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Sample records for level gastroenterological centre

  1. 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.

  2. South African Gastroenterology Review

    African Journals Online (AJOL)

    Journal Homepage Image. The South African Gastroenterology Reviewis written by specialists in the field. Its aim is to publish articles pertinent to the practising Gastroenterologist in South Africa. It is distributed to a broad spectrum of clinicians who have an interest in clinical gastroenterology and hepatology. Other websites ...

  3. American Gastroenterological Association

    Science.gov (United States)

    ... for the October issue of Gastroenterology. To view: http://bit.ly/2xcLu0J Read More Video Association Between ... for the October issue of Gastroenterology. To view: http://bit.ly/2hfffaw Read More Video Statin Use ...

  4. Environmental gamma radiation levels around various DAE research centres

    International Nuclear Information System (INIS)

    Takale, R.A.; Swarnakar, M.; Shetty, P.G.; Sahu, S.K.; Pandit, G.G.

    2014-01-01

    This paper presents the gamma radiation levels of four research centres viz. Bhabha Atomic Research Centre (BARC), Trombay; Indira Gandhi Centre for Atomic Research (IGCAR), Kalpakkam; Variable Energy Cyclotron Centre (VECC), Kolkata; Raja Ramanna Centre for Advanced Technology (RRCAT), Indore; and an industry Board of Radiation and Isotope Technology (BRIT), Vashi. BARC is India's premier nuclear research facility and is a multi-disciplinary research centre with extensive infrastructure for advanced research and development (R and D). IGCAR, Kalpakkam is engaged in scientific research and advanced engineering programme towards the development of Fast Breeder Reactor technology. VECC Kolkata is dedicated to carry out frontier R and D in the fields of Accelerator Science and Technology, Nuclear Science (Theoretical and Experimental), and Material Science etc. RRCAT, Indore has rapidly grown into a premier institute for R and D in lasers, accelerators and their applications. BRIT, Vashi unit is involved in production, development, and supply of radioisotope based products and provision of isotope applications, radiation processing, radio analytical services etc. With an objective to keep a watch on the prevailing environmental background gamma radiation level around all the DAE installations, routine monitoring programme are being carried out using the Thermo Luminescent Dosimeters (TLDs). TLDs provide the simple, inexpensive and precise measurement of small, integrated, external gamma radiation dose rate. The general practice of this programme is to observe the outdoor gamma radiation levels. This paper summarizes the methodology and gamma radiation levels of four research centres viz. BARC, IGCAR, VECC, RRCAT and an industry BRIT, Vashi

  5. The French centralized low level radwaste treatment centre named CENTRACO

    International Nuclear Information System (INIS)

    Barnes, C.; Sixou, Y.

    1996-01-01

    Socodei, a subsidiary company of EdF and Cogema is commissioned to design, finance, build and operate two low level radwaste treatment facilities: a contaminated scrap metal melting unit, and a solid and liquid waste incinerator. These units frame a low level radwaste treatment centre named Centraco, located near Marcoule in the south of France, and will receive in 1998 waste coming from dismantling, maintenance and operating works of French and foreign nuclear sites. The decision to create this centre is due to the low density and large variety of low level radwaste which take a volume out of proportion with their activity, specially in the surface storage centre. Up to now, all low level radwaste were sent and stored with no treatment optimization in surface storage centres. Socodei proposes in one single site, to optimize low level radwaste management and reduce the volume of ultimate waste to be stored: in a ratio of one to ten by casting ingots coming from melting contaminated scrap metals; in a ratio of one to twenty by encapsulating earth ashes and ashes resulting from incineration of solid and liquid waste. This is a centralized treatment centre and that's why Centraco is a new waste management system. Getting together all means in one place reduces costs, avoids mismanagement and risk increase, and allows consistency in safety, environmental impact, transport and personnel radioprotection. (author)

  6. Gastroenterology training in Latin America

    Science.gov (United States)

    Cohen, Henry; Saenz, Roque; de Almeida Troncon, Luiz E; Lizarzabal, Maribel; Olano, Carolina

    2011-01-01

    Latin America is characterized by ethnic, geographical, cultural, and economic diversity; therefore, training in gastroenterology in the region must be considered in this context. The continent’s medical education is characterized by a lack of standards and the volume of research continues to be relatively small. There is a multiplicity of events in general gastroenterology and in sub-disciplines, both at regional and local levels, which ensure that many colleagues have access to information. Medical education programs must be based on a clinical vision and be considered in close contact with the patients. The programs should be properly supervised, appropriately defined, and evaluated on a regular basis. The disparity between the patients’ needs, the scarce resources available, and the pressures exerted by the health systems on doctors are frequent cited by those complaining of poor professionalism. Teaching development can play a critical role in ensuring the quality of teaching and learning in universities. Continuing professional development programs activities must be planned on the basis of the doctors’ needs, with clearly defined objectives and using proper learning methodologies designed for adults. They must be evaluated and accredited by a competent body, so that they may become the basis of a professional regulatory system. The specialty has made progress in the last decades, offering doctors various possibilities for professional development. The world gastroenterology organization has contributed to the speciality through three distinctive, but closely inter-related, programs: Training Centers, Train-the-Trainers, and Global Guidelines, in which Latin America is deeply involved. PMID:21633594

  7. View from the Top: Perspectives on Women in Gastroenterology from Society Leaders.

    Science.gov (United States)

    Schmitt, Colleen M; Allen, John I

    2016-06-01

    Women are making great strides at all levels of medicine, including gastroenterology. The proportion of women members in gastroenterology societies has increased nearly 2-fold and the percent of women trainees is 36%. Although there continue to be challenges for women in academic and community practice, the American Gastroenterological Association, American Society of Gastrointestinal Endoscopy, and other gastroenterology societies have dedicated substantial resources to foster careers of women in gastroenterology and develop women as leaders in our societies. This article outlines ongoing challenges for women in gastroenterology and some key initiatives addressing barriers to success. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Ultrasonography in gastroenterology.

    Science.gov (United States)

    Ødegaard, Svein; Nesje, Lars B; Hausken, Trygve; Gilja, Odd Helge

    2015-06-01

    Ultrasonography (US) is a safe and available real-time, high-resolution imaging method, which during the last decades has been increasingly integrated as a clinical tool in gastroenterology. New US applications have emerged with enforced data software and new technical solutions, including strain evaluation, three-dimensional imaging and use of ultrasound contrast agents. Specific gastroenterologic applications have been developed by combining US with other diagnostic or therapeutic methods, such as endoscopy, manometry, puncture needles, diathermy and stents. US provides detailed structural information about visceral organs without hazard to the patients and can play an important clinical role by reducing the need for invasive procedures. This paper presents different aspects of US in gastroenterology, with a special emphasis on the contribution from Nordic scientists in developing clinical applications.

  9. Resource variation in colorectal surgery: a national centre level analysis.

    Science.gov (United States)

    Drake, T M; Lee, M J; Senapati, A; Brown, S R

    2017-07-01

    Delivery of quality colorectal surgery requires adequate resources. We set out to assess the relationship between resources and outcomes in English colorectal units. Data were extracted from the Association of Coloproctology of Great Britain and Ireland resource questionnaire to profile resources. This was correlated with Hospital Episode Statistics outcome data including 90-day mortality and readmissions. Patient satisfaction measures were extracted from the Cancer Experience Patient Survey and compared at unit level. Centres were divided by workload into low, middle and top tertile. Completed questionnaires were received from 75 centres in England. Service resources were similar between low and top tertiles in access to Confidential Enquiry into Patient Outcome and Death (CEPOD) theatre, level two or three beds per 250 000 population or the likelihood of having a dedicated colorectal ward. There was no difference in staffing levels per 250 000 unit of population. Each 10% increase in the proportion of cases attempted laparoscopically was associated with reduced 90-day unplanned readmission (relative risk 0.94, 95% CI 0.91-0.97, P colorectal ward (relative risk 0.85, 95% CI 0.73-0.99, P = 0.040) was also associated with a significant reduction in unplanned readmissions. There was no association between staffing or service factors and patient satisfaction. Resource levels do not vary based on unit of population. There is benefit associated with increased use of laparoscopy and a dedicated surgical ward. Alternative measures to assess the relationship between resources and outcome, such as failure to rescue, should be explored in UK practice. Colorectal Disease © 2017 The Association of Coloproctology of Great Britain and Ireland.

  10. Radioisotopic investigations in gastroenterology

    International Nuclear Information System (INIS)

    Rain, J.D.; Arrago, J.P.; Ruskone, A.; Jian, R.

    1985-01-01

    The various isotopic techniques used in gastroenterology are reviewed. Nonimaging procedures, although referred to as in vitro studies, the procedures themselves are in vivo since the radiotracer is administered directly to the patient. 51 Cr labelled red blood cells for the detection of gastrointestinal loss of blood and 51 Cr Cl 3 for the detection of gastrointestinal protein loss, 14 CO 2 Breath Test in patients with gastrointestinal disease, malabsorption. Scintigraphic techniques used to detect and localize gastrointestinal bleeding with sup(99m)Tc-labeled red blood cells or with sup(99m)Tc-Sulfur colloid. Scintigraphic studies of esophageal transit and gastroesophageal reflux [fr

  11. Radioisotopic investigations in gastroenterology

    Energy Technology Data Exchange (ETDEWEB)

    Rain, J.D.; Arrago, J.P.; Ruskone, A.; Jian, R.

    1985-01-01

    The various isotopic techniques used in gastroenterology are reviewed. Nonimaging procedures, although referred to as in vitro studies, the procedures themselves are in vivo since the radiotracer is administered directly to the patient. V Cr labelled red blood cells for the detection of gastrointestinal loss of blood and V Cr Cl3 for the detection of gastrointestinal protein loss, UCO2 Breath Test in patients with gastrointestinal disease, malabsorption. Scintigraphic techniques used to detect and localize gastrointestinal bleeding with sup(99m)Tc-labeled red blood cells or with sup(99m)Tc-Sulfur colloid. Scintigraphic studies of esophageal transit and gastroesophageal reflux.

  12. South African Gastroenterology Review: Journal Sponsorship

    African Journals Online (AJOL)

    South African Gastroenterology Review: Journal Sponsorship. Journal Home > About the Journal > South African Gastroenterology Review: Journal Sponsorship. Log in or Register to get access to full text downloads.

  13. Gastroenterology Curriculum in the Canadian Medical School System.

    Science.gov (United States)

    Dang, ThucNhi Tran; Wong, Clarence; Bistritz, Lana

    2017-01-01

    Background and Purpose. Gastroenterology is a diverse subspecialty that covers a wide array of topics. The preclinical gastroenterology curriculum is often the only formal training that medical students receive prior to becoming residents. There is no Canadian consensus on learning objectives or instructional methods and a general lack of awareness of curriculum at other institutions. This results in variable background knowledge for residents and lack of guidance for course development. Objectives. (1) Elucidate gastroenterology topics being taught at the preclinical level. (2) Determine instructional methods employed to teach gastroenterology content. Results . A curriculum map of gastroenterology topics was constructed from 10 of the medical schools that responded. Topics often not taught included pediatric GI diseases, surgery and trauma, food allergies/intolerances, and obesity. Gastroenterology was taught primarily by gastroenterologists and surgeons. Didactic and small group teaching was the most employed teaching method. Conclusion. This study is the first step in examining the Canadian gastroenterology curriculum at a preclinical level. The data can be used to inform curriculum development so that topics generally lacking are better incorporated in the curriculum. The study can also be used as a guide for further curriculum design and alignment across the country.

