal metabolic indices in patients with chronic renal insufficiency (CRI) by means of radioimmunoassay. In 83.3%, patients with CRI at the terminal stage demostrated lipid disorders noted against a background of noticeable hormonal imbalance and characterized by high levels of insulin, parathormone, cortisol, somatropin in the blood serum and a low level of triiodothyronine in the blood. Systematic hemodialysis did not result in significant changes in lipid metabolism. Lipid metabolic disorders in patients with CRI at the terminal stage were detected in 91.7% of cases. Changes in the level of hormones under study were characterized by a decrease in thyroxine concentration thus weakening thyroid function in CRI patients.

  12. Combined metabolomic and correlation networks analyses reveal fumarase insufficiency altered amino acid metabolism.

    Science.gov (United States)

    Hou, Entai; Li, Xian; Liu, Zerong; Zhang, Fuchang; Tian, Zhongmin

    2018-04-01

    Fumarase catalyzes the interconversion of fumarate and l-malate in the tricarboxylic acid cycle. Fumarase insufficiencies were associated with increased levels of fumarate, decreased levels of malate and exacerbated salt-induced hypertension. To gain insights into the metabolism profiles induced by fumarase insufficiency and identify key regulatory metabolites, we applied a GC-MS based metabolomics platform coupled with a network approach to analyze fumarase insufficient human umbilical vein endothelial cells (HUVEC) and negative controls. A total of 24 altered metabolites involved in seven metabolic pathways were identified as significantly altered, and enriched for the biological module of amino acids metabolism. In addition, Pearson correlation network analysis revealed that fumaric acid, l-malic acid, l-aspartic acid, glycine and l-glutamic acid were hub metabolites according to Pagerank based on their three centrality indices. Alanine aminotransferase and glutamate dehydrogenase activities increased significantly in fumarase deficiency HUVEC. These results confirmed that fumarase insufficiency altered amino acid metabolism. The combination of metabolomics and network methods would provide another perspective on expounding the molecular mechanism at metabolomics level. Copyright © 2017 John Wiley & Sons, Ltd.

  13. The impact of a curriculum course on pre-service primary teachers' science content knowledge and attitudes towards teaching science

    OpenAIRE

    Murphy, Clíona; Smith, Greg

    2012-01-01

    Many primary school teachers have insufficient content and pedagogical knowledge of science. This lack of knowledge can often lead to a lack of confidence and competence in teaching science. This article explores the impact of a year-long science methodology (curriculum science) course on second year Bachelor of Education (BEd) students' conceptual and pedagogical knowledge of science and on their attitudes towards teaching science in the primary classroom. A questionnaire, containing closed ...

  14. Delayed diagnosis of pituitary stalk interruption syndrome with severe recurrent hyponatremia caused by adrenal insufficiency

    Directory of Open Access Journals (Sweden)

    Kyung Mi Jang

    2017-09-01

    Full Text Available Pituitary stalk interruption syndrome (PSIS involves the occurrence of a thin or absent pituitary stalk, hypoplasia of the adenohypophysis, and ectopic neurohypophysis. Diagnosis is confirmed using magnetic resonance imaging. Patients with PSIS have a variable degree of pituitary hormone deficiency and a wide spectrum of clinical manifestations. The clinical course of the disease in our patient is similar to that of a syndrome of inappropriate antidiuretic hormone secretion. This is thought to be caused by failure in the suppression of vasopressin secretion due to hypocortisolism. To the best of our knowledge, there is no case report of a patient with PSIS presenting with hyponatremia as the first symptom in Korean children. Herein, we report a patient with PSIS presenting severe recurrent hyponatremia as the first symptom, during adolescence and explain the pathophysiology of hyponatremia with secondary adrenal insufficiency.

  15. Response of geomorphic and geological processes to insufficient ...

    Indian Academy of Sciences (India)

    Depositional models have been constructed for each segment: a constant shelf break model with insufficient sediment supply in the east, and a migration shelf break model with plenty sediment supply in the west. This case study contributes to the understanding of the upper slope sedimentary process and stratigraphic style ...

  16. Prevalence of insufficient, borderline, and optimal hours of sleep among high school students - United States, 2007.

    Science.gov (United States)

    Eaton, Danice K; McKnight-Eily, Lela R; Lowry, Richard; Perry, Geraldine S; Presley-Cantrell, Letitia; Croft, Janet B

    2010-04-01

    We describe the prevalence of insufficient, borderline, and optimal sleep hours among U.S. high school students on an average school night. Most students (68.9%) reported insufficient sleep, whereas few (7.6%) reported optimal sleep. The prevalence of insufficient sleep was highest among female and black students, and students in grades 11 and 12. Published by Elsevier Inc.

  17. Subchondral insufficiency fracture of the femoral head in a patient with alkaptonuria

    Energy Technology Data Exchange (ETDEWEB)

    Hamada, Takahiro; Shida, Jun-ichi; Inokuchi, Akihiko; Arizono, Takeshi [Kyushu Central Hospital, Department of Orthopaedic Surgery, Fukuoka-city (Japan); Yamamoto, Takuaki [Kyushu University, Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Fukuoka-city (Japan)

    2014-06-15

    We report a patient with alkaptonuria accompanied by bilateral rapidly destructive arthrosis of the hip. The destruction of the left hip joint with its severe functional impairment necessitated total hip arthroplasty (THA). The outcome was satisfactory. Both magnetic resonance imaging (MRI) and pathologic findings were compatible with a subchondral insufficiency fracture. A year and half later, during a follow-up visit, the patient complained of right coxalgia. Radiography showed that the right femoral head had already disappeared, requiring THA of the right hip. Although there have been a few reports of rapid destructive hip osteoarthritis associated with ochronotic arthropathy, the pathogenesis of the destructive change is not clear. Subchondral insufficiency fracture was diagnosed on MR imaging and pathologically confirmed in our patient with alkaptonuria, suggesting that subchondral insufficiency fracture is one of the causes of ochronotic hip destruction. (orig.)

  18. Subchondral insufficiency fracture of the femoral head in a patient with alkaptonuria

    International Nuclear Information System (INIS)

    Hamada, Takahiro; Shida, Jun-ichi; Inokuchi, Akihiko; Arizono, Takeshi; Yamamoto, Takuaki

    2014-01-01

    We report a patient with alkaptonuria accompanied by bilateral rapidly destructive arthrosis of the hip. The destruction of the left hip joint with its severe functional impairment necessitated total hip arthroplasty (THA). The outcome was satisfactory. Both magnetic resonance imaging (MRI) and pathologic findings were compatible with a subchondral insufficiency fracture. A year and half later, during a follow-up visit, the patient complained of right coxalgia. Radiography showed that the right femoral head had already disappeared, requiring THA of the right hip. Although there have been a few reports of rapid destructive hip osteoarthritis associated with ochronotic arthropathy, the pathogenesis of the destructive change is not clear. Subchondral insufficiency fracture was diagnosed on MR imaging and pathologically confirmed in our patient with alkaptonuria, suggesting that subchondral insufficiency fracture is one of the causes of ochronotic hip destruction. (orig.)

  19. Subchondral insufficiency fracture of the femoral head in a patient with alkaptonuria.

    Science.gov (United States)

    Hamada, Takahiro; Yamamoto, Takuaki; Shida, Jun-ichi; Inokuchi, Akihiko; Arizono, Takeshi

    2014-06-01

    We report a patient with alkaptonuria accompanied by bilateral rapidly destructive arthrosis of the hip. The destruction of the left hip joint with its severe functional impairment necessitated total hip arthroplasty (THA). The outcome was satisfactory. Both magnetic resonance imaging (MRI) and pathologic findings were compatible with a subchondral insufficiency fracture. A year and half later, during a follow-up visit, the patient complained of right coxalgia. Radiography showed that the right femoral head had already disappeared, requiring THA of the right hip. Although there have been a few reports of rapid destructive hip osteoarthritis associated with ochronotic arthropathy, the pathogenesis of the destructive change is not clear. Subchondral insufficiency fracture was diagnosed on MR imaging and pathologically confirmed in our patient with alkaptonuria, suggesting that subchondral insufficiency fracture is one of the causes of ochronotic hip destruction.

  20. Higher visceral fat area increases the risk of vitamin D insufficiency and deficiency in Chinese adults.

    Science.gov (United States)

    Zhang, Meilin; Li, Ping; Zhu, Yufeng; Chang, Hong; Wang, Xuan; Liu, Weiqiao; Zhang, Yuwen; Huang, Guowei

    2015-01-01

    Visceral fat area (VFA), a novel sex-specific index for visceral fat obesity (VFO) might play a major role in the development of vitamin D deficiency. However, the association between VFA and vitamin D insufficiency and deficiency in Chinese population is less clear. The aim of this study was to explore the population-level association between VFA and vitamin D insufficiency and deficiency among Chinese men and women. This cross-sectional study involved 1105 adults aged 20-70 years living in Tianjin who were randomly selected and medically examined. All subjects underwent the bioelectrical impedance analysis (BIA) method to estimate the VFA. Serum 25-hydroxyvitamin D3 (25(OH) D3) level was assayed by the high-performance liquid chromatography (HPLC) method and defined insufficiency and deficiency following recommended cutoffs. The association between VFA and vitamin D insufficiency and deficiency was estimated using binary regression analysis. The total prevalence of vitamin D insufficiency (25(OH) D3: 20-29 μg/L) and deficiency (25(OH) D3  0.05). Moreover, increased VFA was observed to be associated with higher vitamin D insufficiency or deficiency risk with a positive dose-response trend (P for trend convenience surrogate marker for visceral adipose measurement and could be used in identifying the risk of vitamin D insufficiency and deficiency in routine health examination.

  1. Rectal hydrocortisone during vomiting in children with adrenal insufficiency.

    Science.gov (United States)

    Ní Chróinín, M; Fallon, M; Kenny, D; Moriarty, S; Hoey, H; Costigan, C

    2003-01-01

    To evaluate rectal hydrocortisone as an emergency glucocorticoid replacement therapy in adrenal insufficient children. A parental questionnaire evaluated preferred treatment, problems or benefits of i.m. and rectal hydrocortisone, frequency and indications for administration and who administered treatment. Admissions of children with adrenal insufficiency were monitored. There were 39/52 families who responded to the questionnaire. 93% (26/28) preferred rectal hydrocortisone. Parents or children who previously received emergency treatment from a doctor now self-administered rectal hydrocortisone. The cost of suppositories and i.m. hydrocortisone is similar; however, storage of suppositories was inconvenient. One girl presented with pneumonia and collapse despite rectal hydrocortisone and a hydrocortisone level at admission of >2000 nmol/l with normal electrolytes. Rectal hydrocortisone is an acceptable and safe emergency therapy. We still advise i.m. hydrocortisone if rectal administration is not possible or with suppository extrusion.

  2. Study on a Process-oriented Knowledge Management Model

    OpenAIRE

    Zhang, Lingling; Li, Jun; Zheng, Xiuyu; Li, Xingsen; Shi, Yong

    2007-01-01

    Now knowledge has become the most important resource of enterprises. Process-oriented knowledge management (POKM) is a new and valuable research field. It may be the most practical method to deal with difficulties in knowledge management. The paper analyzes background, hypothesis and proposes of POKM, define the process knowledge, and give a process-oriented knowledge management model. The model integrates knowledge, process, human, and technology. It can improve the decision support capabili...

  3. The Efficiency of Lactobacillus Rhamnosus GG Probiotic in Complex Treatment of Food Allergy at the Background of Pancreas Pathology in Young Children

    Directory of Open Access Journals (Sweden)

    K.V. Savitskaya

    2016-08-01

    Full Text Available In recent years the prevalence of food allergy in children of younger age has become increasingly widespread. For today, secondary pancreatic insufficiency manifested by relative pancreatic insufficiency, is the second largest patho­logy caused by food allergens. The aim of the study was to prove and substantiate the efficacy of Lactobacillus Rhamnosus GG (LGG in the combined therapy of food allergy, occurring against the background of pancreatic pathology in young children. There were observed 54 children, which were divided into two groups: the main group received complex treatment with LGG and the comparison group received traditional therapy. The results of the study indicated the beneficial effect of LGG on the clinical course of symptoms (pain, dyspeptic, asthenoneurotic symptoms, reduction of skin allergic reactions combined with functional pancreatic pathology (dysfunction of Oddi’s sphincter via the pancreatic type with the signs of pancreatic relative insufficiency in children with food allergies. Catamnesis data indicate a longer period of remission when a treatment scheme included LGG.

  4. Reference analysis of the signal + background model in counting experiments

    Science.gov (United States)

    Casadei, D.

    2012-01-01

    The model representing two independent Poisson processes, labelled as ``signal'' and ``background'' and both contributing additively to the total number of counted events, is considered from a Bayesian point of view. This is a widely used model for the searches of rare or exotic events in presence of a background source, as for example in the searches performed by high-energy physics experiments. In the assumption of prior knowledge about the background yield, a reference prior is obtained for the signal alone and its properties are studied. Finally, the properties of the full solution, the marginal reference posterior, are illustrated with few examples.

  5. Lethal Progressive Thoracic Insufficiency in a Neonate Due to Jarcho Levin Syndrome

    Science.gov (United States)

    Bhutia, Euden; Maria, Arti; Verma, Arushi; Sethi, Sidharth Kumar

    2014-01-01

    A rare case of Jarcho Levin syndrome (JLS) presenting as a lethal progressive respiratory insufficiency in early neonatal period is reported. The neonate had classical features of this syndrome including vertebral segmentation defects, typical costo-vertebral fusion defects and scoliosis resulting in small thoracic volume and limited chest expansion; all consistent with a clinical diagnosis of JLS with thoracic insufficiency. In addition, our case had a rare association of dextrocardia and acyanotic congenital heart disease. PMID:24741543

  6. Gastroenterological surgery for patients with chronic respiratory insufficiency.

    Science.gov (United States)

    Shimada, M; Kano, T; Matsuzaki, Y; Miyazaki, N; Ninomiya, K

    1998-01-01

    The aim of this study was to clarify the surgical indications for patients with chronic respiratory insufficiency. Fourteen patients with chronic respiratory insufficiency who underwent abdominal surgical procedures, were retrospectively studied. The surgical indications were carefully determined based primarily on the performance status (PS) of each patient and cardiopulmonary function tests. A PS of equal to or less than 3, which meant the patient's status required bed rest > 50% of the time, and the need for assistance in performing normal activities were all factors considered for surgical indications. During the period studied, two patients were excluded from the surgical indications due to the fact that one was at a terminal stage of pulmonary disease and was completely bedridden (PS = 4), while the other demonstrated active pneumonia with a considerable amount of purulent sputa. Regarding the pulmonary function tests for patients who underwent surgery, the lowest limits of those examinations were as follows: 810 ml of vital capacity (VC), 23.8% of predicted VC, 610 ml of forced expiratory volume in one second (FEV1.0), 38.6% of predicted FEV1.0, 50.5 mmHg of PaO2 while inhaling 4 liters of oxygen and 73.8 mmHg of PaCO2. No surgery related mortality or hospital death within 30 days after operation was observed. Only two patients had cardiopulmonary complications (consisting of pulmonary edema with atrial fibrillation in one patient, and acute myocardial infarction in another patient). However, neither pneumonia, prolonged ventilatory support for more than 2 days, nor the need for a tracheostomy after surgery was observed. Gastroenterological surgery is thus considered to be indicated even for patients with chronic respiratory insufficiency, as long as the PS can be maintained (PS of equal to or less than 3) and no active pneumonia with a considerable amount of purulent sputa is present.

  7. Traumatic tricuspid valve insufficiency. Experience in thirteen patients.

    Science.gov (United States)

    van Son, J A; Danielson, G K; Schaff, H V; Miller, F A

    1994-11-01

    From 1964 through June 1993, thirteen patients with traumatic tricuspid insufficiency were treated surgically; all were male, and the ages ranged from 17 to 64 years (median 39 years). The condition was associated with blunt chest trauma in all patients: motor vehicle accidents in twelve and an explosion of a tank of compressed air in one. The median duration between trauma and operation was 17 years (range 1 month to 37 years). Preoperatively, six patients were in sinus rhythm and seven were in atrial fibrillation. At operation, the right ventricular function appeared moderately to severely depressed in twelve patients. In twelve patients, the anterior leaflet was flail because of chordal rupture (n = 9), rupture of anterior papillary muscle (n = 3), or tear in the anterior leaflet (n = 1). In one patient, the septal leaflet was missing and in another it was retracted and adherent to the ventricular septum. In five patients the tricuspid valve was repaired and in eight it was replaced. In seven patients in the latter group, the chordae, papillary muscles, and/or tricuspid valve leaflet(s) were found to be in a contracted and atrophic state, precluding repair. No early or late deaths occurred. At follow-up extending to 26 years (median 12 years), 12 patients are in New York Heart Association class I and one patient is in class II. Nine patients were in sinus rhythm and four were in atrial fibrillation. Although our experience indicates that good functional results can still be achieved many years after the onset of traumatic tricuspid valve insufficiency, earlier diagnosis and surgical treatment should increase the feasibility of tricuspid valve insufficiency, earlier diagnosis and surgical treatment should increase the feasibility of tricuspid valve repair, prevent progressive deterioration of right ventricular function, and increase the possibility of maintaining late sinus rhythm in a greater number of patients.

  8. Hydrocortisone dose in adrenal insufficiency : Balancing harms and benefits

    NARCIS (Netherlands)

    Werumeus Buning, Jorien

    2017-01-01

    Patients with secondary adrenal insufficiency do not produce cortisol and are therefore treated with hydrocortisone tablets. The optimal substitution dose for hydrocortisone is unknown. We therefore performed this study, in which two different doses of hydrocortisone and its effect on cognition

  9. Subchondral insufficiency fracture of the knee: a non-traumatic injury with prolonged recovery time.

    Science.gov (United States)

    Gourlay, Margaret L; Renner, Jordan B; Spang, Jeffrey T; Rubin, Janet E

    2015-06-08

    Subchondral insufficiency fractures are non-traumatic fractures that occur immediately below the cartilage of a joint. Although low bone density may be present concurrently, it is not the underlying cause of subchondral insufficiency fractures in the majority of patients. Patients with subchondral insufficiency fracture characteristically have unremarkable plain radiographs, while MRI examination may reveal extensive bone marrow oedema and subchondral bone collapse. This article presents a 51-year-old postmenopausal woman, a physician, who had subchondral insufficiency fractures of the knee associated with prolonged standing during clinical work. She was treated with partial weight bearing on crutches until 14 months after the injury, viscosupplementation at 4 months to treat osteoarthritis and teriparatide treatment to improve bone healing at 7 months. By 26 months after the injury, she tolerated independent walking with a fabric knee support but still experienced mild posterolateral knee pain and numbness on prolonged standing. 2015 BMJ Publishing Group Ltd.

  10. Study of knowledge rate of parturient mothers about breast feeding adventages

    Directory of Open Access Journals (Sweden)

    mahnaz mardani

    2008-02-01

    Full Text Available Mardani M1, Mohsen-zadeh A2, Yari-pour M3 1. Assistant professor, Department of Nutritional, Faculty of medicine, Lorestan University of medical sciences 2. Assistant professor, Department of Pediatrics, Faculty of medicine, Lorestan University of medical sciences 3. PhD Student, Faculty of medicine, Lorestan University of medical sciences Abstract Background: Mothers milk is the only nourishing source in the first six months of life. If it is suitable and enough, all nutrients and reguired energe will be provided for a breast–fed to grow. Insufficient knowledge and information, wrong beliefs and traditional information about a breast – fed, working out side the home and the desire of working mothers to feed their children with powdered milk and to start the implementary feeding very early. The increasing of mothers willing to abdominal delivery and being away from the child in the first golden hours and misleading advertisements about powdered milk are all some reasons of decreasing the desire to mothers milk and increasing desire to powdered milk. Therefor, the aim of this study is to consider mothers knowledge about the importance of breast – feeding. Materials and methods: In this study, we completed questionnaires with seventeen questions to parturient mothers who came to Asali hospital in 2006 which included some variables such as benefits of breast feeding, the mother’s milk composition. The information was extracted and analyzed by SPSS software. Results: From 550 parturient mothers who came to Asali hospital in 2006, 33 mothers (6 percent had low knowledge, 216 of them (39 percent had medium knowledge and 301 of them (55 percent had high knowledge. This study indicates that regardless to consider some variables, mothers knowledge has been very high and also there is a significantl relationship between mothers age and their knowledge. The average age of low – knowledge mothers was 26, the medium knowledge was 28 and the high

  11. Knowledge based Entrepreneurship

    DEFF Research Database (Denmark)

    Heebøll, John

    This book is dedicated enterprising people with a technical or a scientific background who consider commercializing ideas and inventions within their field of expertise via a new business activity or a new company. It aims at distilling experiences from many successful and not so successful start......-up ventures from the Technical University of Denmark, 1988 – 2008 into practical, portable knowledge that can be used by future knowledge-based entrepreneurs to set up new companies efficiently or to stay away from it; to do what’s needed and avoid the pitfalls....

  12. Background characterization for the GERDA experiment

    Energy Technology Data Exchange (ETDEWEB)

    Becerici-Schmidt, Neslihan [Max-Planck-Institut fuer Physik, Muenchen (Germany); Collaboration: GERDA-Collaboration

    2013-07-01

    The GERmanium Detector Array (Gerda) experiment at the LNGS laboratory of INFN searches for the neutrinoless double beta (0νββ) decay of {sup 76}Ge. A discovery of this decay can greatly advance our knowledge on the nature and properties of neutrinos. The current best limit on the half-life of {sup 76}Ge 0νββ decay is 1.9 . 10{sup 25} years (90% C.L.). In order to increase the sensitivity on the half-life with respect to past experiments, the background rate in the energy region of interest (ROI) around Q{sub ββ} = 2039 keV has been reduced by a factor 10. Gerda started data-taking with the full set of Phase I detectors in November 2011. Identification of the background in the first phase of the experiment is of major importance to further mitigate the background for Gerda Phase II. An analysis of the Phase I data resulted in a good understanding of the individual components in the Gerda background spectrum. The background components in the ROI have been identified to be mainly due to β- and γ-induced events originating from {sup 214}Bi ({sup 238}U-series), {sup 208}Tl ({sup 232}Th-series), {sup 42}K (progeny of {sup 42}Ar) and α-induced events coming from isotopes in the {sup 226}Ra decay chain. A background decomposition in the ROI will be presented, with a special emphasis on the contribution from α-induced events.

  13. THE METHOD OF MANAGEMENT WOMEN WITH ISTHMIC-CERVICAL INSUFFICIENCY

    Directory of Open Access Journals (Sweden)

    Мария Сергеевна Воронцова

    2018-01-01

    Full Text Available Isthmic-cervical insufficiency (ICI is one of the most common causes of spontaneous premature births. In II trimester of pregnancy in the structure of miscarriages, the share of ICI accounts for about 40 % of cases. The purpose – evaluate the effectiveness of the complex method of correction of isthmic-cervical insufficiency. Materials and methods. A simple, open, prospective, randomized study was performed on the basis of the City Clinical Perinatal Center in Omsk. Under observation, there were 60 patients aged 18-40 years in gestation period of 13-33 weeks 6 days with a proven diagnosis of «isthmic-cervical insufficiency». The main group included 30 patients who received treatment with a new combined method: the obstetric pessary «CVK», which differs from the analogues by a more anatomical ellipsoidal form and an increased number of perforations to improve the outflow of vaginal secretions in combination with intravaginal injection of micronized progesterone in a dosage of 100 mg 2 times a day and a drug normalizing the biocenosis of the vagina, as a lyophilized culture of lactobacilli L. casei rhamnosus Doderleini in a dosage of 340 mg, 1 capsule intravaginally at night 2 times a week. The comparison group consisted of 30 patients who received treatment: obstetric silicone pessary + micronized progesterone at a dosage of 200 mg per day intravaginally. The outcomes of pregnancy and childbirth were evaluated. Results. The total number of premature births in the main group was 4 (13.3 % compared to 12 (40 % in the comparison group (p = 0,023. Based on the results of the study, a statistically significant reduction in patients with recurrent vaginal flora (p = 0,0001 was obtained and, due to a decrease in this indicator, a general decrease in the number of women with complications of pregnancy was registered (p = 0,019. The conclusion. The proposed method of correction of isthmic-cervical insufficiency is more effective

  14. Should we Investigate Gastroenterology Patients for Pancreatic Exocrine Insufficiency? A Dual Centre UK Study.

    Science.gov (United States)

    Campbell, Jennifer A; Sanders, David S; Francis, Katherine A; Kurien, Matthew; Lee, Sai; Taha, Hatim; Ramadas, Arvind; Joy, Diamond; Hopper, Andrew D

    2016-09-01

    Pancreatic exocrine insufficiency may be under recognised in gastroenterological practice. We aimed to identify the prevalence of pancreatic insufficiency in secondary care gastroenterology clinics and determine if co-morbidity or presenting symptoms could predict diagnosis. A secondary aim was to assess response to treatment. A dual centre retrospective analysis was conducted in secondary care gastroenterology clinics. Patients tested for pancreatic exocrine insufficiency with faecal elastase-1 (FEL-1) between 2009 and 2013 were identified in two centres. Demographics, indication and co-morbidities were recorded in addition to dose and response to pancreatic enzyme replacement therapy. Binary logistic regression was used to assess if symptoms or co-morbidities could predict pancreatic insufficiency. 1821 patients were tested, 13.1% had low FEL-1 (<200µg/g). This prevalence was sub-analysed with 5.4% having FEL-1 100-200µg/g (mild insufficiency) and 7.6% having faecal elastase readings <100µg/g. Low FEL-1 was most significantly associated with weight loss or steatorrhoea. Co-morbidity analysis showed that low levels were significantly associated with excess alcohol intake, diabetes mellitus or human immunodeficiency virus; 80.0% treated with enzyme supplements reported symptomatic benefit with no difference in response between high and low dose supplementation (p=0.761). Targeting the use of FEL-1 in individuals with specific symptoms and associated conditions can lead to improved recognition of pancreatic exocrine insufficiency in a significant proportion of secondary care patients. Intervening with lifestyle advice such as smoking cessation and minimising alcohol intake could improve outcomes. In addition, up to 80% of patients with low faecal elastase respond to supplementation.

  15. Knowledge and Perception of Menopause and Climacteric ...

    African Journals Online (AJOL)

    Uche

    Abstract. Background: Menopause alters the physiological, biochemical and psychological environment of a woman. Thus the knowledge and perception of its symptomatology is invaluable to enable appropriate adjustment to this natural phenomenon. Objective: The objective of this study was to determine the knowledge ...

  16. A NANOS3 mutation linked to protein degradation causes premature ovarian insufficiency

    OpenAIRE

    Wu, X; Wang, B; Dong, Z; Zhou, S; Liu, Z; Shi, G; Cao, Y; Xu, Y

    2013-01-01

    Primary ovarian insufficiency (POI), or premature ovarian failure, is defined as the cessation of ovarian function before the age of 40. An insufficient ovarian follicle pool derived from primordial germ cells (PGCs) is an important cause of POI. Although the Nanos gene family is known to be required for PGC development and maintenance in diverse model organisms, the relevance of this information to human biology is not yet clear. In this study, we screened the coding regions of the NANOS1, N...

  17. THE MODERN APPROACH OF CHILDREN’S TREATMENT WITH VELOPHARYNGEAL INSUFFICIENCY IN THE POSTOPERATIVE PERIOD

    Directory of Open Access Journals (Sweden)

    O. V. Nelyubina

    2014-01-01

    Full Text Available Velopharyngeal insufficiency is one of the main causes of speech disorders in children with congenital cleft palate, leading to social exclusion and disability of patients. This article describes an integrated approach to the treatment of velopharyngeal insufficiency, aimed in improving the anatomical and physiological function of velopharyngeal ring. Velopharyngeal ring is considered as the nervemuscle complex in the treatment of patients with this pathology. It is shown that a one-time complex treatment of velopharyngeal insufficiency, estimated with the program «Compare» in the below-described clinical example, increased velopharyngeal closure ring by 25%, thus eliminating nasality and significantly improve the quality of speech.

  18. Semantics-based plausible reasoning to extend the knowledge coverage of medical knowledge bases for improved clinical decision support

    OpenAIRE

    Mohammadhassanzadeh, Hossein; Van Woensel, William; Abidi, Samina Raza; Abidi, Syed Sibte Raza

    2017-01-01

    Background Capturing complete medical knowledge is challenging-often due to incomplete patient Electronic Health Records (EHR), but also because of valuable, tacit medical knowledge hidden away in physicians? experiences. To extend the coverage of incomplete medical knowledge-based systems beyond their deductive closure, and thus enhance their decision-support capabilities, we argue that innovative, multi-strategy reasoning approaches should be applied. In particular, plausible reasoning mech...

  19. The knowledge, concerns and healthcare practices among physicians regarding electronic cigarettes.

    Science.gov (United States)

    Kanchustambham, Venkatkiran; Saladi, Swetha; Rodrigues, Jonathan; Fernandes, Hermina; Patolia, Setu; Santosh, Sadhashiv

    2017-07-01

    Background : Electronic cigarettes (e-cigarettes) are battery-powered devices that deliver aerosolized nicotine. With easy access and over-the-counter availability, many patients consider using electronic cigarettes for smoking cessation. Few studies have looked at long-term safety/efficacy and physician knowledge/attitudes toward e-cigarettes. Physicians have insufficient guidelines for advising their patients about e-cigarettes. Objective : 1) To identify knowledge and attitude of health care practitioners toward electronic cigarettes. 2) To identify the effect of level of training, experience and speciality on knowledge and practice of electronic cigarettes. 3) To identify factors influencing electronic cigarettes advise/prescribing practice. Methods : An anonymous online questionnaire was sent to residents, fellows, and faculty in pre-selected specialties at Saint Louis University (SLU) Hospital. Results : We received 115 responses. Nine percent reported being 'very familiar' with e-cigarettes, while 25% reported no familiarity; 18% of physicians would advise e-cigarettes as nicotine-replacement therapy if asked by patients; 91% were aware of the nicotine content of e-cigarettes, but only 20% and 39%, respectively, were aware of the presence of carcinogens and polyethylene glycol. Only 63% of respondents knew what 'vape' meant. Lack of evidence regarding long-term safety (76%), e-cigarettes as starter products for nonsmokers (50%), absence of Food and Drug Administration (FDA) regulations (51%) and marketing to youth (42%) were major concerns. Stricter regulations (54%), warning labels similar to tobacco products (53%), restricting advertising (36%), banning sales to minors (34%), and banning use in public spaces (25%) were favored as regulatory measures. More than 50% of physicians see a role for e-cigarettes as part of 'harm-reduction strategy'. Conclusions : Further research is needed to assess whether e- cigarettes could be an effective smoking

  20. Preface: conservation of european ponds-current knowledge and future needs

    OpenAIRE

    Miracle, Rosa; Oertli, Beat; Céréghino, Régis; Hull, Andrew P.

    2010-01-01

    Ponds are common elements of the landscape with an important role in the global processes of biosphere and biodiversity preservation. Recent research indicates that ecological characteristics of ponds are different from other inland water systems, but scientific knowledge is still insufficient and poor compared to lakes and rivers. Therefore, whilst indicators and conservation tools have been developed for most aquatic systems, there is also a gap between existing basic information on pond ec...

  1. Readability of online patient education materials for velopharyngeal insufficiency.

    Science.gov (United States)

    Xie, Deborah X; Wang, Ray Y; Chinnadurai, Sivakumar

    2018-01-01

    Evaluate the readability of online and mobile application health information about velopharyngeal insufficiency (VPI). Top website and mobile application results for search terms "velopharyngeal insufficiency", "velopharyngeal dysfunction", "VPI", and "VPD" were analyzed. Readability was determined using 10 algorithms with Readability Studio Professional Edition (Oleander Software Ltd; Vandalia, OH). Subgroup analysis was performed based on search term and article source - academic hospital, general online resource, peer-reviewed journal, or professional organization. 18 unique articles were identified. Overall mean reading grade level was a 12.89 ± 2.9. The highest reading level among these articles was 15.47-approximately the level of a college senior. Articles from "velopharyngeal dysfunction" had the highest mean reading level (13.73 ± 2.11), above "velopharyngeal insufficiency" (12.30 ± 1.56) and "VPI" (11.66 ± 1.70). Articles from peer-reviewed journals had the highest mean reading level (15.35 ± 2.79), while articles from academic hospitals had the lowest (12.81 ± 1.66). There were statistically significant differences in reading levels between the different search terms (P reading level guidelines, online patient education materials for VPI are disseminated with language too complex for most readers. There is also a lack of VPI-related mobile application data available for patients. Patients will benefit if future updates to websites and disseminated patient information are undertaken with health literacy in mind. Future studies will investigate patient comprehension of these materials. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Long-term results of external valvuloplasty in adult patients with isolated great saphenous vein insufficiency

    Directory of Open Access Journals (Sweden)

    Sarac A

    2014-04-01

    Full Text Available Atilla Sarac,1 Artan Jahollari,1 Sureyya Talay,1 Sevket Ozkaya,2 Ertugrul Ozal1 1Department of Cardiovascular Medicine, Samsun Medical Park Hospital, Samsun, Turkey; 2Department of Pulmonary Medicine, Faculty of Medicine, Bahcesehir University, Istanbul, Turkey Objective: The aim of this study is to present our 7-year results of external valvuloplasty for isolated great saphenous vein (GSV insufficiency. Methods: External valvuloplasty was applied in 83 patients with isolated GSV insufficiency. Follow-up consisted of venous color duplex scanning performed on the first postoperative day, the first postoperative month, and then annually. Valvular insufficiency, venous reflux, and venous thrombosis formation in the saphenofemoral junction were the main outcomes. Results: A complete clinical and radiological healing was observed in 50 patients (60%. In 13 cases (15.6%, a secondary surgical treatment was performed consisting of vena saphena magna high ligation/stripping and varicose vein excisions, mainly due to severe and progressive vena saphena magna valvular insufficiency and clinical persistence of symptoms. Eight patients (9.6% developed superficial vein thrombosis, and only one patient (1.2% developed deep vein thrombosis. Contact was lost from 32 patients (38.5% for different reasons. Conclusion: External valvuloplasty is an effective surgical technique for selected cases of isolated GSV insufficiency without extensive varicose dilatations. This alternative method can be safely administered as an alternative to high ligation and conventional GSV stripping. Keyword: vein, saphenous, insufficiency, external valv, valvuloplasty, varicosis

  3. Fatigue and insufficiency fractures

    International Nuclear Information System (INIS)

    Lodwick, G.S.; Rosenthal, D.I.; Kattapuram, S.V.; Hudson, T.M.

    1987-01-01

    The incidence of stress fracture is increasing. In our younger society this is due largely to a preocupation with physical conditioning, but in our elderly population it is due to improved recognition and better methods of detection and diagnosis. Stress fracture of the elderly is an insufficiency fracture which occurs in the spine, the pelvis, the sacrum and other bones afflicted with disorders which cause osteopenia. Stress fracture is frequently misdiagnosed as a malignant lesion of bone resulting in biopsy. Scintiscanning provides the greatest frequency of detection, while computed tomography often provides the definitive diagnosis. With increased interest and experience a better insight into the disease has been achieved, and what was once thought of as a simple manifestation of mechanical stress is now known to be an orderly, complex pattern of physiological changes in bone which conform to a model by Frost. The diffuse nature of these changes can be recognized by scintigraphy, radiography and magnetic resonance imaging. 27 refs.; 8 figs

  4. Knowledge, risk perception and practice regarding tuberculosis ...

    African Journals Online (AJOL)

    Background: Window opening during bus transportation is recommended as a tuberculosis prevention strategy.Yet, drivers are affected by lack knowledge and risk perception of passengers and assistants. Boosting knowledge of and notifying the high risk of tuberculosis transmission for every passenger could be too costly.

  5. Clinicoroentgenological diagnosis of chronic venous ovarian insufficiency

    International Nuclear Information System (INIS)

    Grakova, L.S.; Galkin, E.V.; Naumova, E.B.

    1989-01-01

    The paper is devoted to clinicoroentgenological correlations of venous renogonadal hemodynamics in 168 women of reproductive age (151 women with infertility, habitual abortion, disordered menstrual function and 17 patients without disorders of the reproductive tract). Clinicolaboratory investigation was followed by visceral and parietal flebography for the detection of a pathological venous reflux into the ovarian pampiniform plexus. Clinicoroentgenological semiotics of chronic venous ovarian insufficiency was analyzed. Infertility was shown to be the main clinical manifestation of ovarian varicocele

  6. Respiratory insufficiency with preserved diaphragmatic function in amyotrophic lateral sclerosis.

    Science.gov (United States)

    Yamauchi, Rika; Imai, Tomihiro; Tsuda, Emiko; Hozuki, Takayoshi; Yamamoto, Daisuke; Shimohama, Shun

    2014-01-01

    We performed a longitudinal study to elucidate the correlation between respiratory insufficiency and respiratory biomarkers, including diaphragmatic compound muscle action potential (DCMAP), at the initiation of noninvasive ventilation (NIV) in patients with amyotrophic lateral sclerosis (ALS). The patients were assessed at least every six months. Additional assessments were performed at the start of respiratory therapy when the patients met the criteria for the initiation of NIV. Each assessment consisted of a full neurological examination, a phrenic nerve conduction study, respiratory function tests, and nocturnal pulsed oximetry. We enrolled 43 patients with either definite or probable ALS as defined by the revised El Escorial criteria. The patients were divided into two groups according to the timing of the initiation of respiratory therapy. Seventeen patients (group A) met the criteria for NIV initiation when their DCMAP remained normal. Twenty-six patients (group B) met the criteria when their DCMAP decreased below normal limits. Although respiratory function parameters were significantly worse in group B compared with group A at NIV initiation, more than 80% of the patients in both groups developed nocturnal desaturation during sleep. DCMAP is not always a reliable indicator for determining the optimal timing for NIV initiation during the progression of respiratory insufficiency in ALS. Physicians should be aware of the risk of respiratory insufficiency during sleep in patients with ALS.

  7. Breastfeeding knowledge, attitude and practice among school teachers in Abha female educational district, southwestern Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Al-Binali Ali Mohamed

    2012-08-01

    Full Text Available Abstract Background Inadequate knowledge, or inappropriate practice, of breastfeeding may lead to undesirable consequences. The aim of this study was to assess breastfeeding knowledge, attitude and practice (KAP among female teachers in the Abha Female Educational District and identify factors that may affect breastfeeding practice in the study population. Methods A cross-sectional study using a self-administered questionnaire was conducted among school teachers in Abha Female Educational District during the months of April to June, 2011. Breastfeeding KAP of participants who had at least one child aged five years or younger at the time of the study were assessed using a self-administered questionnaire, based on their experience with the last child. Results A total of 384 women made up of 246 (61.1% primary-, 89 (23.2% intermediate- and 49 (12.8% high-school teachers participated in the study. One hundred and nineteen participants (31% started breastfeeding their children within one hour of delivery, while exclusive breastfeeding for 6 months was reported only by 32 (8.3% participants. Insufficient breast milk and work related problems were the main reasons given by 169 (44% and 148 (38.5% of participants, respectively, for stopping breastfeeding before two years. Only 33 participants (8.6% had attended classes related to breastfeeding. However, 261 participants (68% indicated the willingness to attend such classes, if available, in future pregnancies. Conclusions This study revealed that breast milk insufficiency and adverse work related issues were the main reasons for a very low rate of exclusive breastfeeding among female school teachers in Abha female educational district, Saudi Arabia. A very low rate of attending classes addressing the breastfeeding issues during pregnancy, and an alarming finding of a high percentage of babies receiving readymade liquid formula while still in hospital, were also brought out by the present study. Such

  8. Emergence of classical reality from a quantum mechanical background

    International Nuclear Information System (INIS)

    Sommer, Hanns

    2009-01-01

    A model for the process of knowledge acquisition is presented that shows how naive realism emerges from a quantum mechanical background. We formalise this process of emergence and obtain in this way an illustrative insight to some of the most fundamental physical theories: GRW-theory and E ∞ -theory.

  9. Knowledge management, health information technology and nurses' work engagement

    NARCIS (Netherlands)

    Hendriks, P.H.J.; Ligthart, P.E.M.; Schouteten, R.L.J.

    2016-01-01

    BACKGROUND: Knowledge management (KM) extends the health information technology (HIT) literature by addressing its impact on creating knowledge by sharing and using the knowledge of health care professionals in hospitals. PURPOSE: The aim of the study was to provide insight into how HIT affects

  10. Risk factors for urological symptoms in a cohort of users of the HIV protease inhibitor indinavir sulfate - The ATHENA cohort

    NARCIS (Netherlands)

    Dieleman, Jeanne P.; Sturkenboom, Miriam C. J. M.; Jambroes, Marielle; Gyssens, Inge C.; Weverling, Gerrit-Jan; ten Veen, Jacob H.; Schrey, Gerrit; Reiss, Peter; Stricker, Bruno H. Ch

    2002-01-01

    Background: Nephrolithiasis is a well-known complication of indinavir treatment and may result in urological symptoms ranging from renal colic to renal insufficiency. Objective: To obtain further knowledge regarding the incidence and risk factors of urological symptoms associated with indinavir

  11. Assessing adrenal insufficiency of corticosteroid secretion using free versus total cortisol levels in critical illness

    NARCIS (Netherlands)

    Molenaar, N.; Groeneveld, A.B.J.; Dijstelbloem, H.M.; de Jong, M.F.C.; Girbes, A.R.J.; Heijboer, A.C.; Beishuizen, A.

    2011-01-01

    Purpose: To study the value of free versus total cortisol levels in assessing relative adrenal insufficiency during critical illness-related corticosteroid insufficiency. Methods: A prospective study in a mixed intensive care unit from 2004 to 2007. We consecutively included 49 septic and 63

  12. A doppler-based evaluation of peripheral lower limb arterial insufficiency in diabetes mellitus

    International Nuclear Information System (INIS)

    Shaheen, R.; Sohail, S.

    2010-01-01

    To determine the frequency, level and flow patterns of lower limb arterial insufficiency in diabetic patients on Doppler ultrasound study. Study Design: Cross-sectional study. Place and Duration of Study: Radiology Department, Civil Hospital, Karachi, from February 2007 to September 2008. Methodology: One hundred adult diabetic patients with suspected peripheral vascular insufficiency irrespective of gender were included. Demographic data, presenting complaints, treatment history, and level of HbA1c were recorded. Doppler evaluated arterial status and ankle brachial index (ABI) were recorded on proforma. Statistical analysis were done on SPSS version 12. Results: The mean HbA1c was 8.4 +- 1.4 gm/dl, a majority of 77% having a controlled level of < 10 mg/dl. Arterial insufficiency on Doppler ultrasound was documented in 62% (p=0.016) and the dorsalis paedis artery was the predominant site of stenosis (24%). Spectral broadening and biphasic flow were salient features. The mean value of resistive index in stenotic cases was 0.563 +- 0.16 with a mean velocity difference of 0.37 +- 0.29 m/s (p < 0.001) at the site of stenosis. Conclusion: Peripheral vascular insufficiency was a significant finding in patients having diabetes for an average of 9.8 years, even in the presence of controlled HbA1c. The dorsalis paedis was the commonest site of involvement. The insufficiency was moderate with a biphasic flow pattern in a majority of cases. Difference in resistive index and flow velocities at and above the site of stenosis provided an important clue to the diagnosis of level of stenosis that helps in planning limb salvage management. (author)

  13. Piping and erosion in buffer and backfill materials. Current knowledge

    International Nuclear Information System (INIS)

    Boergesson, Lennart; Sanden, Torbjoern

    2006-09-01

    The water inflow into the deposition holes and tunnels in a repository will mainly take place through fractures in the rock and will lead to that the buffer and backfill will be wetted and homogenised. But in general the buffer and backfill cannot absorb all water that runs through a fracture, which leads to that a water pressure will be generated in the fracture when the inflow is hindered. If the counter pressure and strength of the buffer or backfill is insufficiently high, piping and subsequent erosion may take place. The processes and consequences of piping and erosion have been studied in some projects and several laboratory test series in different scales have been carried through. This brief report describes these tests and the results and conclusions that have emerged. The knowledge of piping and erosion is insufficient today and additional studies are needed and running

  14. Periodontal Disease Awareness and Knowledge among Nigerian ...

    African Journals Online (AJOL)

    Background: Teacher‑led oral health education is equally effective in improving the oral health knowledge and oral hygiene status of adolescents as dentist‑led and peer‑led strategies. Aim: The aim was to determine periodontal disease awareness and knowledge among Nigerian primary school teachers. Subjects and ...

  15. [Experimental validation of the efficacy of laser-magnetic therapy for chronic placental insufficiency].

    Science.gov (United States)

    Ordzhonikidze, N V; Filimonov, V G; Klimenko, P A; Kondrikov, N I; Akin'shina, V S; Berlin, Iu V

    1994-01-01

    A new pathogenetically based non-medicamentous method for correction of uteroplacental bloodflow disturbances has been developed on the model of chronic placental insufficiency in rats. A single 5 min laser-magnetic exposure on day 21 of normal pregnancy resulted in a vasodilating effect with reduction of the peripheral resistance in the uterine horn vessels and with improvement of their blood supply. A new LAMA laser magneto-therapeutic device was employed. Daily 5 min sessions of laser magnetic therapy administered to rats with chronic placental insufficiency from pregnancy days 15-16 to 21 normalized uterine horn contractility and resulted in positive morphofunctional changes in the components of the uterine horns and placenta, being associated with a noticeable improvement of fetal functions. Hence, laser magnetic therapy may be regarded as an effective non-drug method for therapy of chronic placental insufficiency.

  16. Reversible adrenal insufficiency and heterophile antibodies in a case of autoimmune polyendocrinopathy syndrome.

    Science.gov (United States)

    Kharb, Sandeep; Gundgurthi, Abhay; Dutta, Manoj K; Garg, M K

    2013-12-01

    A 27-year-old male was admitted with diabetic ketoacidosis and altered sensorium with slurring of speech and ataxia. He was managed with intravenous insulin and fluids and later shifted to basal bolus insulin regimen and during further evaluation was diagnosed to be suffering from primary hypothyroidism and adrenal insufficiency. He was started on thyroxin replacement and steroids only during stress. After three months of follow up he was clinically euthyroid. His glycemic control was adequate on oral anti-hyperglycemic drugs and adrenal insufficiency recovered. However, his thyrotropin levels were persistently elevated on adequate replacement doses of thyroxin. His repeat TSH was estimated after precipitating serum with polyethylene glycol which revealed normal TSH. Here we report reversible adrenal insufficiency with hypothyroidism with falsely raised TSH because of presence of heterophile antibodies in a case of poly glandular endocrinopathy syndrome.

  17. Photosensitivity and Acute Liver Insufficiency in Late-Onset Erythropoietic Protoporphyria with a Chromosome 18q Abnormality

    Directory of Open Access Journals (Sweden)

    Yuka Oshikawa

    2012-07-01

    Full Text Available Late-onset erythropoietic protoporphyria (EPP is rare, and it is usually associated with an acquired somatic mutation of the ferrochelatase gene secondary to hematological malignancy such as myelodysplastic syndrome or myeloproliferative disorder. In 0.5–1% of patients with EPP, deposition of protoporphyrin in the liver leads to progressive liver insufficiency. Herein, we report the case of a 67-year-old female who developed EPP with typical photosensitivity and hemolytic anemia. Six months later, she was admitted with acute liver damage with a rapidly progressing course, and developed liver insufficiency. She recovered from the liver insufficiency after undergoing plasmapheresis and red blood cell exchange transfusion. A bone marrow examination revealed normal features; however, a cytogenetic analysis identified an abnormal clone of cells with a translocation between chromosomes 13q12 and 18q21.1. This is the first report of a patient who recovered from liver insufficiency. The results of this report suggest that plasmapheresis and red blood cell exchange transfusion are effective for treating liver insufficiency in patients with late-onset EPP.

  18. Background simulations for the Large Area Detector onboard LOFT

    DEFF Research Database (Denmark)

    Campana, Riccardo; Feroci, Marco; Ettore, Del Monte

    2013-01-01

    and magnetic fields around compact objects and in supranuclear density conditions. Having an effective area of similar to 10 m(2) at 8 keV, LOFT will be able to measure with high sensitivity very fast variability in the X-ray fluxes and spectra. A good knowledge of the in-orbit background environment...... is essential to assess the scientific performance of the mission and optimize the design of its main instrument, the Large Area Detector (LAD). In this paper the results of an extensive Geant-4 simulation of the instrumentwillbe discussed, showing the main contributions to the background and the design...... an anticipated modulation of the background rate as small as 10 % over the orbital timescale. The intrinsic photonic origin of the largest background component also allows for an efficient modelling, supported by an in-flight active monitoring, allowing to predict systematic residuals significantly better than...

  19. Chronic Heroin Dependence Leading to Adrenal Insufficiency

    Directory of Open Access Journals (Sweden)

    Gautam Das

    2014-01-01

    Full Text Available Opioids have been the mainstay for pain relief and palliation over a long period of time. They are commonly abused by drug addicts and such dependence usually imparts severe physiologic effects on multiple organ systems. The negative impact of opioids on the endocrine system is poorly understood and often underestimated. We describe a patient who developed severe suppression of the hypothalamic-pituitary adrenal (HPA axis leading to secondary adrenal insufficiency due to long standing abuse of opioids.

  20. Assessing adrenal insufficiency of corticosteroid secretion using free versus total cortisol levels in critical illness

    NARCIS (Netherlands)

    Molenaar, Nienke; Johan Groeneveld, A. B.; Dijstelbloem, Hilde M.; de Jong, Margriet F. C.; Girbes, Armand R. J.; Heijboer, Annemieke C.; Beishuizen, Albertus

    2011-01-01

    To study the value of free versus total cortisol levels in assessing relative adrenal insufficiency during critical illness-related corticosteroid insufficiency. A prospective study in a mixed intensive care unit from 2004 to 2007. We consecutively included 49 septic and 63 non-septic patients with

  1. Why Sleep Matters-The Economic Costs of Insufficient Sleep: A Cross-Country Comparative Analysis.

    Science.gov (United States)

    Hafner, Marco; Stepanek, Martin; Taylor, Jirka; Troxel, Wendy M; van Stolk, Christian

    2017-01-01

    The Centers for Disease Control and Prevention (CDC) in the United States has declared insufficient sleep a "public health problem." Indeed, according to a recent CDC study, more than a third of American adults are not getting enough sleep on a regular basis. However, insufficient sleep is not exclusively a US problem, and equally concerns other industrialised countries such as the United Kingdom, Japan, Germany, or Canada. According to some evidence, the proportion of people sleeping less than the recommended hours of sleep is rising and associated with lifestyle factors related to a modern 24/7 society, such as psychosocial stress, alcohol consumption, smoking, lack of physical activity and excessive electronic media use, among others. This is alarming as insufficient sleep has been found to be associated with a range of negative health and social outcomes, including success at school and in the labour market. Over the last few decades, for example, there has been growing evidence suggesting a strong association between short sleep duration and elevated mortality risks. Given the potential adverse effects of insufficient sleep on health, well-being and productivity, the consequences of sleep-deprivation have far-reaching economic consequences. Hence, in order to raise awareness of the scale of insufficient sleep as a public-health issue, comparative quantitative figures need to be provided for policy- and decision-makers, as well as recommendations and potential solutions that can help tackling the problem.

  2. Pharmacist's knowledge, practice and attitudes toward pharmacovigilance and adverse drug reactions reporting process.

    Science.gov (United States)

    Suyagh, Maysa; Farah, Doaa; Abu Farha, Rana

    2015-04-01

    Adverse drug reactions (ADRs) are a major cause of drug related morbidity and mortality. Pharmacovigilance is the science that plays an essential role in the reduction of ADRs, thus the evolution and growth of this science are critical for effective and safe clinical practice. This study is considered the first study in the region to evaluate pharmacist's knowledge, practice and attitudes toward ADRs reporting after establishing the national ADRs reporting center in Jordan. A cross sectional study was used to evaluate pharmacist knowledge and attitude toward ADRs reporting. A structured validated questionnaire was developed for this purpose and a total of 208 pharmacists were recruited to participate in this study. The majority of pharmacists have insufficient awareness and lack of knowledge about pharmacovigilance and ADRs reporting. Also the rate of reporting of ADRs was extremely poor. Several factors were found to discourage pharmacists from reporting ADRs, which include inadequate information available from the patient, unavailability of pharmacist ADRs form when needed, unawareness of the existence of the national ADRs reporting system. Also pharmacists think that ADRs are unimportant or they did not know how to report them. The results of this study suggest that pharmacists have insufficient knowledge about the concept of pharmacovigilance and spontaneous ADRs reporting. On the other hand, pharmacists had positive attitudes toward pharmacovigilance, despite their little experience with ADRs reporting. Educational programs are needed to increase pharmacist's role in the reporting process, and thus to have a positive impact on the overall patient caring process.

  3. Nocturnal foot blood flow in patients with arterial insufficiency

    DEFF Research Database (Denmark)

    Jelnes, Rolf; Tønnesen, K H

    1984-01-01

    Twenty-four hour continuous recording of xenon (133Xe) wash-out from the forefoot was performed on patients with normal circulations (n = 10) and on patients with different degrees of arterial insufficiency (n = 36). During day hours the calculated subcutaneous blood flow in the forefoot was on a...

  4. Emergence of classical reality from a quantum mechanical background

    Energy Technology Data Exchange (ETDEWEB)

    Sommer, Hanns [Department of Mechanical Engineering, University of Kassel, 34109 Kassel, Moenchebergstr 7 (Germany)], E-mail: hanns.sommer@mrt.uni-kassel.de

    2009-02-15

    A model for the process of knowledge acquisition is presented that shows how naive realism emerges from a quantum mechanical background. We formalise this process of emergence and obtain in this way an illustrative insight to some of the most fundamental physical theories: GRW-theory and E{sup {infinity}}-theory.

  5. Familiarity, opinions, experiences and knowledge about scalp cooling: a Dutch survey among breast cancer patients and oncological professionals

    Directory of Open Access Journals (Sweden)

    Mijke Peerbooms

    2015-01-01

    Full Text Available Objective: Scalp cooling (SC is applied to reduce chemotherapy-induced alopecia (CIA. The aim of this study was to investigate patients′ familiarity and opinions and oncological professionals′ attitude and knowledge about SC in the Netherlands. Methods: Ex breast cancer patients, nurses and medical oncologists (MDs from SC and non-SC hospitals filled out questionnaires. Results: The majority of MDs and nurses were satisfied with the results of SC, as were SC patients. Over 33% of MDs and nurses perceived their knowledge level insufficient to inform patients about effectiveness, which was over 43% for information about safety. MDs main reason to not apply SC was doubt about effectiveness and safety. Nurses generally offered SC to a minority of eligible patients. Patients were frequently unfamiliar with SC before diagnosis. Seventy percent of SC patients with insufficient results (20/52 reported to mind it very much. With expected success rates of 35% and 50%, respectively, 36% and 54% of patients would use SC again. Conclusion: Room for improvement has been shown for both patients′ familiarity and oncological professionals′ knowledge about SC. Sharing knowledge about results, safety and patients′ experiences will improve patient counseling and SC availability. The results of this survey led to the development of a national standard on CIA and SC.

  6. Renal and suprarenal insufficiency secondary to familial Mediterranean fever associated with amyloidosis: a case report

    Directory of Open Access Journals (Sweden)

    Sari Nagehan

    2011-08-01

    Full Text Available Abstract Introduction Familial Mediterranean fever is an autosomal recessive disease that predominantly affects people of the Mediterranean coast. One of the most frequent complications of the disease is amyloidosis. This clinical entity is known as secondary (also called AA amyloidosis. Case presentation In this report, we describe the case of a 33-year-old Turkish man with familial Mediterranean fever and chronic renal insufficiency. He was admitted to our clinic with symptoms of suprarenal insufficiency. The patient died three months later as a result of cardiac arrest. Conclusion Our aim is to make a contribution to the literature by reporting a case of combined insufficiency due to the accumulation of renal and adrenal amyloid in a patient with familial Mediterranean fever, which has very rarely been described in the literature. We hope that adrenal insufficiency, which becomes fatal if not diagnosed and treated rapidly, will come to mind as easily as chronic renal failure in clinical practice.

  7. Exploiting thesauri knowledge in medical guideline formalization

    OpenAIRE

    Serban, R.C.; ten Teije, A.C.M.

    2009-01-01

    Objectives: As in software product lifecycle, the effort spent in maintaining medical knowl edge in guidelines can be reduced, if modularization, formalization and tracking of domain knowledge are employed across the guideline development phases. Methods: We propose to exploit and combine knowledge templates with medical background knowledge from existing thesauri in order to produce reusable building blocks used in guideline development. These tem- plates enable easier guideline formalizatio...

  8. Functional pancreatic insufficiency after surgical treatment in the light of the latest international recommendations

    Directory of Open Access Journals (Sweden)

    D. S. Bordin

    2017-01-01

    Full Text Available Exocrine  and  endocrine   insufficiencies  are  frequent complications of surgical treatment for pancreatic diseases. The presence  and  extent  of the insufficiency depend on the underlying  disorder, type of surgical procedure, extent of pancreatic resection, and anatomical reconstruction. Increased surgical  activity  determines  the  importance  of the  evidence-based guidelines  for management of patients  after  pancreatic  surgery. The article presents  an  overview of international Evidence-based Guidelines for the Management of Exocrine Pancreatic  Insufficiency after  Pancreatic  Surgery (2016 and United European Gastroenterology evidence-based guidelines  for the  diagnosis  and therapy of chronic pancreatitis (HaPanEU, 2017.

  9. Retrospective study of effect of therapy on computer vision syndrome patients having convergence insufficiency

    Directory of Open Access Journals (Sweden)

    Nidhi Tiwari

    2017-01-01

    Full Text Available Aim: To study effect of therapy among computer users having convergence insufficiency. Materials and Methods: Hundred people between age group of 20-35 and who worked in IT companies were enrolled in the study. They were subjected to orthoptic evaluation to establish diagnosis of convergence insufficiency. They were then called for in-office therapy for 12 days daily. They underwent brock string exercises and at the end of therapy re-evaluation was done. Results: All the patients who underwent the therapy showed improvement in Near point of convergence at the end of therapy. They were also symptomatically better. Conclusions: Convergence insufficiency is a common occupation hazard among IT professionals. But it can be treated with appropriate therapy.

  10. The Effect of the Reader's Background on Reading Comprehension Performance

    Directory of Open Access Journals (Sweden)

    Bushra Saadoon Mohammed Al-Noori

    2014-12-01

    Full Text Available This study aims at measuring the amount of the effect of the reader's background knowledge on performance in reading comprehension tests through the assessment of information gained in reading comprehension (RC tests across-four testing techniques, short answer questions ,true-false items , multiple - choice items , and cloze test and re-test. This technique involves the examinees in two types of tasks, i.e. pre-reading and post -reading task. Two hypotheses have been proposed to achieve the aims of this study. They are  1-There are no significant differences between the pre-reading and post-reading performances of examinees on reading comprehension(RC. 2-There are no significant differences in information gain scores across the different techniques of testing reading comprehension (RC in EFL. To verify the validity of these two hypotheses, a number of statistical procedures have been used such as arithmetical mean, t-test for correlated and independent samples to analyze the performance of third and fourth year College students studying at the Department of English at University of Baghdad /Ibn Rushd College of Education for Humanities on two reading passages taken from TOEFL practice tests (2011. The analysis of the data has shown the following results: 1-The background knowledge has an effect on the performance on reading comprehension (RC. 2-There is a significant difference in students' performance on reading comprehension (RC. 3-The effect of background knowledge is investable on reading comprehension (RC tests, but it can be identified or neutralized. Based on these conclusions, the researcher presented a number of recommendations.

  11. Background reduction in the SNO+ experiment

    Energy Technology Data Exchange (ETDEWEB)

    Segui, L. [University of Oxford, Denys Wilkinson Building, Keble Road, OX1 Oxford (United Kingdom)

    2015-08-17

    SNO+ is a large multi-purpose liquid scintillator experiment, which first aim is to detect the neutrinoless double beta decay of {sup 130}Te. It is placed at SNOLAB, at 6000 m.w.e. and it is based on the SNO infrastructure. SNO+ will contain approximately 780 tonnes of liquid scintillator, loaded with {sup 130}Te inside an acrylic vessel (AV) with an external volume of ultra pure water to reduce the external backgrounds. Light produced in the scintillator by the interaction of particles will be detected with about 9,000 photomultiplier’s. For the neutrinoless double beta decay phase, due to its the extremely low rate expected, the control, knowledge and reduction of the background is essential. Moreover, it will also benefit other phases of the experiment focused on the study of solar neutrinos, nucleon decay, geoneutrinos and supernovae. In order to reduce the internal background level, a novel purification technique for tellurium loaded scintillators has been developed by the collaboration that reduces the U/Th concentration and several cosmic-activated isotopes by at least a factor 10{sup 2} -10{sup 3} in a single pass. In addition, different rejection techniques have been developed for the remaining internal backgrounds based on Monte-Carlo simulations. In this work, the scintillator purification technique and the levels obtained with it will be discussed. Furthermore, an overview of the different backgrounds for the double-beta phase will be presented, highlighting some of the techniques developed to reject the remained decays based on their expected timing differences.

  12. Nasopharyngeal pushback in treatment of velopharyngeal insufficiency.

    Science.gov (United States)

    Smith, H W; Lee, K J

    1976-02-01

    We describe a new technique for extensive retropositioning of the soft palate for the treatment of velopharyngeal insufficiency. This technique is identified as a nasopharyngeal pushback, and has been used repeatedly in conjunction with both a Cronin nasal flap and a superiorly based pharyngeal flap when maximum retropositioning was needed. This procedure has been used for over ten years, each time obtaining an additional pushback distance equal to or greater than the distance achieved by freeling the soft palate from the posterior border of the hard palate.

  13. Intervention Studies in Suicide Prevention Research

    NARCIS (Netherlands)

    Huisman, A.; Pirkis, J; Robinson, J.

    2010-01-01

    Background: Despite the growing strength of the field of suicidology, various commentators have recently noted that insufficient effort is being put into intervention research, and that this is limiting our knowledge of which suicide prevention strategies might be the most effective. Aims: To

  14. [An update on the treatment of venous insufficiency in pregnancy].

    Science.gov (United States)

    Rodríguez-Nora, B; Álvarez-Silvares, E

    Chronic venous insufficiency is a long-term pathological condition resulting from anatomical or functional alterations of the venous system. This leads to the appearance of symptoms and physical signs that affect a large part of the population and particularly pregnant women, due to the physiology of pregnancy. The few published studies on the use of pharmacological treatments of venous insufficiency in this group of the population, often makes the management of this condition difficult in routine clinical practice. A review is presented in this article, with all the latest updates in the treatment of this condition during pregnancy. There are numerous general, and some pharmacological, recommendations, that we can safely offer the pregnant patient. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Mechanism of high-temperature background of internal friction in metals

    International Nuclear Information System (INIS)

    Shapoval, B.I.; Arzhavitin, V.M.

    1988-01-01

    Data of theoretical and experimental studies on energy dissipation in vibrating metal at small amplitudes and elevated temperatures (high temperature background of internal friction) are generalized and systematized. Evolution of knowledge of the background as a phenomenon influenced mainly by crystal structure defects - their form, quantity, mobility and interaction is followed. Considered is a wide range of investigated metal states and measurement conditions, and interrelations with other characteristics, for instance, strength ones. On the basis of the data obtained by authors and other investigations a concept of an additional third stage of the background increase with the temperature - the stage of deviation from exponential dependence at premelting point, is introduced. 107 refs.; 32 figs.; 3 tabs

  16. Chemotherapy-Induced Regression of an Adrenocorticotropin-Secreting Pituitary Carcinoma Accompanied by Secondary Adrenal Insufficiency

    Directory of Open Access Journals (Sweden)

    Robert Frank Cornell

    2013-01-01

    Full Text Available Purpose. Adrenocorticotropin- (ACTH- secreting pituitary carcinomas are rare and require multimodality treatment. The aim of this study was to report the response to various therapies and discuss the potential development of secondary adrenal insufficiency with cytotoxic chemotherapy. Methods. This report describes a man with a large silent corticotroph adenoma progressing to endogenous hypercortisolism and metastatic ACTH-secreting pituitary carcinoma over a period of 14 years. Results. Seven years after initial presentation, progressive tumor enlargement associated with the development of hypercortisolism mandated multiple pituitary tumor debulking procedures and radiotherapy. Testing of the Ki-67 proliferation index was markedly high and he developed a hepatic metastasis. Combination therapy with cisplatin and etoposide resulted in a substantial reduction in tumor size, near-complete regression of his liver metastasis, and dramatic decrease in ACTH secretion. This unexpectedly resulted in symptomatic secondary adrenal insufficiency. Conclusions. This is the first reported case of secondary adrenal insufficiency after use of cytotoxic chemotherapy for metastatic ACTH-secreting pituitary carcinoma. High proliferative indices may be predictive of dramatic responses to chemotherapy. Given the potential for such responses, the development of secondary adrenal insufficiency may occur and patients should be monitored accordingly.

  17. Evaluation of the Geographical and Family Background of Student Nurses and Midwives and their Knowledge of Cancer and Nutrition.

    Science.gov (United States)

    Turkistanli, Esin Ceber; Ergun, Fisun Enuzun; Sari, Dilek; Dalli, Dilek; Aydemir, Gulsun

    2002-01-01

    Plant foods are the custodians of numerous dietary constituents, including vitamins, minerals, fibre, and other potentially anticarcinogenic agents. Eating habits are influenced by many biological, social, psychological, and cultural factors. Despite the relative paucity of definite evidence relevant to prevention in cancer and the tools available for early detection of cancer, people should be informed about the protective factors (dietary influence, life-style and exercise) continuously to develop new habits which will protect against cancer. A descriptive study was here designed to examine the effects of geographical and family background on nutrition of nursing students and their knowledge of recommended dietary guidelines for health promotion and cancer prevention. Most of students and their families lived in Aegean and Marmara regions, and in general they regularly consumed vegetables, fruits and cereals. Fresh vegetable and fruit consumption is rather high in Thrace, Aegean, Marmara and Mediterranean regions of Turkey. Students were found to be well informed during courses on dietary guidelines for health promotion and cancer prevention. The greatest promise for cancer prevention rests on our ability to change multiple and often interrelated behaviours that have been shown to increase the risk of cancer.

  18. Nudging toward Inquiry: Awakening and Building upon Prior Knowledge

    Science.gov (United States)

    Fontichiaro, Kristin, Comp.