  14. A survey on gastroenterology training in Europe

    Science.gov (United States)

    Bisschops, R; Wilmer, A; Tack, J

    2002-01-01

    Background: Specialist training in gastroenterology and hepatology is not standardised in different European countries. Aim: The aim of this survey was to assess the different teaching and socioeconomic aspects of training programmes in Europe. Methods: Seventy questionnaires were distributed to last year trainees or newly graduated gastroenterologists. Forty two respondents (60%) from 34 major training centres in 10 different European countries replied. Results: Overall, the data revealed major diversity for all aspects analysed, between and within the different European countries. Both the duration of training (range 4–10.4 years) and workload (range 48.5–89.2 hours per week) differed markedly between countries. The average number of endoscopic procedures (gastroscopies, range 300–2600; colonoscopies, range 73–550; endoscopic retrograde cholangiopancreatographies, range 1–385) differed also. One third of last year trainees reported that they felt uncertain in some endoscopic procedure. The European trainee was on call for 5–6 nights a month on average (range 1–8). Monthly wages differed considerably between countries, ranging from 767 to 2180 Euro. Conclusion: We found major differences in the professional aspects and socioeconomic conditions of gastroenterologist/hepatologist training in 10 different European countries, probably leading to differences in quality of training. In several countries or centres the average number of procedures was below the threshold issued by the European Board of Gastroenterlogy or the American Gastroenterological Association. Issuing a European diploma for gastroenterology is a valuable effort towards meeting this problem. Further studies are needed to re-evaluate the training programmes in Europe and to define threshold numbers and technical end points for assessment of endoscopic skills. PMID:11950824

  15. Archives: Nigerian Journal of Gastroenterology and Hepatology

    African Journals Online (AJOL)

    Items 1 - 15 of 15 ... Archives: Nigerian Journal of Gastroenterology and Hepatology. Journal Home > Archives: Nigerian Journal of Gastroenterology and Hepatology. Log in or Register to get access to full text downloads.

  16. Nigerian Journal of Gastroenterology and Hepatology: Journal ...

    African Journals Online (AJOL)

    Nigerian Journal of Gastroenterology and Hepatology: Journal Sponsorship. Journal Home > About the Journal > Nigerian Journal of Gastroenterology and Hepatology: Journal Sponsorship. Log in or Register to get access to full text downloads.

  17. Quality of gastroenterology research published in Saudi Arabian scientific journals.

    Science.gov (United States)

    Almaghrabi, Majed M; Alamoudi, Abdullah S; Radi, Suhaib A; Merdad, Anas A; Makhdoum, Ahmad M; Batwa, Faisal A

    2015-01-01

    Evidence-based medicine has established itself in the field of gastroenterology. In this study we aim to assess the types of study designs of gastroenterology-related articles published in Saudi scientific journals. An online review using PubMed was carried out to review gastroenterology-related articles published in six Saudi medical journals in the time interval from 2003 to 2012. To classify the level of evidence in these articles we employed the Oxford's levels of evidence. One-way analysis of variance was used to compare the levels of evidence between published articles. A total of 721 gastroenterology-related articles were reviewed, of which 591 articles met our inclusion criteria; 80.7% were level IV. The three most common types of studies we encountered were cross-sectional (33.9%), case reports (27.9%), and case series (18.8%). Forty-three percent of the published research was in the field of hepatobiliary and spleen. The total number of articles increased from 260 articles in the 1 st 5-year period (2003-2007) to 330 in the 2 nd period (2008-2012). However, no statistically significant difference in the level of evidence was noted. In Annals of Saudi Medicine Journal, articles with level II increased from 0 to 10% with a P value 0.02. In our review of gastroenterology-related published articles in Saudi scientific journals, we observed an increase in the quantity of articles with the quality and level of evidence remaining unchanged. Further research is recommended to explore different reasons affecting the volume and quality of gastroenterology-related research in Saudi scientific journals.

  18. Children and adolescents admitted to a university-level trauma centre in Denmark 2002-2011

    DEFF Research Database (Denmark)

    Ekström, Danny Stefan; Hviid Larsen, Rasmus; Lauritsen, Jens Martin

    2017-01-01

    INTRODUCTION: The epidemiology of children or adolescents admitted to a Scandinavian trauma centre is largely unknown. The aim of this paper was to describe the epidemiology and severity of potentially severely injured children and adolescents admitted to a university hospital trauma centre....... METHODS: This was a descriptive study of all children and adolescents aged 0-17 admitted to the university level trauma centre at Odense University Hospital, Denmark in the 2002-2011 period. Data were extracted from the Southern Danish Trauma Register and from medical records. RESULTS: A total of 950...

  19. The Mexican consensus on probiotics in gastroenterology.

    Science.gov (United States)

    Valdovinos, M A; Montijo, E; Abreu, A T; Heller, S; González-Garay, A; Bacarreza, D; Bielsa-Fernández, M; Bojórquez-Ramos, M C; Bosques-Padilla, F; Burguete-García, A I; Carmona-Sánchez, R; Consuelo-Sánchez, A; Coss-Adame, E; Chávez-Barrera, J A; de Ariño, M; Flores-Calderón, J; Gómez-Escudero, O; González-Huezo, M S; Icaza-Chávez, M E; Larrosa-Haro, A; Morales-Arámbula, M; Murata, C; Ramírez-Mayans, J A; Remes-Troche, J M; Rizo-Robles, T; Peláez-Luna, M; Toro-Monjaraz, E M; Torre, A; Urquidi-Rivera, M E; Vázquez, R; Yamamoto-Furusho, J K; Guarner, F

    Probiotics are frequently prescribed in clinical practice. Their efficacy in treating gastrointestinal disorders is supported by a significant number of clinical trials. However, the correct prescription of these agents is hampered due to a lack of knowledge of the scientific evidence and to the different presentations and microbial compositions of the probiotics that are currently available. To provide the clinician with a consensus review of probiotics and recommendations for their use in gastroenterology. Controlled clinical trials, meta-analyses, and systematic reviews published up to 2015 were selected, using the MESH terms: probiotics, gastrointestinal diseases, humans, adults, AND children. The Delphi method was employed. Eighteen gastroenterologists treating adult patients and 14 pediatric gastroenterologists formulated statements that were voted on until agreement>70% was reached. The level of evidence based on the GRADE system was evaluated for each statement. Eleven statements on the general concepts of probiotics and 27 statements on the use of probiotics in gastrointestinal diseases in both adults and children were formulated. The consensus group recommends the use of probiotics under the following clinical conditions: the prevention of diarrhea associated with antibiotics, the treatment of acute infectious diarrhea, the prevention of Clostridium difficile infection and necrotizing enterocolitis, the reduction of adverse events from Helicobacter pylori eradication therapy, relief from irritable bowel syndrome symptoms, the treatment of functional constipation in the adult, and the induction and maintenance of remission in patients with ulcerative colitis and pouchitis, and the treatment of covert and overt hepatic encephalopathy. Copyright © 2016 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

  20. 21 CFR 876.1075 - Gastroenterology-urology biopsy instrument.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gastroenterology-urology biopsy instrument. 876... SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Diagnostic Devices § 876.1075 Gastroenterology-urology biopsy instrument. (a) Identification. A gastroenterology-urology biopsy instrument is a...

  1. 21 CFR 876.4370 - Gastroenterology-urology evacuator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gastroenterology-urology evacuator. 876.4370... (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4370 Gastroenterology-urology evacuator. (a) Identification. A gastroenterology-urology evacuator is a device used to remove...

  2. 21 CFR 876.4530 - Gastroenterology-urology fiberoptic retractor.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gastroenterology-urology fiberoptic retractor. 876... SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4530 Gastroenterology-urology fiberoptic retractor. (a) Identification. A gastroenterology-urology fiberoptic retractor...

  3. Pancreatitis in Pregnancy | Naidoo | South African Gastroenterology ...

    African Journals Online (AJOL)

    South African Gastroenterology Review. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 8, No 2 (2010) >. Log in or Register to get access to full text downloads.

  4. Traveller's diarrhoea | Girwood | South African Gastroenterology ...

    African Journals Online (AJOL)

    South African Gastroenterology Review. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 2 (2007) >. Log in or Register to get access to full text downloads.

  5. Do pediatric gastroenterology doctors address pediatric obesity?

    OpenAIRE

    Batra, Suruchi; Yee, Caitlin; Diez, Bernadette; Nguyen, Nicholas; Sheridan, Michael J; Tufano, Mark; Sikka, Natalie; Townsend, Stacie; Hourigan, Suchitra

    2017-01-01

    Objectives: To assess how often obesity is acknowledged at pediatric gastroenterology outpatient visits. Methods: A retrospective chart review was performed to identify obese children seen at a gastroenterology subspecialty clinic over a 1-year period of time; 132 children were identified. Demographics, obesity comorbidities, reasons for referral, diagnosis of obesity, and a plan to address obesity were abstracted. Chi-square or Fisher?s exact tests were used to examine statistical associatio...

  6. Pediatric Gastroenterology in Cuba: Evolution and Challenges.

    Science.gov (United States)

    Castañeda-Guillot, Carlos

    2016-10-01

    INTRODUCTION The professional practice of pediatric gastroenterology arose in Cuba as an expression of the specialty's development internationally and Cuba's new strategies in public health, and in response to national needs for health care expertise in digestive diseases of infants, older children and adolescents. OBJECTIVES Describe the history of pediatric gastroenterology's development in Cuba since its inception at the National Gastroenterology Institute in the early 1970s, its contributions, and efforts to extend it to pediatric hospitals throughout Cuba. EVIDENCE ACQUISITION This is a historical review based on document analysis. Institutional sources from the National Gastroenterology Institute and Ministry of Public Health were reviewed, as well as international and national literature on the history of pediatric gastroenterology and unpublished texts since its emergence in 1972. DEVELOPMENT Although pediatric gastroenterology has not been formally recognized as a medical specialty in Cuba, there have been important achievements in establishing a network of specialized health care services for digestive diseases of children and adolescents. Gastrointestinal endoscopy and other auxiliary diagnostic modalities have been introduced for children and play a major role in clinical trials and research. This article describes the international context that promoted the specialty's development in Cuba. Reference is made to specialized training from its initial stages in 1972, its consolidation as an emerging discipline in Cuban medicine, and its diffusion in Latin American and Caribbean countries. Professional development and specialized training to meet health human resource needs in pediatric hospitals are described, as well as Cuban participation in the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition. National and international milestones, publications, awards and recognitions that indicate advances despite difficulties are also

  7. Aube's storage centre for low and intermediate level wastes: Annual report 2008

    International Nuclear Information System (INIS)

    2008-01-01

    After a presentation of the ANDRA (the French national Agency for radioactive waste management), its missions, its facilities, and its financing, this report reviews the activity of its storage centre for low and intermediate level wastes located on the territory of three towns in the Aube district. It briefly describes the facilities, the different categories of liquid effluents and their associated networks. It indicates some important figures characterizing the centre's operation. It describes the main safety objectives, technical measures and results in terms of radioprotection. It reports the main events in the relationship with the safety authority. It also briefly describes the incidents and accidents which occurred in 2008. It presents and specifies some results of the numerous environmental analyses performed around the centre (radioactivity measurements in air, water, milk, mushrooms, fishes, and so on), comments the radiologic impact of releases, and actions to improve these results. It gives assessments of the amount of produced wastes and describes their processing and management. Information actions are presented and the CHSCT (Committee of hygiene, safety, and working conditions) are reported

  8. Transforming Gastroenterology Care With Telemedicine.

    Science.gov (United States)

    Siegel, Corey A

    2017-04-01

    Health care is changing rapidly, so we must change with the times to develop more efficient, practical, cost-effective, and, importantly, high-quality methods to care for patients. We teach medical students that optimal patient care requires face-to-face interaction to collect information on the patient's history and perform the physical examination. However, management of many patients-especially those with chronic diseases-does not always require physical examination. Telemedicine offers an opportunity to take advantage of technology while leveraging the progressive push toward efficiency and value but also requires the belief that excellent patient care is not always provided in person. Telemedicine can include a variety of aspects of patient care adapted to be performed remotely, such as telemonitoring, tele-education, teleconsultation, and telecare. All of these have been evaluated in gastroenterology practice and have demonstrated feasibility and patient preference but have produced mixed results regarding patient outcomes. By combining telemedicine tools and new care models, we can redesign chronic disease management to include fewer in-person visits when patients are well yet increase access for patients who need to be seen. This change could lead to higher-value care by improving the experience of care, decreasing costs, and improving the health of the population. Barriers include reimbursement, licensing, and fear of litigation. However, if we hope to meet the needs of patients within our changing health care system, telemedicine should be incorporated into our strategy. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  9. Methodological quality of guidelines in gastroenterology.