    2010-01-01

    "Prior knowledge" (sometimes called schema or background knowledge) is information one already knows that helps him/her make sense of new information. New learning builds on existing prior knowledge. In traditional reporting-style research projects, students bypass this crucial step and plow right into answer-finding. It's no wonder that many…

  19. The Proteomic Analysis of Pancreatic Exocrine Insufficiency Protein Marker in Type 2 Diabetes Mellitus Patients

    Science.gov (United States)

    Srihardyastutie, Arie; Soeatmadji, DW; Fatchiyah; Aulanni'am

    2018-01-01

    Type 2 Diabetes Mellitus (T2D) is the vast majority case of diabetes. Patient with T2D is at higher risk for developing acute or chronic pancreatitis. Prolonged hyperglycemia results in damages to tissue, which also causes dysfunctions of some organ systems, including enzyme or hormone secretions. Commonly, dysfunction or insufficiency of pancreatic exocrine is evaluated by increasing activity of serum pancreatic enzyme, such as amylase and lipase. Although incidence of pancreatitis was found in Indonesian T2D, the pathogenic mechanism still unclear. The aim of this study was to characterize the marker protein that indicated the correlation of pancreatic exocrine insufficiency with progression of T2D. Proteomic analysis using LC-MS/MS was used in identification and characterization of protein marker which indicates insufficiency pancreatic exocrine. First step, protein profile was analyzed by SDS-PAGE methods using serum sample of T2D compared with normal or healthy control, as negative control, and pancreatitis patients, as positive control. Protein with 18 kDa was found as a candidate protein marker which indicated the pancreatic exocrine insufficiency in T2D. The further identification of that protein using LC-MS/MS showed 4 peptide fragments. In silico analysis of the peptide fragment indicated the correlation of pancreatic exocrine insufficiency with progression of T2D was METTL10 - methyltransferase like protein-10.

  20. Background factors related to and/or influencing occupation in mentally disordered offenders.

    Science.gov (United States)

    Lindstedt, Helena; Ivarsson, Ann-Britt; Söderlund, Anne

    2006-09-01

    Knowledge of background and occupational related factors of mentally disordered offenders are missing. It is essential to understand these issues when planning discharge from forensic psychiatric hospital care to enable community dwelling. One aim was to investigate mentally disordered offenders' background factors, confidence in and how they value occupations. Another aim was to investigate MDOs background factors' in relation to and the influences on Occupational Performance and Social Participation. Data was collected with an explorative, correlative design after informed consent, from 74 mentally disordered offenders (mean age 34,2) cared for in forensic psychiatric hospitals. Assessments were Allen Cognitive Level Screen, Capability to Perform Daily Occupations, Interview Schedule of Social Interaction, Manchester Short Assessment of Quality of Life, Self-efficacy Scale and Importance scale. Eight background factors were assembled from the individual forensic psychiatric investigation. Most of the investigated background factors relate to and half of them influence occupational performance, particular the cognitive aspect of occupational performance. The influences on occupation originate from adulthood, such as suffering from schizophrenia, psycho/social problems, and having performed violent crimes. These findings indicate that staff in forensic hospital care should initiate rehabilitation with knowledge about MDOs' complex daily occupations. For avoiding information bias, information gathering preceding treatment planning should be performed in collaboration between caring staff and mentally disordered offenders.

  1. Secondary Teachers’ Mathematics-related Beliefs and Knowledge about Mathematical Problem-solving

    Science.gov (United States)

    E Siswono, T. Y.; Kohar, A. W.; Hartono, S.

    2017-02-01

    This study investigates secondary teachers’ belief about the three mathematics-related beliefs, i.e. nature of mathematics, teaching mathematics, learning mathematics, and knowledge about mathematical problem solving. Data were gathered through a set of task-based semi-structured interviews of three selected teachers with different philosophical views of teaching mathematics, i.e. instrumental, platonist, and problem solving. Those teachers were selected from an interview using a belief-related task from purposively selected teachers in Surabaya and Sidoarjo. While the interviews about knowledge examine teachers’ problem solving content and pedagogical knowledge, the interviews about beliefs examine their views on several cases extracted from each of such mathematics-related beliefs. Analysis included the categorization and comparison on each of beliefs and knowledge as well as their interaction. Results indicate that all the teachers did not show a high consistency in responding views of their mathematics-related beliefs, while they showed weaknesses primarily on problem solving content knowledge. Findings also point out that teachers’ beliefs have a strong relationship with teachers’ knowledge about problem solving. In particular, the instrumental teacher’s beliefs were consistent with his insufficient knowledge about problem-solving, while both platonist and problem-solving teacher’s beliefs were consistent with their sufficient knowledge of either content or pedagogical problem solving.

  2. Baseline incidence and severity of renal insufficiency evaluated by estimated glomerular filtration rates in patients scheduled for contrast-enhanced CT

    International Nuclear Information System (INIS)

    Utsunomiya, Daisuke; Yanaga, Yumi; Oda, Seitaro; Namimoto, Tomohiro; Yamashita, Yasuyuki; Awai, Kazuo; Funama, Yoshinori

    2011-01-01

    Background Although pre-existing renal insufficiency (RI) is the most important risk factor for contrast-induced nephropathy (CIN), the background distribution of baseline renal function has not been investigated thoroughly in patients scheduled for contrast-enhanced CT. Purpose To investigate the incidence and severity of baseline RI evaluated by estimated glomerular filtration rates (eGFR) in patients who underwent contrast-enhanced CT at an academic center. Material and Methods A total of 6586 patients (3630 men and 2956 women; mean age 57.0 ± 11.9 years) who underwent contrast-enhanced CT between January and December 2008 were retrospectively studied. Of these, 829 had cardiovascular diseases (CVD), 5116 had oncologic diseases, 178 had diabetes mellitus (DM), and 1572 had chronic liver disease (CLD). The eGFR (mL/min/1.73 m 2 ) was calculated from their serum creatinine level. Mild, moderate-a, moderate-b, and severe RI were recorded at 60 2 at baseline was high in patients with advanced age, CVD and DM and in patients without oncologic disease

  3. Non-genetic health professionals' attitude towards, knowledge of and skills in discussing and ordering genetic testing for hereditary cancer

    NARCIS (Netherlands)

    Douma, Kirsten F. L.; Smets, Ellen M. A.; Allain, Dawn C.

    2016-01-01

    Non-genetic health professionals (NGHPs) have insufficient knowledge of cancer genetics, express educational needs and are unprepared to counsel their patients regarding their genetic test results. So far, it is unclear how NGHPs perceive their own communication skills. This study was undertaken to

  4. Standard precautions and infection control, medical students' knowledge and behavior at a Saudi university: the need for change.

    Science.gov (United States)

    Amin, Tarek Tawfik; Al Noaim, Khalid Ibrahim; Bu Saad, Mohammed Ahmed; Al Malhm, Turki Ahmed; Al Mulhim, Abdullah Abdulaziz; Al Awas, Marwah Abdulaziz

    2013-04-21

    No previous studies have reported the knowledge of Saudi medical students about Standard Precautions (SPs) and infection control. The objectives of this study were to assess medical students' knowledge in clinical years at King Faisal University, Saudi Arabia about SPs' and to explore their attitudes toward the current curricular/training in providing them with effective knowledge and necessary skills with regard to SPs. This cross sectional study targeted students in clinical stage at College of Medicine, King Faisal University, Saudi Arabia. A pre-tested anonymous self administered data collection form was used. Inquires about students' characteristics, general concepts of infection control/SPs, hand hygiene, personal protective equipment, sharp injuries and disposal, and care of health providers were included. The main source of information for each domain was also inquired. The second part dedicated to explore the attitudes toward the curricular and teaching relevant to SPs. A total of 251 students were included. Knowledge scores in all domains were considerably low, 67 (26.7%) students scored ? 24 (out of 41points) which was considered as an acceptable level of knowledge, 22.2% in 4th year, 20.5% in 5th year and 36.8% in 6th year. Sharp injuries, personal protective equipment and health care of the providers showed the least knowledge scores. The main sources of knowledge were self learning, and informal bed side practices The majority of students' believed that the current teaching and training are insufficient in providing them with the necessary knowledge and skills regarding SPs. The overall knowledge scores for SPs were low especially in the domains of hand hygiene, sharp management, and personal protective equipment reflecting insufficient and ineffective instructions received by medical students through the current curriculum posing them vulnerable to health facilities related infections. Proper curricular reform and training are required to protect

  5. Adrenal hypoplasia congenita: a rare cause of primary adrenal insufficiency and hypogonadotropic hypogonadism

    Directory of Open Access Journals (Sweden)

    Marta Loureiro

    2015-09-01

    Full Text Available Primary adrenal insufficiency is defined by the impaired synthesis of adrenocortical hormones due to an intrinsic disease of the adrenal cortex. Determining its etiology is crucial to allow adequate long-term management and genetic counseling. We report the case of a male adolescent that presented in the neonatal period with adrenal crisis and received replacement therapy for primary adrenal insufficiency. During follow-up, adrenal hypoplasia congenita (AHC was suspected given his persistently raised adrenocorticotropic hormone levels, with markedly low 17-OH progesterone and androstenedione levels. DNA sequence analysis revealed a mutation in NR0B1 gene (c.1292delG, confirming the diagnosis. Delayed puberty and persistent low levels of gonadotropins led to testosterone replacement therapy. X-linked AHC is a rare cause of primary adrenal insufficiency and hypogonadotropic hypogonadism, related to mutations in NR0B1 gene. Despite its rarity, AHC should be considered in patients who present with primary adrenal failure, low levels of 17-OH progesterone and hypogonadotropic hypogonadism.

  6. The physical mechanism of successful treatment for cervical insufficiency

    Science.gov (United States)

    Baumer, Alexa; Amechi, Alexis; Codrington, Paige; Leftwich, Megan C.

    2017-11-01

    Cervical insufficiency is a medical condition during pregnancy in which the uterine cervix softens and begins to dilate before reaching full term, usually between 18 and 22 weeks gestation. It is the most common cause of second trimester pregnancy loss. One clinical technique used to treat cervical insufficiency is the cervical cerclage, a procedure to close the cervix with a purse-string stitch. There are conflicting findings on the efficacy of a cerclage, with most studies relying on statistical evidence. The purpose of this investigation is to examine the mechanical limitations of a cervical cerclage by pressurizing a stitched, synthetic cervix until rupture. A synthetic model of the cervix is generated using ultrasound images collected by clinical collaborators and fabricated with silicon to imitate physiological properties. Medical residents from The George Washington University Hospital stitch the synthetic cervixes using clinical techniques. Pressure transducers record the maximum force on the stitch before rupture. The results of this study will provide insight into the most effective clinical interventions and the mechanism of their success.

  7. Insufficient Living

    DEFF Research Database (Denmark)

    Rasmussen, Trine Bernholdt; Zwisler, Ann-Dorthe; Moons, Philip

    2015-01-01

    BACKGROUND:: Infective endocarditis (IE) is a traumatic health event, and recovery is often associated with massive physical deconditioning and reduced quality of life. Patients also report reduced cognitive functioning and are at risk of developing anxiety and depression as well as posttraumatic......." Patients experience an altered life and shocking weakness, and on the road to recovery, support is needed. Research in follow-up care, supporting patients' ability to cope with potential physical and psycho-emotional consequences of IE, is encouraged as a result of these findings....

  8. Knowledge about osteoporosis prevention among women screened by bone densitometry

    Directory of Open Access Journals (Sweden)

    Mariola Janiszewska

    2016-07-01

    Full Text Available Introduction : Osteoporosis is an illness characterized by the handicapped endurance of the bones, causing an increased risk of fracture. Aim of the study was to establish the level of knowledge about osteoporosis prevention among women screened by bone densitometry and to answer the question whether the level of knowledge is dependent on socio-demographic factors. Material and methods: The research was realized by means of a survey method, a poll technique in 2014. The study involved 292 women aged 51-83. The examined women were patients undergoing bone densitometry in the healthcare centres in Lublin. The osteoporosis knowledge test (OKT, revised 2011 by Phyllis Gendler was used as a research tool. Gathered material was subject to descriptive and statistical analysis. Tukey’s test, t-Student test and variance analysis (ANOVA were all applied. A statistical significance level was set at  = 0.05. Results and conclusions : Respondents presented the basic exercise knowledge (M = 9.97 and low knowledge concerning risk factors, screening and treatment of osteoporosis (M = 7.87. The calcium knowledge remained on an average level (M = 14.03. Better educated women, city inhabitants as well as women having very good or good social and welfare conditions showed a significantly higher level of knowledge about osteoporosis prevention. Even women undergoing bone densitometry examination present insufficient knowledge about osteoporosis prevention.

  9. Knowledge, attitude and practice of physiotherapists towards promotion of physically active lifestyles in patient management

    Directory of Open Access Journals (Sweden)

    Aweto Happiness A

    2013-01-01

    Full Text Available Abstract Background Physiotherapists as primary health care practitioners are well placed in promoting physically active lifestyles, but their role and practice towards its promotion among patients in Nigeria has not been fully investigated. This study was therefore aimed at determining the knowledge, attitude and practice of Nigerian physiotherapists towards promotion of non-treatment physical activity among patients. Methods Three hundred and eight practicing physiotherapists from various public and private hospitals in 14 states of Nigeria completed an adopted 20-item questionnaire, which collected information on physical activity promotion in physiotherapy practice. Result Respondents with good knowledge and attitude towards physical activity promotion in patient management were 196(63.6% and 292(94.8% respectively. Only 111 (36% of the respondents counselled more than 10 patients in the past one month on the benefits of adopting a more physically active lifestyle. Chi-square analysis showed a significant association between low practice of physical activity promotion in patient management with inadequate consultation time (ℵ2 = 3.36, p = 0.043, years of working experience of physiotherapists (ℵ2 = 11.37, p =0.023 and relative physical activity levels of physiotherapists (ℵ2 = 11.82, p = 0.037. The need for Physical activity recommendation guideline was supported by 287 (97% respondents. Conclusion Nigerian physiotherapists have good knowledge and attitude towards promotion of physically active lifestyle in their patients but do not counsel many of them, due to insufficient consultation time. Integrating brief counselling into usual treatment sessions is perceived as the most feasible form of physical activity promotion in patient management.

  10. Cervical spondylosis: a rare and curable cause of vertebrobasilar insufficiency.

    Science.gov (United States)

    Denis, Daniel J; Shedid, Daniel; Shehadeh, Mohammad; Weil, Alexander G; Lanthier, Sylvain

    2014-05-01

    Spondylotic vertebral artery (VA) compression is a rare cause of vertebrobasilar insufficiency and stroke. A 53-year-old man experienced multiple brief vertebrobasilar transient ischemic attacks (TIAs) and strokes, not apparently triggered by neck movements. Brain magnetic resonance imaging (MRI) documented consecutive infarcts, first in the left then right medial posterior inferior cerebellar artery (PICA) territories. Angiography showed two extracranial right vertebral artery (VA) stenoses, left VA hypoplasia, absence of left PICA and a dominant right PICA. Computed tomography angiography revealed right VA compression by osteophytes at C5-C6 and C6-C7 levels. No further vertebrobasilar insufficiency symptoms occurred in the 65 months following VA surgical decompression. Our literature review found 49 published surgical cases with vertebrobasilar symptoms caused by cervical spondylosis. Forty cases had one or more brief TIAs frequently triggered by neck movements. Three cases presented with stroke without prior TIA, with symptoms suggesting a top of the basilar artery embolic infarcts (one combined with a PICA infarct). Six cases had both TIAs and minor stroke. VA compression by uncovertebral osteophytes at the C5-C6 level was common. Dynamic angiography done in 38 cases systematically revealed worsening of VA stenosis or complete occlusion with either neck extension or rotation (ipsilateral when specified). Contralateral VA incompetence was found in 14 patients. Spondylotic VA stenosis can cause hemodynamic TIAs and watershed strokes, especially when contralateral VA insufficiency is combined to specific neck movements. Low-amplitude neck movement may suffice in severe cases. Embolic vertebrobasilar events are less frequent. VA decompression from spondylosis may prevent recurrent ischemic episodes.

  11. Knowledge and use of emergency contraception among educated ...

    African Journals Online (AJOL)

    Background: One of the effective ways to reduce unwanted pregnancy and its consequences is the knowledge and effective use of emergency contraception among the population. Aim: To evaluate the knowledge of emergency contraception among educated men and women and how often they use it. Methodology: ...

  12. Predictive factors of endocrine and exocrine insufficiency after resection of a benign tumour of the pancreas.

    Science.gov (United States)

    Neophytou, Hélène; Wangermez, Marc; Gand, Elise; Carretier, Michel; Danion, Jérôme; Richer, Jean-Pierre

    2018-04-01

    The aim of the present study is to evaluate the risk factors of endocrine and exocrine insufficiency occurring few years after pancreatic resections in a consecutive series of patients who underwent pancreatoduodenectomy (PD), left pancreatectomy (LP) or enucleation for benign neoplasms at a referral centre. Pancreatic exocrine insufficiency (PEI) was defined by the onset of steatorrhea associated with weight loss, and endocrine insufficiency was determinate by fasting plasma glucose. Association between pancreatic insufficiency and clinical, pathological, and perioperative features was studied using univariate and multivariate Cox regression analysis. A prospective cohort of 92 patients underwent PD (48%), LP (44%) or enucleation (8%) for benign tumours, from 2005 to 2016 in the University Hospital in Poitiers (France). The median follow-up was 68.6±42.4months. During the following, 54 patients developed exocrine insufficiency whereas 32 patients presented endocrine insufficiency. In the Cox model, a BMI>28kg/m 2 , being a man and presenting a metabolic syndrome were significantly associated with a higher risk to develop postoperative diabetes. The risks factors for the occurrence of PEI were preoperative chronic pancreatitis, a BMIpancreatic head, biological markers of chronic obstruction and fibrotic pancreas. Undergoing LP or enucleation were protective factors of PEI. Histological categories such as neuroendocrine tumours and cystadenomas were also associated with a decreased incidence of PEI. Men with metabolic syndrome and obesity should be closely followed-up for diabetes, and patients with obstructive tumours, pancreatic fibrosis or chronic pancreatitis require a vigilant follow up on their pancreatic exocrine function. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  13. Activity – based costing in sport organizations:Theoretical background & future prospects

    Directory of Open Access Journals (Sweden)

    PANAGIOTIS E. DIMITROPOULOS

    2007-01-01

    Full Text Available Costing systems in recent years have shown a significantdevelopment and activity-based costing (ABC specificallyhas been considered as a major contribution to cost management, particularly in service businesses. The sport sector is composed to a great extent of service functions, yet considerably less have been reported of the use of activity based costing to support cost management in sport organizations. Since the power of information becomes continuously crucial for the implementation of effective business administration, the traditional methods of cost measurementproved insufficient on this issue, leading to the invention ofABC. The aim of this paper is twofold. First of all we wantto present the main theoretical background of ABC and itssubstantiated benefits, and secondly to present some practical steps for the implementation of ABC in sport organizations.

  14. Current Controversies in Diagnosis and Management of Cleft Palate and Velopharyngeal Insufficiency

    Science.gov (United States)

    Ysunza, Pablo Antonio; Repetto, Gabriela M.; Pamplona, Maria Carmen; Calderon, Juan F.; Shaheen, Kenneth; Chaiyasate, Konkgrit; Rontal, Matthew

    2015-01-01

    Background. One of the most controversial topics concerning cleft palate is the diagnosis and treatment of velopharyngeal insufficiency (VPI). Objective. This paper reviews current genetic aspects of cleft palate, imaging diagnosis of VPI, the planning of operations for restoring velopharyngeal function during speech, and strategies for speech pathology treatment of articulation disorders in patients with cleft palate. Materials and Methods. An updated review of the scientific literature concerning genetic aspects of cleft palate was carried out. Current strategies for assessing and treating articulation disorders associated with cleft palate were analyzed. Imaging procedures for assessing velopharyngeal closure during speech were reviewed, including a recent method for performing intraoperative videonasopharyngoscopy. Results. Conclusions from the analysis of genetic aspects of syndromic and nonsyndromic cleft palate and their use in its diagnosis and management are presented. Strategies for classifying and treating articulation disorders in patients with cleft palate are presented. Preliminary results of the use of multiplanar videofluoroscopy as an outpatient procedure and intraoperative endoscopy for the planning of operations which aimed to correct VPI are presented. Conclusion. This paper presents current aspects of the diagnosis and management of patients with cleft palate and VPI including 3 main aspects: genetics and genomics, speech pathology and imaging diagnosis, and surgical management. PMID:26273595

  15. Current Controversies in Diagnosis and Management of Cleft Palate and Velopharyngeal Insufficiency

    Directory of Open Access Journals (Sweden)

    Pablo Antonio Ysunza

    2015-01-01

    Full Text Available Background. One of the most controversial topics concerning cleft palate is the diagnosis and treatment of velopharyngeal insufficiency (VPI. Objective. This paper reviews current genetic aspects of cleft palate, imaging diagnosis of VPI, the planning of operations for restoring velopharyngeal function during speech, and strategies for speech pathology treatment of articulation disorders in patients with cleft palate. Materials and Methods. An updated review of the scientific literature concerning genetic aspects of cleft palate was carried out. Current strategies for assessing and treating articulation disorders associated with cleft palate were analyzed. Imaging procedures for assessing velopharyngeal closure during speech were reviewed, including a recent method for performing intraoperative videonasopharyngoscopy. Results. Conclusions from the analysis of genetic aspects of syndromic and nonsyndromic cleft palate and their use in its diagnosis and management are presented. Strategies for classifying and treating articulation disorders in patients with cleft palate are presented. Preliminary results of the use of multiplanar videofluoroscopy as an outpatient procedure and intraoperative endoscopy for the planning of operations which aimed to correct VPI are presented. Conclusion. This paper presents current aspects of the diagnosis and management of patients with cleft palate and VPI including 3 main aspects: genetics and genomics, speech pathology and imaging diagnosis, and surgical management.

  16. Ideal Timing of Starting Weight-Bearing After Calcaneal Insufficiency Fracture: A Case Report and Review of the Literature

    OpenAIRE

    Imamura; Mochizuki; Kawakami; Momohara

    2016-01-01

    Introduction Criteria for starting weight-bearing on the heel with a symptomatic calcaneal insufficiency fracture have not yet been reported. Case Presentation We describe a rare case of a 52-year-old woman with a calcaneal insufficiency fracture who sustained a second ipsilateral calcaneal insufficiency fracture within a short time span. The initial fracture was not evident radiographically, but was detected using magnetic resona...

  17. Adverse childhood experiences and frequent insufficient sleep in 5 U.S. States, 2009: a retrospective cohort study.

    Science.gov (United States)

    Chapman, Daniel P; Liu, Yong; Presley-Cantrell, Letitia R; Edwards, Valerie J; Wheaton, Anne G; Perry, Geraldine S; Croft, Janet B

    2013-01-03

    Although adverse childhood experiences (ACEs) have previously been demonstrated to be adversely associated with a variety of health outcomes in adulthood, their specific association with sleep among adults has not been examined. To better address this issue, this study examines the relationship between eight self-reported ACEs and frequent insufficient sleep among community-dwelling adults residing in 5 U.S. states in 2009. To assess whether ACEs were associated with frequent insufficient sleep (respondent did not get sufficient rest or sleep ≥ 14 days in past 30 days) in adulthood, we analyzed ACE data collected in the 2009 Behavioral Risk Factor Surveillance System, a random-digit-dialed telephone survey in Arkansas, Louisiana, New Mexico, Tennessee, and Washington. ACEs included physical abuse, sexual abuse, verbal abuse, household mental illness, incarcerated household members, household substance abuse, parental separation/divorce, and witnessing domestic violence before age 18. Smoking status and frequent mental distress (FMD) (≥ 14 days in past 30 days when self-perceived mental health was not good) were assessed as potential mediators in multivariate logistic regression analyses of frequent insufficient sleep by ACEs adjusted for race/ethnicity, gender, education, and body mass index. Overall, 28.8% of 25,810 respondents reported frequent insufficient sleep, 18.8% were current smokers, 10.8% reported frequent mental distress, 59.5% percent reported ≥ 1 ACE, and 8.7% reported ≥ 5 ACEs. Each ACE was associated with frequent insufficient sleep in multivariate analyses. Odds of frequent insufficient sleep were 2.5 (95% CI, 2.1-3.1) times higher in persons with ≥ 5 ACEs compared to those with no ACEs. Most relationships were modestly attenuated by smoking and FMD, but remained significant. Childhood exposures to eight indicators of child maltreatment and household dysfunction were significantly associated with frequent insufficient sleep during

  18. Suicide risk among persons with foreign background in Denmark

    DEFF Research Database (Denmark)

    Sundaram, V; Qin, Ping; Zøllner, L.

    2006-01-01

    There is a dearth of knowledge about factors correlated with suicide risk among minority groups in Western societies. In the present study we compared suicide risk among persons with foreign background with that of the majority population to determine whether certain minority groups...... are at a particular risk for suicide, as well as to illuminate gender differences herein. Suicide risk was generally higher among persons with foreign background compared with the majority population and the risk was highest among Nordic-born persons. Overall, suicide risk was significantly lower among Asian......-born persons; however, there were gender differences in correlations between ethnicity and suicide risk...

  19. Failures of knowledge production in nuclear power risk management

    International Nuclear Information System (INIS)

    Sanne, Johan M.

    2008-09-01

    Risks are ascribed in processes of knowledge production, where risk objects are defined and measures taken. This knowledge is also the basis for regulatory action. Thus, uncertainties in knowledge production, based upon choices of assumptions, methods, calculations and evidence criteria for reliable data create vulnerabilities for risk management and risk regulation. A recent incident in Swedish nuclear power plant provides an opportunity to develop theories of knowledge production in complex organizations. Knowledge modes within nuclear power can be characterized as either calculated logics where evidence claims need numbers, real time logics based upon subtle signals and tacit knowledge or as policy logics, navigating between internal and external demands for safety, trustworthiness and profit. The plant had neither foreseen the triggering event nor designed the plant to withstand it. I analyze how the plant and the regulator have interpreted the event, its significance and the measures taken to prevent similar events. I also discuss alternative interpretations, lack of knowledge and the generic deficiencies in knowledge production that the event indicates. First, the plant was not as robustly designed as expected. Deficiencies in diversification may have been caused by overconfidence in the reliability of its design. Second, inadequate design was ascribed to various deficient knowledge production processes: original design of the plant, reconstruction or caused by inadequate learning from previous events. The failures in knowledge production were probably caused by insufficient integration of different knowledge processes and limitations in engineering analysis. Knowledge about risks from nuclear power operations is mainly based upon calculations and simulations, not upon real events. But knowledge and design could be improved also without accidents. Control room operators and maintenance staff can provide invaluable knowledge and methods; to improve causal

  20. Failures of knowledge production in nuclear power risk management

    Energy Technology Data Exchange (ETDEWEB)

    Sanne, Johan M.

    2008-09-15

    Risks are ascribed in processes of knowledge production, where risk objects are defined and measures taken. This knowledge is also the basis for regulatory action. Thus, uncertainties in knowledge production, based upon choices of assumptions, methods, calculations and evidence criteria for reliable data create vulnerabilities for risk management and risk regulation. A recent incident in Swedish nuclear power plant provides an opportunity to develop theories of knowledge production in complex organizations. Knowledge modes within nuclear power can be characterized as either calculated logics where evidence claims need numbers, real time logics based upon subtle signals and tacit knowledge or as policy logics, navigating between internal and external demands for safety, trustworthiness and profit. The plant had neither foreseen the triggering event nor designed the plant to withstand it. I analyze how the plant and the regulator have interpreted the event, its significance and the measures taken to prevent similar events. I also discuss alternative interpretations, lack of knowledge and the generic deficiencies in knowledge production that the event indicates. First, the plant was not as robustly designed as expected. Deficiencies in diversification may have been caused by overconfidence in the reliability of its design. Second, inadequate design was ascribed to various deficient knowledge production processes: original design of the plant, reconstruction or caused by inadequate learning from previous events. The failures in knowledge production were probably caused by insufficient integration of different knowledge processes and limitations in engineering analysis. Knowledge about risks from nuclear power operations is mainly based upon calculations and simulations, not upon real events. But knowledge and design could be improved also without accidents. Control room operators and maintenance staff can provide invaluable knowledge and methods; to improve causal

  1. Relationship of renal insufficiency and clinical features or comorbidities with clinical outcome in patients hospitalised for acute heart failure syndromes.

    Science.gov (United States)

    Kajimoto, Katsuya; Sato, Naoki; Takano, Teruo

    2017-12-01

    Renal insufficiency is a well-known predictor of adverse events in patients with acute heart failure syndromes (AHFS). However, it remains unclear whether there are subgroups of AHFS patients in whom renal insufficiency is related to a higher risk of adverse events because of the heterogeneity of this patient population. Therefore, we investigated the relationship between renal insufficiency, clinical features or comorbidities, and the risk of adverse events in patients with AHFS. Of 4842 patients enrolled in the Acute Decompensated Heart Failure Syndromes (ATTEND) registry, 4628 patients (95.6%) were evaluated in the present study in order to assess the relationship of renal insufficiency and clinical features or comorbidities with all-cause mortality after admission. Renal insufficiency was defined as an estimated creatinine clearance of ⩽40 mL/min (calculated by the Cockcroft-Gault formula) at admission. The median follow-up period after admission was 524 (391-789) days. The all-cause mortality rate after admission was significantly higher in patients with renal insufficiency (36.7%) than in patients without renal insufficiency (14.4%). Stratified analysis was performed in order to explore the heterogeneity of the influence of renal insufficiency on all-cause mortality. This analysis revealed that an ischaemic aetiology and a history of diabetes, atrial fibrillation, serum sodium, and anaemia at admission had significant influences on the relationship between renal insufficiency and all-cause mortality. The present study demonstrated that the relationship between renal insufficiency and all-cause mortality of AHFS patients varies markedly with clinical features or comorbidities and the mode of presentation due to the heterogeneity of this patient population.

  2. Posaconazole-Induced Adrenal Insufficiency in a Case of Chronic Myelomonocytic Leukemia

    Directory of Open Access Journals (Sweden)

    Ann Miller

    2018-01-01

    Full Text Available Introduction. Posaconazole is an azole used in treatment and prophylaxis of a broad spectrum of fungal infections. Antifungals such as ketoconazole have been shown to cause primary adrenal insufficiency (AI as a result of direct inhibition on the steroidogenesis pathway. There is only one reported case of primary AI induced by posaconazole in a patient with mucormycosis. We report a case of posaconazole-related primary AI. Case. A 63-year-old man with chronic myelomonocytic leukemia was admitted for fatigue and intermittent nausea and vomiting. He had recently discontinued prophylactic posaconazole 300 mg daily. He was assessed for AI with a morning cortisol of 1.9 mcg/dL followed by a failed cosyntropin stimulation (CS test. Adrenocorticotropic hormone (ACTH level was 154.6 pg/mL with negative 21-hydroxylase antibodies. The patient’s symptoms improved with initiation of hydrocortisone and fludrocortisone. One year after discontinuation of posaconazole, he underwent a repeat CS test which showed normal adrenal function with normal ACTH at 34.1 pg/mL. Conclusion. In this case, we demonstrate that prolonged use of posaconazole is associated with primary AI. As use of posaconazole increases, knowledge of the potential risk of AI is important and must be included in the differential diagnosis when these patients present with hypotension, hypoglycemia, and failure to thrive.

  3. Knowledge, attitudes and perceptions of epilepsy among secondary ...

    African Journals Online (AJOL)

    Background: The attitudes toward people with epilepsy are influenced by the degree of knowledge of the condition. The social problems encountered by school children with epilepsy as a result of negative attitude and beliefs are quite enormous. Objectives The study therefore looked at the knowledge, attitudes, and ...

  4. Postoperative pain : Knowledge and beliefs of patients and nurses

    NARCIS (Netherlands)

    van Dijk, Jacqueline Fm; Schuurmans, Marieke J.; Alblas, Eva E.; Kalkman, Cor J.; van Wijck, Albert Jm

    2017-01-01

    Aims and objectives: To describe patients' and nurses' knowledge and beliefs regarding pain management. Moreover, to explore the effect of information and education on patients' and nurses' knowledge and beliefs regarding pain management. Background: In the treatment of postoperative pain, patients'

  5. Benchmarking the Particle Background in the LHC Experiments

    CERN Document Server

    Gschwendtner, E

    2000-01-01

    The experiments for the Large Hadron Collider LHC at CERN have to work for 15 years in the presence of a very high particle background of photons in the energy range from 100\\,keV to 10\\,MeV and neutrons in the range from thermal energies ($\\approx 0.025\\,$eV) to 20\\,MeV. \\\\ The background is so high that it becomes a major design criterion for the ATLAS ex\\-peri\\-ment, a general purpose experiment at LHC that will be operational in the year 2005. The exact level of this background is poorly known. At present an uncertainty factor of five has to be assumed to which the limited knowledge of the shower processes in the absorber material and the ensueing neutron and photon production is estimated to contribute with a factor 2.5. \\\\ So far, the background has been assessed only through extensive Monte Carlo evaluation with the particle transport code FLUKA. The lack of relevant measurements, which were not done up to now, are to a large extent responsible for this uncertainty. Hence it is essential to benchmark t...

  6. A new peroxisomal disorder with fetal and neonatal adrenal insufficiency

    NARCIS (Netherlands)

    Vanhole, C.; de Zegher, F.; Casaer, P.; Devlieger, H.; Wanders, R. J.; Vanhove, G.; Jaeken, J.

    1994-01-01

    A boy with a new type of adrenoleukodystrophy is described. This was characterised by fetal and neonatal adrenal insufficiency, a neurological picture as seen in neonatal adrenoleukodystrophy, but with a normal number of peroxisomes in the liver and a peroxisomal dysfunction limited to the very long

  7. Polymorphisms in Genes Coding for Cytokines, Mannose-Binding Lectin, Collagen Metabolism and Thrombophilia in Women with Cervical Insufficiency

    DEFF Research Database (Denmark)

    Sundtoft, Iben; Uldbjerg, Niels; Steffensen, Rudi

    2015-01-01

    OBJECTIVE: To study the association between cervical insufficiency and single nucleotide polymorphisms in seven genes coding for pro- and anti-inflammatory cytokine-related factors, mannose-binding lectin 2 (MBL2), collagen1α1 (COL1A1), factor II and factor V Leiden genes. METHODS: In a case......-control study, potential maternal biomarkers for cervical insufficiency were investigated in 30 women with a history of second-trimester miscarriage or preterm birth due to cervical insufficiency and in 70 control women. RESULTS: Homozygous carriers of the interleukin 6 (IL6) -174 genotype GG had an odds ratio...... (OR) of 3.1 [95% confidence interval (95% CI) 1.3-7.4, p = 0.01] and MBL2 genotypes coding for low or intermediate levels of plasma MBL had an OR of 3.3 (95% CI 1.2-9.0, p = 0.01) for cervical insufficiency compared with controls. Serum MBL levels were lower in women with cervical insufficiency than...

  8. Effective antihypertensive treatment postpones renal insufficiency in diabetic nephropathy

    DEFF Research Database (Denmark)

    Parving, H H; Smidt, U M; Hommel, E

    1993-01-01

    The effect of long-term, aggressive, antihypertensive treatment on kidney function in diabetic nephropathy was studied prospectively in 11 insulin-dependent diabetic patients (mean age, 30 years). Renal function was assessed every 4 months by measurement of glomerular filtration rate (GFR) (single...... infarction (GFR, 46 mL/min/1.73 m2). Effective antihypertensive treatment postpones renal insufficiency in diabetic nephropathy....

  9. Diagnosis of tricuspid insufficiency by Doppler flowmetry in the inferior vena cava. A comparison with right ventricular angiography

    Energy Technology Data Exchange (ETDEWEB)

    Smith, H.J.

    Eighty-five patients subjected to routine heart catheterization were examined with duplex scanning of the inferior vena cava. Adequate Doppler recordings and a right ventricular angiography were obtained in 79 of them. Tricuspid insufficiency was found to be present in 34 patients at angiography and in 24 at duplex examination. No false positive Doppler diagnoses of tricuspid insufficiency occurred. The possibility of false positive angiographic diagnoses is discussed. A high correlation was found between percentage reversed flow in the inferior vena cava during ventricular systole and degree of angiographic tricuspid insufficiency. It is concluded that duplex scanning of the inferior vena cava seems to be a good alternative to angiography in the diagnosis and quantification of tricuspid insufficiency.

  10. Various musculoskeletal manifestations of chronic renal insufficiency

    International Nuclear Information System (INIS)

    Lim, C.Y.; Ong, K.O.

    2013-01-01

    Musculoskeletal manifestations in chronic renal insufficiency are caused by complex bone metabolism alterations, now described under the umbrella term of chronic kidney disease mineral- and bone-related disorder (CKD-MBD), as well as iatrogenic processes related to renal replacement treatment. Radiological imaging remains the mainstay of disease assessment. This review aims to illustrate the radiological features of CKD-MBD, such as secondary hyperparathyroidism, osteomalacia, adynamic bone disease, soft-tissue calcifications; as well as features associated with renal replacement therapy, such as aluminium toxicity, secondary amyloidosis, destructive spondyloarthropathy, haemodialysis-related erosive arthropathy, tendon rupture, osteonecrosis, and infection

  11. Business Incubators - the savior of startups? : An exploratory study on knowledge acquisition in a business incubator from a startup perspective

    OpenAIRE

    Pettersson, Beatrice; Götsén, Anna

    2016-01-01

    Startups play a vital role in economic development, however, have a high rate of failure, partly due to insufficient knowledge resources. A business incubator is an institution aimed to assist startups with services and resources in order to facilitate their development. There is, however, a gap in previous research regarding knowledge flows and acquisition in business incubators. Furthermore, few scholars have conducted research from the startup perspective in this context. This study, there...

  12. Knowledge of medical ethics among Nigerian medical doctors ...

    African Journals Online (AJOL)

    Background: The knowledge of medical ethics is essential for health care practitioners worldwide. The main objective of this study was to evaluate the knowledge of medical doctors in a tertiary care hospital in Nigeria in the area of medical ethics. Materials and Methods: A cross– sectional questionnaire‑based study ...

  13. Knowledge of appropriate blood product use in perioperative ...

    African Journals Online (AJOL)

    Background: Blood products are an expensive and scarce resource with inherent risks to patients. The current knowledge of rational blood product use among clinicians in South Africa is unknown. Purpose of research: To describe the level of clinicians' knowledge related to all aspects of the ordering and administration of ...

  14. Vitamin D Insufficiency and Cognitive Function Trajectories in Older Adults: The Rancho Bernardo Study.

    Science.gov (United States)

    Laughlin, Gail A; Kritz-Silverstein, Donna; Bergstrom, Jaclyn; Reas, Emilie T; Jassal, Simerjot K; Barrett-Connor, Elizabeth; McEvoy, Linda K

    2017-01-01

    Evidence of a role for vitamin D (VitD) in cognitive aging is mixed and based primarily on extreme VitD deficiency. We evaluated the association of VitD insufficiency with cognitive function in older, community-dwelling adults living in a temperate climate with year-round sunshine. A population-based longitudinal study of 1,058 adults (median age 75; 62% women) who had cognitive function assessed and serum levels of 25-hydroxyvitaminD (25OHD) measured in 1997-99 and were followed for up to three additional cognitive function assessments over a 12-year period. Overall, 14% (n = 145) of participants had VitD insufficiency defined as 25OHD age, sex, education, and season, VitD insufficiency was associated with poorer baseline performance on the Mini-Mental Status Exam (MMSE) (p = 0.013), Trails Making Test B (Trails B) (p = 0.015), Category Fluency (p = 0.006), and Long Term Retrieval (p = 0.019); differences were equivalent to 5 years of age. For those with VitD insufficiency, the odds of mildly impaired performance at baseline were 38% higher for MMSE (p = 0.08), 78% higher for Trails B (p = 0.017), and 2-fold higher for Category Fluency and Long Term Retrieval (both p = 0.001). VitD insufficiency was not related to the rate of cognitive decline on any test or the risk of developing impaired performance during follow-up. In this population with little VitD deficiency, even moderately low VitD was associated with poorer performance on multiple domains of cognitive function. Low VitD did not predict 12-year cognitive decline. Clinical trials are essential to establish a causal link between VitD and cognitive well-being.

  15. Food insufficiency, housing and health-related quality of life: results from the Positive Spaces, Healthy Places study.

    Science.gov (United States)

    Choi, Stephanie K Y; Fielden, Sarah; Globerman, Jason; Koornstra, J J Jay; Hambly, Keith; Walker, Glen; Sobota, Michael; O'Brien-Teengs, Doe; Watson, James; Bekele, Tsegaye; Greene, Saara; Tucker, Ruthann; Hwang, Stephen W; Rourke, Sean B; Healthy Places Team, The Positive Spaces

    2015-01-01

    Studies of people living with HIV who are homeless or unstably housed show a high prevalence of food insufficiency (>50%) and associated poor health outcomes; however, most evidence is in the form of cross-sectional studies. To better understand this issue, we conducted a longitudinal study to examine the impact of food insufficiency and housing instability on overall physical and mental health-related quality of life (HRQoL) among people living with HIV in Ontario. Six hundred and two adults living with HIV were enrolled in the Positive Spaces, Healthy Places study and followed from 2006 to 2009. Interviewer-administered questionnaires were used, and generalized linear mixed-effects models constructed to examine longitudinal associations between food insufficiency, housing instability and physical and mental HRQoL. At baseline, 57% of participants were classified as food insufficient. After adjusting for potential confounders, longitudinal analyses revealed a significant, negative association between food insufficiency and physical and mental HRQoL outcomes, respectively [effect size (ES) with 95% confidence interval (CI): (ES = -2.1, CI = -3.9,-0.3); (ES = -3.5, CI = -6.1,-1.5)]. Furthermore, difficulties meeting housing costs were shown to have additional negative impacts on mental HRQoL. Food insufficiency is highly prevalent among people living with HIV in Ontario, particularly for those with unstable housing. This vulnerable group of individuals is in urgent need of changes to current housing programmes, services and policies, as well as careful consideration of their unmet nutritional needs.

  16. Contraception knowledge and attitudes: truths and myths among African Australian teenage mothers in Greater Melbourne, Australia.

    Science.gov (United States)

    Ngum Chi Watts, Mimmie C; Liamputtong, Pranee; Carolan, Mary

    2014-08-01

    To discuss the contraception knowledge, attitudes and beliefs of African Australian teenagers and women with a refugee background in Melbourne. The numbers of African Australian persons continue to increase, with a significant proportion being refugee women and children. Attitudes and behaviours towards contraception in this group continue to be influenced by culture, family and beliefs. This study is based on qualitative research that was underpinned by intersectionality theory, cultural competency and phenomenology. Sixteen teenagers and women who had experienced teenage pregnancy in Greater Melbourne, Australia, were interviewed. In-depth interviews were conducted with the sixteen African Australian teenagers and women. Following data collection, data were transcribed verbatim, and coded, and key themes identified and analysed using thematic analysis. Knowledge of contraception among this group of migrants was low and filled with myths. Attitudes towards contraception use were insufficient and influenced by beliefs and external factors such as partner, family and community attitudes towards contraception. Migration status and other instabilities in the lives of these participants all intersected to shape their health beliefs and contraception decision-making. Refugee teenage mothers' knowledge of contraception was low and their attitude towards contraceptive use was poor. Myths and external factors continued to influence teenagers' and women's attitudes towards contraceptives. The events and life experiences of African Australian teenagers/women, culture, and family and community influences should be taken into consideration when providing healthcare services and sexual health education to this migrant group. Service providers should consider the multiple intersections in the lives of these women when delivering healthcare services and information to them. © 2013 John Wiley & Sons Ltd.

  17. The role of the anterolateral ligament in ACL insufficient and reconstructed knees on rotary stability

    DEFF Research Database (Denmark)

    Tavlo, Mette; Eljaja, S; Tranum-Jensen, Jørgen

    2016-01-01

    Studies suggest that the anterolateral ligament (ALL) is important for knee stability. The purpose was to clarify ALL's effect on rotatory and anterior-posterior stability in the anterior cruciate ligament (ACL)-insufficient and reconstructed knees and the effect of reconstruction of an insuffici......Studies suggest that the anterolateral ligament (ALL) is important for knee stability. The purpose was to clarify ALL's effect on rotatory and anterior-posterior stability in the anterior cruciate ligament (ACL)-insufficient and reconstructed knees and the effect of reconstruction...... of an insufficient ALL. Eighteen cadaveric knees were included. Stability was tested for intact (+ALL), detached (-ALL) and reconstructed (+ reALL) ALL, with ACL removed (-ACL) and reconstructed (+ACL) in six combinations. All were tested in 0, 30, 60, and 90 °C flexion. Anterior-posterior stability was measured...... with a rolimeter. Rotation with a torque of 8.85 Nm was measured photographically. The ALL was well defined in 78% of knees. ACL reconstruction had a significant effect on anterior-posterior stability. Detaching the ALL had a significant effect on internal rotatory stability and on anterior-posterior stability...

  18. Adrenal insufficiency in critically ill septic patients at Dr George ...

    African Journals Online (AJOL)

    Adele

    eosinophillia and hypoglycemia. Hyponatremia and hyperkalemia are uncommon. There has been much controversy regarding the criteria for the diagnosis of adrenal insufficiency.10,11,12 The diagnosis would be best made using an end-organ marker of adrenal steroid action. No such marker is available at present. Free.

  19. 24 CFR 982.454 - Termination of HAP contract: Insufficient funding.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Termination of HAP contract... Assistance Payments Contract and Owner Responsibility § 982.454 Termination of HAP contract: Insufficient funding. The PHA may terminate the HAP contract if the PHA determines, in accordance with HUD requirements...

  20. A Case of Rathke’s Cleft Cyst Associated with Transient Central Adrenal Insufficiency and Masked Diabetes Insipidus

    Directory of Open Access Journals (Sweden)

    Masahiro Asakawa

    2014-01-01

    Full Text Available A 73-year-old woman admitted to our hospital because of headache, poor appetite, malaise, weight loss, and vomiting was found to have central adrenal insufficiency and thyrotoxicosis due to silent thyroiditis. Polyuria developed after replacement with glucocorticoid (masked diabetes insipidus, which was controlled with nasal administration of desmopressin. Magnetic resonance imaging of the brain showed a large cystic pituitary mass (18 × 18 × 12 mm extending suprasellarly to the optic chiasm. Transsphenoidal surgery revealed that the pituitary tumor was Rathke’s cleft cyst. Following surgery, replacement with neither glucocorticoid nor desmopressin was needed any more. Therefore, it is suggested that Rathke’s cleft cyst is responsible for the masked diabetes insipidus and the central insufficiency. Furthermore, it is speculated that thyrotoxicosis with painless thyroiditis might induce changes from subclinical adrenal insufficiency to transiently overt insufficiency.

  1. Successful pregnancy with donor eggs in-vitro fertilization after premature ovarian insufficiency in a tertiary hospital in a low-income setting: a case report

    Directory of Open Access Journals (Sweden)

    Thomas Obinchemti Egbe

    2016-11-01

    Full Text Available Abstract Background Premature Ovarian Insufficiency (POI is classically defined as 4–6 months of cessation of menses (amenorrhea in women under 40, associated with menopausal level of serum gonadotropins FSH > 40 IU/L and hypo-estrogenism and is also referred to as hypergonadotropic hypogonadism. This disorder can manifest as primary amenorrhea without the onset of menses (menarche, or as secondary amenorrhea after menarche and pubertal development. The diagnosis of this condition in Cameroon is sometimes difficult because of the high cost of hormonal assays and the few laboratories offering these services. Case presentation The patient was a 38-year-old G2P0020, blood group O Rh positive, genotype AA and BMI 19 kg/m2 who came to our service because of secondary amenorrhea and infertility of 2 years’ duration. She has a history of pulmonary tuberculosis that was treated in Cameroon. After laparoscopy and hormonal profile, the diagnosis of premature ovarian insufficiency was reached. The woman underwent a successful donor egg in-vitro fertilization cycle and delivered a female fetus. Two years later YE requested IVF with autologous eggs, which was not possible, and since then she has remained with one child. Conclusion The diagnosis of premature ovarian insufficiency is difficult in Cameroon because of the high cost of laboratory investigations and difficult access to the tests. In-vitro fertilization with donor egg is a better treatment option. Unfortunately, it is not accessible to most Cameroonians because of lack of technical ability and the existence of cultural and financial barriers.

  2. E-mail Writing: Providing Background Information in the Core of Computer Assisted Instruction

    Directory of Open Access Journals (Sweden)

    Behzad NAZARI

    2015-01-01

    Full Text Available The present study highly supported the effective role of providing background information via e-mail by the teacher to write e-mail by the students in learners’ writing ability. A total number of 50 EFL advanced male students aged between 25 and 40 at different branches of Iran Language Institute in Tehran, Tehran. Through the placement test of Oxford English Language Placement Test (OELPT the students' proficiency level seems to be nearly the same. Participants were randomly assign into two groups of experimental and control, each consisting of 25 students. After the administration of the proficiency test, all groups were assigned to write topic 1 as the pre-test. Next, the teacher involved the learners in the new instruction (treatment. During writing topics 2, 3, 4, 5, 6, and 7 experimental group’s background knowledge was activated through e-mail before writing and e-mailing topics while the control group received no background knowledge activation through e-mail. After the treatment was given to the experimental group, the students in both groups were required to write another composition about the last topic, topic 8. Again, in this phase, none of the groups received any background information. The results indicated that providing background information via e-mail by the teacher to write e-mail by the students significantly improved learners’ writing ability.

  3. The Soft Palate Friendly Speech Bulb for Velopharyngeal Insufficiency.

    Science.gov (United States)

    Kahlon, Sukhdeep Singh; Kahlon, Monaliza; Gupta, Shilpa; Dhingra, Parvinder Singh

    2016-09-01

    Velopharyngeal insufficiency is an anatomic defect of the soft palate making palatopharyngeal sphincter incomplete. It is an important concern to address in patients with bilateral cleft lip and palate. Speech aid prosthesis or speech bulbs are best choice in cases where surgically repaired soft palate is too short to contact pharyngeal walls during function but these prosthesis have been associated with inadequate marginal closure, ulcerations and patient discomfort. Here is a case report of untreated bilateral cleft lip and palate associated with palatal insufficiency treated by means of palate friendly innovative speech bulb. This modified speech bulb is a combination of hard acrylic and soft lining material. The hard self-curing acrylic resin covers only the hard palate area and a permanent soft silicone lining material covering the soft palate area. A claw-shaped wire component was extended backwards from acrylic and was embedded in soft silicone to aid in retention and approximation of two materials. The advantage of adding the soft lining material in posterior area helped in covering the adequate superior extension and margins for maximal pharyngeal activity. This also improved the hypernasality, speech, comfort and overall patient acceptance.

  4. Assess the knowledge level of POZ patients on the diagnosis and treatment of type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Małgorzata Żebrowska

    2017-07-01

    Full Text Available Background: Diabetes is considered a civilization disease. It is now one of the major problems of the modern world. More than 123 million people suffer from it. About 3.5% of the general population suffer from this disease every year. This causes a huge health, social and economic problem. The reason for such a high incidence of illness is beyond the aging population, poor lifestyle: diet and low physical activity. Diabetes affects people of all ages. Having a disease means a very serious problem for the patient. It essentially changes its life, requires long-term treatment, proper care and lifestyle changes. Aim: Defining the knowledge level of POZ patients on the diagnosis and treatment of type 2 diabetes. Material and method: The study group consisted of patients reporting to the POZ clinic at the Independent Public Health Care Unit in Bychawa. The research group comprised 36 women and 37 men. The research tool was an author's questionnaire, which included a total of 47 questions, 11 of them metric, and the remaining 36 related to knowledge about diabetes. Questions were closed questions. The results of the study were statistically analyzed. The values of the measured measurable parameters are expressed by means of mean, standard deviation, minimum and maximum values, and non-measurable characteristics by means of numerical and interest. Standard deviation is a popular measure of dispersion reflecting the degree of dispersion of measurements around the arithmetic mean. The correlation between variables was used to correlate Sperman (R rankings. The significance level p <0.05 has been assumed to indicate the existence of statistically significant differences or dependencies. The database and statistical studies were based on Statistica 9.1 computer software. (StatSoft, Poland. Results: The knowledge of patients with type II diabetes mellitus is incomplete and high, and quite often they have knowledge in this field. Most respondents have

  5. First experience using navigation-guided radiofrequency kyphoplasty for sacroplasty in sacral insufficiency fractures

    Energy Technology Data Exchange (ETDEWEB)

    Klingler, J.H.; Kluge, P.; Sircar, R.; Kogias, E.; Scholz, C.; Krueger, M.T.; Scheiwe, C.; Hubbe, U. [Freiburg Univ. Medical Center, Freiburg (Germany). Dept. of Neurosurgery

    2013-08-15

    Purpose: To evaluate the efficacy and safety of navigation-guided radiofrequency kyphoplasty for sacroplasty in patients with sacral insufficiency fractures. Methods: In this single-center retrospective observational study, four consecutive patients with sacral insufficiency fractures were treated with navigation-guided radiofrequency kyphoplasty for sacroplasty between April 2010 and May 2012. Symptom characteristics, pain duration and pain intensity were recorded for each patient. Cement extravasation was evaluated in thin-sliced and triplanar reconstructed CT scans of the sacrum. Results: Four female patients with painful sacral insufficiency fractures and extensive osteopenic areas significantly improved from an average pre-treatment VAS score of 8.3 {+-} 0.5 to 2.3 {+-} 1.0 (p < 0.001) on the first postoperative day and to 1.3 {+-} 1.9 (p < 0.004) at follow-up (mean, 20.1 weeks). Slight cement extravasations were observed without evidence of being symptomatic. No major complications or procedure-related morbidity were noted. Conclusion: From the limited experience in four patients, navigation-guided radiofrequency kyphoplasty appears to be a safe and effective treatment option for sacral insufficiency fractures even though asymptomatic cement extravasation was noted. The use of navigation based on intraoperative 3 D images simplifies the positioning of the navigated bone needles via the long axis approach. The radiofrequency kyphoplasty system provides the possibility to administer a sufficient amount of bone cement with a well-defined viscosity over the entire period of the procedure leading to high security and low cement extravasation. Sacroplasty provides rapid and enduring pain relief and facilitates prompt mobilization. (orig.)

  6. Knowledge Transfer in Family Business Successions

    DEFF Research Database (Denmark)

    Boyd, Britta; Royer, Susanne; Pei, Rong

    Knowledge often is the fundament for strategic competitive advantage. Thus, it is highly relevant to understand better how knowledge is transferred from one generation to the next in family businesses. Building on the contingency model of family business succession (Royer, Simons, Boyd & Rafferty......, 2008) knowledge transfer in different cultures is investigated in this paper. From a resource-oriented perspective two family businesses with a similar industry background from China and Europe are compared regarding education processes and knowledge transfer in the context of family firm succession...... taking into account the respective transaction atmosphere. For the European family business from the Danish-German border region twelve successions were investigated in a former study: Access to experiential knowledge was found to be a driver of competitive advantage with a shift towards the relevance...

  7. MRI of congenital pituitary insufficiency

    International Nuclear Information System (INIS)

    Almeida Magalhaes, Alvaro C. de; Uehara, Karla C.; Iezzi, Denise

    1995-01-01

    We compare 1,5 T magnetic resonance (MR) image findings in 193 patients with congenital pituitary congenital insufficiency. One hundred and thirty nine of the MR studies were obtained in patients who had isolated growth hormone deficiency. Other fifth - four patients had multiple pituitary hormone deficiency. On MR images, normal anterior and posterior lobes of the pituitary glands can be clearly differentiated because the posterior lobe has a characteristic high intensity on TI-weighted images. In fifty-four patients, the high- intensity of the posterior lobe was not seen, but a similar high signal intensity was observed at the proximal stump in fifty-one patients. this high- intensity area is the newly formed ectopic posterior lobe, which also secrets anti-diuretic hormone just as the posterior lobe would. MR imaging can demonstrate the transection of the pituitary stalk and the formation of the ectopic lobe, revealing to be a useful diagnostic tool in the definition of the type of alteration in growth defects of endocrine origin. (author)

  8. 21 CFR 516.36 - Insufficient quantities of MUMS-designated drugs.

    Science.gov (United States)

    2010-04-01

    ... SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS NEW ANIMAL DRUGS FOR MINOR USE AND MINOR SPECIES Designation of a Minor Use or Minor Species New Animal Drug § 516.36 Insufficient quantities of... the 7-year period of exclusive marketing rights. (b) If, within the time that FDA specifies, the...

  9. Midwives' knowledge and use of partographs at Juba Teaching ...

    African Journals Online (AJOL)

    Background: Evidence shows that good knowledge of partographs and proper application of this knowledge results in a remarkable reduction in prolonged and obstructed labour and reduces maternal mortality. Obstructed labour can be prevented by a simple and cost-effective health intervention tool, the partograph.

  10. Treatment of insufficient lactation is often not evidence-based

    DEFF Research Database (Denmark)

    Axelsson, Paul Bryde; Bjerrum, Flemming; Løkkegaard, Ellen Christine Leth

    2014-01-01

    INTRODUCTION: Breast milk has many advantages over formula for infants in developed and developing countries alike. Despite intentions of breastfeeding, some women develop insufficient lactation. Treatment options traditionally include breastfeeding education and pharmacotherapy. MATERIAL AND MET...... be initiated by counselling and education. Only when these treatment options are exhausted should pharmacotherapy with a suitable medication be considered. FUNDING: not relevant. TRIAL REGISTRATION: not relevant....

  11. Knowledge Engineering (Or, Catching Black Cats in Dark Rooms).

    Science.gov (United States)

    Ruyle, Kim E.

    1993-01-01

    Discusses knowledge engineering, its relationship to artificial intelligence, and possible applications to developing expert systems, job aids, and technical training. The educational background of knowledge engineers is considered; the role of subject matter experts is described; and examples of flow charts, lists, and pictorial representations…

  12. Assessment of knowledge of acute kidney injury among non ...

    African Journals Online (AJOL)

    Background: Adequate knowledge of acute kidney injury (AKI) among doctors is essential for its prevention, early diagnosis and management. Assessing knowledge of AKI among doctors is necessary to identify areas of deficiencies and key areas to be emphasized when organizing educational programs aimed at ...

  13. Knowledge, attitudes, and behaviors of dentists regarding child physical abuse in Jeddah, Saudi Arabia.

    Science.gov (United States)

    Mogaddam, Meaad; Kamal, Iman; Merdad, Leena; Alamoudi, Najlaa

    2016-04-01

    A large proportion of child physical abuse cases go undocumented and unreported. Dentists can play an important role in identifying and reporting these cases, but little has been reported about this issue in Saudi Arabia. The aims of the study were to (1) assess dentists' knowledge of child physical abuse, (2) assess dentists' attitudes towards child physical abuse, and (3) assess the behaviors of dentists in identifying and reporting child physical abuse. A cross-sectional survey of pediatric dentists, pediatric dentistry residents, and dental interns practicing at all of the dental schools in Jeddah, Saudi Arabia was conducted using an anonymous, self-administered questionnaire. The participants in current study demonstrated insufficient knowledge of the signs and symptoms of child physical abuse, actions that should be taken in suspected cases, circumstances in which to report such cases, and the legal authorities to which they should be reported. The attitudes of participants towards detecting and reporting cases were generally positive. Only 11% of the participants had suspected a case of child abuse, and only 3% of them reported it. Lack of knowledge about referral procedures and fear of anger from family members were the main causes of underreporting. In conclusion, this study showed that dentists have insufficient knowledge about child physical abuse but positive attitudes towards their role in detecting and reporting it. This topic should be covered and emphasized in dental schools' curricula, and healthcare and academic institutes must have a clear protocol to be followed if a case of abuse is suspected. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  14. Tobacco use, knowledge and attitude among Malaysians age 18 and above.

    Science.gov (United States)

    Lim, K H; Sumarni, M G; Amal, N M; Hanjeet, K; Wan Rozita, W M; Norhamimah, A

    2009-04-01

    This study aims to determine the level of knowledge and to understand their attitude towards smoking and secondly to determine how sociodemographic background, smoking status and knowledge on the health risks of smoking contribute toward the development of such attitude. A total of 10,545 respondents age 18 years and above across Malaysia were interviewed. Results indicated that level of knowledge and attitude varied by gender, education level, smoking status, age, ethnicity and smoker category. Smokers' low education, poor knowledge on the dangers of smoking and being males had more positive or greater impact on their attitudes towards smoking. Formulation and implementation of a holistic programme aimed at increasing knowledge and attitude change that accounts for sociodemographic background of the population is recommended in order to bring down smoking rates and thus reduce smoking related health problems in this country.

  15. 77 FR 21992 - Proposed Renewal of Information Collection: Applicant Background Survey

    Science.gov (United States)

    2012-04-12

    ... customers. By including employees of all backgrounds, all DOI employees gain a measure of knowledge... barriers in our recruitment and selection processes, DOI must track the demographic groups that apply for... need and use of the information: This information is required to obtain the source of recruitment...

  16. Population-based estimates of the prevalence of FMR1 expansion mutations in women with early menopause and primary ovarian insufficiency.

    Science.gov (United States)

    Murray, Anna; Schoemaker, Minouk J; Bennett, Claire E; Ennis, Sarah; Macpherson, James N; Jones, Michael; Morris, Danielle H; Orr, Nick; Ashworth, Alan; Jacobs, Patricia A; Swerdlow, Anthony J

    2014-01-01

    Primary ovarian insufficiency before the age of 40 years affects 1% of the female population and is characterized by permanent cessation of menstruation. Genetic causes include FMR1 expansion mutations. Previous studies have estimated mutation prevalence in clinical referrals for primary ovarian insufficiency, but these are likely to be biased as compared with cases in the general population. The prevalence of FMR1 expansion mutations in early menopause (between the ages of 40 and 45 years) has not been published. We studied FMR1 CGG repeat number in more than 2,000 women from the Breakthrough Generations Study who underwent menopause before the age of 46 years. We determined the prevalence of premutation (55-200 CGG repeats) and intermediate (45-54 CGG repeats) alleles in women with primary ovarian insufficiency (n = 254) and early menopause (n = 1,881). The prevalence of the premutation was 2.0% in primary ovarian insufficiency, 0.7% in early menopause, and 0.4% in controls, corresponding to odds ratios of 5.4 (95% confidence interval = 1.7-17.4; P = 0.004) for primary ovarian insufficiency and 2.0 (95% confidence interval = 0.8-5.1; P = 0.12) for early menopause. Combining primary ovarian insufficiency and early menopause gave an odds ratio of 2.4 (95% confidence interval = 1.02-5.8; P = 0.04). Intermediate alleles were not significant risk factors for either early menopause or primary ovarian insufficiency. FMR1 premutations are not as prevalent in women with ovarian insufficiency as previous estimates have suggested, but they still represent a substantial cause of primary ovarian insufficiency and early menopause.

  17. Background to the workshop: purpose and objectives

    International Nuclear Information System (INIS)

    Griffiths, J.S.

    2000-01-01

    In its report on future regulatory challenges, CNRA identified the human element as one of the most critical aspects of maintaining regulatory effectiveness, efficiency and quality of work. There is a need to preserve among the staff a collective knowledge in all relevant technical disciplines with sufficient depth to permit adequate independent assessment of safety issues. Quality organisations require well educated well trained and well motivated staff. In some countries national R and D programmes are being replaced to such a point that forming an independent regulatory position might be in jeopardy. If a significant problem occurred over the next ten years there might not be sufficient knowledge and capability to deal with it in a timely manner if the current trend continues. It is against this background that CNRA recommended this workshop should be organised to consider these human issues in relation to maintaining corporate knowledge, both within the industry and regulatory bodies. This is a complex issue as there are different circumstances in each country arising from the status of the industry and its economic and political interactions. A simple model for considering these interactions is set out in Figure 1. (author)

  18. Quality of life and cognitive function in patients with pituitary insufficiency

    NARCIS (Netherlands)

    Burman, P.; Deijen, J.B.

    1998-01-01

    This review is concerned with the psychosocial functioning and the quality of life in patients with pituitary insufficiency who are receiving conventional hormone replacement therapy. The possible negative effects of pituitary surgery, treatment with irradiation, and suboptimal replacement regimens

  19. Demographic attributes and knowledge acquisition among graduate-entry medical students.

    Science.gov (United States)

    Finucane, Paul; Flannery, Denise; McGrath, Deirdre; Saunders, Jean

    2013-01-01

    Recent changes to undergraduate (basic) medical education in Ireland have linked an expansion of student numbers with wide-ranging reforms. Medical schools have broadened access by admitting more mature students from diverse backgrounds and have increased their international student numbers. This has resulted in major changes to the demographic profile of students at Irish medical schools. To determine whether the demographic characteristics of students impact on their academic performance and specifically on their rate of knowledge acquisition. As a formative assessment exercise, we administered a progress test to all students twice each year during a 4 year graduate-entry medical programme. We compared scores over time between students from different age cohorts, of different gender, of different nationalities and from different academic backgrounds. In the 1143 tests taken by 285 students to date, there were no significant differences in the rate of knowledge acquisition between the various groups. Early in the course, students from a non-biological science background performed less well than others but outperformed their peers by the time of graduation. Neither age, gender, nationality nor academic background impacts on the rate of knowledge acquisition among graduate-entry medical students.

  20. Telomere Elongation and Naive Pluripotent Stem Cells Achieved from Telomerase Haplo-Insufficient Cells by Somatic Cell Nuclear Transfer

    Directory of Open Access Journals (Sweden)

    Li-Ying Sung

    2014-12-01

    Full Text Available Summary: Haplo-insufficiency of telomerase genes in humans leads to telomere syndromes such as dyskeratosis congenital and idiopathic pulmonary fibrosis. Generation of pluripotent stem cells from telomerase haplo-insufficient donor cells would provide unique opportunities toward the realization of patient-specific stem cell therapies. Recently, pluripotent human embryonic stem cells (ntESCs have been efficiently achieved by somatic cell nuclear transfer (SCNT. We tested the hypothesis that SCNT could effectively elongate shortening telomeres of telomerase haplo-insufficient cells in the ntESCs with relevant mouse models. Indeed, telomeres of telomerase haplo-insufficient (Terc+/− mouse cells are elongated in ntESCs. Moreover, ntESCs derived from Terc+/− cells exhibit naive pluripotency as evidenced by generation of Terc+/− ntESC clone pups by tetraploid embryo complementation, the most stringent test of naive pluripotency. These data suggest that SCNT could offer a powerful tool to reprogram telomeres and to discover the factors for robust restoration of telomeres and pluripotency of telomerase haplo-insufficient somatic cells. : Sung et al. demonstrate in a mouse model that telomeres of telomerase haplo-insufficient cells can be elongated by somatic cell nuclear transfer. Moreover, ntESCs derived from Terc+/− cells exhibit pluripotency evidenced by generation of Terc+/−ntESC clone pups by tetraploid embryo complementation, the most stringent test of naive pluripotency.

  1. Organizing for External Knowledge Sourcing

    DEFF Research Database (Denmark)

    Rabbiosi, Larissa; Reichstein, Toke

    2011-01-01

    The aim of this article is to provide an introduction to the special issue. We briefly consider the external knowledge sourcing and organizing for innovation literatures, which offer a background for the special issue, and we highlight their mutual dialogue. We then illustrate the main findings o...

  2. Distortions in the Rayleigh-Jeans region of the cosmic background radiation spectrum

    International Nuclear Information System (INIS)

    De Zotti, G.

    1982-01-01

    The theory of the origin and evolution of distortions in the Rayleigh-Jeans region of the cosmic background radiation spectrum is reviewed. Some proposed experiments, designed to substantially improve our knowledge of that portion of the spectrum, are briefly described. (author)

  3. Duration of adrenal insufficiency during treatment for childhood acute lymphoblastic leukemia

    DEFF Research Database (Denmark)

    Vestergaard, Therese Risom; Juul, Anders; Lausten-Thomsen, Ulrik

    2011-01-01

    Children with acute lymphoblastic leukemia (ALL) recive high doses of glucocorticosteroid as part of their treatment. This may lead to suppression of the hypothalamic-pituitary-adrenal axis, acute adrenal insufficiency, and ultimately to life-threatening conditions. This study explores the adrena...