    Science.gov (United States)

    Malheiro, Rui; de Monteiro-Soares, Matilde; Hassan, Cesare; Dinis-Ribeiro, Mário

    2014-06-01

    Clinical guidelines are a common feature in modern endoscopy practice and they are being produced faster than ever. However, their methodological quality is rarely assessed. This study evaluated the methodological quality of current clinical guidelines in the field of gastroenterology, with an emphasis on endoscopy. Practice guidelines published by the American College of Gastroenterology (ACG), American Gastroenterological Association (AGA), American Society for Gastrointestinal Endoscopy (ASGE), European Society of Gastrointestinal Endoscopy (ESGE), British Society of Gastroenterology (BSG), National Institute for Health and Care Excellence (NICE), and the Scottish Intercollegiate Guidelines Network (SIGN) were searched between September and October 2012 and evaluated using the AGREE II (Appraisal of Guidelines for Research and Evaluation) instrument (23 items, scores 1 - 7 for each item; higher scores mean better quality). A total of 100 guidelines were assessed. The mean number of items scoring 6 or 7 per guideline was 9.2 (out of 23 items). Overall, 99 % of guidelines failed to include the target population in the development process, and 96 % did not report facilitators and barriers to guideline application. In addition, 86 % did not include advice or tools, and 94 % did not present monitoring or auditing criteria. The global methodological quality of clinical guidelines in the field of gastroenterology is poor, particularly regarding involvement of the target population in the development of guidelines and in the provision of clear suggestions to practitioners. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Level of commitment of the fans of the Thermas of Centre of Portugal in Facebook

    Directory of Open Access Journals (Sweden)

    Maria Filomena Torres

    2016-05-01

    Full Text Available Social networks like Facebook have revolutionized communication strategies of the brands and its effects are clear and deep, and have transformed the way in which society is communicated to changed perceptions and social norms and, therefore, have transformed the dynamics of communication. In this sense, it is pertinent to analyze the presence of Termas of Centre of Portugal in social networks is essential, once that allows them to transmit information about their services and products.  The aim of this study is to measure, through digital indicators, the level of interaction of the Termas of Centre of Portugal (in the official pages of Facebook with his audience, in order to compare and measure the participation and interaction of each one of the pages with their users, and thus help managers to develop content strategies that make possible increasing the level of participation of the fans to the brand. The choice of Termas which are establishments where health care is provided, in which it is performed harnessing the therapeutic properties of a medicinal mineral water for prevention of ailments, therapeutic, etc., it is based on the importance today is acquiring health tourism in Portugal, being Termas its main representative. The working methodology is based on quantitative analysis using the analysis of digital metrics PageMarch and Kaushik together with an analysis of the content of the official website of Termas on Facebook. The sampling process was non-probabilistic intentional and collection was carried out between June and October 2015.It is observed that the amount of information available on the pages, just for them, is not responsible for the increased level of commitment. It was verified that most of the pages of the Termas of Centre of Portugal on Facebook, do not take this tool, which Facebook has become, in order to communicate through Electronic Word-of-mouse with your audience.

  11. Enhancing High Value Care in Gastroenterology Practice.

    Science.gov (United States)

    Camilleri, Michael; Katzka, David A

    2016-10-01

    The objective of this review is to identify common areas in gastroenterology practice where studies performed provide an opportunity for enhancing value or lowering costs. We provide examples of topics in gastroenterology where clinicians could enhance value by either using less invasive testing, choosing a single best test, or by using patient symptoms to guide additional testing. The topics selected for review are selected in esophageal, pancreatic, and colorectal cancer; functional gastrointestinal diseases (irritable bowel syndrome, bacterial overgrowth, constipation); immune-mediated gastrointestinal diseases; and pancreaticobiliary pathology. We propose guidance to alter practice based on current evidence. These studies support the need to review current practice and to continue performing research to further validate the proposed guidance to enhance value of care in gastroenterology and hepatology. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

  12. Gastroenterology in developing countries: Issues and advances

    Science.gov (United States)

    Mandeville, Kate L; Krabshuis, Justus; Ladep, Nimzing Gwamzhi; Mulder, Chris JJ; Quigley, Eamonn MM; Khan, Shahid A

    2009-01-01

    Developing countries shoulder a considerable burden of gastroenterological disease. Infectious diseases in particular cause enormous morbidity and mortality. Diseases which afflict both western and developing countries are often seen in more florid forms in poorer countries. Innovative techniques continuously improve and update gastroenterological practice. However, advances in diagnosis and treatment which are commonplace in the West, have yet to reach many developing countries. Clinical guidelines, based on these advances and collated in resource-rich environments, lose their relevance outside these settings. In this two-part review, we first highlight the global burden of gastroenterological disease in three major areas: diarrhoeal diseases, hepatitis B, and Helicobacter pylori. Recent progress in their management is explored, with consideration of future solutions. The second part of the review focuses on the delivery of clinical services in developing countries. Inadequate numbers of healthcare workers hamper efforts to combat gastroenterological disease. Reasons for this shortage are examined, along with possibilities for increased specialist training. Endoscopy services, the mainstay of gastroenterology in the West, are in their infancy in many developing countries. The challenges faced by those setting up a service are illustrated by the example of a Nigerian endoscopy unit. Finally, we highlight the limited scope of many clinical guidelines produced in western countries. Guidelines which take account of resource limitations in the form of “cascades” are advocated in order to make these guidelines truly global. Recognition of the different working conditions facing practitioners worldwide is an important step towards narrowing the gap between gastroenterology in rich and poor countries. PMID:19533805

  13. A quantitative readability analysis of patient education resources from gastroenterology society websites.

    Science.gov (United States)

    Hansberry, David R; Patel, Sahil R; Agarwal, Prateek; Agarwal, Nitin; John, Elizabeth S; John, Ann M; Reynolds, James C

    2017-06-01

    The lay public frequently access and rely on online information as a source of their medical knowledge. Many medical societies are unaware of national patient education material guidelines and subsequently fail to meet them. The goal of the present study was to evaluate the readability of patient education materials within the medical field of gastroenterology. Two hundred fourteen articles pertaining to patient education materials were evaluated with ten well-established readability scales. The articles were available on the websites for the American College of Gastroenterology (ACG), the American Gastroenterological Association (AGA), the American Society of Gastrointestinal Endoscopy (ASGE), the British Society of Gastroenterology (BSG), and the NIH section National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). One-way analysis of variance (ANOVA) and Tukey's honest significant difference (HSD) post hoc analysis were conducted to determine any differences in level of readability between websites. The 214 articles were written at an 11.8 ± 2.1 grade level with a range of 8.0 to 16.0 grade level. A one-way ANOVA and Tukey's HSD post hoc analysis determined the ACG was written at a significantly (p gastroenterology content.

  14. The changing epidemiology of spinal trauma: a 13-year review from a Level I trauma centre.

    Science.gov (United States)

    Oliver, M; Inaba, K; Tang, A; Branco, B C; Barmparas, G; Schnüriger, B; Lustenberger, T; Demetriades, D

    2012-08-01

    Spinal injuries secondary to trauma are a major cause of patient morbidity and a source of significant health care expenditure. Increases in traffic safety standards and improved health care resources may have changed the characteristics and incidence of spinal injury. The purpose of this study was to review a single metropolitan Level I trauma centre's experience to assess the changing characteristics and incidence of traumatic spinal injuries and spinal cord injuries (SCI) over a 13-year period. A retrospective review of patients admitted to a Level I trauma centre between 1996 and 2008 was performed. Patients with spinal fractures and SCI were identified. Demographics, mechanism of injury, level of spinal injury and Injury Severity Score (ISS) were extracted. The outcomes assessed were the incidence rate of SCI and in-hospital mortality. Over the 13-year period, 5.8% of all trauma patients suffered spinal fractures, with 21.7% of patients with spinal injuries having SCI. Motor vehicle accidents (MVAs) were responsible for the majority of spinal injuries (32.6%). The mortality rate due to spinal injury decreased significantly over the study period despite a constant mean ISS. The incidence rate of SCI also decreased over the years, which was paralleled by a significant reduction in MVA associated SCI (from 23.5% in 1996 to 14.3% in 2001 to 6.7% in 2008). With increasing age there was an increase in spinal injuries; frequency of blunt SCI; and injuries at multiple spinal levels. This study demonstrated a reduction in mortality attributable to spinal injury. There has been a marked reduction in SCI due to MVAs, which may be related to improvements in motor vehicle safety and traffic regulations. The elderly population was more likely to suffer SCI, especially by blunt injury, and at multiple levels. Underlying reasons may be anatomical, physiological or mechanism related. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Nigerian Journal of Gastroenterology and Hepatology: Editorial ...

    African Journals Online (AJOL)

    Reviewers are to recognise that acceptance and publication of papers reviewed still rests solely on the Editorial Board of the Nigerian Journal of Gastroenterology and Hepatology, and this is without prejudice to appreciation of the worth of their unremunerated efforts. aims to serve clinical and basic scientists in areas of ...

  16. Colorectal cancer screening: World Gastroenterology Organisation ...

    African Journals Online (AJOL)

    Colorectal cancer screening: World Gastroenterology Organisation/International Digestive Cancer Alliance Practice Guidelines. S Winawer, M Classen, R Lambert, M Fried, P Dite, K L Goh, F Guarner, D Lieberman, R Eliakim, B Levin, R Saenz, A G Khan, I Khalif, A Lanas, G Lindberg, M J O'Brien, G Young, J Krabshuis ...

  17. "Bending the cost curve" in gastroenterology.