  4. HIV knowledge and sexual risk behavior among street adolescents ...

    African Journals Online (AJOL)

    HIV knowledge and sexual risk behavior among street adolescents in rehabilitation centres in Kinshasa; DRC: gender differences. ... Background: Street children, common in Africa, are increasingly vulnerable to alcohol and drugs of abuse and lack access to both healthcare and knowledge about HIV and AIDS. Hence, this ...

  5. Prevalence and distribution of oral health knowledge according to ...

    African Journals Online (AJOL)

    Background: Having knowledge about health issues is necessary for making informed decisions related to practicing lifestyles conducive to good health. The aim of this study was to identify socio-demographic, behavioural and clinical covariates of knowledge related to the cause and prevention of oral diseases among ...

  6. Studying Computer Science in a Multidisciplinary Degree Programme: Freshman Students' Orientation, Knowledge, and Background

    Science.gov (United States)

    Kautz, Karlheinz; Kofoed, Uffe

    2004-01-01

    Teachers at universities are facing an increasing disparity in students' prior IT knowledge and, at the same time, experience a growing disengagement of the students with regard to involvement in study activities. As computer science teachers in a joint programme in computer science and business administration, we made a number of similar…

  7. Tricuspid insufficiency detected by equilibrium gated radionuclide study

    International Nuclear Information System (INIS)

    Handler, B.; Pavel, D.G.; Lam, W.; Byrom, E.; Swiryn, S.; Pietras, R.; Rosen, K.M.

    1981-01-01

    The results of a gated radionuclide cardiac study are reported in a patient with biventricular failure and tricuspid insufficiency demonstrated by clinical evaluation, M-mode and 2-D sector echocardiography, and cardia catheterization. The processed gated radionuclide cardiac study showed a left ventricular/right ventricular stroke volume ratio of 0.5; expansion of the hepatic blood pool demonstrated by hepatic time activity curve and calculation of an '''expansion fraction''; and synchronous changes of count rate of the atrial and hepatic regions detected by phase analysis

  8. Knowledge at the Core: Don Hirsch, Core Knowledge, and the Future of the Common Core

    Science.gov (United States)

    Finn, Chester E., Jr., Ed.; Petrilli, Michael J., Ed.

    2014-01-01

    Children cannot be truly literate without knowing about history, science, art, music, literature, civics, geography, and more. Indeed, they cannot satisfactorily comprehend what they read unless they possess the background knowledge that makes such comprehension possible. Yet most American primary schools have been marching in the opposite…

  9. Impact of information technology on the role of medical libraries in information managment: normative background

    Directory of Open Access Journals (Sweden)

    Anamarija Rožić-Hristovski

    1998-01-01

    Full Text Available Exponential growth of biomedical knowledge and information technology development is changing the infrastructure of health care systems, education and research. So medical libraries roles have shifted from managing containers of information toward influencing biomedical information resource content and education. These new tasks are formalised in modem American standards for medical libraries, stressing information management role in evolving environment.In Slovenia medical libraries also are aware of development imperative of information activities for advances in medicine. At one side they are faced with lack of specific guidelines for proactive action and on the other with inadequate assessment in legal documents and insufficient funding.

  10. The efficacy of supplemental intraosseous anesthesia after insufficient mandibular block

    Directory of Open Access Journals (Sweden)

    Samir Prohić

    2005-02-01

    Full Text Available It is a well-known scientific fact that only a small percentage of infiltration of inferior alveolar nerve is clinically proven to be efficient. The objective of this study was to determine the anesthetic efficacy of supplemental intraosseous injection, used after the insufficient classical mandibular block that didn't provide deep pulp anesthesia of mandibular molar planed for extraction. The experimental teeth consisted of 98 mandibular molars with clinical indication for extraction. Based on the history of disease, we indicated the extraction of the tooth. After that each tooth was tested with a electric pulp tester P1. We tested the pulp vitality and precisely determined the level of vitality. After that, each patient received classical mandibular block, and the pulp vitality was tested again. If the pulp tester indicated negative vitality for the certain mandibular molar, and the patient didn't complain about pain or discomfort during the extraction, the molar was extracted and the result was added to anesthetic success rate for the classical mandibular block. If, five minutes after receiving the mandibular block, the pulp tester indicated positive vitality (parameters of vitality or the patient complained about pain or discomfort (parameters of pain and discomfort, we used the Stabident intraosseous anesthesia system. Three minutes after the application of supplemental intraosseous injection the molar was tested with the pulp tester again. The anesthetic solution used in both anesthetic techniques is lidocaine with 1:100.000 epinephrine. The results of this study indicate that the anesthetic efficacy of the mandibular block is 74.5%, and that supplemental intraosseous anesthesia, applied after the insufficient mandibular block, provides pulpal anesthesia in 94.9% of mandibular molars. The difference between anesthetic efficacy of the classical mandibular block and anesthetic efficacy of the supplemental intraosseous anesthesia, applied

  11. The efficacy of supplemental intraosseous anesthesia after insufficient mandibular block.

    Science.gov (United States)

    Prohić, Samir; Sulejmanagić, Halid; Secić, Sadeta

    2005-02-01

    It is a well-known scientific fact that only a small percentage of infiltration of inferior alveolar nerve is clinically proven to be efficient. The objective of this study was to determine the anesthetic efficacy of supplemental intraosseous injection, used after the insufficient classical mandibular block that didn't provide deep pulp anesthesia of mandibular molar planed for extraction. The experimental teeth consisted of 98 mandibular molars with clinical indication for extraction. Based on the history of disease, we indicated the extraction of the tooth. After that each tooth was tested with a electric pulp tester P1. We tested the pulp vitality and precisely determined the level of vitality. After that, each patient received classical mandibular block, and the pulp vitality was tested again. If the pulp tester indicated negative vitality for the certain mandibular molar, and the patient didn't complain about pain or discomfort during the extraction, the molar was extracted and the result was added to anesthetic success rate for the classical mandibular block. If, five minutes after receiving the mandibular block, the pulp tester indicated positive vitality (parameters of vitality) or the patient complained about pain or discomfort (parameters of pain and discomfort), we used the Stabident intraosseous anesthesia system. Three minutes after the application of supplemental intraosseous injection the molar was tested with the pulp tester again. The anesthetic solution used in both anesthetic techniques is lidocaine with 1:100.000 epinephrine. The results of this study indicate that the anesthetic efficacy of the mandibular block is 74.5%, and that supplemental intraosseous anesthesia, applied after the insufficient mandibular block, provides pulpal anesthesia in 94.9% of mandibular molars. The difference between anesthetic efficacy of the classical mandibular block and anesthetic efficacy of the supplemental intraosseous anesthesia, applied after the

  12. Extension of the Calvert formula to patients with severe renal insufficiency.

    Science.gov (United States)

    Oguri, Tomoyo; Shimokata, Tomoya; Ito, Isao; Yasuda, Yoshinari; Sassa, Naoto; Nishiyama, Masami; Hamada, Akinobu; Hasegawa, Yoshinori; Ando, Yuichi

    2015-07-01

    The Calvert formula was derived from the study among patients with glomerular filtration rates (GFRs) of 33-135 ml/min, and it remains unclear whether the formula can be used to calculate optimal and safe dosages of carboplatin in patients with severe renal insufficiency. We evaluated the utility of this formula in patients with severe renal insufficiency. For pharmacokinetic analysis, we studied nine adult Japanese patients with advanced cancer who had an estimated GFR of lower than 30 ml/min/1.73 m(2), as calculated by the Japanese equation for estimating GFR, or who were receiving hemodialysis. The dose of carboplatin was calculated with the Calvert formula, in which GFR was measured by inulin clearance or was assumed to be 0 in patients requiring hemodialysis. Hemodialysis was started 23 h after the end of carboplatin infusion. Although there was a significant correlation between the estimated and measured carboplatin clearance, the estimated clearance was consistently higher than the measured clearance [mean prediction error ± standard deviation = 41.0 ± 26.3 %] in all seven patients with renal insufficiency (GFR, median 21.4, range 7.8-31.4 ml/min) and in the two hemodialysis patients. Actual areas under the concentration-time curve (AUC) (mg/ml min) were 5.4, 5.7, 6.2, and 9.0 for the four patients with a target AUC (mg/ml min) of 5; 5.7, 6.2, and 7.1 for the three patients with a target AUC (mg/ml min) of 4; and 5.1 and 8.7 for the two hemodialysis patients with a target AUC (mg/ml min) of 5. The measured clearance of carboplatin ranged from 23.0 to 51.3 ml/min in the seven patients not receiving hemodialysis. The pre-hemodialysis carboplatin clearance in the hemodialysis patients was 20.5 and 11.1 ml/min, respectively. For adult patients with severe renal insufficiency, the Calvert formula causes carboplatin overdosing by overestimating the carboplatin clearance.

  13. Community nephrology: audit of screening for renal insufficiency in a high risk population.

    Science.gov (United States)

    Kissmeyer, L; Kong, C; Cohen, J; Unwin, R J; Woolfson, R G; Neild, G H

    1999-09-01

    The rate of acceptance onto dialysis programmes has doubled in the past 10 years and is steadily increasing. Early detection and treatment of renal failure slows the rate of progression. Is it feasible to screen for patients who are at increased risk of developing renal failure? We have audited primary care records of patients aged 50-75 years who have either hypertension or diabetes, and are therefore considered to be at high risk of developing renal insufficiency. Our aim was to see whether patients had had their blood pressure measured and urine tested for protein within 12 months, and plasma creatinine measured within 24 months. This was a retrospective study of case notes and computer records in 12 general practices from inner and greater London. A total of 16,855 patients were aged 50-75 years. From this age group, 2693 (15.5%) patients were identified as being either hypertensive or diabetic, or both. Of the 2561 records audited, 1359 (53.1%) contained a plasma creatinine measured within 24 months, and 11% of these (150) had a value > 125 micromol/l. This equates to a prevalence of renal insufficiency of > 110,000 patients per million in this group. Forty two patients (28%) had been referred to a nephrologist. Of records audited, 73% contained a blood pressure measurement and 29% contained a test for proteinuria within 12 months. There is a high prevalence of chronic renal insufficiency in hypertensive and diabetic patients. It is feasible to detect renal insufficiency at a primary care level, but an effective system will require computerized databases that code for age, ethnicity, measurement of blood pressure and renal function, as well as diagnoses.

  14. Elevated hair cortisol concentrations in children with adrenal insufficiency on hydrocortisone replacement therapy.

    Science.gov (United States)

    Noppe, G; van Rossum, E F C; Vliegenthart, J; Koper, J W; van den Akker, E L T

    2014-12-01

    Glucocorticoid replacement therapy in patients with adrenal insufficiency needs to be tailored to the individual patient based on body composition and clinical signs and symptoms as no objective method for assessment of treatment adequacy is available. Current treatment regimens are often not satisfactory, which is shown by the adverse metabolic profile and doubled mortality rates in treated adrenal insufficiency patients. Measurement of cortisol concentrations in hair reflect the long-term systemic cortisol exposure and may be of use in refinement of hydrocortisone treatment. We aimed to study whether long-term cortisol (hydrocortisone) levels, as measured in scalp hair, are similar in children with adrenal insufficiency and healthy children. We set up a case control study, measuring anthropometric characteristics and hair cortisol concentrations (HCC) in 54 hydrocortisone substituted children with adrenal insufficiency (AI patients) in the age of 4-18 years and 54 healthy children matched for gender and age. Mean HCC were significantly higher in AI patients compared with healthy controls (mean 13·3 vs 8·2 pg/mg, P = 0·02). AI patients also had a higher BMI (P < 0·001) and waist circumference (WC) (P = 0·02). HCC was significantly associated with BMI (P = 0·002) and WC (P = 0·002). HCC explained 13% of the difference in BMI and 29% of the difference in WC between AI patients and controls. Hydrocortisone-treated AI patients have increased HCC and adverse anthropometric characteristics compared with healthy controls. HCC measurement may be of value in identifying overtreatment and thereby improve hydrocortisone replacement therapy. © 2014 John Wiley & Sons Ltd.

  15. Environmental literacy based on educational background

    Science.gov (United States)

    Agfar, A.; Munandar, A.; Surakusumah, W.

    2018-05-01

    This research aims to examine attitude, knowledge and cognitive skill. To collect data we used survey method, was conducted in Pahawang, Lampung. Respondents of this research are coastal society of Pahawang, 114 participants determined using purposive sampling, from two areas in the village, Pahawang and Penggetahan. Data were analyzed using both quantitative and descriptive. Environmental literacy of the society which is primary school graduate is moderate category (85.61), consist of 38.90% in low category and 61.10% in moderate category. Environmental literacy of junior high school graduate is moderate (99.36), consist of 12% in low category, 76% in moderate category and 12% in high category. Environmental literacy of senior high school graduate is moderate (108.85), consist of 84.90% moderate category and 15.10% in high category. But, undergraduate society is high category (118.53). Details 0% low category 52.94% moderate category and 47.06% in high category. This finding research has revelaed that the educational background affects the level of environmental literacy. This finding research has revealed that the educational background affects the level of environmental literacy.

  16. Why do patients with severe arterial insufficiency get pain during sleep?

    DEFF Research Database (Denmark)

    Jelnes, Rolf; Bülow, J; Tønnesen, K H

    1987-01-01

    Simultaneous measurement during 24 h of mean arterial blood pressure (MABP) and forefoot subcutaneous adipose tissue blood flow (SBF) was undertaken in eight patients (15 feet) with different degrees of arterial insufficiency. The recordings were undertaken with the patients in the supine position...

  17. Diuretics, calciuria and secondary hyperparathyroidism in the Chronic Renal Insufficiency Cohort

    Science.gov (United States)

    Isakova, Tamara; Anderson, Cheryl A. M.; Leonard, Mary B.; Xie, Dawei; Gutiérrez, Orlando M.; Rosen, Leigh K.; Theurer, Jacquie; Bellovich, Keith; Steigerwalt, Susan P.; Tang, Ignatius; Anderson, Amanda Hyre; Townsend, Raymond R.; He, Jiang; Feldman, Harold I.; Wolf, Myles

    2011-01-01

    Background. Secondary hyperparathyroidism is a common complication of chronic kidney disease (CKD) that is associated with bone disease, cardiovascular disease and death. Pathophysiological factors that maintain secondary hyperparathyroidism in advanced CKD are well-known, but early mechanisms of the disease that can be targeted for its primary prevention are poorly understood. Diuretics are widely used to control volume status and blood pressure in CKD patients but are also known to have important effects on renal calcium handling, which we hypothesized could alter the risk of secondary hyperparathyroidism. Methods. We examined the relationship of diuretic treatment with urinary calcium excretion, parathyroid hormone (PTH) levels and prevalence of secondary hyperparathyroidism (PTH ≥ 65 pg/mL) in a cross-sectional study of 3616 CKD patients in the Chronic Renal Insufficiency Cohort. Results. Compared with no diuretics, treatment with loop diuretics was independently associated with higher adjusted urinary calcium (55.0 versus 39.6 mg/day; P secondary hyperparathyroidism (odds ratio 2.1; 95% CI 1.7–2.6). Thiazide monotherapy was associated with lower calciuria (25.5 versus 39.6 mg/day; P hyperparathyroidism (odds ratio 1.3 versus 2.1; P for interaction = 0.05) compared with loop diuretics alone. Conclusions. Loop diuretic use was associated with greater calciuria, PTH levels and odds of secondary hyperparathyroidism compared to no treatment. These associations were attenuated in patients who were coadministered thiazides. Diuretic choice is a potentially modifiable determinant of secondary hyperparathyroidism in CKD. PMID:21382989

  18. Autoimmune hyperthyroidism due to secondary adrenal insufficiency: resolution with glucocorticoids.

    Science.gov (United States)

    Skamagas, Maria; Geer, Eliza B

    2011-01-01

    To describe the course of autoimmune hyperthyroid disease in a patient with corticotropin (ACTH) deficiency treated with glucocorticoids. We report the clinical presentation, laboratory data, imaging studies, and management of a patient with weight loss, fatigue, apathy, hallucinations, and arthritis. Autoimmune hyperthyroidism (positive thyroperoxidase and thyroglobulin antibodies and borderline positive thyrotropin receptor antibody) was diagnosed in a 71-year-old woman. New psychotic symptoms prompted brain magnetic resonance imaging, which revealed a partially empty sella. Undetectable morning cortisol, undetectable ACTH, and failure to stimulate cortisol with synthetic ACTH (cosyntropin 250 mcg) secured the diagnosis of long-standing secondary adrenal insufficiency. Hydrocortisone replacement improved the patient's symptoms, resolved the thyroid disease, and decreased thyroid antibody titers. In retrospect, the patient recalled severe postpartum hemorrhage requiring blood transfusion at age 38 years. A Sheehan event probably occurred 33 years before the patient presented with corticotropin deficiency. Hyperthyroidism accelerated cortisol metabolism and provoked symptoms of adrenal insufficiency. The hypocortisolemic state may precipitate hyperimmunity and autoimmune thyroid disease. Rapid resolution of hyperthyroidism and decreased thyroid antibody titers with glucocorticoid treatment support this hypothesis.

  19. Knowledge And Intake of Fruit And Vegetables Consumption Among ...

    African Journals Online (AJOL)

    Background: Fruit and vegetable consumption is an essential source of vital nutrients for the body's micronutrient requirements. However, the knowledge and intake of this essential aspect of nutrition is globally poor. This study therefore aimed at assessing the knowledge and intake of vegetables and fruits among adults in ...

  20. Intracultural variation of knowledge about wild plant uses in the Biosphere Reserve Grosses Walsertal (Austria

    Directory of Open Access Journals (Sweden)

    Schunko Christoph

    2012-07-01

    Full Text Available Abstract Background Leading scholars in ethnobiology and ethnomedicine continuously stress the need for moving beyond the bare description of local knowledge and to additionally analyse and theorise about the characteristics and dynamics of human interactions with plants and related local knowledge. Analyses of the variation of local knowledge are thereby perceived as minimal standard. In this study we investigate the distribution and variation of wild plant knowledge in five domains: food, drinks, human medicine, veterinary medicine and customs. We assess relations between the wild plant knowledge of informants and their socio-demographic as well as geographic background. Method Research was conducted in the Biosphere Reserve Grosses Walsertal, Austria. Structured questionnaires were used to inquire wild plant knowledge from 433 informants with varying socio-demographic and geographic background. Children assisted in the data collection. Data was analysed using descriptive statistics and generalized linear models. Results and discussion A majority of respondents is familiar with wild plant uses, however to varying degrees. Knowledge variations depend on the socio-demographic and geographic background of the informants as well as on the domains of knowledge under investigation: women, older informants and homegardeners report more human medicinal applications and applications in drinks than men, younger informants and non-homegardeners; farmers know a greater variety of veterinary medicinal applications than non-farmers; the place of residence relates significantly to food and veterinary uses. Customs are difficult to investigate in standardized matrices. The household-related distribution of work and the general socio-cultural context are especially helpful in order to explain intracultural variation of knowledge in the Grosses Walsertal. Conclusions Research on the intracultural variation of local knowledge exposes cultural characteristics and

  1. Radiation protection for surgeons and anesthetists: practices and knowledge before and after training.

    Science.gov (United States)

    Brun, A; Mor, R Alcaraz; Bourrelly, M; Dalivoust, G; Gazazian, G; Boufercha, R; Lehucher-Michel, M P; Sari-Minodier, I

    2018-03-01

    The use of radiological activity in the operating room (OR) and a regulatory decrease of the eye lens dose warrant an assessment of how medical staff are protected from radiation. This study aims to evaluate practices and knowledge in radiation protection (RP) for OR doctors before and after training. A descriptive study of surgeons and anesthetists in a French public hospital center was conducted in 2016. An ad hoc questionnaire concerning occupational practices and knowledge about RP was distributed before and one month after RP training. Among 103 doctors attending the training, 90 answered the questionnaire before the training. Results showed a lack of knowledge and good practice in RP. Most of the participants (86.7%) had never been trained in RP and recognized insufficient knowledge. Most of them (92.2%) wore a lead apron, 50.0% a thyroid-shield, 5.6% lead glasses, 53.3% a passive dosimeter and 17.8% an electronic dosimeter. None of them benefitted from collective protective equipment such as a ceiling suspended screen. The questionnaire following the training was completed by only 35 doctors. A comparison before and after training results showed an improvement in knowledge (scores of correct responses: 5.5/16 before and 9.5/16 after training) but not in RP good practices (scores of correct responses: 3.2/7 before and 3.3/7 after training). One training session appears to be insufficient to improve the application of the safety rules when x-rays are used. Communication needs to be improved regarding RP among anesthetists and surgeons, such as training renewal, workstation analysis in OR related to x-ray use and occupational medical follow-up. Otherwise, radiological risks in OR need to be given better consideration, such as radio-induced cataract risk. It is necessary to encourage the use of dosimeters and protective equipment and to strengthen access to lead glasses and collective protective equipment, such as ceiling suspended screens. All these

  2. Two-stage triolein breath test differentiates pancreatic insufficiency from other causes of malabsorption

    International Nuclear Information System (INIS)

    Goff, J.S.

    1982-01-01

    In 24 patients with malabsorption, [ 14 C]triolein breath tests were conducted before and together with the administration of pancreatic enzymes (Pancrease, Johnson and Johnson, Skillman, N.J.). Eleven patients with pancreatic insufficiency had a significant rise in peak percent dose per hour 14 CO 2 excretion after Pancrease, whereas 13 patients with other causes of malabsorption had no increase in 14 CO 2 excretion (2.61 +/- 0.96 vs. 0.15 +/- 0.45, p less than 0.001). The two-stage [ 14 C]triolein breath test appears to be an accurate and simple noninvasive test of fat malabsorption that differentiates steatorrhea secondary to pancreatic insufficiency from other causes of steatorrhea

  3. Adolescent Premature Ovarian Insufficiency Following Human Papillomavirus Vaccination

    Directory of Open Access Journals (Sweden)

    Deirdre Therese Little MBBS, DRANZCOG, FACRRM

    2014-10-01

    Full Text Available Three young women who developed premature ovarian insufficiency following quadrivalent human papillomavirus (HPV vaccination presented to a general practitioner in rural New South Wales, Australia. The unrelated girls were aged 16, 16, and 18 years at diagnosis. Each had received HPV vaccinations prior to the onset of ovarian decline. Vaccinations had been administered in different regions of the state of New South Wales and the 3 girls lived in different towns in that state. Each had been prescribed the oral contraceptive pill to treat menstrual cycle abnormalities prior to investigation and diagnosis. Vaccine research does not present an ovary histology report of tested rats but does present a testicular histology report. Enduring ovarian capacity and duration of function following vaccination is unresearched in preclinical studies, clinical and postlicensure studies. Postmarketing surveillance does not accurately represent diagnoses in adverse event notifications and can neither represent unnotified cases nor compare incident statistics with vaccine course administration rates. The potential significance of a case series of adolescents with idiopathic premature ovarian insufficiency following HPV vaccination presenting to a general practice warrants further research. Preservation of reproductive health is a primary concern in the recipient target group. Since this group includes all prepubertal and pubertal young women, demonstration of ongoing, uncompromised safety for the ovary is urgently required. This matter needs to be resolved for the purposes of population health and public vaccine confidence.

  4. Newly graduated nurses' use of knowledge sources

    DEFF Research Database (Denmark)

    Voldbjerg, Siri Lygum; Grønkjaer, Mette; Sørensen, Erik Elgaard

    2016-01-01

    AIM: To advance evidence on newly graduated nurses' use of knowledge sources. BACKGROUND: Clinical decisions need to be evidence-based and understanding the knowledge sources that newly graduated nurses use will inform both education and practice. Qualitative studies on newly graduated nurses' use...... underscoring progression in knowledge use and perception of competence and confidence among newly graduated nurses. CONCLUSION: The transition phase, feeling of confidence and ability to use critical thinking and reflection, has a great impact on knowledge sources incorporated in clinical decisions....... The synthesis accentuates that for use of newly graduated nurses' qualifications and skills in evidence-based practice, clinical practice needs to provide a supportive environment which nurtures critical thinking and questions and articulates use of multiple knowledge sources....

  5. Knowledge of Pharmacogenetics among Healthcare Professionals ...

    African Journals Online (AJOL)

    Background: Pharmacogenetics has a potential for optimizing drug response and identifying risk of toxicity for patients. Pharmacogenetics knowledge of healthcare professionals and the unmet need for pharmacogenetics education in health training institutions are some of the challenges of integrating pharmacogenetics ...

  6. Urinary hemosiderin: role in evaluation of chronic venous insufficiency

    Directory of Open Access Journals (Sweden)

    Ashish Lal Shrestha

    2012-08-01

    Full Text Available Chronic venous insufficiency (CVI leads to skin changes with dermal hemosiderin deposition. We studied the presence of hemosiderin in the urine to assess if this could be used as a biochemical marker for CVI. Hereby we present a case control study conducted in a tertiary care centre in South India. There were 100 cases with evidence of advanced CVI (the Clinical-Etiology-Anatomy-Pathophysiology classification: C5, C6 confirmed by duplex scanning. Controls were 50 patients with leg ulcers due to other etiologies. All patients were subjected to urinary hemosiderin testing. In all 100 patients with CVI (C5 and C6 disease axial venous reflux was confirmed by duplex ultrasound. Superficial venous reflux was noted in 71% of patients and deep venous reflux in 54.%. Primary venous insufficiency was the etiology in 81% of patients. Only 4/100 patients had detectable amounts of hemosiderin in the urine. Urine hemosiderin testing to determine presence or absence of CVI yielded the following values: positive predictive value-80%; negative predictive value-33%; sensitivity-4% and specificity-98%. The test could not be recommended as a marker of CVI. In Indian patients urinary hemosiderin is not a useful screening test in CVI.

  7. History of cervical insufficiency increases the risk of pelvic organ prolapse and stress urinary incontinence in parous women.

    Science.gov (United States)

    Sheyn, David; Addae-Konaedu, Kateena L; Bauer, Alison M; Dawodu, Konyinsola I; Hackney, David N; El-Nashar, Sherif A

    2018-01-01

    A likely contributor to pelvic floor disorders is injury and degradation of connective tissue components such as collagen and elastin, leading to weakening of the pelvic floor. Prior studies have found similar connective tissue component changes in women with cervical insufficiency (CI). However, the connection between pelvic floor disorders and cervical insufficiency has not previously been evaluated. Our objective was to determine whether a history of cervical insufficiency is associated with an increased risk of pelvic organ prolapse and stress urinary incontinence after controlling for confounders. The study used de-identified clinical data from a large multi-institution electronic health records HIPAA-compliant data web application, Explorys Inc. (Cleveland, Ohio, USA). Women with a history of at least one prior delivery after at least 20 weeks' gestation between the years 1999 and 2016 were identified. Logistic regression models were used to identify risk factors and adjust for confounders. The primary outcome was subsequent development of either stress incontinence or pelvic organ prolapse. A total of 1,182,650 women were identified, of whom 30,890 (2.6%) had a history of cervical cerclage or insufficiency. A history of cervical insufficiency was associated with an increased risk of either pelvic organ prolapse or stress urinary incontinence (aOR=1.93, 95%CI: 1.84-2.02). A history of cervical insufficiency was more strongly associated with an increased risk of pelvic organ prolapse (aOR=2.06, 95%CI: 1.91-2.21) than with stress urinary incontinence (aOR=1.91, 95%CI: 1.80-2.02). A history of cervical insufficiency is associated with an increased risk of development of pelvic organ prolapse and stress urinary incontinence. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Autoimmune polyglandular syndrome type 3 (APS-3) among patients with premature ovarian insufficiency (POI).

    Science.gov (United States)

    Szlendak-Sauer, Katarzyna; Jakubik, Daniel; Kunicki, Michał; Skórska, Jolanta; Smolarczyk, Roman

    2016-08-01

    Autoimmune polyglandular syndrome type 3 - (APS-3), is defined as the coexistence of autoimmune thyroiditis with other non-ovarian autoimmune diseases without primary adrenal insufficiency. Additionally the definition of APS-3 also includes primary ovarian insufficiency (POI) coexistence with autoimmune thyroiditis. The main goal of that study is to assess the prevalence of APS-3 defined as coexistence of autoimmune thyroiditis with POI in population of 46 XX karyotype women with primary ovarian insufficiency (POI). The second goal is to investigate hormonal profile and insulin sensitivity in women with POI and subgroups of women with APS-3 - POI/APS-3(+) and without APS 3 - POI/APS-3(-). Anthropometric measurements, coexistence of autoimmune diseases, androgens, fasting glucose and insulin, glucose and insulin at 60' and 120' of oral glucose tolerance test (OGTT) and homeostasis model for insulin resistance (HOMA-IR), were determine in 98 patients aged between 18 and 39 with spontaneous 46 XX primary ovarian insufficiency (POI), in 33 POI/APS-3(+), 65 POI/APS-3(-), and 75 healthy controls. Continuous data were summarized by the mean±standard deviation (SD), and categorical data by number (percentages). Data were checked for normality using Shapiro-Wilk test, the comparison between groups were performed using non-parametric Mann-Whitney or Kruskall-Wallis test. Pearson's correlation coefficient was used to assess the relationships between parameters. Statistical significance was defined as p values APS-3(+) and POI/APS-3(-) showed significantly lower serum androgens in comparison to controls. Additionally women with POI/APS-3(+) showed hyperinsulinemia after 1h of OGTT; No significant differences in serum fasting glucose, insulin and during 2h OGTT between groups were observed. The prevalence of APS-3 is 33.7% in patients with spontaneous 46 XX primary ovarian insufficiency. Women with POI, POI/APS-3(+) and POI/APS-3(-) feature lower testosterone, androstendione

  9. Distal vertebral artery reconstruction when managing vertebrobasilar insufficiency

    Directory of Open Access Journals (Sweden)

    D. M. Galaktionov

    2017-11-01

    Full Text Available This article presents a literature review devoted to the reconstruction of the distal vertebral artery and a clinical case of successful surgical treatment of a patient suffering from vertebrobasilar insufficiency caused by occlusion of the vertebral artery in a proximal segment. The external carotid artery-distal vertebral artery bypass was performed by using the radial artery.Received 27 February 2017. Revised 25 July 2017. Accepted 3 August 2017.Funding: The study did not have sponsorship.Conflict of interest: The authors declare no conflict of interest. 

  10. Cervical collagen is reduced in non-pregnant women with a history of cervical insufficiency and a short cervix

    DEFF Research Database (Denmark)

    Sundtoft, Iben; Langhoff-Roos, Jens; Sandager, Puk

    2017-01-01

    INTRODUCTION: Preterm cervical shortening and cervical insufficiency may be caused by a constitutional weakness of the cervix. The aim of this study was to assess the cervical collagen concentration in non-pregnant women with a history of cervical insufficiency or of a short cervix in the second...... trimester of pregnancy. MATERIAL AND METHODS: In this case-control study we included non-pregnant women one year or more after pregnancy: 55 controls with a history of normal delivery; 27 women with a history of cervical insufficiency; and 10 women with a history of a short cervix (... women with a history of a long cervix (>95th percentile) at gestational weeks 18-20. We obtained biopsies (3 × 3-4 mm) from the ectocervix and determined the collagen concentration by measuring the hydroxyproline concentration. RESULTS: Women with cervical insufficiency had lower collagen concentrations...

  11. Breastfeeding knowledge and practice of mothers with infants less ...

    African Journals Online (AJOL)

    Background: Exclusive breastfeeding is the ideal for infants in the first six months, however the practice is low. The role of mothers' knowledge of breastfeeding on practise is not clear.This study was designed to assess knowledge and practice of nursing mothers concerning breastfeeding in the selected Local Government ...

  12. Knowledge, Practices and Education of Clients on Cervical Cancer ...

    African Journals Online (AJOL)

    Background: Most patients with cancer of the cervix present late with poor prognosis. Health workers' knowledge and utilization of the screening services might influence their clients. The aim of this study was to determine the knowledge, practice and education of clients on cervical cancer and its screening among female ...

  13. Knowledge Translation Tools are Emerging to Move Neck Pain Research into Practice.

    Science.gov (United States)

    Macdermid, Joy C; Miller, Jordan; Gross, Anita R

    2013-01-01

    Development or synthesis of the best clinical research is in itself insufficient to change practice. Knowledge translation (KT) is an emerging field focused on moving knowledge into practice, which is a non-linear, dynamic process that involves knowledge synthesis, transfer, adoption, implementation, and sustained use. Successful implementation requires using KT strategies based on theory, evidence, and best practice, including tools and processes that engage knowledge developers and knowledge users. Tools can provide instrumental help in implementing evidence. A variety of theoretical frameworks underlie KT and provide guidance on how tools should be developed or implemented. A taxonomy that outlines different purposes for engaging in KT and target audiences can also be useful in developing or implementing tools. Theoretical frameworks that underlie KT typically take different perspectives on KT with differential focus on the characteristics of the knowledge, knowledge users, context/environment, or the cognitive and social processes that are involved in change. Knowledge users include consumers, clinicians, and policymakers. A variety of KT tools have supporting evidence, including: clinical practice guidelines, patient decision aids, and evidence summaries or toolkits. Exemplars are provided of two KT tools to implement best practice in management of neck pain-a clinician implementation guide (toolkit) and a patient decision aid. KT frameworks, taxonomies, clinical expertise, and evidence must be integrated to develop clinical tools that implement best evidence in the management of neck pain.

  14. The Soft Palate Friendly Speech Bulb for Velopharyngeal Insufficiency

    OpenAIRE

    Kahlon, Sukhdeep Singh; Kahlon, Monaliza; Gupta, Shilpa; Dhingra, Parvinder Singh

    2016-01-01

    Velopharyngeal insufficiency is an anatomic defect of the soft palate making palatopharyngeal sphincter incomplete. It is an important concern to address in patients with bilateral cleft lip and palate. Speech aid prosthesis or speech bulbs are best choice in cases where surgically repaired soft palate is too short to contact pharyngeal walls during function but these prosthesis have been associated with inadequate marginal closure, ulcerations and patient discomfort. Here is a case report of...

  15. A survey of resident physicians′ knowledge concerning transfusion medicine in Shiraz, Iran

    Directory of Open Access Journals (Sweden)

    Leila Kasraian

    2014-01-01

    Full Text Available Objective: The knowledge of physicians concerning blood transfusion has a significant impact on the optimal use of blood and blood products. The aim was to survey their knowledge regarding this area and identify whether additional training is required. Material and Methods: This cross-sectional study was conducted on all 1 st year resident physicians at Shiraz University of Medical Sciences, Iran in 2011. The questionnaire solicited information on demographic variables, knowledge regarding transfusion medicine, education and experience regarding blood transfusion. Results: The mean total knowledge score regarding transfusion medicine was 15.44 ± 3.3 (7-25 out of 29. Only about one-fourth (27.4% replied correctly to over 60% of questions. The mean score of knowledge was higher among residents who stated that they received special training regarding blood transfusion in their medical courses (P < 0.01. Seventy-five percent of residents believed that they had received insufficient education and 97.8% believed that they need additional training. Conclusion: The results reflect the uncertainties among resident physicians regarding blood transfusion. It has been suggested that a special transfusion medicine educational program should be added to the medical education curriculum.

  16. Discourses of anxiety and transference in nursing practice: the subject of knowledge.

    Science.gov (United States)

    Evans, Alicia M; Pereira, David A; Parker, Judith M

    2009-09-01

    The nurses' relationship to knowledge has been theorised in a variety of different ways, not the least being in relation to medical dominance. In this study, the authors report on one of the findings of a case study into nurses' anxiety informed by psychoanalytic theory. They argue that the nurse's subjection to the knowledge of the other health professional, inclusive of the doctor, can be a transference arising in the context of anxiety for the nurse. Grasped by anxiety, the nurse finds their own knowledge insufficient and in this moment can operate a transference to their non-nursing colleague, who obligingly, responds. This transference is not present in the change-of-shift handover report though, when the other's knowledge is suspect, even open to derision. Thus, this reference to the knowledge of the other is not consistently present in nursing and can be seen to be just one way that nurses organise themselves in relation to anxiety. Therefore, those wanting to break down the medical dominance of the nursing profession might consider other ways nurses might organise themselves in relation to anxiety, so that the political dominance of the other is not reinforced via transference to that other.

  17. Predicting Mycobacterium tuberculosis Complex Clades Using Knowledge-Based Bayesian Networks

    Directory of Open Access Journals (Sweden)

    Minoo Aminian

    2014-01-01

    Full Text Available We develop a novel approach for incorporating expert rules into Bayesian networks for classification of Mycobacterium tuberculosis complex (MTBC clades. The proposed knowledge-based Bayesian network (KBBN treats sets of expert rules as prior distributions on the classes. Unlike prior knowledge-based support vector machine approaches which require rules expressed as polyhedral sets, KBBN directly incorporates the rules without any modification. KBBN uses data to refine rule-based classifiers when the rule set is incomplete or ambiguous. We develop a predictive KBBN model for 69 MTBC clades found in the SITVIT international collection. We validate the approach using two testbeds that model knowledge of the MTBC obtained from two different experts and large DNA fingerprint databases to predict MTBC genetic clades and sublineages. These models represent strains of MTBC using high-throughput biomarkers called spacer oligonucleotide types (spoligotypes, since these are routinely gathered from MTBC isolates of tuberculosis (TB patients. Results show that incorporating rules into problems can drastically increase classification accuracy if data alone are insufficient. The SITVIT KBBN is publicly available for use on the World Wide Web.

  18. Disentangling the Role of Domain-Specific Knowledge in Student Modeling

    Science.gov (United States)

    Ruppert, John; Duncan, Ravit Golan; Chinn, Clark A.

    2017-08-01

    This study explores the role of domain-specific knowledge in students' modeling practice and how this knowledge interacts with two domain-general modeling strategies: use of evidence and developing a causal mechanism. We analyzed models made by middle school students who had a year of intensive model-based instruction. These models were made to explain a familiar but unstudied biological phenomenon: late onset muscle pain. Students were provided with three pieces of evidence related to this phenomenon and asked to construct a model to account for this evidence. Findings indicate that domain-specific resources play a significant role in the extent to which the models accounted for provided evidence. On the other hand, familiarity with the situation appeared to contribute to the mechanistic character of models. Our results indicate that modeling strategies alone are insufficient for the development of a mechanistic model that accounts for provided evidence and that, while learners can develop a tentative model with a basic familiarity of the situation, scaffolding certain domain-specific knowledge is necessary to assist students with incorporating evidence in modeling tasks.

  19. Research of level of formed knowledge, abilities and skills on basket-ball for the students of faculty of physical education.

    Directory of Open Access Journals (Sweden)

    Kovalenko J.A.

    2011-06-01

    Full Text Available The results of a zero control of students of faculty of physical education are presented. The estimation of theoretical knowledge's is conducted, abilities and skills on basket-ball for the students of a 1 course of directions of preparation «Physical education», «Health of man» and «Sport». It is set that the level of their formed at most students of different directions of preparation is insufficient. It is certain that by reason of such position, foremost, there is insufficient preparation and playing practice of students during teaching at general school. A diary is developed on basket-ball for student general schools.

  20. A knowledge-based support system for mechanical ventilation of the lungs. The KUSIVAR concept and prototype.

    Science.gov (United States)

    Rudowski, R; Frostell, C; Gill, H

    1989-09-01

    The KUSIVAR is an expert system for mechanical ventilation of adult patients suffering from respiratory insufficiency. Its main objective is to provide guidance in respirator management. The knowledge base includes both qualitative, rule-based knowledge and quantitative knowledge expressed in the form of mathematical models (expert control) which is used for prediction of arterial gas tensions and optimization purposes. The system is data driven and uses a forward chaining mechanism for rule invocation. The interaction with the user will be performed in advisory, critiquing, semi-automatic and automatic modes. The system is at present in an advanced prototype stage. Prototyping is performed using KEE (Knowledge Engineering Environment) on a Sperry Explorer workstation. For further development and clinical use the expert system will be downloaded to an advanced PC. The system is intended to support therapy with a Siemens-Elema Servoventilator 900 C.

  1. Low incidence of adrenal insufficiency after transsphenoidal surgery in patients with acromegaly: a long-term follow-up study

    NARCIS (Netherlands)

    Burgers, Anne Marij G.; Kokshoorn, Nieke E.; Pereira, Alberto M.; Roelfsema, Ferdinand; Smit, Johannes W. A.; Biermasz, Nienke R.; Romijn, Johannes A.

    2011-01-01

    The long-term prevalence of adrenal insufficiency after transsphenoidal surgery for GH-secreting pituitary adenomas is unknown. However, recently a single study reported a high prevalence of adrenal insufficiency in acromegalic patients after surgical and/or medical treatment without postoperative

  2. Changes of serum aldosterone levels in patients with different stages of chronic renal insufficiency

    International Nuclear Information System (INIS)

    Zou Jun; Du Xueliang; Jiang Gengru

    2005-01-01

    Objective: To study the correlationship between the serum aldosterone levels and different stages of chronic renal insufficiency. Methods: Plasma renin activity (PRA), serum angiotensin II (Ang II) contents and serum aldosterone concentration (SACs) were determined with RIA in 42 patients with chronic renal insufficiency from various causes. The patients were divided into three groups according to their endogenous creatinine clearance rate: Group 1, (n=14) Ccr≥60ml/(min·1.73m 2 ); Group 2, (n =13) 20ml/(min·1.73m 2 ) ≤Ccr 2 ); Group 3, (n=15) Ccr 2 ). Results: The SACs values in Group 3 patients were significantly higher than those in Group 1 and Group 2 patients (P<0.01). The SACs values in Group 2 patients were also significantly higher than those in Group 1 patients (P<0.05). Ccr values were higher negatively correlated with the SACs values (r= -0.685, P<0.001). Conclusion: As the creatine clearance rate gradually deteriorated, the SACs values increased correspondingly in patients with chronic renal insufficiency from various causes. (authors)

  3. Knowledge, Perceptions, and Communication about Colorectal Cancer Screening among Chinese American Primary Care Physicians

    Directory of Open Access Journals (Sweden)

    Wenchi Liang D.D.S., Ph.D.

    2008-01-01

    Full Text Available Objective To assess Chinese American primary care physicians’ knowledge, attitude, and barriers to recommending colorectal cancer (CRC screening to their Chinese American patients. Methods Chinese American primary care physicians serving Chinese American patients in two metropolitan areas were invited to complete a mailed survey on CRC screening knowledge, attitudes toward shared decision making and CRC screening, and CRC screening recommendation patterns. Results About half of the 56 respondents did not know CRC incidence and mortality figures for Chinese Americans. Those aged 50 and younger, graduating from U.S. medical schools, or working in non-private settings had higher knowledge scores ( p < 0.01. Physicians graduating from U.S. medical schools had more favorable attitudes toward shared decision making ( p < 0.01. Lack of health insurance, inconsistent guidelines, and insufficient time were the most frequently cited barriers to recommending CRC screening. Conclusions Most Chinese American physicians had knowledge, attitude, and communication barriers to making optimal CRC screening recommendations.

  4. Prevalence and Effects of Functional Vitamin K Insufficiency : The PREVEND Study

    NARCIS (Netherlands)

    Riphagen, Ineke J; Keyzer, Charlotte A; Drummen, Nadja E A; de Borst, Martin H; Beulens, Joline W J; Gansevoort, Ron T; Geleijnse, Johanna M; Muskiet, Frits A J; Navis, Gerjan; Visser, Sipke T; Vermeer, Cees; Kema, Ido P; Bakker, Stephan J L

    2017-01-01

    Matrix Gla Protein (MGP) is a strong vitamin K-dependent inhibitor of soft tissue calcification. We assessed the prevalence of functional vitamin K insufficiency, as derived from plasma desphospho-uncarboxylated MGP (dp-ucMGP), and investigated whether plasma dp-ucMGP is associated with all-cause

  5. Factors predicting the duration of adrenal insufficiency in patients successfully treated for Cushing disease and nonmalignant primary adrenal Cushing syndrome.

    Science.gov (United States)

    Prete, Alessandro; Paragliola, Rosa Maria; Bottiglieri, Filomena; Rota, Carlo Antonio; Pontecorvi, Alfredo; Salvatori, Roberto; Corsello, Salvatore Maria

    2017-03-01

    Successful treatment of Cushing syndrome causes transient or permanent adrenal insufficiency deriving from endogenous hypercortisolism-induced hypothalamus-pituitary-adrenal-axis suppression. We analyzed pre-treatment factors potentially affecting the duration of adrenal insufficiency. We conducted a retrospective analysis on patients successfully treated for Cushing disease (15 patients) who underwent transsphenoidal surgery, and nonmalignant primary adrenal Cushing syndrome (31 patients) who underwent unilateral adrenalectomy, divided into patients with overt primary adrenal Cushing syndrome (14 patients) and subclinical primary adrenal Cushing syndrome (17 patients). Epidemiological data, medical history, and hormonal parameters depending on the etiology of hypercortisolism were collected and compared to the duration of adrenal insufficiency. The median duration of follow-up after surgery for Cushing disease and primary adrenal Cushing syndrome was 70 and 48 months, respectively. In the Cushing disease group, the median duration of adrenal insufficiency after transsphenoidal surgery was 15 months: younger age at diagnosis and longer duration of signs and symptoms of hypercortisolism before diagnosis and surgery were associated with longer duration of adrenal insufficiency. The median duration of adrenal insufficiency was 6 months for subclinical primary adrenal Cushing syndrome and 18.5 months for overt primary adrenal Cushing syndrome. The biochemical severity of hypercortisolism, the grade of hypothalamus-pituitary-adrenal-axis suppression, and treatment with ketoconazole before surgery accounted for longer duration of adrenal insufficiency. In patients with Cushing disease, younger age and delayed diagnosis and treatment predict longer need for glucocorticoid replacement therapy after successful transsphenoidal surgery. In patients with primary adrenal Cushing syndrome, the severity of hypercortisolism plays a primary role in influencing the duration of

  6. An almost knowledge-free approach to XPS intensity evaluation where use of atomic photoemission cross sections suffices for yielding material-specific inelastic background

    Energy Technology Data Exchange (ETDEWEB)

    Jo, Masatoshi, E-mail: m-jo@aist.go.jp

    2017-02-15

    assumption that the peak intensities should be proportional to Scofield’s values. The relative deviation of thus determined λ(E) in level III from those by the well-known calculation (Tanuma, Powell, and Penn, TPP) is less than 1.7% between E = 600 and 2000 eV if their values at 800 eV are assumed to coincide. The normalized peak shapes and relative intensities after background subtraction in this level are also very similar to those obtained in level II starting with λ(E) by TPP that is currently known to be reliable. These findings indicate that an almost knowledge-free analysis, which is free from the detail of the solid’s properties such as chemical composition and nevertheless retains the material-dependent results, became possible for the first time, as long as one keeps away from the discussion of absolute intensity.

  7. Robust Target Tracking with Multi-Static Sensors under Insufficient TDOA Information.

    Science.gov (United States)

    Shin, Hyunhak; Ku, Bonhwa; Nelson, Jill K; Ko, Hanseok

    2018-05-08

    This paper focuses on underwater target tracking based on a multi-static sonar network composed of passive sonobuoys and an active ping. In the multi-static sonar network, the location of the target can be estimated using TDOA (Time Difference of Arrival) measurements. However, since the sensor network may obtain insufficient and inaccurate TDOA measurements due to ambient noise and other harsh underwater conditions, target tracking performance can be significantly degraded. We propose a robust target tracking algorithm designed to operate in such a scenario. First, track management with track splitting is applied to reduce performance degradation caused by insufficient measurements. Second, a target location is estimated by a fusion of multiple TDOA measurements using a Gaussian Mixture Model (GMM). In addition, the target trajectory is refined by conducting a stack-based data association method based on multiple-frames measurements in order to more accurately estimate target trajectory. The effectiveness of the proposed method is verified through simulations.

  8. Knowledge of who a dentist is among patients in a government ...

    African Journals Online (AJOL)

    Background: Lack of knowledge of a dentist by implication may mean lack of knowledge of its role in oral health care. This may affect patients' attitude towards oral health care. This study aimed at assessing patients' knowledge of a dentist and its effect on attitude towards oral health care. Methods: Cross-sectional study of ...

  9. NASA/DOD Aerospace Knowledge Diffusion Research Project. Paper 59: Japanese Technological Innovation. Implications for Large Commercial Aircraft and Knowledge Diffusion

    Science.gov (United States)

    Pinelli, Thomas E.; Barclay, Rebecca O.; Kotler, Mindy L.

    1997-01-01

    This paper explores three factors-public policy, the Japanese (national) innovation system, and knowledge-that influence technological innovation in Japan. To establish a context for the paper, we examine Japanese culture and the U.S. and Japanese patent systems in the background section. A brief history of the Japanese aircraft industry as a source of knowledge and technology for other industries is presented. Japanese and U.S. alliances and linkages in three sectors-biotechnology, semiconductors, and large commercial aircraft (LCA)-and the importation, absorption, and diffusion of knowledge and technology are examined next. The paper closes with implications for diffusing knowledge and technology, U.S. public policy, and LCA.

  10. Designing for knowledge: bridging socio-hydrological monitoring and beyond

    Science.gov (United States)

    Mao, F.; Clark, J.; Buytaert, W.; Ochoa-Tocachi, B. F.; Hannah, D. M.

    2016-12-01

    Many methods and applications have been developed to research socio-hydrological systems, such as participatory monitoring, environmental big data processing and sensor network data transmission. However, these data-centred activities are insufficient to guarantee successful knowledge co-generation, decision making or governance. This research suggests a shift of attentions in designing socio-hydrological monitoring tools, from designing for data to designing for knowledge (DfK). Compared to the former strategy, DfK has at least three features as follows. (1) Why monitor? DfK demands the data produced by the newly introduced monitoring application to have potentials to generate socio-hydrological knowledge that supports decision making or management. It means that when designing a monitoring tool, we should not only answer how to collect data, but also questions such as how to best use the collected data in the form of knowledge. (2) What is the role of monitoring? DfK admits that the socio-hydrological data and knowledge generated by monitoring is just one of many kinds to support decision making and management. It means that the importance of monitoring and scientific evidence should not be overestimated, and knowledge cogeneration and synthesis should be considered in advance in the monitoring design process. (3) Who participate? DfK implies a wider engagement of stakeholders, which is not restricted between volunteers as data collectors and providers, and scientist and researcher communities as main data users. It requires a broader consideration of users, including not only data collectors, processors and interpreters, but also local and indigenous knowledge providers, and decision makers who use the knowledge and data. In summary, this research proposes a knowledge-centred strategy in designing participatory socio-hydrological monitoring tools, in order to make monitoring more useful and effective.

  11. Research on Extraction of Ship Target in Complex Sea-sky Background

    International Nuclear Information System (INIS)

    Kang, W J; Ding, X M; Cui, J W; Ao, L

    2006-01-01

    Research on the extraction of ship target in complex sea-sky background has important value to improve the capability of imaging-typed sea navigation and nautical traffic control systems. According to the imaging property of complex sea-sky background, a reliable ship target extraction method is proposed in this paper. The general guide line is that getting the sea-sky division line as a priori knowledge and then the target potential area is determined through discontinuous region of the sea-sky division line. Firstly, a local selective window filter is adopted to filter the image; secondly, eight directions Sobel operator edge detection method and gradient Hough transform are combined to extract sea-sky division line in the image; then a multi-histogram matching technique is adopted to remove the sea and sky background and thus ship target is extracted from complex background. The experiments show that our method has the merits of robustness to noise, small computational complexity and stability

  12. Initial clinical experience with a novel biodegradable ring in patients with functional tricuspid insufficiency: Kalangos Biodegradable Tricuspid Ring.

    Science.gov (United States)

    Burma, O; Ustunsoy, H; Davutoglu, V; Celkan, M A; Kazaz, H; Pektok, E

    2007-08-01

    Tricuspid annuloplasty procedures have been widely performed in clinics for many years. The Kalangos Biodegradable Tricuspid Ring (Kalangos Biodegradable Tricuspid Ring, Bioring SA, Lonay, Switzerland) is a novel prosthesis for the treatment of tricuspid insufficiency. The aim of this study was to evaluate the clinical and echocardiographic results of this novel prosthesis for functional tricuspid insufficiency. Between October 2005 and May 2006, 15 patients with the diagnosis of moderate or severe functional tricuspid insufficiency were treated by implantation of a Kalangos Biodegradable Tricuspid Ring. All patients were evaluated clinically and by echocardiography preoperatively, and control tests were performed at the end of the 1st and 6th month following surgery. Moderate and severe insufficiency was documented in 11 and 4 patients, respectively, in the preoperative tests. 1 and 6 months after surgery, 4 patients had trace and 1 patient had mild tricuspid insufficiency, while 10 patients had none. At the 1st and 6th month follow-up, systolic pulmonary arterial pressure, right atrial dimension and right ventricular diastolic diameter were found to be significantly lower than the preoperative values ( P tricuspid valve area had decreased significantly at the end of the 1st month; however, no significant difference was found between the 1st and 6th month tests ( P > 0.05). Three-quarters of the annuloplasty ring had degraded at 6 months. No complications related to the prosthesis or the procedure occurred within this period. Kalangos Biodegradable Ring is a promising prosthesis in patients with functional tricuspid insufficiency, with encouraging initial results.

  13. Prospects of detecting gravitational background radiation by Doppler tracking interplanetary spacecraft

    International Nuclear Information System (INIS)

    Bertotti, B.; Carr, B.J.

    1980-01-01

    We examine the theoretical and experimental prospects of detecting a low-frequency, continuous, stochastic background of gravitational waves by Doppler tracking interplanetary spacecraft. From a theoretical standpoint, such a background may have been generated by various postgalactic processes or by pregalactic black hole formation; there could also exist a primordial background which goes back to the beginning of the universe. We review the characteristic frequency and density ranges which one might anticipate for these backgrounds. From an experimental standpoint, one's ability to detect a background is limited by the finite length of the record available and by an imperfect knowledge of the spectrum of various sources of noise. The fundamental contribution to the noise comes from the clock which regulates the frequency of the tracking waves. If one uses a hydrogen maser clock, this noise becomes progressively less important with decreasing frequency: one might hope to detect a critical density of background radiation at frequencies below 10 -2 Hz and a background with 10 -4 times the critical density at frequencies below 10 -5 Hz. It is encouraging that some of the sorts of background which we anticipate from theoretical considerations fall within the observable regime. We discuss the extent to which other sources of noise may exceed the clock noise and the degree to which they can be eliminated

  14. Prenatal screening for congenital anomalies: exploring midwives' perceptions of counseling clients with religious backgrounds.

    Science.gov (United States)

    Gitsels-van der Wal, Janneke T; Manniën, Judith; Gitsels, Lisanne A; Reinders, Hans S; Verhoeven, Pieternel S; Ghaly, Mohammed M; Klomp, Trudy; Hutton, Eileen K

    2014-07-19

    In the Netherlands, prenatal screening follows an opting in system and comprises two non-invasive tests: the combined test to screen for trisomy 21 at 12 weeks of gestation and the fetal anomaly scan to detect structural anomalies at 20 weeks. Midwives counsel about prenatal screening tests for congenital anomalies and they are increasingly having to counsel women from religious backgrounds beyond their experience. This study assessed midwives' perceptions and practices regarding taking client's religious backgrounds into account during counseling. As Islam is the commonest non-western religion, we were particularly interested in midwives' knowledge of whether pregnancy termination is allowed in Islam. This exploratory study is part of the DELIVER study, which evaluated primary care midwifery in The Netherlands between September 2009 and January 2011. A questionnaire was sent to all 108 midwives of the twenty practices participating in the study. Of 98 respondents (response rate 92%), 68 (69%) said they took account of the client's religion. The two main reasons for not doing so were that religion was considered irrelevant in the decision-making process and that it should be up to clients to initiate such discussions. Midwives' own religious backgrounds were independent of whether they paid attention to the clients' religious backgrounds. Eighty midwives (82%) said they did not counsel Muslim women differently from other women. Although midwives with relatively many Muslim clients had more knowledge of Islamic attitudes to terminating pregnancy in general than midwives with relatively fewer Muslim clients, the specific knowledge of termination regarding trisomy 21 and other congenital anomalies was limited in both groups. While many midwives took client's religion into account, few knew much about Islamic beliefs on prenatal screening for congenital anomalies. Midwives identified a need for additional education. To meet the needs of the changing client population

  15. Pneumonia in patients on the background of blood cancer

    Directory of Open Access Journals (Sweden)

    Pertseva T.A.

    2014-03-01

    Full Text Available Problematic issues of etiologic diagnosis and treatment of community-acquired and nosocomial pneumonia are being studied actively. At the same time specific features of pneumonia in patients with severe immune defects, against blood cancer including are studied insufficiently. By the result of microbiological examinations of 149 patients with pneumonia on the background of blood cancer, who have undergone treatment in hematological center of CE “Dnipropetrovsk local multi-field clinical hospital №4” in 2010-2012, bacterial causative agents were determined in 59,7% of accidents, among which gram-negative microorganisms made up 69,7%, gram-positive – 30,3%. In 63% of accidents the asso¬ciations of causative agents were determined: the combination of fungal flora made up 58, 4% bacterial associations – 25, 8%. Invasive methods of research have demonstrated a considerably bigger informativeness in determination of possible etiological diagnosis of pneumonia. In determination of causative agent in fluid of brochoalveolar lavage the part of positive results made up 77,4% against 30,3% in examination of sputum.

  16. Cytogenetic Analysis of 65 Women with Premature Ovarian Insufficiency

    OpenAIRE

    Seda Ates

    2016-01-01

    Aim: Premature ovarian insufficiency (POI) is characterized as amenorrhea for more than 6 months, occurring before the age of 40, with an increased follicle-stimulating hormone and low estrogen concentrations. The aim of our study is to determine the types and distribution of cytogenetic abnormalities among women with POI. Material and Method: The study is based on the retrospective karyotype analysis of 65 women with idiopathic POI referred to the Medical Genetics Department at the Bezmialem...

  17. Osteoporotic compression fracture of the thoracolumbar spine and sacral insufficiency fracture: incidence and analysis of the relationship according to the clinical factors

    International Nuclear Information System (INIS)

    Kong, Jeong Hwa; Park, Ji Sun; Ryu, Kyung Nam

    2006-01-01

    To evaluate the incidence of sacral insufficiency fracture in osteoporotic patient with compression fracture of the thoracolumbar (T-L) spine on magnetic resonance image (MRI), and to analyze the correlation of variable clinical factors and the incidence of sacral insufficiency fracture. We retrospectively reviewed 160 patients (27 men, 133 women; age range of 50 to 89 years) who underwent spinal MRI and had compression fracture of the T-L spine. Compression fractures due to trauma or tumor were excluded. We evaluated the incidence of sacral insufficiency fracture according to the patients' age, sex, number of compression fractures, and the existence of bone marrow edema pattern of compression fracture. During the same period, we evaluated the incidence of spinal compression fracture in the patients of pelvic insufficiency fracture. Out of the 160 patients who had compression fracture in the T-L spine, 17 (10.6%) had insufficiency fracture of the sacrum. Compression fracture occurred almost 5 times more frequently in women (27:133), but the incidence of sacral insufficiency fracture was 2/27 for men (7.4%) and 15/133 for women (11.3%), with no statistically significant difference (ρ = 0.80). According to age, the ratio of insufficiency fracture to compression fracture was 0% (0/23) in the 50's, 10.6% (7/66) in the 60's, 12.5% (7/56) in the 70's, and 20.0% (3/15) in the 80's. In respect of single and multiple compression fracture, the incidence of sacral insufficiency fracture was 8/65 for men (12.3%) and 9/95 for women (9.5%), showing no significant difference (ρ = 0.37). In the patients with and without compression fracture with bone marrow edema, insufficiency fracture occurred in 5/76 (6.6%) and 12/84 (14.3%), respectively. On the other hand, of the 67 patients who had pelvic insufficiency fracture, 27 (40.3%) also had spinal compression fracture. About 10% of the patients with osteoporotic compression fracture in the T/L spine also had pelvic sacral

  18. The prevalence of smoking and the knowledge of smoking hazards ...

    African Journals Online (AJOL)

    Background. While the detrimental effects of smoking among HIV-positive patients have been well documented, there is a paucity of data regarding cigarette smoking prevalence among these patients in South Africa (SA). Objectives. To establish the frequency, demographics, knowledge of harmful effects, and knowledge of ...

  19. Knowledge of spacer device, peak flow meter and inhaler technique ...

    African Journals Online (AJOL)

    Background: Metered dose inhalers are cornerstone in effective management of bronchial asthma when correctly used. Most studies hitherto have focused on assessing patient's knowledge of inhaler technique. We sought to assess the knowledge of inhaler technique, spacer device and peak flow meter among doctors and ...

  20. Comparative analysis of intraoral radiographs with variation of tube angulation to detect insufficient crown margins.

    Science.gov (United States)

    Sailer, Benjamin F; Geibel, Margrit-Ann

    2013-01-01

    Variations in angulation of the x-ray tube affect the appearance of insufficient approximal crown margins on intraoral radiographs. This study examines the impact of such angular variation on the assessment of digital radiographs using three different X-ray tubes--Heliodent DS (Sirona), Gendex Expert DC (KaVo Dental) and Focus (KaVo Dental)--as well as the Gendex Visualix eHD CCD sensor (KaVo Dental). The test specimens, crowned teeth 46 from two mandibles provided by the Institute of Anatomy and Cell Biology, were examined with each tube. The results indicate great differences in the angles indicative of insufficient crown margins on X-ray images. Because of beam divergence and the crown marginal gap, the length and width of which frequently varies, it is difficult to infer any optimum angle from the data. This leads to the conclusion that at present, it is not possible to establish ideal angles for visualization of insufficient approximal crown margins.

  1. No Postoperative Adrenal Insufficiency in a Patient with Unilateral Cortisol-Secreting Adenomas Treated with Mifepristone before Surgery

    Directory of Open Access Journals (Sweden)

    Rachel M. Saroka

    2016-01-01

    Full Text Available Background Glucocorticoid replacement is commonly required to treat secondary adrenal insufficiency after surgical resection of unilateral cortisol-secreting adrenocortical adenomas. Here, we describe a patient with unilateral cortisol-secreting adenomas in which the preoperative use of mifepristone therapy was associated with recovery of the hypothalamic–pituitary–adrenal (HPA axis, eliminating the need for postoperative glucocorticoid replacement. Case Presentation A 66-year-old Caucasian man with type 2 diabetes mellitus, hyperlipidemia, hypertension, and obesity was hospitalized for Fournier's gangrene and methicillin-resistant Staphylococcus aureus sepsis. Abdominal computed tomography scan revealed three left adrenal adenomas measuring 1.4, 2.1, and 1.2 cm and an atrophic right adrenal gland. Twenty-four-hour urinary free cortisol level was elevated (237 µg/24 hours, reference range 0–50 µg/24 hours. Hormonal evaluation after resolution of the infection showed an abnormal 8 mg overnight dexamethasone suppression test (cortisol postdexamethasone 14.5 µg/dL, suppressed adrenocorticotropic hormone (ACTH; <5 pg/mL, reference range 7.2–63.3 pg/mL, and low-normal dehydroepiandrosterone sulfate (50.5 µg/dL, male reference range 30.9–295.6 µg/dL. Because of his poor medical condition and uncontrolled diabetes, his Cushing's syndrome was treated with medical therapy before surgery. Mifepristone therapy was started and, within five months, his diabetes was controlled and insulin discontinued. The previously suppressed ACTH increased to above normal range accompanied by an increase in dehydroepiandrosterone sulfate levels, indicating recovery of the HPA axis and atrophic contralateral adrenal gland. The patient received one precautionary intraoperative dose of hydrocortisone and none thereafter. Two days postoperatively, ACTH (843 pg/mL and cortisol levels (44.8 µg/dL were significantly elevated, reflecting an appropriate HPA axis

  2. No Postoperative Adrenal Insufficiency in a Patient with Unilateral Cortisol-Secreting Adenomas Treated with Mifepristone Before Surgery

    Science.gov (United States)

    Saroka, Rachel M.; Kane, Michael P.; Robinson, Lawrence; Busch, Robert S.

    2016-01-01

    BACKGROUND Glucocorticoid replacement is commonly required to treat secondary adrenal insufficiency after surgical resection of unilateral cortisol-secreting adrenocortical adenomas. Here, we describe a patient with unilateral cortisol-secreting adenomas in which the preoperative use of mifepristone therapy was associated with recovery of the hypothalamic–pituitary–adrenal (HPA) axis, eliminating the need for postoperative glucocorticoid replacement. CASE PRESENTATION A 66-year-old Caucasian man with type 2 diabetes mellitus, hyperlipidemia, hypertension, and obesity was hospitalized for Fournier’s gangrene and methicillin-resistant Staphylococcus aureus sepsis. Abdominal computed tomography scan revealed three left adrenal adenomas measuring 1.4, 2.1, and 1.2 cm and an atrophic right adrenal gland. Twenty-four-hour urinary free cortisol level was elevated (237 µg/24 hours, reference range 0–50 µg/24 hours). Hormonal evaluation after resolution of the infection showed an abnormal 8 mg overnight dexamethasone suppression test (cortisol postdexamethasone 14.5 µg/dL), suppressed adrenocorticotropic hormone (ACTH; <5 pg/mL, reference range 7.2–63.3 pg/mL), and low-normal dehydroepiandrosterone sulfate (50.5 µg/dL, male reference range 30.9–295.6 µg/dL). Because of his poor medical condition and uncontrolled diabetes, his Cushing’s syndrome was treated with medical therapy before surgery. Mifepristone therapy was started and, within five months, his diabetes was controlled and insulin discontinued. The previously suppressed ACTH increased to above normal range accompanied by an increase in dehydroepiandrosterone sulfate levels, indicating recovery of the HPA axis and atrophic contralateral adrenal gland. The patient received one precautionary intraoperative dose of hydrocortisone and none thereafter. Two days postoperatively, ACTH (843 pg/mL) and cortisol levels (44.8 µg/dL) were significantly elevated, reflecting an appropriate HPA axis response to

  3. Knowledge, attitude and practice on blood donation among nurses ...

    African Journals Online (AJOL)

    Background: There is some evidence to suggest that the greater one's knowledge in the blood donation process and the need to donate blood, the more likely one would donate blood. Generally, the lack of knowledge among participants in most studies on blood donation issues seems to be a major concern. There is a ...

  4. Impact of parents’ nutritional knowledge on the nutrition and frequency of consumption of selected products in children and adolescents practicing football in a football club in Bydgoszcz, Poland

    Directory of Open Access Journals (Sweden)

    Monika Anna Ameryk

    2017-02-01

    A correlation between the parents’ nutritional knowledge and the frequency of consumption of selected products by their children was observed. Parents with insufficient knowledge less frequently served dark bread and thick groats than those with good and sufficient knowledge. Parents with good and sufficient knowledge less frequently served instant soups, canned meat, energy and isotonic drinks. No impact of the parents’ knowledge was observed with reference to white cheese, vegetable oils and sweets. Nutritional education of the parents of young athletes is necessary regardless of their nutritional knowledge. Improving eating habits can positively affect children’s development and achievements in sports.   Keywords: Nutrition; Knowledge; Sport; Young Athletes; Eating habits.