    Science.gov (United States)

    Slattery, E; Harewood, G C; Murray, F; Patchett, S

    2013-12-01

    Increasing attention is being focused on reigning in escalating costs of healthcare, i.e. trying to 'bend the cost curve'. In gastroenterology (GI), inpatient hospital care represents a major component of overall costs. This study aimed to characterize the trend in cost of care for GI-related hospitalizations in recent years and to identify the most costly diagnostic groups. All hospital inpatients admitted between January 2008 and December 2009 with a primary diagnosis of one of the six most common GI-related Diagnosis Related Groups (DRGs) in this hospital system were identified; all DRGs contained at least 40 patients during the study period. Patient Level Costing (PLC) was used to express the total cost of hospital care for each patient; PLC comprised a weighted daily bed cost plus cost of all medical services provided (e.g., radiology, pathology tests) calculated according to an activity-based costing approach; cost of medications were excluded. All costs were discounted to 2009 values. Mean length of stay (LOS) was also calculated for each DRG. Over 2 years, 470 patients were admitted with one of the six most common GI DRGs. Mean cost of care increased from 2008 to 2009 for all six DRGs with the steepest increases seen in 'GI hemorrhage (non-complex)' (31 % increase) and 'Cirrhosis/Alcoholic hepatitis (non-complex)' (45 % increase). No differences in readmission rates were observed over time. There was a strong correlation between year-to-year change in costs and change in mean LOS, r = 0.93. The cost of GI-related inpatient care appears to be increasing in recent years with the steepest increases observed in non-complex GI hemorrhage and non-complex Cirrhosis/Alcoholic hepatitis. Efforts to control the increasing costs should focus on these diagnostic categories.

  18. Design and operational experience of the centre for the collection treatment and storage of low level radioactive wastes

    International Nuclear Information System (INIS)

    Zorrilla, S.

    1986-01-01

    The activities of the Centre for Collection, Treatment and Storage of Low-Level Radioactive Wastes (CRTADRBN) are presented. The objective of this centre is the final storage of radioactive waste and radiation sources generated by medicine, industry teaching and research. Safety, storage capacity and economy are considered in the design. The types of treatment for liquid wastes are described and the containement system is specified. (M.C.K.) [pt

  19. [Environmental noise levels in 2 intensive care units in a tertiary care centre].

    Science.gov (United States)

    Ornelas-Aguirre, José Manuel; Zárate-Coronado, Olivia; Gaxiola-González, Fabiola; Neyoy-Sombra, Venigna

    2017-04-03

    The World Health Organisation (WHO) has established a maximum noise level of 40 decibels (dB) for an intensive care unit. The aim of this study was to compare the noise levels in 2 different intensive care units at a tertiary care centre. Using a cross-sectional design study, an analysis was made of the maximum noise level was within the intensive coronary care unit and intensive care unit using a digital meter. A measurement was made in 4 different points of each room, with 5minute intervals, for a period of 60minutes 7:30, 14:30, and 20:30. The means of the observations were compared with descriptive statistics and Mann-Whitney U. An analysis with Kruskal-Wallis test was performed to the mean noise level. The noise observed in the intensive care unit had a mean of 64.77±3.33dB (P=.08), which was similar to that in the intensive coronary care unit, with a mean of 60.20±1.58dB (P=.129). Around 25% or more of the measurements exceeded the level recommended by the WHO by up to 20 points. Noise levels measured in intensive care wards exceed the maximum recommended level for a hospital. It is necessary to design and implement actions for greater participation of health personnel in the reduction of environmental noise. Copyright © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

  20. Readability levels of health pamphlets distributed in hospitals and health centres in Athens, Greece.

    Science.gov (United States)

    Kondilis, B K; Akrivos, P D; Sardi, T A; Soteriades, E S; Falagas, M E

    2010-10-01

    Health literacy is important in the medical and social sciences due to its impact on behavioural and health outcomes. Nevertheless, little is known about it in Greece, including patients' level of understanding health brochures and pamphlets distributed in Greek hospitals and clinics. Observational study in the greater metropolitan area of Athens, Greece. Pamphlets and brochures written in the Greek language were collected from 17 hospitals and healthcare centres between the spring and autumn of 2006. Readability of pamphlets using the Flesch-Kincaid, Simple Measure of Gobbledygook (SMOG) and Fog methods was calculated based on a Greek readability software. Out of 70 pamphlets collected from 17 hospitals, 37 pamphlets met the criteria for the study. The average readability level of all scanned pamphlets was ninth to 10th grade, corresponding to a readability level of 'average'. A highly significant difference (PPamphlets from private hospitals were one grade more difficult than those from public hospitals. Approximately 43.7% of the Greek population aged ≥20 years would not be able to comprehend the available pamphlets, which were found to have an average readability level of ninth to 10th grade. Further research examining readability levels in the context of health literacy in Greece is warranted. This effort paves the way for additional research in the field of readability levels of health pamphlets in the Greek language, the sources of health information, and the level of understanding of key health messages by the population. Copyright © 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  1. Clinical recommendations of Cochrane reviews in pediatric gastroenterology: systematic analysis.

    Science.gov (United States)

    Goda, Yvonne; Sauer, Harald; Schöndorf, Dominik; Hennes, Pia; Gortner, Ludwig; Gräber, Stefan; Meyer, Sascha

    2015-01-01

    Systematic and up-to-date Cochrane reviews in pediatrics in general and in pediatric gastroenterology in particular are important tools in disseminating the best available evidence to the medical community, thus providing the physician at the bedside with invaluable information and recommendations with regard to specific clinical questions. A systematic literature review was conducted, including all Cochrane reviews published by the Cochrane Review Group in the field of pediatric gastroenterology between 1993 and 2012, with regard to the percentage of reviews that concluded that a certain intervention provided a benefit, percentage of reviews that concluded that a certain intervention should not be performed, and percentage of studies that concluded that the current level of evidence was inconclusive. In total, 86 reviews in the field of pediatric gastroenterology were included. The majority of reviews assessed pharmacological interventions (46/86); other important fields included prevention (15/86) and nutrition (9/86). A total of 33/86 reviews issued definite recommendations (positive, 19/86; negative, 14/86). The remaining 53/86 reviews were either inconclusive (24/86) or only of limited conclusiveness (29/86). The percentage of inconclusive reviews increased from 9% (1998-2002) to 19% (2003-2007; P < 0.05) to finally 24% (2008-2012) (P < 0.05). The three most common reasons for the need for further research were heterogeneity of studies (26/86), small number of patients (18/86), and insufficient data (16/86). Further high-quality research is necessary to increase the proportion of reviews with clear recommendations. Funding and research agencies are key to selecting the most appropriate research programs. © 2014 Japan Pediatric Society.

  2. Manche centre

    International Nuclear Information System (INIS)

    1997-05-01

    After a general presentation of radioactivity and radioactive wastes and of the French national agency for the management of radioactive wastes (ANDRA), this brochure gives a general overview of the Manche low- and medium-level radioactive waste disposal centre: principles of storage safety, waste containers (first confinement barrier), storage facility and cover (second confinement barrier), the underground (third confinement barrier), the impact of the centre on its environment, and the control of radioactivity in the vicinity of the centre. (J.S.)

  3. Conditioning of low level radioactive waste at the Research Centre Seibersdorf

    International Nuclear Information System (INIS)

    Chalupa, G.; Petschnik, G.

    1986-09-01

    The conditioning (solidification) of LLW at the Austrian Research Centre Seibersdorf are explained. In first part of this paper the comentation of ashes are described and criterias for the application of recipes for conditioning, quality inspection, determination of leaching rates are given. Enclosed to that some figures show you the installed equipment and the handling for conditioning of LLW at the Research Centre. (Author)

  4. Ultrasonography in Gastroenterology: The Need for Training

    Directory of Open Access Journals (Sweden)

    João Pinto

    2018-02-01

    Full Text Available The use of ultrasonography (US as an imaging modality in medicine has spread across almost every clinical specialty. This diffusion is based on the simplicity, accessibility, portability and affordability of the technique producing real-time high-resolution images using non-ionising radiation. On the other hand, this trend also extended the technique to settings other than healthcare, such as public facilities, private houses or remote sites. This tendency can be observed worldwide, from developing countries to prestigious medical schools and tertiary referral hospitals. Furthermore, point-of-care US (POCUS, i.e., US executed at the patient’s bedside to obtain real-time objective information with diagnostic and clinical monitoring purposes or to guide invasive procedures, has been incorporated in many specialties. In gastroenterology, despite the essential role of endoscopy, clinical practice is highly dependent on non-endoscopic imaging techniques. However, as in other specialties, the indications of US in gastroenterology have been increasing steadily, covering a broad range of conditions. In response to the generalised employment of US by non-radiologists, institutions such as the European Federation of Societies for Ultrasound in Medicine and Biology and the Royal College of Radiologists issued recommendations to ensure high-quality practice. These theoretical and practical requisites include performing a certain number of examinations and mandatory skills in order to achieve certification to execute unsupervised US. Therefore, there is a need for modern gastroenterology to include US as a basic skill in its clinical practice. To ensure the provision of high-quality US, adequate instruction of future specialists should be guaranteed by the gastroenterology departments and required in the residency training programme.

  5. Functional Bowel Disorders Gastroenterology's 75th anniversary.

    Science.gov (United States)

    Wiley, John W; Chang, Lin

    2018-02-15

    Articles appearing in Gastroenterology have played an integral role in the evolution of our understanding of Functional Bowel Disorders (FBD), including Irritable Bowel Syndrome (IBS), beginning with the prescient contributions of Almy and Tulin in 1947 and 1949 that highlighted the role of stress to enhance perception of abdominal pain and promote colon contractions. Subsequent publications have codified diagnostic criteria and stratified subpopulations of FBD (Manning and ROME I-IV), which resulted in improved symptom-based therapeutic interventions. Advances in our understanding of the pathophysiology of FBD, particularly IBS, published in Gastroenterology has led to our current appreciation that FBD represent dysfunction in the bidirectional brain-gut axis, intestinal barrier dysfunction and interactions with the microbiota and dietary factors. Team science and the application of next-generation -omics methods are leading the way to improved diagnostic criteria and targeted therapeutic interventions. As the field evolves, publications appearing in Gastroenterology will continue to be at the forefront of these advances. Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.

  6. The Bockus International Society of Gastroenterology: Historical review

    Science.gov (United States)

    Chaun, Hugh

    2012-01-01

    The Bockus International Society of Gastroenterology was founded in 1958 in honour of Dr Henry L Bockus (1894–1982) by his former students, residents and fellows at the Graduate School of Medicine of the University of Pennsylvania, Philadelphia, USA. It was a celebrated tribute to Dr Bockus’ outstanding leadership in the development and teaching of clinical gastroenterology as a subspecialty, which was in its infancy in the post-World War II era. He established the first formal training course in clinical gastroenterology in America. His department of gastroenterology became the leading graduate school of clinical gastroenterology in the world, training many clinical gastroenterologists in America and from many regions around the world. For many years, Dr Bockus was the most prominent American in world gastroenterology. The Bockus Society holds biennial scientific congresses in different continents, thus continuing to foster Dr Bockus’ lifelong interest and vision to promote international medical friendship, and excellence in education and research collaboration. PMID:22506261

  7. Allocation of substance use disorder patients to appropriate levels of care: feasibility of matching guidelines in routine practice in Dutch treatment centres

    NARCIS (Netherlands)

    Merkx, Maarten J. M.; Schippers, Gerard M.; Koeter, Maarten J. W.; Vuijk, Pieter Jelle; Oudejans, Suzan; de Vries, Carlijn C. Q.; van den Brink, Wim

    2007-01-01

    AIMS: To examine the feasibility of implementing evidence-based guidelines for patient-treatment-matching to levels of care in two Dutch substance abuse treatment centres. DESIGN: Multi-centre observational follow-up study. SETTING: Two large substance abuse treatment centres (SATCs). PARTICIPANTS:

  8. [Vitamin B12 levels in the patient population attending an urban health centre in Madrid].