  5. Background of the Degree in Public Accounting

    Directory of Open Access Journals (Sweden)

    José G. Vargas-Hernández

    2012-08-01

    Full Text Available This paper aims to review public accountant education in terms of the interrelated subjects as well as its background. The results of this education development project improve the formation of the accountant public education because of its linkage between teachers and students in the research process and the design of new teaching strategies that contribute to solving real problems and facilitate the social projection. The academic administration is characterized by processes that arise and is generated within the same individuals, focused on the construction and reconstruction of knowledge, proper training and formation of builders of their own processes.

  6. Teaching in Multicultural Background in the States

    Institute of Scientific and Technical Information of China (English)

    潘若芸

    2010-01-01

    The diversity present in every aspect of American life is an inevitable consequence of its multicultural society.Schools across the country are a reflection of what is,and always has been,an ever changing demographic constitution.Classroom teachers,especially teachers who have no teaching experience in the country,face a stiff challenge of teaching all students,regardless of their backgrounds.As a Chinese guest teacher in the States,I learned that the"growing-up"of a teacher requires positive changes in three areas:knowledge,attitudes and skills.Support from administrators is also vital in the"growing-up"process.

  7. A prospective evaluation of pancreatic exocrine function in patients with acute pancreatitis: correlation with extent of necrosis and pancreatic endocrine insufficiency.

    Science.gov (United States)

    Boreham, B; Ammori, B J

    2003-01-01

    The aim of this prospective study was to assess pancreatic exocrine function in patients recovering from a first attack of acute pancreatitis, and to evaluate its relationship to severity of attack, extent of pancreatic necrosis and severity of pancreatic endocrine insufficiency. Between December 2000 and November 2001, 23 patients were prospectively evaluated. Pancreatic exocrine function was measured by the faecal elastase-1 test and insufficiency was classified as moderately impaired or severely impaired. Pancreatic necrosis was determined by contrast-enhanced CT scan, and its extent was categorised according to Balthazar's classification. The severity of pancreatic endocrine insufficiency was categorised according to insulin dependence. Attacks were classified as mild (n = 16) or severe (n = 7) according to the Atlanta criteria. Pancreatic exocrine insufficiency was significantly more frequent in patients recovering from severe attacks than mild (n = 6, 86% vs. n = 2, 13%; p = 0.002), and in those who developed pancreatic necrosis or pseudocyst than those who did not (6 of 7 patients vs. 2 of 16 patients, and 5 of 5 patients vs. 3 of 18 patients respectively; p = 0.002). The development of exocrine insufficiency correlated strongly with the extent of pancreatic necrosis (r = -0.754, p pancreatic endocrine insufficiency (n = 4, r = -0.453, p = 0.03). Pancreatic exocrine insufficiency is a common occurrence in patients recovering from severe acute pancreatitis, and its severity correlates with the extent of pancreatic necrosis and the severity of concomitant pancreatic endocrine insufficiency. Copyright 2003 S. Karger AG, Basel and IAP

  8. Food insufficiency and food insecurity as risk factors for physical disability among Palestinian refugees in Lebanon: Evidence from an observational study.

    Science.gov (United States)

    Salti, Nisreen; Ghattas, Hala

    2016-10-01

    Potential interactions between malnutrition and disability are increasingly recognized, and both are important global health issues. Causal effects working from nutrition to disability and from disability back to nutrition present an empirical challenge to measuring either of these effects. However, disability affects nutrition whatever the cause of disability, whereas nutrition is likelier to affect disease-related disability than war- or work-related disability. This paper investigates the association of food insufficiency with the risk of physical disability. Data on disability by cause allow us to address the difficulty of reverse causality. Multinomial logit regressions of disability by cause on food insufficiency are run using survey data from 2010 on 2575 Palestinian refugee households in Lebanon. Controls include household sociodemographic, health and economic characteristics. Regressions of food insufficiency on disability by cause are also run. Disability has a significant coefficient in regressions of food insufficiency, whatever the cause of disability; but in regressions of disability on food insufficiency, food insufficiency is significant only for disease-related disability (log odds of disease-related disability .78 higher, p = .008). The difference in the results by cause of disability is evidence of a significant association between food insufficiency and disease-related disability, net of any reverse effect from disability to food access. The association between disease-related disability and food insufficiency is statistically significant suggesting that even taking into account feedback from disability to nutrition, nutrition is an effective level of intervention to avert the poverty-disability trap resulting from the impoverishing effect of disability. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Evidence of perception of AIDS insufficient for verdict.

    Science.gov (United States)

    1997-11-28

    The 8th U.S. Circuit Court of Appeals overturned the jury verdict in favor of [name removed], a welder who claimed he was fired because his employer, [name removed] National Vendor, thought he had AIDS. According to [name removed], when his health and physical appearance began deteriorating due to Graves disease, a thyroid condition, he was terminated. [Name removed] filed a grievance through his labor union and filed a lawsuit under the Americans with Disabilities Act (ADA). The Circuit Court panel determined there was insufficient evidence to conclude that the company's officials and key decision makers regarded [name removed] as having AIDS.

  10. Does chronic sunscreen use reduce vitamin D production to insufficient levels?

    DEFF Research Database (Denmark)

    Norval, M.; Wulf, Hans Chr.

    2009-01-01

    decrease in solar-induced previtamin D-3 in the skin, resulting in a vitamin D level which is considered insufficient for protection against a wide range of diseases. In this article the published evidence to support and to question this view is presented. It is concluded that, although sunscreens can...

  11. Knowledge Management Course for Master Program in Nuclear Engineering

    International Nuclear Information System (INIS)

    Geraskin, N.I.; Kosilov, A.N.; Kulikov, E.G.

    2014-01-01

    Background for NKM Course: • A basic level of nuclear knowledge is a part of the general human culture. • An intermediate level of nuclear knowledge is a part of general scientific-technical culture and is taught at university. • An advanced level of nuclear knowledge has been accumulated by many experienced workers in both power and non-power applications. • KM in the last 20 years has established itself as a key strategic approach for management of intellectual assets and knowledge that can improve efficiency and safety, increase innovation and help preserve and enhance current nuclear knowledge. • Considering the critical importance of nuclear knowledge for power generation, medicine, agriculture, it is timely to introduce the concept of managing knowledge at the university level

  12. Fractures due to insufficient pelvic girdle

    International Nuclear Information System (INIS)

    Garcia Aguayo, F.J.; Martinez Almagro, A.

    1995-01-01

    Eleven cases are presented of postmenopausal women with a total of 37 fractures due to insufficient pelvic girdle: 15 located in sacrum, ten in the pubic rami, four in ilium proximal to the sacroiliac joint, three in iliac fossa, two in iliac tuberosity and three in the public body. Eight of the patients were diagnosed over a period of six years when seeking medical attention for bone pain. The other three were diagnosed retrospectively among a group of 33 cancer patients (the majority having having breast cancer) who presented positive pelvic radionuclide bone scan. CT was superior to conventional radiology in detecting fractures of this type, especially those of sacrum and ilium. Radionuclide bone scan was highly sensitive but its specificity was low, requiring back-up radiology and above all CT to establish the differential diagnosis with respect to other types of lesions, especially metastases. (Author) 14 refs

  13. Association of vitamin D insufficiency/deficiency with thyroid artery Doppler ultrasonography in patients with Hashimoto thyroiditis.

    Science.gov (United States)

    Nalbant, Ahmet; Aydin, Ayhan; Karacan, Alper; Onmez, Attila; Tamer, Ali; Cinemre, Hakan

    2017-01-01

    During the course of the autoimmune thyroid diseases, ultrasonography change parallel to histopathology. Vitamin D is associated with autoimmune diseases and thus can affect thyroid blood flow. Our aim was to investigate the relationship between vitamin D insufficiency/deficiency and thyroid hemodynamic indices in patients with Hashimoto thyroiditis. A total of 93 patients who presented to Sakarya University Endocrinology outpatient clinic from April to September 2016 and diagnosed with Hashimoto thyroiditis were included in this study. Clinical and serologic data, thyroid antibodies and 25(OH)D3 were evaluated. Mean peak systolic velocity(mPSV), mean end-diastolic velocity (EDV), mean resistive index (RI) flows of superior and inferior thyroid arteries were measured with B-mode Doppler ultrasonography. Vitamin D insufficiency/deficiency was detected in 59 (63.4%). TPO Ab and TgAb levels were found higher in patients with vitamin D insufficiency/deficiency. In the normal vitamin D group, superior thyroid artery mPSV (32.21±6.73cm/s) and EDV(13.27±2.80 cm/s) were higher than in the low vitamin D group [mPSV (28.32±8.99cm/s) and EDV(10.67±3.68 cm/s)] (P=0.034, P=0.001, respectively). Inferior thyroid artery EDV value was higher in the normal compared to the low vitamin D group (0.032). RI measured in all arteries were higher in the vitamin D insufficient/deficient group compared to the Vitamin D normal group (p=0.001). Vitamin-D insufficiency/deficiency has led to reduced parenchymal blood supply and increased micro-vascular resistance in Hashimoto thyroiditis patients.

  14. Knowledge, attitude and practice of maternity unit staff in Jos ...

    African Journals Online (AJOL)

    Background: Health care workers in maternity units are exposed to potentially infectious body fluids in the course of their duties. The study assessed the knowledge, attitude and practice of maternity unit staff in Jos Metropolis regarding Universal Precautions (UP) against the background of the high HIV seroprevalence in ...

  15. RH knowledge and service utilization among unmarried rural-to-urban migrants in three major cities, China

    Directory of Open Access Journals (Sweden)

    Li Zi

    2011-02-01

    Full Text Available Abstract Background Large numbers of unmarried migrants are on the continuous move from rural-to-urban areas within China mainland, meanwhile their Reproductive Health (RH is underserved when it is compared with the present urban RH policies. The purpose of this study is to investigate the RH knowledge and the utilization of RH services among unmarried migrants. Methods A cross-section survey was performed in three cities in China-Shenzhen, Guangzhou and Wuhan. A total of 3,450 rural-to-urban unmarried migrants were chosen according to a purposive sampling method. Around 3,412 (male: 1,680, female: 1,732 were qualified for this study. A face-to-face structured questionnaire survey was used, which focused on the knowledge concerning "fertility, contraception and STD/AIDS," as well as RH service utilization. Results Among unmarried migrants the RH knowledge about pregnancy-fertilization (29.4% and contraception (9.1% was at its lowest level. Around 21% of unmarried migrants had pre-marital sexual experience and almost half (47.4% never used condoms during sexual intercourse. The most obtained RH services was about STD/AIDS health education (female: 49.6%, male: 50.2% and free prophylactic use of contraceptives and/or condoms (female: 42.5%, male: 48.3%. As for accessing RH checkup services it was at its lowest level among females (16.1%. Those who migrated to Shenzhen (OR = 0.64 and Guangzhou (OR = 0.53 obtained few RH consultations compared to those in Wuhan. The white collar workers received more RH consultations and checkup services than the blue collar workers (all group P Conclusion RH knowledge and the utilization of RH services amongst unmarried migrants remain insufficient in the three studied major cities. This study reveals the important gaps in the RH services' delivery, and highlights the requirements for tailored interventions, including further research, to address more effectively the demands and the needs of the unmarried migrant

  16. Korean women: breast cancer knowledge, attitudes and behaviors

    Directory of Open Access Journals (Sweden)

    Ryujin Lisa T

    2001-08-01

    Full Text Available Abstract Introduction Clustered within the nomenclature of Asian American are numerous subgroups, each with their own ethnic heritage, cultural, and linguistic characteristics. An understanding of the prevailing health knowledge, attitudes, and screening behaviors of these subgroups is essential for creating population-specific health promotion programs. Methods Korean American women (123 completed baseline surveys of breast cancer knowledge, attitudes, and screening behaviors as part of an Asian grocery store-based breast cancer education program evaluation. Follow-up telephone surveys, initiated two weeks later, were completed by 93 women. Results Low adherence to the American Cancer Society's breast cancer screening guidelines and insufficient breast cancer knowledge were reported. Participants' receptiveness to the grocery store-based breast cancer education program underscores the importance of finding ways to reach Korean women with breast cancer early detection information and repeated cues for screening. The data also suggest that the Asian grocery store-based cancer education program being tested may have been effective in motivating a proportion of the women to schedule a breast cancer screening between the baseline and follow-up surveys. Conclusion The program offers a viable strategy to reach Korean women that addresses the language, cultural, transportation, and time barriers they face in accessing breast cancer early detection information.

  17. Internal Medicine Residents Do Not Accurately Assess Their Medical Knowledge

    Science.gov (United States)

    Jones, Roger; Panda, Mukta; Desbiens, Norman

    2008-01-01

    Background: Medical knowledge is essential for appropriate patient care; however, the accuracy of internal medicine (IM) residents' assessment of their medical knowledge is unknown. Methods: IM residents predicted their overall percentile performance 1 week (on average) before and after taking the in-training exam (ITE), an objective and well…

  18. Awareness, knowledge and attitude on cleft lip and palate among ...

    African Journals Online (AJOL)

    Background: Adequate knowledge and awareness of cleft lip and palate (CLP) deformity may help to counter the negative beliefs and attitudes toward the condition. The objective of this study was to assess the level of awareness, knowledge and attitude of women attending antenatal clinics about CLP. Materials and ...

  19. Technical and Symbolic Knowledge in CNC Machining: A Study of Technical Workers of Different Backgrounds.

    Science.gov (United States)

    Martin, Laura M. W.; Beach, King

    Performances of 45 individuals with varying degrees of formal and informal training in machining and programming were compared on tasks designed to tap intellectual changes that may occur with the introduction of computer numerical control (CNC). Participants--30 machinists, 8 machine operators, and 7 engineers--were asked background questions and…

  20. The Extragalactic Background Light and the Gamma-ray Opacity of the Universe

    Science.gov (United States)

    Dwek, Eli; Krennrich, Frank

    2012-01-01

    The extragalactic background light (EBL) is one of the fundamental observational quantities in cosmology. All energy releases from resolved and unresolved extragalactic sources, and the light from any truly diffuse background, excluding the cosmic microwave background (CMB), contribute to its intensity and spectral energy distribution. It therefore plays a crucial role in cosmological tests for the formation and evolution of stellar objects and galaxies, and for setting limits on exotic energy releases in the universe. The EBL also plays an important role in the propagation of very high energy gamma-rays which are attenuated en route to Earth by pair producing gamma-gamma interactions with the EBL and CMB. The EBL affects the spectrum of the sources, predominantly blazars, in the approx 10 GeV to 10 TeV energy regime. Knowledge of the EBL intensity and spectrum will allow the determination of the intrinsic blazar spectrum in a crucial energy regime that can be used to test particle acceleration mechanisms and VHE gamma-ray production models. Conversely, knowledge of the intrinsic gamma-ray spectrum and the detection of blazars at increasingly higher redshifts will set strong limits on the EBL and its evolution. This paper reviews the latest developments in the determination of the EBL and its impact on the current understanding of the origin and production mechanisms of gamma-rays in blazars, and on energy releases in the universe. The review concludes with a summary and future directions in Cherenkov Telescope Array techniques and in infrared ground-based and space observatories that will greatly improve our knowledge of the EBL and the origin and production of very high energy gamma-rays.

  1. Knowledge and views of professors of nutrition about food irradiation

    International Nuclear Information System (INIS)

    Silva, Kelly Daiane; Braga, Vilma de Oliveira; Quintaes, Kesia Diego

    2010-01-01

    Food irradiation is an efficient technology that can be used in the conservation of foods. However, consumers' knowledge about irradiated foods has proved insufficient resulting in low acceptance of such foods. Considering that dietitians and nutritionists are the qualified health professionals to guide patients and consumers towards the ingestion and selection of foods, this study aims to evaluate the knowledge and views about radiated foods of professors of nutrition working in higher education institutions in the city of Belo Horizonte - MG, Brazil. A total of 86.4% out of the 66 participants had general knowledge about irradiated foods. However, 71.2% were not familiar with the process, 75.8% were totally unaware of the specific legislation, 21.2% were not sure of the purposes of irradiation, 12.1% considered irradiated foods radioactive, and 31.8% believed that food irradiation results in the reduction of the nutritional value of foods. Irradiated foods would not be rejected by professionals with Ph.D. degree, but they would be rejected by five masters and six experts questioned. The study concluded that the current higher education of future dietitians and nutritionists has been provided without the minimum necessary knowledge regarding irradiated foods corroborating the negative view of consumers about this kind of food. (author)

  2. Efficacy and safety of benazepril for advanced chronic renal insufficiency.

    Science.gov (United States)

    Hou, Fan Fan; Zhang, Xun; Zhang, Guo Hua; Xie, Di; Chen, Ping Yan; Zhang, Wei Ru; Jiang, Jian Ping; Liang, Min; Wang, Guo Bao; Liu, Zheng Rong; Geng, Ren Wen

    2006-01-12

    Angiotensin-converting-enzyme inhibitors provide renal protection in patients with mild-to-moderate renal insufficiency (serum creatinine level, 3.0 mg per deciliter or less). We assessed the efficacy and safety of benazepril in patients without diabetes who had advanced renal insufficiency. We enrolled 422 patients in a randomized, double-blind study. After an eight-week run-in period, 104 patients with serum creatinine levels of 1.5 to 3.0 mg per deciliter (group 1) received 20 mg of benazepril per day, whereas 224 patients with serum creatinine levels of 3.1 to 5.0 mg per deciliter (group 2) were randomly assigned to receive 20 mg of benazepril per day (112 patients) or placebo (112 patients) and then followed for a mean of 3.4 years. All patients received conventional antihypertensive therapy. The primary outcome was the composite of a doubling of the serum creatinine level, end-stage renal disease, or death. Secondary end points included changes in the level of proteinuria and the rate of progression of renal disease. Of 102 patients in group 1, 22 (22 percent) reached the primary end point, as compared with 44 of 108 patients given benazepril in group 2 (41 percent) and 65 of 107 patients given placebo in group 2 (60 percent). As compared with placebo, benazepril was associated with a 43 percent reduction in the risk of the primary end point in group 2 (P=0.005). This benefit did not appear to be attributable to blood-pressure control. Benazepril therapy was associated with a 52 percent reduction in the level of proteinuria and a reduction of 23 percent in the rate of decline in renal function. The overall incidence of major adverse events in the benazepril and placebo subgroups of group 2 was similar. Benazepril conferred substantial renal benefits in patients without diabetes who had advanced renal insufficiency. (ClinicalTrials.gov number, NCT00270426.) Copyright 2006 Massachusetts Medical Society.

  3. Insufficient incentives for investment in electricity generations

    Energy Technology Data Exchange (ETDEWEB)

    Neuhoff, K. [Cambridge University (United Kingdom). Dept. of Applied Economics; De Vries, L. [Delft University of Technology (Netherlands). Faculty of Technology, Policy and Management

    2004-12-01

    In theory, competitive electricity markets provide incentives for efficient investment in generation capacity. We show that if consumers and investors are risk averse, investment is efficient only if investors in generation capacity can sign long-term contracts with consumers. Otherwise the uncovered price risk increases financing costs, reduces equilibrium investment levels, distorts technology choice towards less capital-intensive generation and reduces consumer utility. We observe insufficient levels of long-term contracts in existing markets, possibly because retail companies are not credible counter-parties if their final customers can switch easily between them. With a consumer franchise, retailers can sign long-term contracts, but this solution comes at the expense of retail competition. Alternative capacity mechanisms to stimulate investment are discussed. (author)

  4. Benchmarking of the simulation of the ATLAS HaLL background

    International Nuclear Information System (INIS)

    Vincke, H.

    2000-01-01

    The LHC, mainly to be used as a proton-proton collider, providing collisions at energies of 14 TeV, will be operational in the year 2005. ATLAS, one of the LHC experiments, will provide high accuracy measurements concerning these p-p collisions. In these collisions also a high particle background is produced. This background was already calculated with the Monte Carlo simulation program FLUKA. Unfortunately, the prediction concerning this background rate is only understood within an uncertainty level of five. The main contribution of this factor can be seen as limited knowledge concerning the ability of FLUKA to simulate these kinds of scenarios. In order to reduce the uncertainty, benchmarking simulations of experiments similar to the ATLAS background situation were performed. The comparison of the simulations with the experiments proves to which extent FLUKA is able to provide reliable results concerning the ATLAS background situation. In order to perform this benchmark, an iron construction was irradiated by a hadron beam. The primary particles had ATLAS equivalent energies. Behind the iron structure, the remnants of the shower processes are measured and simulated. The simulation procedure and its encouraging results, including the comparison with the measured numbers, are presented and discussed in this work. (author)

  5. Acute Cerebral Insufficiency in Patients with Severe Forms of Alcoholic Psychoses

    Directory of Open Access Journals (Sweden)

    V. V. Zverev

    2006-01-01

    Full Text Available The paper summarizes the results of studies of cerebral metabolism in 38 patients with delirium tremens. The findings have led to the conclusion that the leading factor of the pathogenesis of acute cerebral insufficiency in this case is energy deficiency caused by impaired cerebral glucose utilization rather than hypoxia itself.

  6. Hanford Site background: Part 1, Soil background for nonradioactive analytes

    International Nuclear Information System (INIS)

    1993-04-01

    Volume two contains the following appendices: Description of soil sampling sites; sampling narrative; raw data soil background; background data analysis; sitewide background soil sampling plan; and use of soil background data for the detection of contamination at waste management unit on the Hanford Site

  7. [Delayed complications after pancreatic surgery: Pancreatic insufficiency, malabsorption syndrome, pancreoprivic diabetes mellitus and pseudocysts].

    Science.gov (United States)

    Nitsche, U; Siveke, J; Friess, H; Kleeff, J

    2015-06-01

    Benign and malignant pathologies of the pancreas can result in a relevant chronic disease burden. This is aggravated by morbidities resulting from surgical resections as well as from progression of the underlying condition. The aim was to summarize the current evidence regarding epidemiology, pathophysiology, diagnosis and treatment of endocrine and exocrine pancreatic insufficiency, as well as of pancreatic pseudocysts. A selective literature search was performed and a summary of the currently available data on the surgical sequelae after pancreatic resection is given. Reduction of healthy pancreatic parenchyma down to 10-15 % leads to exocrine insufficiency with malabsorption and gastrointestinal complaints. Orally substituted pancreatic enzymes are the therapy of choice. Loss of pancreatic islets and/or islet function leads to endocrine insufficiency and pancreoprivic diabetes mellitus. Inflammatory, traumatic and iatrogenic injuries of the pancreas can lead to pancreatic pseudocysts, which require endoscopic, interventional or surgical drainage if symptomatic. Finally, pancreatic surgery harbors the long-term risk of gastrointestinal anastomotic ulcers, bile duct stenosis, portal vein thrombosis and chronic pain syndrome. As the evidence is limited, an interdisciplinary and individually tailored approach for delayed pancreatic morbidity is recommended.

  8. Impact of insufficient energy content in the design time history on the structure response

    International Nuclear Information System (INIS)

    Ma, D.C.; Gvildys, J.; Chang, Y.W.; Seidensticker, R.W.

    1989-01-01

    In the design of nuclear power plants, it is often desirable to use the time history method in the soil-structure interaction analysis to determine the plant floor response to seismic loads. Because many design criteria are specified in terms of design response spectra, the artificial time history needs to be generated under the requirement that the response spectra of the artificial history should envelop the given design response spectra. However, recent studies indicate that the artificial time history used in the plant design may have insufficient energy in the frequency range of interest, even though the response spectra of the design time history closely envelop the design response spectra. This paper presents an investigation of the effects of the insufficient energy content in the design time history on the response of the soil-structure system. Numerical studies were carried out. Both the real earthquake records and the artificial time histories were used as the input motions in a simple lumped-mass soil-structure interaction model. The results obtained from this study provide a better understanding of the effects of the insufficient energy content in the design time history on the structural response

  9. Preschool Education in Today's World: Teaching Children with Diverse Backgrounds and Abilities

    Science.gov (United States)

    Burns, M. Susan; Johnson, Richard T.; Assaf, Mona M.

    2012-01-01

    Future early childhood educators need to know how to teach "all" young learners effectively--including children with diverse cultural, linguistic, and economic backgrounds and children with special needs. This core textbook equips early childhood educators with the knowledge they'll need to succeed in the classroom and ensure the best…

  10. High prevalence of vitamin D insufficiency and its association with obesity and metabolic syndrome among Malay adults in Kuala Lumpur, Malaysia.

    Science.gov (United States)

    Moy, Foong-Ming; Bulgiba, Awang

    2011-09-27

    Vitamin D status, as indicated by 25-hydroxyvitamin D is inversely associated with adiposity, glucose homeostasis, lipid profiles, and blood pressure along with its classic role in calcium homeostasis and bone metabolism. It is also shown to be inversely associated with metabolic syndrome and cardiovascular diseases in western populations. However, evidence from the Asian population is limited. Therefore, we aim to study the prevalence of vitamin D insufficiency (obesity, HDL-cholesterol, diastolic blood pressure), insufficient Vitamin D status was significantly associated with 1-year age increments (OR: 0.93; 95% CI: 0.88, 0.98), being female (OR: 8.68; 95% CI: 5.08, 14.83) and abdominal obesity (OR: 2.57; 95% CI: 1.51, 4.39). Respondents with insufficient vitamin D were found to have higher odds of having Metabolic Syndrome (OR: 1.73; 95% CI: 1.02, 2.92) after adjusting for age and sex. Our results highlight the high prevalence of vitamin D insufficiency among Malay adults in Kuala Lumpur. Vitamin D insufficiency is independently associated with younger age, female sex and greater abdominal obesity. Vitamin D insufficiency is also associated with Metabolic Syndrome.

  11. A statistical background noise correction sensitive to the steadiness of background noise.

    Science.gov (United States)

    Oppenheimer, Charles H

    2016-10-01

    A statistical background noise correction is developed for removing background noise contributions from measured source levels, producing a background noise-corrected source level. Like the standard background noise corrections of ISO 3741, ISO 3744, ISO 3745, and ISO 11201, the statistical background correction increases as the background level approaches the measured source level, decreasing the background noise-corrected source level. Unlike the standard corrections, the statistical background correction increases with steadiness of the background and is excluded from use when background fluctuation could be responsible for measured differences between the source and background noise levels. The statistical background noise correction has several advantages over the standard correction: (1) enveloping the true source with known confidence, (2) assuring physical source descriptions when measuring sources in fluctuating backgrounds, (3) reducing background corrected source descriptions by 1 to 8 dB for sources in steady backgrounds, and (4) providing a means to replace standardized background correction caps that incentivize against high precision grade methods.

  12. Can Stoss Therapy Be Used in Children with Vitamin D Deficiency or Insufficiency without Rickets?

    Science.gov (United States)

    Koçyiğit, Cemil; Çatlı, Gönül; İnce, Gülberat; Özkan, Elif Büşra; Dündar, Bumin Nuri

    2017-06-01

    Stoss vitamin D treatment has been recommended for its non-skeletal benefits in adults, but there is a lack of data on the optimal dose of vitamin D stoss therapy in children with vitamin D deficiency/insufficiency without rickets. This study aimed to compare efficiency/side effects of two different stoss therapy regimens (10 000 IU/kg and 300 000 IU vitamin D3) administered in children with vitamin D deficiency/insufficiency without rickets. Sixty-four children who had vitamin D deficiency/insufficiency were studied. A serum 25-hydroxyvitamin-D (25-OH-D) level of 15-20 ng/mL was considered as vitamin D insufficient and <15 ng/mL was considered as vitamin D deficient. The patients were divided into two groups according to the stoss therapy doses they received. Serum calcium, phosphate, alkaline phosphatase, 25-OH-D, parathyroid hormone levels, and spot urine calcium/creatinine ratios before/after treatment were recorded. Wrist radiography and renal ultrasonography were performed. The mean age of the subjects was 10.6±4.4 years. Thirty-two children were treated with a single vitamin D3 dose of 10 000 IU/kg and 32 patients received 300 000 IU. No difference was found in 25-OH-D levels between the two groups at presentation. The mean level of 25-OH-D was higher in the 10 000 IU/kg group at the second week of therapy. There was no difference between the groups at post-treatment weeks 4 and 12. The 25-OH-D was found to be below optimal levels (≥30 ng/mL) in 66.5% and <20 ng/mL in 21.8% of patients at the third month in both groups. None developed hypercalcemia and/or hypercalciuria. Nephrolithiasis was not detected in any patient. This study showed that both doses of stoss therapy used in the treatment of vitamin D insufficiency/deficiency are effective and safe. However, an optimal level of 25-OH-D cannot be maintained for more than three months.

  13. Anemia and the risk of contrast-induced nephropathy in patients with renal insufficiency undergoing contrast-enhanced MDCT

    International Nuclear Information System (INIS)

    Murakami, Ryusuke; Kumita, Shin-ichiro; Hayashi, Hiromitsu; Sugizaki, Ken-ichi; Okazaki, Emi; Kiriyama, Tomonari; Hakozaki, Kenta; Tani, Hitomi; Miki, Izumi; Takeda, Minako

    2013-01-01

    Purpose: The purpose of this study was to assess the effect of anemia on the incidence of contrast-induced nephropathy (CIN) in patients with renal impairment undergoing MDCT. Materials and methods: Institutional review board approval was waived for this retrospective review of 843 patients with stable renal insufficiency (eGFR between 15 and 60 mL/min) who had undergone contrast-enhanced MDCT. Baseline hematocrit and hemoglobin values were measured. Serum creatinine (SCr) was assessed at the baseline and at 48–72 h after contrast administration. Results: The overall incidence of CIN in the patient population with renal insufficiency was 6.9%. CIN developed in 7.8% (54 of 695) of anemic patients, and in 2.8% (4 of 148) of non-anemic patients (P = .027). After adjustment for confounders, low hemoglobin and low hematocrit values remained independent predictors of CIN (odds ratio 4.6, 95% CI 1.0–20.5, P = .046). Conclusions: Anemia is associated with a higher incidence of CIN in patients with renal insufficiency. Anemia is a potentially modifiable risk factor for CIN, and has an unfavorable impact on prognosis in patients with renal insufficiency undergoing contrast-enhanced MDCT

  14. Anemia and the risk of contrast-induced nephropathy in patients with renal insufficiency undergoing contrast-enhanced MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Murakami, Ryusuke, E-mail: rywakana@nms.ac.jp; Kumita, Shin-ichiro; Hayashi, Hiromitsu; Sugizaki, Ken-ichi; Okazaki, Emi; Kiriyama, Tomonari; Hakozaki, Kenta; Tani, Hitomi; Miki, Izumi; Takeda, Minako

    2013-10-01

    Purpose: The purpose of this study was to assess the effect of anemia on the incidence of contrast-induced nephropathy (CIN) in patients with renal impairment undergoing MDCT. Materials and methods: Institutional review board approval was waived for this retrospective review of 843 patients with stable renal insufficiency (eGFR between 15 and 60 mL/min) who had undergone contrast-enhanced MDCT. Baseline hematocrit and hemoglobin values were measured. Serum creatinine (SCr) was assessed at the baseline and at 48–72 h after contrast administration. Results: The overall incidence of CIN in the patient population with renal insufficiency was 6.9%. CIN developed in 7.8% (54 of 695) of anemic patients, and in 2.8% (4 of 148) of non-anemic patients (P = .027). After adjustment for confounders, low hemoglobin and low hematocrit values remained independent predictors of CIN (odds ratio 4.6, 95% CI 1.0–20.5, P = .046). Conclusions: Anemia is associated with a higher incidence of CIN in patients with renal insufficiency. Anemia is a potentially modifiable risk factor for CIN, and has an unfavorable impact on prognosis in patients with renal insufficiency undergoing contrast-enhanced MDCT.

  15. A systematic analysis of the XMM-Newton background: III. Impact of the magnetospheric environment

    Science.gov (United States)

    Ghizzardi, Simona; Marelli, Martino; Salvetti, David; Gastaldello, Fabio; Molendi, Silvano; De Luca, Andrea; Moretti, Alberto; Rossetti, Mariachiara; Tiengo, Andrea

    2017-12-01

    A detailed characterization of the particle induced background is fundamental for many of the scientific objectives of the Athena X-ray telescope, thus an adequate knowledge of the background that will be encountered by Athena is desirable. Current X-ray telescopes have shown that the intensity of the particle induced background can be highly variable. Different regions of the magnetosphere can have very different environmental conditions, which can, in principle, differently affect the particle induced background detected by the instruments. We present results concerning the influence of the magnetospheric environment on the background detected by EPIC instrument onboard XMM-Newton through the estimate of the variation of the in-Field-of-View background excess along the XMM-Newton orbit. An important contribution to the XMM background, which may affect the Athena background as well, comes from soft proton flares. Along with the flaring component a low-intensity component is also present. We find that both show modest variations in the different magnetozones and that the soft proton component shows a strong trend with the distance from Earth.