    Science.gov (United States)

    Camarero-Shelly, M

    2018-04-01

    Vitamin B 12 levels are usually measured in Primary Care when the patients have symptoms or risk factors associated with its deficiency, mostly in the elderly. However, no evidence has been found to support the recommendation of screening in the general population. The aim of this study is to assess the relevance of having extended the screening of vitamin B 12 deficiency to a younger population, after observing an increase in the prescription of this injected vitamin in a population under 65 years, by analysing the vitamin B 12 values obtained. A descriptive, retrospective, observational study was conducted on a sample consisting of 5,531 patients from Barajas Health Primary Centre, Madrid, between 2008 and 2012, and on whom a blood test was performed for any reason, with values of vitamin B 12 . A deficiency was found in 9.1% (SD 2.3) of the patients, of whom 49.4% were less than 65 years. The deficiencies were associated (P<.001, 95% CI) with age, dementia, changes in blood red cell counts, memory, and with the taking of metformin and proton pump inhibitors (P=.007). The prevalence of vitamin B 12 deficiency in our served population is similar in patients older and younger than 65 years. The extended screening was relevant. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Clinical nutrition knowledge of gastroenterology fellows: is there anything omitted?

    Science.gov (United States)

    Eslamian, Ghazaleh; Jacobson, Kevan; Hekmatdoost, Azita

    2013-01-01

    Despite the increased emphasis on chronic non-communicable diseases, there are notable deficits about nutrition education in many medicine training programs particularly gastroenterology fellowship programs. In the present cross-sectional study, we examined the nutritional knowledge related to clinical nutrition among Iranian gastroenterology fellows. Thirty-six gastroenterology fellows currently enrolled in a gastroenterology fellowship program completed a questionnaire, including two sections. The first of which assessed the gastroenterology fellows experience about nutrition training, nutrition management of patients with gastrointestinal (GI) disorders and evaluating perceived nutrition education needs. The second section consisted of multiple choice questions that assessed nutritional knowledge. A total of 32 gastroenterology fellows completed the first section. The majority of gastroenterology fellows failed to partake in any nutrition education during their fellowship training particularly for inpatients despite the availability to participate in the nutrition training especially for the purpose of nutrition support. Mean correct response rates for the second section was 38%. The highest mean score was seen in nutrition assessment (48.1%), followed by scores of 40.5% in nutrition support, 37.0% nutrition in GI disease, and 25.0% in micro and macronutrients. Iranian gastroenterology fellows have serious deficits in their nutrition knowledge. This study paves the way for the development of an education program to improve nutritional knowledge of gastroenterology fellows.

  10. The Role of Parents' Educational Level and Centre Type in Parent Satisfaction with Early Childhood Care Centres: A Study in Greece

    Science.gov (United States)

    Kelesidou, Sofia; Chatzikou, Maria; Tsiamagka, Evmorfia; Koutra, Evangelia; Abakoumkin, Georgios; Tseliou, Eleftheria

    2017-01-01

    This research examines specific facets of parent satisfaction with childcare centres, namely satisfaction with parent-centre communication and the educational services they provide, as well as respective parent beliefs. These were investigated in relation to centre type (private vs public) and parents' education. Parents of different educational…

  11. General medical training in gastroenterology: views from specialist trainees on the challenges of dual accreditation.

    Science.gov (United States)

    Neale, James R; Basford, Peter J

    2015-02-01

    Higher specialist training in general internal medicine (GIM) and the medical specialties has been subject to many changes and increasing subspecialisation in recent years. The 'Shape of Training' review proposes 'broad-based specialty training', shortening of training by one year, and subspecialisation to be undertaken after the certificate of specialty training is obtained. All higher level gastroenterology trainees based in the UK were invited to complete an online survey between July and September 2012 to assess their experience of gastroenterology and GIM training. Overall, 72.7% of trainees expressed satisfaction with their training in gastroenterology but significantly fewer (43.5%) expressed satisfaction with their training in GIM. Satisfaction with gastroenterology training thus is good, but satisfaction with GIM training is lower and levels of dissatisfaction have increased significantly since 2008. Up to 50% of trainees are not achieving the minimum recommended number of colonoscopy procedures for their stage of training. Experience in GIM is seen as service orientated, with a lack of training opportunities. There is a worrying difficulty in gaining the minimum required experience in endoscopy. If the length of specialist training is shortened and generalised, training in key core specialist skills such as endoscopy may be compromised further. © 2015 Royal College of Physicians.

  12. 78 FR 49530 - Gastroenterology Regulatory Endpoints and the Advancement of Therapeutics; Public Workshop

    Science.gov (United States)

    2013-08-14

    ...] Gastroenterology Regulatory Endpoints and the Advancement of Therapeutics; Public Workshop AGENCY: Food and Drug... for Drug Evaluation and Research, in cosponsorship with the American College of Gastroenterology, the... American Society for Pediatric Gastroenterology, Hepatology, and Nutrition, and the Pediatric IBD...

  13. Snapshot of an integrated psychosocial gastroenterology service.

    Science.gov (United States)

    Kinsinger, Sarah W; Ballou, Sarah; Keefer, Laurie

    2015-02-14

    To characterize the patients utilizing a gastroenterology behavioral medicine service and examine the effect of treatment on health care utilization. Patients were referred by their gastroenterologists for psychological treatment during a 15 mo period. Patients seen for an intake with a psychologist completed the Brief Symptom Inventory (BSI) and a checklist of psychosocial concerns. A subset of patients with functional bowel disorders also completed a disease specific quality of life measure. Chart review was conducted to obtain information on type and frequency of sessions with the psychologist, the number of outpatient gastroenterology visits, and number of gastroenterology-related medical procedures during the 6 mo following psychological intake. Of 259 patients referred for treatment, 118 (46%) completed an intake with a psychologist. Diagnoses included: irritable bowel syndrome (42%), functional dyspepsia (20%), inflammatory bowel diseases (20%), esophageal symptoms (10%), and "other" (8%). Demographic variables and disease type did not differentiate between those who did and did not schedule an intake. Mean t-scores for the BSI global score index and the depression, anxiety, and somatization subscales fell below the cutoff for clinical significance (t = 63). Treatments were predominantly gut-directed hypnosis (48%) and cognitive behavioral therapy (44%). Average length of treatment was 4 sessions. Among functional gastrointestinal (GI) patients, those patients who initiated treatment received significantly fewer GI-related medical procedures during the 6 mo following the referral than patients who did not schedule an intake [t (197) = 2.69, P < 0.01]. Patients are receptive to psychological interventions for GI conditions and there is preliminary evidence that treatment can decrease health-care utilization among patients with functional GI conditions.

  14. Radio-isotopes in gastro-enterology

    International Nuclear Information System (INIS)

    Pettengell, K.E.; Houlder, A.

    1988-01-01

    Many recent advances in nuclear imaging have applications in gastro-enterology, and these have shown an increasing shift of emphasis away from the simple demonstration of anatomy towards methods suitable for the investigation of gastro-intestinal (GI) function and pathophysiology. Scintigraphic techniques are non-invasive, well tolerated by ill patients and perhaps most importantly permit quantitation of abnormal physiology. It is therefore not surprising that nuclear imaging is gaining an increasingly important place in routine patient management. This article discuss its value in the fields of GI bleeding, inflammatory bowel disease, tumour localisation and oesophageal motility

  15. Digestive oncologist in the gastroenterology training curriculum

    Science.gov (United States)

    Mulder, Chris Jacob Johan; Peeters, Marc; Cats, Annemieke; Dahele, Anna; Droste, Jochim Terhaar sive

    2011-01-01

    Until the late 1980s, gastroenterology (GE) was considered a subspecialty of Internal Medicine. Today, GE also incorporates Hepatology. However, Digestive Oncology training is poorly defined in the Hepatogastroenterology (HGE)-curriculum. Therefore, a Digestive Oncology curriculum should be developed and this document might be a starting point for such a curriculum. HGE-specialists are increasingly resisting the paradigm in which they play only a diagnostic and technical role in the management of digestive tumors. We suggest minimum end-points in the standard HGE-curriculum for oncology, and recommend a focus year in the Netherlands for Digestive Oncology in the HGE-curriculum. To produce well-trained digestive oncologists, an advanced Digestive Oncology training program with specific qualifications in Digestive Oncology (2 years) has been developed. The schedule in Belgium includes a period of at least 6 mo to be spent in a medical oncology department. The goal of these programs remains the production of well-trained digestive oncologists. HGE specialists are part of the multidisciplinary oncological teams, and some have been administering chemotherapy in their countries for years. In this article, we provide a road map for the organization of a proper training in Digestive Oncology. We hope that the World Gastroenterology Organisation and other (inter)national societies will support the necessary certifications for this specific training in the HGE-curriculum. PMID:21556128

  16. What factors encourage high levels of student participation in a self-access centre?

    Directory of Open Access Journals (Sweden)

    Keith Barrs

    2010-06-01

    Full Text Available The motivation to write about Self-Access Centres (SACs comes from experiencing a marked difference in the frequency and depth of student participation at two separate centres; one in a university in Japan and one in a private language school in England. In this context ‘frequency’ means how often the students use the centre and ‘depth’ means in what ways and to what extent the equipment and resources are used. At the SAC in Japan, the facilities are continually exploited by a large number of students with many of them visiting three or four times a week, on an optional basis, for usually over an hour each time. The activities in which the students are engaged include listening to music while annotating lyrics, practising pronunciation in speaking booths, reading English language novels and graded-readers, and communicating in the target-language with other students and learning advisors. In contrast, the SAC at the institution in England is only frequented by a very small number of students and the activities are generally limited to the issuance and return of books and the use of computers for online social networking, which is usually conducted in the native languages of the students.

  17. Surgical strategies in polytraumatized patients with femoral shaft fractures - comparing a German and an Australian level I trauma centre.

    Science.gov (United States)

    Andruszkow, Hagen; Dowrick, Adam S; Frink, Michael; Zeckey, Christian; Krettek, Christian; Hildebrand, Frank; Edwards, Elton R; Mommsen, Philipp

    2013-08-01

    Femoral shaft fractures are one of the most common injuries in multiple trauma patients. Due to their prognostic relevance, there is an ongoing controversial discussion as to the optimal treatment strategy in terms of Damage Control Orthopaedics (DCO) and Early Total Care (ETC). We aimed to describe the differences in fracture management and clinical outcome of multiple trauma patients with concomitant femoral shaft fractures treated at a German and an Australian level I trauma centre using the same inclusion criteria. Polytraumatized patients (ISS ≥ 16) with a femoral shaft fracture aged ≥ 16 years treated at a German and an Australian trauma centre between 2003 and 2007 were included. According to ETC and DCO management principles, we evaluated demographic parameters as well as posttraumatic complications and clinical outcome. Seventy-three patients were treated at the German and 134 patients at the Australian trauma centre. DCO was performed in case of increased injury severity in both hospitals. Prolonged mechanical ventilation time, and length of ICU and hospital stay were demonstrated in DCO treatment regardless of the trauma centre. No differences concerning posttraumatic complications and survival were found between both centres. Survival of patients after DCO was similar to those managed using ETC despite a greater severity of injury and lower probability of survival. There was no difference in the incidence of ARDS. DCO was, however, associated with a greatly increased length of time on mechanical ventilation and length of stay in the ICU. We found no differences concerning patient demographics or clinical outcomes in terms of incidence of ARDS, MODS, or mortality. As such, we propose that comparability between German and Australian trauma populations is justified. Despite a higher ISS in the DCO group, there were no differences in posttraumatic complications and survival depending on ETC or DCO treatment. Further research is required to confirm

  18. Role of Orvosi Hetilap in the development of Hungarian gastroenterology

    Science.gov (United States)

    Buzás, György Miklós

    2010-01-01

    AIM: To analyze the contribution of Orvosi Hetilap (Hungarian Medical Journal) to the field of gastroenterology. METHODS: All issues of the journal between 1857 and 2008 and identified original articles and reviews dealing with gastroenterology were reviewed. The rate of publications, the thematic distribution and foreign sources of knowledge were assessed. The dates that major achievements in gastroenterology were introduced in Hungary were compared to those dates in Western medicine. RESULTS: A total of 4799 original/research articles on gastroenterology were published, which represents 11.1% of the total publications. Thematic rankings showed that liver and biliary diseases represented 20.36% of the total, followed by gastric diseases (9.35%) and surgery (8.77%). A total of 268 foreign journals were reviewed: 50.9% were German, 30.4% English, 12.1% French and only 6.6% were in other languages. The major achievements of gastroenterology were introduced with varying delays compared to Western countries. CONCLUSION: Orvosi Hetilap has made a large contribution to the development of Hungarian gastroenterology. The high proportion of gastroenterology studies underlines the importance of digestive diseases in public health. PMID:20458774

  19. One size fits one: pharmacogenetics in gastroenterology.

    Science.gov (United States)

    Porayette, Prashanth; Flockhart, David; Gupta, Sandeep K

    2014-04-01

    Individual variability in response and development of adverse effects to drugs is a major challenge in clinical practice. Pharmacogenomics refers to the aspect of personalized medicine where the patient's genetic information instructs the selection and dosage of therapy while also predicting its adverse effects profile. Sequencing of the entire human genome has given us the opportunity to study commonly used drugs as well as newer therapeutic agents in a new light, opening up opportunities for better drug efficacy and decreased adverse effects. This article highlights developments in pharmacogenomics, relates these to practice of gastroenterology, and outlines roadblocks in translation of this knowledge into clinical practice. Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.

  20. CLINICAL USE OF ENZYMES IN PEDIATRIC GASTROENTEROLOGY

    Directory of Open Access Journals (Sweden)

    А.N. Surkov

    2011-01-01

    Full Text Available High incidence of various pediatric gastroenterologic diseases including congenital still remains an important issue for a Russian healthcare. The latter may be attended by relative or total excretory pancreatic failure with the following symptoms: stool abnormalities, abdominal pain, meteorism, weakness, low appetite and physical exercise, weight reduction and growth retardation. Pancreatic enzymes that contribute to protein, lipids and carbohydrates digestion are often used as a replacement therapy in pediatric care. Nowadays there is a plenty of choice among enzymatic medications. However, not all aforesaid medications can ensure adequate replacement treatment especially in children with chronic pancreatic failure. That is why among agents of choice are modern and highly effective microgranulated encapsulated pancreatines. For example Micrazim.Key words: children, pancreas, pancreatic failure, enzymotherapy.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (3: 114–118

  1. Student-Centred Teaching Strategies by Gender, Grade Level, and Teacher’s Self-Concept in Mexico

    Directory of Open Access Journals (Sweden)

    PEDRO SÁNCHEZ-ESCOBEDO

    2018-05-01

    Full Text Available This study examined the student-centred teaching strategies of Mexican teachers by gender, grade level, and self-concept as an instructor. A conventional sample of 573 teachers from diverse school settings in the state of Yucatan in Mexico responded to a paper and pencil questionnaire. Results indicated, in general, that teachers prioritized classroom management and independent learning activities, in contrast with teaching strategies emphasized by policies and teacher´s training programs in the country, such as cooperative learning, differentiation, or promoting critical thinking. There were some gender and grade level differences. In general, female teachers promoted more independent activities than males. As expected, primary school teachers were more concerned with using differentiation teaching strategies than secondary education teachers, considering the greatest variance in younger students. Teachers self-concept had differential effects. Whilst self-efficacy feelings had no influence in the use of specific student-centred teaching strategies, high self-esteem teachers used more student-centred teaching strategies. The importance of asking teachers what they did, and how they felt as teachers was argued in light of results. Future research avenues regarding self-concept and teaching strategies are posited.

  2. South African Gastroenterology Review - Vol 2, No 1 (2004)

    African Journals Online (AJOL)

    The South African Gastroenterology Review. Message from Prof J.E.J. Krige: SAGES President: from the president · EMAIL FULL TEXT EMAIL FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. JEJ Krige, 2-2 ...

  3. Editorial | Lesi | Nigerian Journal of Gastroenterology and Hepatology

    African Journals Online (AJOL)

    Nigerian Journal of Gastroenterology and Hepatology. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 8, No 1 (2016) >. Log in or Register to get access to full text downloads.

  4. Editorial | Lesi | Nigerian Journal of Gastroenterology and Hepatology

    African Journals Online (AJOL)

    Nigerian Journal of Gastroenterology and Hepatology. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 7, No 1 (2015) >. Log in or Register to get access to full text downloads.

  5. North American Society for Pediatric Gastroenterology, Hepatology and Nutrition

    Science.gov (United States)

    North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Skip to Navigation NASPGHAN Annual Meeting and Postgraduate ... transition well. Moreover, Doc4me provides information about medications, nutrition and living with IBD. Please help us promote ...

  6. Guided Self-Education in the Undergraduate Teaching of Gastroenterology

    Science.gov (United States)

    Dworken, Harvey J.

    1974-01-01

    The objective of the study reported was to develop and to evaluate a multifaceted teaching program in gastroenterology for second-year students of medicine. Critical information is defined in a narrative, problem-oriented, pathophysiological core syllabus. (Editor)

  7. The association between estimated average glucose levels and fasting plasma glucose levels in a rural tertiary care centre

    Directory of Open Access Journals (Sweden)

    Raja Reddy P

    2013-01-01

    Full Text Available The level of hemoglobin A1c (HbA1c, also known as glycated hemoglobin, determines how well a patient’s blood glucose level has been controlled over the previous 8-12 weeks. HbA1c levels help patients and doctors understand whether a particular diabetes treatment is working and whether adjustments need to be made to the treatment. Because the HbA1c level is a marker of blood glucose for the previous 60- 90 days, average blood glucose levels can be estimated using HbA1c levels. Aim in the present study was to investigate the relationship between estimated average glucose levels, as calculated by HbA1c levels, and fasting plasma glucose levels. Methods: Type 2 diabetes patients attending medicine outpatient department of RL Jalappa hospital, Kolar between March 2010 and July 2012 were taken. The estimated glucose levels (mg/dl were calculated using the following formula: 28.7 x HbA1c-46.7. Glucose levels were determined using the hexokinase method. HbA1c levels were determined using an HPLC method. Correlation and independent t- test was the test of significance for quantitative data. Results: A strong positive correlation between fasting plasma glucose level and estimated average blood glucose levels (r=0.54, p=0.0001 was observed. The difference was statistically significant. Conclusion: Reporting the estimated average glucose level together with the HbA1c level is believed to assist patients and doctors determine the effectiveness of blood glucose control measures.

  8. Level of patient and operator dose in the largest cardiac centre in Greece

    International Nuclear Information System (INIS)

    Tsapaki, V.; Patsilinakos, S.; Voudris, V.; Magginas, A.; Pavlidis, S.; Maounis, T.; Theodorakis, G.; Koutelou, M.; Vrantza, T.; Nearchou, M.; Nikolaki, N.; Kollaros, N.; Kyrozi, E.; Kottou, S.; Karaiskos, P.; Neofotistou, E.; Cokkinos, D.

    2008-01-01

    The objective of this study was to investigate the patient and staff doses in the most frequent interventional cardiology (IC) procedures performed in Onassio, the largest Cardiac Centre in Greece. Data were collected from three digital X-ray systems for 212 coronary angiographies, 203 percutaneous transluminal coronary angio-plasties (PTCA) and 134 various electrophysiological studies. Patient skin dose was measured using suitably calibrated slow radiotherapy films and cardiologist dose using suitably calibrated thermoluminescent dosemeters placed on left arm, hand and foot. Patient median dose area product (DAP) (all examinations) ranged between 6.7 and 83.5 Gy cm 2 . Patient median skin dose in PTCA was 799 mGy (320-1660 mGy) and in RF ablation 160 mGy (35-1920 mGy). Median arm, hand and foot dose to the cardiologist were 12.6, 27 and 13 μSv, respectively, per procedure. The great range of radiation doses received by both patients and operators confirms the need for continuous monitoring of all IC techniques. (authors)

  9. Gastroenterology-Urology Devices; Manual Gastroenterology-Urology Surgical Instruments and Accessories. Final rule; technical amendment.

    Science.gov (United States)

    2017-03-01

    The Food and Drug Administration (FDA) is amending the identification of manual gastroenterology-urology surgical instruments and accessories to reflect that the device does not include specialized surgical instrumentation for use with urogyencologic surgical mesh specifically intended for use as an aid in the insertion, placement, fixation, or anchoring of surgical mesh during urogynecologic procedures ("specialized surgical instrumentation for use with urogynecologic surgical mesh"). These amendments are being made to reflect changes made in the recently issued final reclassification order for specialized surgical instrumentation for use with urogynecologic surgical mesh.

  10. Association between proportion of US medical graduates and program characteristics in gastroenterology fellowships.

    Science.gov (United States)

    Atsawarungruangkit, Amporn

    2017-01-01

    Gastroenterology is one of the most competitive internal medicine fellowship. However, factors that associated with program competitiveness have not been documented. The objective of this study was to evaluate associations between characteristics of gastroenterology fellowship programs and their competitiveness through the proportion of US medical graduates for the academic year 2016/17. This study used a retrospective, cross-sectional design with data obtained from the American Medical Association. The proportion of US medical graduates in gastroenterology fellowships was used as an indicator of program competitiveness. Using both univariate and multivariate linear regression analyses, we analyzed the association between the proportion of medical graduates in each program and 27 program characteristics based on a significance level of 0.05. In total, 153 out of 171 gastroenterology fellowship programs satisfied the inclusion criteria. A multivariate analysis revealed that a higher proportion of US medical graduates was significantly associated with five program characteristics: that it was a university-based program (p < 0.001), the ratio of full-time paid faculty to fellow positions (p < 0.001), the proportion of females in the program (p = 0.002), location in the Pacific region (p = 0.039), and a non-smoker hiring policy (p = 0.042). Among the five significant factors, being university based, located in the Pacific, and having a non-smoker hiring policy were likely to remain unchanged over a long period. However, program directors and candidates should pay attention to equivalence between full-time paid faculty and fellowship positions, and the proportion of women in the program. The former indicates the level of supervision while the latter has become increasingly important owing to the higher proportion of women in medicine.

  11. [Why are there few publications by the Argentine gastroenterology? Considerations on a bibliometric analysis of Argentine publications on gastroenterology].