  16. Association of TGFβ1, TNFα, CCR2 and CCR5 gene polymorphisms in type-2 diabetes and renal insufficiency among Asian Indians

    Directory of Open Access Journals (Sweden)

    Gupta Arvind

    2007-04-01

    Full Text Available Abstract Background Cytokines play an important role in the development of diabetic chronic renal insufficiency (CRI. Transforming growth factor β1 (TGF β1 induces renal hypertrophy and fibrosis, and cytokines like tumor necrosis factor-alpha (TNFα, chemoattractant protein-1 (MCP-1, and regulated upon activation and normal T cell expressed and secreted (RANTES mediate macrophage infiltration into kidney. Over expression of these chemokines leads to glomerulosclerosis and interstitial fibrosis. The effect of MCP-1 and RANTES on kidney is conferred by their receptors i.e., chemokine receptor (CCR-2 and CCR-5 respectively. We tested association of nine single nucleotide polymorphisms (SNPs from TGFβ1, TNFα, CCR2 and CCR5 genes among individuals with type-2 diabetes with and without renal insufficiency. Methods Type-2 diabetes subjects with chronic renal insufficiency (serum creatinine ≥ 3.0 mg/dl constituted the cases, and matched individuals with diabetes of duration ≥ 10 years and normoalbuminuria were evaluated as controls from four centres in India. Allelic and genotypic contributions of nine SNPs from TGFβ1, TNFα, CCR2 and CCR5 genes to diabetic CRI were tested by computing odds ratio (OR and 95% confidence intervals (CI. Sub-analysis of CRI cases diabetic retinopathy status as dependent variable and SNP genotypes as independent variable in a univariate logistic regression was also performed. Results SNPs Tyr81His and Thr263Ile in TGF β1 gene were monomorphic, and Arg25Pro in TGF β1 gene and Δ32 polymorphism in CCR5 gene were minor variants (minor allele frequency A SNP of CCR5 gene has been observed and the allele 59029A seems to confer predisposition to development of diabetic CRI (OR 1.39; CI 1.04–1.84. In CRI subjects a compound group of genotypes "GA and AA" of SNP G>A -800 was found to confer predisposition for proliferative retinopathy (OR 3.03; CI 1.08–8.50, p = 0.035. Conclusion Of the various cytokine gene

  17. Knowledge, attitude, and practice on emergency contraceptives ...

    African Journals Online (AJOL)

    Background: Unwanted pregnancy followed by unsafe abortion can be avoided by using different contraceptive methods, including emergency contraceptives. Information on knowledge, attitude and practice of emergency contraceptives among women is particularly important because of high rates of teenage and ...

  18. Metallic stent placement in hemodialysis graft patients after insufficient balloon dilation

    International Nuclear Information System (INIS)

    Liang, Huei-Lung; Pan, Huay-Ben; Lin, Yih-Huie; Chen, Chiung-Yu; Lai, Pin-Hong; Yang, Chien-Fang; Chung, Hsiao-Min; Wu, Tung-Ho; Chou, Kang-Ju

    2006-01-01

    We wanted to report our experience of metallic stent placement after insufficient balloon dilation in graft hemodialysis patients. Twenty-three patients (13 loop grafts in the forearm and 10 straight grafts in the upper arm) underwent metallic stent placement due to insufficient flow after urokinase thrombolysis and balloon dilation. The indications for metallic stent deployment included 1) recoil and/or kinked venous stenosis in 21 patents (venous anastomosis: 17 patients, peripheral outflow vein: four patients); and 2) major vascular rupture in two patients. Metallic stents 8-10mm in diameter and 40-80 mm in length were used. Of them, eight stents were deployed across the elbow crease. Access patency was determined by clinical follow-up and the overall rates were calculated by Kaplan-Meier survival analysis. No procedure-related complications (stent fracture or central migration) were encountered except for a delayed Wallstent shortening/migration at the venous anastomosis, which resulted in early access failure. The overall primary and secondary patency rates (±standard error) of all the vascular accesses in our 23 patients at 3, 6, 12 and 24 months were 69%±9 and 88%±6,41% ±10 and 88%±6, 30%±10 and 77%±10, and 12%±8 and 61%±13, respectively. For the forearm and upper-arm grafts, the primary and secondary patency rates were 51%±16 and 86%±13 vs 45%±15 and 73%±13 at 6 months, and 25%±15 and 71%±17 vs 23%±17 and 73%±13 at 12 months (ρ = .436 and .224), respectively. Metallic stent placement is a safe and effective means for treating peripheral venous lesions in dialysis graft patients after insufficient balloon dilation. No statistically difference in the patency rates between the forearm and upper-arm patient groups was seen

  19. A magnetic diverter for charged particle background rejection in the SIMBOL-X telescope

    Science.gov (United States)

    Spiga, D.; Fioretti, V.; Bulgarelli, A.; Dell'Orto, E.; Foschini, L.; Malaguti, G.; Pareschi, G.; Tagliaferri, G.; Tiengo, A.

    2008-07-01

    Minimization of charged particle background in X-ray telescopes is a well known issue. Charged particles (chiefly protons and electrons) naturally present in the cosmic environment constitute an important background source when they collide with the X-ray detector. Even worse, a serious degradation of spectroscopic performances of the X-ray detector was observed in Chandra and Newton-XMM, caused by soft protons with kinetic energies ranging between 100 keV and some MeV being collected by the grazing-incidence mirrors and funneled to the detector. For a focusing telescope like SIMBOL-X, the exposure of the soft X-ray detector to the proton flux can increase significantly the instrumental background, with a consequent loss of sensitivity. In the worst case, it can also seriously compromise the detector duration. A well-known countermeasure that can be adopted is the implementation of a properly-designed magnetic diverter, that should prevent high-energy particles from reaching the focal plane instruments of SIMBOL-X. Although Newton-XMM and Swift-XRT are equipped with magnetic diverters for electrons, the magnetic fields used are insufficient to effectively act on protons. In this paper, we simulate the behavior of a magnetic diverter for SIMBOL-X, consisting of commercially-available permanent magnets. The effects of SIMBOL-X optics is simulated through GEANT4 libraries, whereas the effect of the intense required magnetic fields is simulated along with specifically-written numerical codes in IDL.

  20. [Health education for puerperal women in neonatal rooming-in: knowledge acquisition with an educational game].

    Science.gov (United States)

    Fonseca, Luciana Mara Monti; Scochi, Carmen Gracinda Silvan; de Mello, Débora Falleiros

    2002-01-01

    The study aims at verifying knowledge acquisition through health education activities mediated by the use of an educational game on breast-feeding and basic care provided to the newborn, in rooming-in. Study accomplished at a philanthropic maternity of Ribeirão Preto-SP. Educational activities were accomplished in group, coordinated by the nurse, using board game. Through structured interview guided by a route before and after-game, the authors verified the knowledge acquisition, classifying the answers in insufficient (0-4), regular (5-9), good (10-14) and excellent (15-20). Of the mothers' previous knowledge, 16.7% of answers were excellent increasing for 77.8% after participation in the educational activity. They concluded that the game constituted in appropriate strategy to facilitate change of experiences between puerperas and the development of the health education through ludic-pedagogical activities.

  1. Chronic cerebrospinal venous insufficiency in multiple sclerosis: clinical correlates from a multicentre study

    Directory of Open Access Journals (Sweden)

    Bastianello Stefano

    2011-10-01

    Full Text Available Abstract Background Chronic cerebrospinal venous insufficiency (CCSVI has recently been reported to be associated with multiple sclerosis (MS. However, its actual prevalence, possible association with specific MS phenotypes, and potential pathophysiological role are debated. Method We analysed the clinical data of 710 MS patients attending six centres (five Italian and one Canadian. All were submitted to venous Doppler sonography and diagnosed as having or not having CCSVI according to the criteria of Zamboni et al. Results Overall, CCSVI was diagnosed in 86% of the patients, but the frequency varied greatly between the centres. Even greater differences were found when considering singly the five diagnostic criteria proposed by Zamboni et al. Despite these differences, significant associations with clinical data were found, the most striking being age at disease onset (about five years greater in CCSVI-positive patients and clinical severity (mean EDSS score about one point higher in CCSVI-positive patients. Patients with progressive MS were more likely to have CCSVI than those with relapsing-remitting MS. Conclusion The methods for diagnosing CCSVI need to be refined, as the between-centre differences, particularly in single criteria, were excessively high. Despite these discrepancies, the strong associations between CCSVI and MS phenotype suggest that the presence of CCSVI may favour a later development of MS in patients with a lower susceptibility to autoimmune diseases and may increase its severity.

  2. Characterization of ions in urine of animal model with acute renal insufficiency using NAA

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Laura C.; Zamboni, Cibele B. [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Pessoa, Edson A.; Borges, Fernanda T. [Universidade Federal de Sao Paulo (UNIFESP), SP (Brazil)

    2010-07-01

    Full text: In last the years, important advances had been obtained in the investigation of the ARI (Acute Renal Insufficiency) what is defined as an abrupt or rapid decline in renal filtration function, what is a situation in which the kidneys fail to function adequately, caused by the Ischemia and Reperfusion (I/R). However, the incidence of the mortality had not diminished in the last few decades. This kidney dysfunction includes a complex interaction between the tubular injury, inflammation and alterations in the renal homo dynamic. In this investigation we intend to quantify ions of clinical relevance in urine of Wistar rats of control group, an experimental model for ARI, and in urine of Wistar with ARI, using NAA technique (Neutron Activation Analysis). The use of this technique is an alternative to perform biochemistry analysis when the biological material is scarce. The quantitative knowledge of these elements allows an evaluation of the functions that regulate the kidneys behavior. The measurements in urine were performed before, during and after the ARI caused by ischemia-induced. The results of NAA indicated that the occurrence of the elements K and Mg evaluated in the ARI group (during and after de I/R) have no similarities when compared with control group. (author)

  3. Repair of traumatic tricuspid insufficiency via minimally invasive port access.

    Science.gov (United States)

    Kasahara, Hirofumi; Kudo, Mikihiko; Kawajiri, Hiroyuki; Yozu, Ryohei

    2010-04-01

    We report on a successful tricuspid valve plasty using port-access minimally invasive cardiac surgery (MICS) for severe traumatic tricuspid insufficiency caused by blunt chest trauma suffered 15 years previously. A combination repair procedure, consisting of cleft closures, plication of the anteroseptal commissure, and ring annuloplasty, was necessary to achieve valve competence and proved possible via port access without difficulty. Port-access MICS is an alternative approach for tricuspid valve surgery.

  4. Intracultural Differences in Local Botanical Knowledge and Knowledge Loss among the Mexican Isthmus Zapotecs.

    Directory of Open Access Journals (Sweden)

    Alfredo Saynes-Vásquez

    Full Text Available This study reports on the socio-demographic and locality factors that influence ethnobiological knowledge in three communities of Zapotec indigenous people of the Isthmus of Tehuantepec, Mexico. It uses local botanical nomenclature as a proxy for general ethnobiological knowledge. In each of these communities (one urban and two rural, 100 adult men were interviewed aided with a field herbarium. Fifty had a background in farming, and 50 worked in the secondary or tertiary sector as their main economic activity, totaling 300 interviews. Using a field herbarium with samples of 30 common and rare wild regional species, we documented visual recognition, knowledge of the local life form, generic and specific names and uses (five knowledge levels measuring knowledge depth. The relationship between sociodemographic variables and knowledge was analyzed with simple correlations. Differences between the three communities and the five knowledge levels were then evaluated with a discriminant analysis. A general linear analysis identified factors and covariables that influenced the observed differences. Differences between the groups with different economic activities were estimated with a t-test for independent samples. Most of the relationships found between sociodemographic variables and plant knowledge were expected: age and rurality were positively related with knowledge and years of formal schooling was negatively related. However, the somewhat less rural site had more traditional knowledge due to local circumstances. The general linear model explained 70-77% of the variation, a high value. It showed that economic activity was by far the most important factor influencing knowledge, by a factor of five. The interaction of locality and economic activity followed. The discriminant analysis assigned interviewees correctly to their localities in 94% of the cases, strengthening the evidence for intracultural variation. Both sociodemographic and historic

  5. Local Knowledge and Professional Background Have a Minimal Impact on Volunteer Citizen Science Performance in a Land-Cover Classification Task

    Directory of Open Access Journals (Sweden)

    Carl Salk

    2016-09-01

    Full Text Available The idea that closer things are more related than distant things, known as ‘Tobler’s first law of geography’, is fundamental to understanding many spatial processes. If this concept applies to volunteered geographic information (VGI, it could help to efficiently allocate tasks in citizen science campaigns and help to improve the overall quality of collected data. In this paper, we use classifications of satellite imagery by volunteers from around the world to test whether local familiarity with landscapes helps their performance. Our results show that volunteers identify cropland slightly better within their home country, and do slightly worse as a function of linear distance between their home and the location represented in an image. Volunteers with a professional background in remote sensing or land cover did no better than the general population at this task, but they did not show the decline with distance that was seen among other participants. Even in a landscape where pasture is easily confused for cropland, regional residents demonstrated no advantage. Where we did find evidence for local knowledge aiding classification performance, the realized impact of this effect was tiny. Rather, the inherent difficulty of a task is a much more important predictor of volunteer performance. These findings suggest that, at least for simple tasks, the geographical origin of VGI volunteers has little impact on their ability to complete image classifications.

  6. Nutrient Intake Is Insufficient among Senegalese Urban School Children and Adolescents: Results from Two 24 h Recalls in State Primary Schools in Dakar

    Directory of Open Access Journals (Sweden)

    Marion Fiorentino

    2016-10-01

    Full Text Available Due to rapid urbanization and high food prices and in the absence of nutrition programs, school children from urban areas in West Africa often have insufficient and inadequate diet leading to nutrient deficiencies that affect their health and schooling performance. Acute malnutrition and micronutrient deficiencies are prevalent in children from primary state schools of Dakar (Senegal. The objectives of the present study were to assess the overall diet of these children, to report insufficient/excessive energy and nutrient intakes and to investigate association between insufficient nutrient intake and micronutrient deficiencies. Children attending urban state primary schools in the Dakar area were selected through a two-stage random cluster sampling (30 schools × 20 children. Dietary intake data were obtained from two 24 h recalls and blood samples were collected from 545 children (aged 5–17 years, 45% < 10 years, 53% girls and adjusted for intra-individual variability to estimate nutrient usual intakes. Energy intake was insufficient and unbalanced with insufficient contribution of protein and excessive contribution of fat to global energy intake in one third of the children. Proportions of children with insufficient intake were: 100% for calcium, 100% for folic acid, 79% for vitamin A, 69% for zinc, 53% for vitamin C and 46% for iron. Insufficient iron and protein intake were risk factors for iron deficiency (odds ratio, OR 1.5, 2.2. Insufficient zinc intake and energy intake from protein were risk factors for zinc deficiency (OR 1.8, 3.0, 1.7, 2.9. Insufficient iron and vitamin C intake, and insufficient energy intake from protein were risk factors for marginal vitamin A status (OR 1.8, 1.8, 3.3. To address nutritional deficiencies associated with a diet deficient in energy, protein and micronutrients, nutrition education or school feeding programs are needed in urban primary schools of Senegal.

  7. Nutrient Intake Is Insufficient among Senegalese Urban School Children and Adolescents: Results from Two 24 h Recalls in State Primary Schools in Dakar

    Science.gov (United States)

    Fiorentino, Marion; Landais, Edwige; Bastard, Guillaume; Carriquiry, Alicia; Wieringa, Frank T.; Berger, Jacques

    2016-01-01

    Due to rapid urbanization and high food prices and in the absence of nutrition programs, school children from urban areas in West Africa often have insufficient and inadequate diet leading to nutrient deficiencies that affect their health and schooling performance. Acute malnutrition and micronutrient deficiencies are prevalent in children from primary state schools of Dakar (Senegal). The objectives of the present study were to assess the overall diet of these children, to report insufficient/excessive energy and nutrient intakes and to investigate association between insufficient nutrient intake and micronutrient deficiencies. Children attending urban state primary schools in the Dakar area were selected through a two-stage random cluster sampling (30 schools × 20 children). Dietary intake data were obtained from two 24 h recalls and blood samples were collected from 545 children (aged 5–17 years, 45% < 10 years, 53% girls) and adjusted for intra-individual variability to estimate nutrient usual intakes. Energy intake was insufficient and unbalanced with insufficient contribution of protein and excessive contribution of fat to global energy intake in one third of the children. Proportions of children with insufficient intake were: 100% for calcium, 100% for folic acid, 79% for vitamin A, 69% for zinc, 53% for vitamin C and 46% for iron. Insufficient iron and protein intake were risk factors for iron deficiency (odds ratio, OR 1.5, 2.2). Insufficient zinc intake and energy intake from protein were risk factors for zinc deficiency (OR 1.8, 3.0, 1.7, 2.9). Insufficient iron and vitamin C intake, and insufficient energy intake from protein were risk factors for marginal vitamin A status (OR 1.8, 1.8, 3.3). To address nutritional deficiencies associated with a diet deficient in energy, protein and micronutrients, nutrition education or school feeding programs are needed in urban primary schools of Senegal. PMID:27775598

  8. Knowledge of Stroke Risk Factors among Stroke Survivors in Nigeria

    OpenAIRE

    Grace Vincent-Onabajo; Taritei Moses

    2016-01-01

    Background. Knowledge of stroke risk factors is expected to reduce the incidence of stroke?whether first-ever or recurrent. This study examined knowledge of stroke risk factors and its determinants among stroke survivors. Methods. A cross-sectional survey of consenting stroke survivors at two physiotherapy facilities in Nigeria was carried out. Sociodemographic and clinical data were obtained and knowledge of stroke risk factors (defined as the ability to mention at least one correct risk fac...

  9. Hand hygiene knowledge and perceptions among anesthesia providers.

    Science.gov (United States)

    Fernandez, Patrick G; Loftus, Randy W; Dodds, Thomas M; Koff, Matthew D; Reddy, Sundara; Heard, Stephen O; Beach, Michael L; Yeager, Mark P; Brown, Jeremiah R

    2015-04-01

    Health care worker compliance with hand hygiene guidelines is an important measure for health care-associated infection prevention, yet overall compliance across all health care arenas remains low. A correct answer to 4 of 4 structured questions pertaining to indications for hand decontamination (according to types of contact) has been associated with improved health care provider hand hygiene compliance when compared to those health care providers answering incorrectly for 1 or more questions. A better understanding of knowledge deficits among anesthesia providers may lead to hand hygiene improvement strategies. In this study, our primary aims were to characterize and identify predictors for hand hygiene knowledge deficits among anesthesia providers. We modified this previously tested survey instrument to measure anesthesia provider hand hygiene knowledge regarding the 5 moments of hand hygiene across national and multicenter groups. Complete knowledge was defined by correct answers to 5 questions addressing the 5 moments for hand hygiene and received a score of 1. Incomplete knowledge was defined by an incorrect answer to 1 or more of the 5 questions and received a score of 0. We used a multilevel random-effects XTMELOGIT logistic model clustering at the respondent and geographic location for insufficient knowledge and forward/backward stepwise logistic regression analysis to identify predictors for incomplete knowledge. The survey response rates were 55.8% and 18.2% for the multicenter and national survey study groups, respectively. One or more knowledge deficits occurred with 81.6% of survey respondents, with the mean number of correct answers 2.89 (95% confidence interval, 2.78- 2.99). Failure of providers to recognize prior contact with the environment and prior contact with the patient as hand hygiene opportunities contributed to the low mean. Several cognitive factors were associated with a reduced risk of incomplete knowledge including providers responding

  10. EPR dosimetry of radiation background in the Urals region

    Energy Technology Data Exchange (ETDEWEB)

    Shishkina, E.A.; Degteva, M.O.; Shved, V.A. [Urals Research Center for Radiation Medicine, 48-A Vorovsky, Chelyabinsk 454076 (Russian Federation); Fattibene, P.; Onori, S. [Istituto Superiore di Sanita and Istituto Nazionale di Fisica Nucleare (Italy); Wieser, A. [GSF, Forschungszentrum fuer Umwelt und Gesundheit, Ingolstaedter Landstr (Germany); Ivanov, D.V.; Bayankin, S.N. [Institute of Metal Physics, Russian Academy of Sciences (Russian Federation); Knyazev, V.A.; Vasilenko, E.I.; Gorelov, M. [ZAO, Closed Corporation ' Company GEOSPETSECOLOGIA' (Russian Federation)

    2006-07-01

    Method of Electron Paramagnetic Resonance is extensively applied to individual retrospective dosimetry. The background dose is unavoidable component of cumulative absorbed dose in the tooth enamel accumulated during the lifetime of donor. Estimation of incidental radiation dose using tooth enamel needs in extraction of background dose. Moreover, the variation of background doses in the population is a limited factor for reliable detection of additional irradiation especially for low dose level. Therefore the accurate knowledge of the natural background radiation dose is a critical element of EPR studies of exposed populations. In the Urals region the method applies for such two large cohorts as the workers of Mayak (Ozersk citizens) and Techa River riverside inhabitants (rural population). Current study aimed to investigate the Urals radiation background detected by EPR spectrometry. For this aim two group of unexposed Urals residents were separated, viz: citizens of Ozersk and rural inhabitants of Chelyabinsk region. Comparison of two investigated territories has demonstrated that from the point of view of radiation background it is impossible to assume the Urals population as uniform. The reliable difference between the urban and rural residents has been found. The average background doses of Ozersk donors is in average 50 mGy higher than those detected for rural residents. The individual variability of background doses for Osersk has been higher than in the rural results. The difference in background dose levels between two population results in different limits of accidental dose detection and individualization. The doses for 'Mayak' workers (Ozyorsk citizens) can be classed as anthropogenic if the EPR measurements exceed 120 mGy for teeth younger than 40 years, and 240 mGy for teeth older than 70 years. The anthropogenic doses for Techa River residents (rural population) would be higher than 95 mGy for teeth younger than 50 years and 270 mGy for

  11. EPR dosimetry of radiation background in the Urals region

    International Nuclear Information System (INIS)

    Shishkina, E.A.; Degteva, M.O.; Shved, V.A.; Fattibene, P.; Onori, S.; Wieser, A.; Ivanov, D.V.; Bayankin, S.N.; Knyazev, V.A.; Vasilenko, E.I.; Gorelov, M.

    2006-01-01

    Method of Electron Paramagnetic Resonance is extensively applied to individual retrospective dosimetry. The background dose is unavoidable component of cumulative absorbed dose in the tooth enamel accumulated during the lifetime of donor. Estimation of incidental radiation dose using tooth enamel needs in extraction of background dose. Moreover, the variation of background doses in the population is a limited factor for reliable detection of additional irradiation especially for low dose level. Therefore the accurate knowledge of the natural background radiation dose is a critical element of EPR studies of exposed populations. In the Urals region the method applies for such two large cohorts as the workers of Mayak (Ozersk citizens) and Techa River riverside inhabitants (rural population). Current study aimed to investigate the Urals radiation background detected by EPR spectrometry. For this aim two group of unexposed Urals residents were separated, viz: citizens of Ozersk and rural inhabitants of Chelyabinsk region. Comparison of two investigated territories has demonstrated that from the point of view of radiation background it is impossible to assume the Urals population as uniform. The reliable difference between the urban and rural residents has been found. The average background doses of Ozersk donors is in average 50 mGy higher than those detected for rural residents. The individual variability of background doses for Osersk has been higher than in the rural results. The difference in background dose levels between two population results in different limits of accidental dose detection and individualization. The doses for 'Mayak' workers (Ozyorsk citizens) can be classed as anthropogenic if the EPR measurements exceed 120 mGy for teeth younger than 40 years, and 240 mGy for teeth older than 70 years. The anthropogenic doses for Techa River residents (rural population) would be higher than 95 mGy for teeth younger than 50 years and 270 mGy for teeth older

  12. Vitamin D insufficiency is associated with insulin resistance independently of obesity in primary schoolchildren. The healthy growth study.

    Science.gov (United States)

    Moschonis, George; Androutsos, Odysseas; Hulshof, Toine; Dracopoulou, Maria; Chrousos, George P; Manios, Yannis

    2018-04-02

    To explore the associations of vitamin D status and obesity with insulin resistance (IR) in children. A sample of 2282 schoolchildren (9-13 years old) in Greece was examined. Sociodemographic, anthropometric (weight, height), biochemical (fasting plasma glucose, serum insulin and 25(OH)D), pubertal status and physical activity data were collected, using standard methods. The "Vitamin D Standardization Program" protocol was applied to standardize serum 25(OH)D values. The prevalence of vitamin D insufficiency (serum 25(OH)D < 50 nmol/L) was higher in obese children compared to their over- and normal-weight counterparts (60.5% vs 51.6% and 51%, P = .017). Furthermore, children with IR (both obese and non-obese) had higher prevalence of vitamin D insufficiency compared to non-obese, non-insulin resistant children (66% and 59.2% vs 49.8%, P < .05), possibly indicating that IR is associated with vitamin D insufficiency, independently of obesity. In line with the above, the results from logistic regression analyses controlled for several potential confounders, showed a 1.48 (95% C.I: 1.2-1.84) higher likelihood for vitamin D insufficiency for insulin resistant children compared to the non-insulin resistant ones, while no significant association was observed with obesity. The present study revealed a high prevalence of vitamin D insufficiency among schoolchildren in Greece, particularly among obese and insulin resistant ones. In addition, it highlighted that the significant association of vitamin D insufficiency with IR is possibly independent of obesity. Further clinical trials are needed to confirm this possible independent association but also explore the potential beneficial effect of vitamin D supplementation on IR and possibly on weight management too. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Lack of chart reminder effectiveness on family medicine resident JNC-VI and NCEP III guideline knowledge and attitudes

    Directory of Open Access Journals (Sweden)

    Upshur Ross EG

    2004-07-01

    Full Text Available Abstract Background The literature demonstrates that medical residents and practicing physicians have an attitudinal-behavioral discordance concerning their positive attitudes towards clinical practice guidelines (CPG, and the implementation of these guidelines into clinical practice patterns. Methods A pilot study was performed to determine if change in a previously identified CPG compliance factor (accessibility would produce a significant increase in family medicine resident knowledge and attitude toward the guidelines. The primary study intervention involved placing a summary of the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI and the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (NCEP III CPGs in all patient (>18 yr. charts for a period of three months. The JNC VI and NCEP III CPGs were also distributed to each Wayne State family medicine resident, and a copy of each CPG was placed in the preceptor's area of the involved clinics. Identical pre- and post- intervention questionnaires were administered to all residents concerning CPG knowledge and attitude. Results Post-intervention analysis failed to demonstrate a significant difference in CPG knowledge. A stastically significant post-intervention difference was found in only on attitude question. The barriers to CPG compliance were identified as 1 lack of CPG instruction; 2 lack of critical appraisal ability; 3 insufficient time; 4 lack of CPG accessibility; and 5 lack of faculty modeling. Conclusion This study demonstrated no significant post intervention changes in CPG knowledge, and only one question that reflected attitude change. Wider resident access to dedicated clinic time, increased faculty modeling, and the implementation of an electronic record/reminder system that uses a team-based approach are compliance factors that

  14. The Use of Functional Assessment and Frequency Building Procedures to Increase Product Knowledge and Data Entry Skills among Foremen in a Construction Organization

    Science.gov (United States)

    Pampino, Ralph N.; Wilder, David A.; Binder, Carl

    2005-01-01

    A functional assessment procedure, which was designed to identify insufficient skills that may have been responsible for employee performance problems, was administered to four foremen employed in a large construction organization. Results of this assessment procedure identified two skill areas, product knowledge and data entry, as deficient.…

  15. Dentists' knowledge of occlusal splint therapy for bruxism and temporomandibular joint disorders.

    Science.gov (United States)

    Candirli, C; Korkmaz, Y T; Celikoglu, M; Altintas, S H; Coskun, U; Memis, S

    2016-01-01

    The aim of this study was to investigate dentist's approaches to the use of splint therapy for myofascial pain, bruxism, and temporomandibular joint (TMJ) disorders and to assessment of treatment modalities. A 12-item questionnaire was developed to determine dentists' knowledge of TMJ disorders and approaches for occlusal splint treatments. The researchers spoke with each dentist included in the study at his/her clinic or by telephone to assess their immediate knowledge and approach to the TMJ disorders. Chi-squared test was performed to analyze the values. The confidence interval was set as 95%. A total of 370 dentists working in Turkey were participated in this study. The most common splint application reason for occlusal splint treatment was bruxism (77.8%) while TMJ pain was very rare (%1.4). The use of hard splint ratios for 0-5 years of professional experience was 57.0%, 42.4.0%, and 26.8% for the experience of 5-15 years and over 15 years groups, respectively (P < 0.001). While the dentists' with sufficient knowledge soft splint application rates were 11.6%, hard splint application rates were 43.4% for the dentists with sufficient knowledge. Occlusion adjustment rate of dentists who practice in all three groups was under 16.0%. The knowledge of the dentists about TMJ disorders and occlusal splint therapy were found to be insufficient. Their knowledge decreased with increasing experience.

  16. Understanding Sources of Knowledge for Coaches of Athletes with Intellectual Disabilities

    Science.gov (United States)

    MacDonald, Dany J.; Beck, Katie; Erickson, Karl; Côté, Jean

    2016-01-01

    Background: Recent research has investigated development of coaching knowledge; however, less research has investigated the development of coaches who coach athletes with intellectual disabilities. The purpose of this study was to understand how coaches of athletes with intellectual disabilities gain their knowledge. Method: Forty-five Special…

  17. Knowledge of cervical cancer and screening practices of nurses at a ...

    African Journals Online (AJOL)

    Background: Cervical cancer, the most common cancer among women in Tanzania is strongly linked to Human Papilloma Virus. Precancerous lesions can be ... There was a significant association between knowledge levels of causes of cervical cancer and transmission of HPV and age. Knowledge was more adequate ...

  18. Knowledge, Attitudes, and Practices of Pediatric Dentists Regarding Speech Evaluation of Patients: Implications for Dental Education.

    Science.gov (United States)

    Van Eyndhoven, Lisa; Chussid, Steven; Yoon, Richard K

    2015-11-01

    The aim of this cross-sectional study was to determine pediatric dentists' attitudes about speech evaluation in the dental setting and assess their knowledge of speech development and pathology. In October 2013, members of the American Academy of Pediatric Dentistry were invited to participate in an electronic questionnaire. Categories of questions were demographics, attitudes and confidence in speech pathology, and theoretical and practical knowledge of speech development and speech pathology. Theoretical knowledge was assessed using questions about phonetics and speech milestones. Practical knowledge was determined with three 30-second interview-style video clips. A total of 539 responses were received for a response rate of 10.4%. The majority of respondents reported feeling that speech evaluation should be part of the pediatric dental visit (72.8%) and felt confident in their ability to detect speech issues (73.2%). However, they did poorly on the theoretical knowledge questions (41.9%) as well as the practical knowledge questions (8.5%). There was a statistically significant difference in theoretical score between gender and type of occupation (pspeech issues, they currently have insufficient training and knowledge to do so.

  19. Data Series Subtraction with Unknown and Unmodeled Background Noise

    Science.gov (United States)

    Vitale, Stefano; Congedo, Giuseppe; Dolesi, Rita; Ferroni, Valerio; Hueller, Mauro; Vetrugno, Daniele; Weber, William Joseph; Audley, Heather; Danzmann, Karsten; Diepholz, Ingo; hide

    2014-01-01

    LISA Pathfinder (LPF), the precursor mission to a gravitational wave observatory of the European Space Agency, will measure the degree to which two test masses can be put into free fall, aiming to demonstrate a suppression of disturbance forces corresponding to a residual relative acceleration with a power spectral density (PSD) below (30 fm/sq s/Hz)(sup 2) around 1 mHz. In LPF data analysis, the disturbance forces are obtained as the difference between the acceleration data and a linear combination of other measured data series. In many circumstances, the coefficients for this linear combination are obtained by fitting these data series to the acceleration, and the disturbance forces appear then as the data series of the residuals of the fit. Thus the background noise or, more precisely, its PSD, whose knowledge is needed to build up the likelihood function in ordinary maximum likelihood fitting, is here unknown, and its estimate constitutes instead one of the goals of the fit. In this paper we present a fitting method that does not require the knowledge of the PSD of the background noise. The method is based on the analytical marginalization of the posterior parameter probability density with respect to the background noise PSD, and returns an estimate both for the fitting parameters and for the PSD. We show that both these estimates are unbiased, and that, when using averaged Welchs periodograms for the residuals, the estimate of the PSD is consistent, as its error tends to zero with the inverse square root of the number of averaged periodograms. Additionally, we find that the method is equivalent to some implementations of iteratively reweighted least-squares fitting. We have tested the method both on simulated data of known PSD and on data from several experiments performed with the LISA Pathfinder end-to-end mission simulator.

  20. Vitamin D insufficiency and schizophrenia risk: evaluation of hyperprolinemia as a mediator of association.

    Science.gov (United States)

    Clelland, James D; Read, Laura L; Drouet, Valérie; Kaon, Angela; Kelly, Alexandra; Duff, Karen E; Nadrich, Robert H; Rajparia, Amit; Clelland, Catherine L

    2014-06-01

    25-Hydroxyvitamin D (25(OH)D) deficits have been associated with schizophrenia susceptibility and supplementation has been recommended for those at-risk. Although the mechanism by which a deficit confers risk is unknown, vitamin D is a potent transcriptional modulator and can regulate proline dehydrogenase (PRODH) expression. PRODH maps to chromosome 22q11, a region conferring the highest known genetic risk of schizophrenia, and encodes proline oxidase, which catalyzes proline catabolism. l-Proline is a neuromodulator at glutamatergic synapses, and peripheral hyperprolinemia has been associated with decreased IQ, cognitive impairment, schizoaffective disorder, and schizophrenia. We investigated the relationship between 25(OH)D and schizophrenia, comparing fasting plasma 25(OH)D in 64 patients and 90 matched controls. We then tested for a mediating effect of hyperprolinemia on the association between 25(OH)D and schizophrenia. 25(OH)D levels were significantly lower in patients, and 25(OH)D insufficiency associated with schizophrenia (OR 2.1, adjusted p=0.044, 95% CI: 1.02-4.46). Moreover, 25(OH)D insufficient subjects had three times greater odds of hyperprolinemia than those with optimal levels (p=0.035, 95% CI: 1.08-8.91), and formal testing established that hyperprolinemia is a significantly mediating phenotype that may explain over a third of the effect of 25(OH)D insufficiency on schizophrenia risk. This study presents a mechanism by which 25(OH)D insufficiency confers risk of schizophrenia; via proline elevation due to reduced PRODH expression, and a concomitant dysregulation of neurotransmission. Although definitive causality cannot be confirmed, these findings strongly support vitamin D supplementation in patients, particularly for those with elevated proline, who may represent a large subgroup of the schizophrenia population. Copyright © 2014 Elsevier B.V. All rights reserved.