    Science.gov (United States)

    Barreyro, Fernando J; Krabshuis, Justus; Planzer del Campo, Marcela; Bai, Julio C

    2009-03-01

    The publication of scientific findings is the main way to communicate advances. Our aim was to perform a bibliometric and comparative analysis of the Argentinean gastroenterological research output. We analyzed Argentinean gastroenterological publications selectively retrieved from LILACS (between years 1982-2006) and EMBASE (1996-2007) databases by means of specially constructed filter based on author address and subject headings. The global Argentinean scientific research output is far below that of developed countries and has been affected in direct manner by economic, political and social disturbances in the country. The gastroenterological research output from Argentina represent about 6% of national biomedical research. While 54% belongs to gastroenterology and 46% to hepatology, 65% are based on clinical research and 67% were originally contributions. Only 11% have been published in high impact factor journals. The comparative analysis within countries with health indicators similarities has shown a low biomedical and gastroenterology research output, however, the rate of acceptance at the 18 top gastroenterological journals is acceptable (15%). The contributions of registered specialists were lower for gastroenterologists compared with those from hepatologists (8.7% and 16.4% respectively). The research projects at public hospital funded by the pharmaceutical industry overcome those funded independently. Indeed, it seems that the independent research is being progressively replaced by that supported by the industry due to economic benefits for researchers even when there is a very low participation rate in publications (3%) by Argentinean researchers. We conclude that the Argentinean biomedical and gastroenterological research output is scanty compared with developed countries and countries with comparable health indicators. Our analysis suggests that efforts must be taken to attain objectives directed to develop and improve the Argentinean biomedical and

  12. The Gastroenterology Fellowship Match: A Decade Later.

    Science.gov (United States)

    Huang, Robert J; Triadafilopoulos, George; Limsui, David

    2017-06-01

    Following a period of uncertainty and disorganization, the gastroenterology (GI) national leadership decided to reinstitute the fellowship match (the Match) under the auspices of the National Residency Matching Program (NRMP) in 2006. Although it has now been a decade since the rebirth of the Match, there have been limited data published regarding progress made. In this piece, we discuss reasons for the original collapse of the GI Match, including most notably a perceived oversupply of GI physicians and a poor job market. We discuss the negative impacts the absence of the Match had on programs and on applicants, as well as the impetus to reorganize the Match under the NRMP. We then utilize data published annually by the NRMP to demonstrate that in the decade since its rebirth, the GI Match has been remarkably successful in terms of attracting the participation of applicants and programs. We show that previous misguided concerns of an oversupply of GI physicians were not realized, and that GI fellowship positions remain highly competitive for internal medicine applicants. Finally, we discuss possible implications of recent changes in the healthcare landscape on the GI Match.

  13. New Photosensitizers for Photodynamic Therapy in Gastroenterology

    Directory of Open Access Journals (Sweden)

    SG Bown

    1999-01-01

    Full Text Available Most applications of photodynamic therapy (PDT in gastroenterology to date have used porfimer sodium as the photosensitizing agent. For destroying small lesions in the wall of the gastrointestinal tract in inoperable patients, it has proved to be most effective, but attempts to achieve circumferential mucosal ablation, as in the treatment of Barrett’s esophagus, have led to a high incidence of strictures, and all patients have cutaneous photosensitivity, which can last up to three months. Two new photosensitizers are of particular interest to gastroenterologists. PDT with metatetrahydroxyphenyl chlorin produces a similar biological effect as PDT with porfimer sodium, but the light doses required are much smaller, and cutaneous photosensitivity lasts only two to three weeks. Further, it can be used with percutaneous light delivery to destroy localized pancreatic cancers. The photosensitizing agent 5-amino levulinic acid, converted in vivo into the photoactive derivative protoporphyrin IX, sensitizes the mucosa much more than the underlying layers. This makes it feasible to destroy areas of abnormal mucosa without damaging the underlying muscle and is, therefore, better for treating Barrett’s esophagus. Detailed clinical studies are required to establish the real role of PDT with the use of these and other new photosensitizers.

  14. Transition of gastroenterological patients from paediatric to adult care: A position statement by the Italian Societies of Gastroenterology.

    Science.gov (United States)

    Elli, Luca; Maieron, Roberto; Martelossi, Stefano; Guariso, Graziella; Buscarini, Elisabetta; Conte, Dario; di Giulio, Emilio; Staiano, Annamaria; Barp, Jacopo; Bassotti, Gabrio; Bianco, Maria Antonia; Buri, Luigi; Carrara, Maurizio; Ghidini, Benedetta; Giannini, Olivia; Knafelz, Daniela; Miele, Erasmo; Peralta, Sergio; Riccio, Elisabetta; Tomba, Carolina; Zilli, Maurizio; Guadagnini, Tiziana

    2015-09-01

    In 2013, four Italian Gastroenterological Societies (the Italian Society of Paediatric Gastroenterology, Hepatology and Nutrition, the Italian Society of Hospital Gastroenterologists and Endoscopists, the Italian Society of Endoscopy, and the Italian Society of Gastroenterology) formed a joint panel of experts with the aim of preparing an official statement on transition medicine in Gastroenterology. The transition of adolescents from paediatric to adult care is a crucial moment in managing chronic diseases such as celiac disease, inflammatory bowel disease, liver disease and liver transplantation. Improved medical treatment and availability of new drugs and surgical techniques have improved the prognosis of many paediatric disorders, prolonging survival, thus making the transition to adulthood possible and necessary. An inappropriate transition or the incomplete transmission of data from the paediatrician to the adult Gastroenterologist can dramatically decrease compliance to treatment and prognosis of a young patient, particularly in the case of severe disorders. For these reasons, the Italian gastroenterological societies decided to develop an official shared transition protocol. The resulting document discusses the factors influencing the transition process and highlights the main points to accomplish to optimize compliance and prognosis of gastroenterological patients during the difficult transition from childhood to adolescence and adulthood. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  15. An evaluation of the level of satisfaction with a dedicated inpatient venepuncture service at a rehabilitation centre.

    Science.gov (United States)

    Oatey, Anthea; Stiller, Kathy

    2009-12-01

    The purpose of this prospective observational study was to determine the levels of satisfaction of the three main 'customers' of a dedicated inpatient venepuncture service at a rehabilitation centre, namely the patients, medical staff and nursing staff. The venepuncture service was delivered by two part-time nurses. One hundred and six patients, 14 medical staff and 35 nurses participated in the study. Three purpose-designed surveys were administered to investigate levels of satisfaction. High degrees of satisfaction were reported by all three 'customer' groups. Patients were highly satisfied with the interpersonal skills of the venepuncture nurses and their ability to obtain blood on the first pass, medical staff agreed that a dedicated venepuncture service gave them more time to spend in patient care, and nursing staff believed that a dedicated venepuncture service caused less disruption to patients' daily schedule.

  16. Blood lead levels in children with neurological disorders: a single centre preliminary study.

    Science.gov (United States)

    Mahmoudian, Touran; Modaresi, Mohamadreza; Zarei, Ali; Poursafa, Parinaz; Kelishadi, Roya

    2009-11-01

    Lead poisoning is a potentially devastating problem among young children. Chronic low level lead exposure can lead to learning disabilities and behavior changes such as colic, insomnia, hyperactivity, impaired growth, hearing loss and upper extremity weakness. The purpose of this cross sectional study was to determine the blood lead level in children with neurological disorders in comparison with healthy controls. Blood lead concentrations were measured by flame atomic absorption spectrometry in 100 children aged 1-10 years and suffering from various neurological disorders. One hundred age and sex-matched healthy children served as controls. The mean blood lead concentration was higher in children with neurological disorders than in controls (113.2 + or - 47.5 microg/L vs 84.7 + or - 38.0 microg/L; pchildren with neurological disorders and 19% of controls were found to have increased blood lead levels, i.e.>100 microg/L. An increase in blood lead level in children might be related to neurological disorders. The measurement of blood lead level might be included in diagnostic eveluation of children with neurological disorders.

  17. Aube storage centre for short-lived low- and intermediate-level wastes. Annual report 2009

    International Nuclear Information System (INIS)

    2010-06-01

    The National Radioactive Waste Management Agency (Andra), was established by the December 1991 Waste Act as a public body in charge of the long-term management of all radioactive waste, under the supervision of the Ministry of Ecology, Energy, Sustainable Development and the Sea (formerly the Ministry of Industry and the Ministry of Environment), and the Ministry of Research. The Andra operates two storage centers in the Aube region (France): the center for short-lived low- and intermediate-level wastes, and the center for very-low-level radioactive wastes. This document is the 2009 activity report of the center for short-lived low- and intermediate-level wastes. It presents a review of the activities of the center: presentation of the installations, safety and radiation protection, events or incidents, environmental monitoring, wastes management, public information, opinion of the Health and safety Committee (CHSCT)

  18. Levels of surface contamination with radioactive materials at workplaces of nuclear research centre at Rez

    International Nuclear Information System (INIS)

    Hoelgye, Z.; Nemcova, I.; Kasikova, M.; Popper, J.; Chysky, J.

    1983-01-01

    A hygiene supervision unit at workplaces of the nuclear Research Institute in Rez monitored on a long-term basis surface contamination with radioactive substances. Surface contamination was found at workplaces with open sources. Of the 4343 monitored places action levels were only exceeded in 13 cases. The obtained data were used for typifying workplaces with the highest level of surface contamination, to determine in certain instances the mechanism of the escape of radioactive substances from insulating facilities and to determine the rate of the spread of the radioactive substance into adjacent non-active workplaces. (author)

  19. A nationwide survey of training satisfaction and employment prospects among Greek gastroenterology fellows during the economic recession.

    Science.gov (United States)

    Gkolfakis, Paraskevas; Tziatzios, Georgios; Papadopoulos, Vasilios; Dimitriadis, George D; Georgopoulos, Sotirios D; Triantafyllou, Konstantinos

    2017-01-01

    This study assessed Greek gastroenterology fellows' satisfaction regarding training, working conditions, quality of life and future employment perspectives. Greek gastroenterology fellows completed an anonymous multiple-choice electronic questionnaire designed to rate their satisfaction using a five-step Likert scale in two major domains: 1) fellowship program (training, working conditions, research activity, acquisition of endoscopic competencies, quality of life); and 2) professional expectations. Pareto analysis was used to determine the factors that had the most negative effect on fellows' satisfaction. In 2016, over a two-month period, 121 invitations were distributed and 70 (58%) fellows responded. Overall, responders reported a low level of satisfaction with their training programs: the mean total satisfaction score was 42.94±11.55 (range 15-75). Pareto analysis revealed that the main factors negatively affecting satisfaction were financial remuneration, routine or menial work, and uncertainty about professional future (98.6%, 94.3% and 92.9% unfavorable answers, respectively). Of the total participants, 53% felt tired or very tired and 44.3% of them reported high levels of stress following a normal working day. Although the majority of the fellows did not regret choosing gastroenterology fellowship training, 34.4% of them would choose a different training environment, if possible. Our study revealed that Greek gastroenterology fellows are dissatisfied with their training programs and with their professional perspectives. It also detected the issues that contribute most to this unfavorable outcome.

  20. Investigation of reference levels and radiation dose associated with abdominal EVAR (endovascular aneurysm repair) procedures across several European Centres

    Energy Technology Data Exchange (ETDEWEB)

    Tuthill, E.; Rainford, L. [University College Dublin, Diagnostic Imaging, School of Medicine, Dublin (Ireland); O' Hora, L.; O' Donohoe, M. [Mater Misericordiae University Hospital, Dublin (Ireland); Panci, S. [San Giovanni di Dio Hospital, Florence (Italy); Gilligan, P.; Fox, E. [Mater Private Hospital, Dublin (Ireland); Campion, D. [Mauriziano-Umberto Hospital, Turin (Italy); Trenti, R. [Policlinico S. Orsola-Malpighi, Bologna (Italy); Catania, D. [AITRI, Association of Italian Interventional Radiographers, Milan (Italy)

    2017-11-15

    Endovascular aneurysm repair (EVAR) is considered the treatment of choice for abdominal aortic aneurysms with suitable anatomy. In order to improve radiation safety, European Directive (2013/59) requires member states to implement diagnostic reference levels (DRLs) in radio-diagnostic and interventional procedures. This study aimed to determine local DRLs for EVAR across five European centres and identify an interim European DRL, which currently remains unestablished. Retrospective data was collected for 180 standard EVARs performed between January 2014 and July 2015 from five specialist centres in Ireland (n=2) and Italy (n=3). Data capture included: air kerma-area product (P{sub KA}), total air kerma at the reference point (K{sub a,r}), fluoroscopic time (FT), number of acquisitions, frame rate of acquisition, type of acquisition, patient height, weight, and gender. The mean values for each site A, B, C, D, and E were: P{sub KA}s of 4343 ± 994 μGym{sup 2}, 18,200 ± 2141 μGym{sup 2}, 11,423 ± 1390 μGym{sup 2}, 7796 ± 704 μGym{sup 2}, 31,897 ± 5798 μGym{sup 2}; FTs of 816 ± 92 s, 950 ± 150 s, 708 ± 70 s, 972 ± 61 s, 827 ± 118 s; and number of acquisitions of 6.72 ± 0.56, 10.38 ± 1.54, 4.74 ± 0.19, 5.64 ± 0.36, 7.28 ± 0.65, respectively. The overall pooled 75th percentile P{sub KA} was 15,849 μGym{sup 2}. Local reference levels were identified. The pooled data has been used to establish an interim European DRL for EVAR procedures. (orig.)

  1. Predictive value of Borrelia burgdorferi IgG antibody levels in patients referred to a tertiary Lyme centre.

    Science.gov (United States)

    Zwerink, M; Zomer, T P; van Kooten, B; Blaauw, G; van Bemmel, T; van Hees, B C; Vermeeren, Y M; Landman, G W

    2018-03-01

    A two-step testing strategy is recommended in serological testing for Lyme borreliosis; positive and indeterminate enzyme-linked immunosorbent assay (ELISA) results are confirmed with immunoblots. Several ELISAs quantify the concentration of antibodies tested, however, no recommendation exists for an upper cut-off value at which an IgG ELISA is sufficient and the immunoblot can be omitted. The study objective was to determine at which IgG antibody level an immunoblot does not have any additional predictive value compared to ELISA results. Data of adult patients who visited a tertiary Lyme centre between 2008 and 2014 were analysed. Both an ELISA (Enzygnost Lyme link VlsE IgG) and immunoblot (recomLine blot Borrelia) were performed. Clinical data were extracted from the patient's digital medical record. Positive predictive values (PPVs) for either previous or active infection with Borrelia burgdorferi s.l. were calculated for different cut-off ELISA IgG antibody levels where the immunoblot was regarded as reference test. In total, 1454 patients were included. According to the two-step test strategy, 486 (33%), 69 (5%) and 899 (62%) patients had positive, indeterminate and negative Borrelia IgG serology, respectively. At IgG levels of 500 IU/ml and higher, all immunoblots were positive, resulting in a 100% PPV (95% CI: 97.0-100). At IgG levels of 200 IU/ml and higher, the PPV was 99.3% (95% CI: 97.4-99.8). In conclusion, at IgG levels of 200 IU/ml and higher, an ELISA was sufficient to detect antibodies to Borrelia burgdorferi s.l. At those IgG levels, a confirmatory immunoblot may be omitted in patients referred to a tertiary Lyme centre. Before these results can be implemented in routine diagnosis of Lyme borreliosis, confirmation of the results is necessary in other patient populations and using other quantitative ELISAs and immunoblots. Copyright © 2017 Elsevier GmbH. All rights reserved.

  2. The Canadian Association of Gastroenterology Education Committee Report

    Directory of Open Access Journals (Sweden)

    Ronald J Bridges

    2004-01-01

    Full Text Available I am pleased to provide an update regarding the activities and future directions of the Canadian Association of Gastroenterology (CAG Education Committee. The mandate of the CAG Education Committee is to facilitate, develop and promote excellence as it pertains to educational initiatives for the Canadian gastroenterology community. Professional education has long remained a priority of the CAG - a fact well recognized by the membership. The 2002 CAG Strategic Planning Survey showed that members rate Canadian Digestive Diseases Week (CDDW as the most important CAG service, on par with Digestive Diseases Week regarding its usefulness (1. CDDW 2004 offered delegates a variety of basic science and clinical symposia, the popular and well received 'Breakfast with the Expert' sessions and a comprehensive Postgraduate Course reviewing key developments in gastroenterology, nutrition and hepatology.

  3. [Continuing medical education in gastroenterology and recertification in Peru].

    Science.gov (United States)

    Castillo Contreras, Ofelia; Soriano Álvarez, César

    2017-01-01

    The field of action of gastroenterology has been expanded due to technological development and the advent of new sub-specialties, such as gastroenterology oncology. Currently, there is no standardization of medical training programs in gastroenterology in our country. The health system and education are changing, so medical practice and competency assessment for medical certification and recertification should reflect these changes. On the other hand, the quality of a specialized unit, service or medical department is directly related to the quality of human resources. Lifelong learning is reflected in continuing medical education (CME). The goal of CME should be to achieve changes in staff conduct, through continuous improvement in daily practice. This requires knowing the social, institutional and individual needs and developing new, more flexible and individualized CME programs. Recertification at fixed intervals should be abandoned in favor of a model that promotes continuous professional development based on health needs and with curricular materials that support competency assessments.

  4. Outcome of Pediatric Gastroenterology Outpatients With Fever and Central Line.

    Science.gov (United States)

    Alexander, Thomas; Blatt, Julie; Skinner, Asheley Cockrell; Jhaveri, Ravi; Jobson, Meghan; Freeman, Katherine

    2016-11-01

    Although management algorithms for fever and central venous catheters (CVCs) have been implemented for pediatric oncology (PO) patients, management of pediatric outpatients with noncancer diagnoses and CVCs lacks clear protocols. The aim of the study was to assess outcomes for pediatric outpatients with gastrointestinal disorders presenting with fever and CVC. Using a microbiology database and emergency department records, we created a database of pediatric gastroenterology (PGI) and PO outpatients with fever and a CVC who presented to our emergency department or clinics from January 2010 through December 2012. We excluded patients who had severe neutropenia (absolute neutrophil count, gastroenterology outpatients with fever and a CVC have a high prevalence of bloodstream infection. Algorithms for management need to be subspecialty specific. Pediatric gastroenterology patients presenting to emergency departments or clinics with fever and CVC require admission for monitoring and management.

  5. Clinical nutrition in medical gastroenterology: room for improvement

    DEFF Research Database (Denmark)

    Johansson, U.; Rasmussen, H.H.; Mowe, M.

    2009-01-01

    BACKGROUND & AIMS: Undernutrition is a problem in hospitals, with lack of nutritional routines. Recently, guidelines concerning the nutritional care process were developed from ESPEN. This study was conducted to assess the present status of nutritional routines among doctors and nurses in internal...... medicine (IM) and medical gastroenterology (MG), in comparison with the ESPEN guidelines. METHOD: A questionnaire-based investigation among doctors and nurses working in departments of internal medicine and gastroenterology in Scandinavia, based on further analysis of previous data. RESULTS: Overall, 4512...... (1753 doctors, 2759 nurses) answered the questionnaire, of which 1155 were from internal medicine and 193 from gastroenterology. A similar, non-significant, discrepancy in attitudes and nutritional routines was noted in gastroenterologists and internists. Concerning basic nutritional education, 46...

  6. Epidemiological Trends of Spine Trauma: An Australian Level 1 Trauma Centre Study

    Science.gov (United States)

    Tee, J. W.; Chan, C. H. P.; Fitzgerald, M. C. B.; Liew, S. M.; Rosenfeld, J. V.

    2013-01-01

    Knowledge of current epidemiology and spine trauma trends assists in public resource allocation, fine-tuning of primary prevention methods, and benchmarking purposes. Data on all patients with traumatic spine injuries admitted to the Alfred Hospital, Melbourne between May 1, 2009, and January 1, 2011, were collected from the Alfred Trauma Registry, Alfred Health medical database, and Victorian Orthopaedic Trauma Outcomes Registry. Epidemiological trends were analyzed as a general cohort, with comparison cohorts of nonsurvivors versus survivors and elderly versus nonelderly. Linear regression analysis was utilized to demonstrate trends with statistical significance. There were 965 patients with traumatic spine injuries with 2,333 spine trauma levels. The general cohort showed a trimodal age distribution, male-to-female ratio of 2:2, motor vehicle accidents as the primary spine trauma mechanism, 47.7% patients with severe polytrauma as graded using the Injury Severity Score (ISS), 17.3% with traumatic brain injury (TBI), the majority of patients with one spine injury level, 7% neurological deficit rate, 12.8% spine trauma operative rate, and 5.2% mortality rate. Variables with statistical significance trending toward mortality were the elderly, motor vehicle occupants, severe ISS, TBI, C1–2 dissociations, and American Spinal Injury Association (ASIA) A, B, and C neurological grades. Variables with statistical significance trending toward the elderly were females; low falls; one spine injury level; type 2 odontoid fractures; subaxial cervical spine distraction injuries; ASIA A, B, and C neurological grades; and patients without neurological deficits. Of the general cohort, 50.3% of spine trauma survivors were discharged home, and 48.1% were discharged to rehabilitation facilities. This study provides baseline spine trauma epidemiological data. The trimodal age distribution of patients with traumatic spine injuries calls for further studies and intervention targeted

  7. Procedures for the site location of an storage centre of medium and low level radioactive wastes

    International Nuclear Information System (INIS)

    Pena G, P.; Garcia B, M.

    2001-01-01

    In order to establish the procedures for the location of a new and definitive storage center for medium and low level radioactive wastes which will be the place where confining, controlling and keeping those waste products of radioactive materials which were used in the hospitable centers, clinics and institutions (research and techniques development) as well as those obtained from industry. The site studies for nuclear facilities, require the participation of a several professionals with different specialities to be able to make use of competence in different disciplines. The result is the exclusion of unacceptable zones followed them by a pre-selection, a selection and a systematic comparison of those sites which are in the remaining zones considered as acceptable. (Author)

  8. Development of quality measures for monitoring and improving care in gastroenterology.

    Science.gov (United States)

    Germansky, Katharine A; Leffler, Daniel A

    2011-06-01

    Over the past decade, most quality assurance (QA) efforts in gastroenterology have been aimed at endoscopy. Endoscopic quality improvement was the rational area to begin QA work in gastroenterology due to the relatively acute nature of complications and the high volume of procedures performed. While endoscopy is currently the focus of most quality assurance (QA) measures in gastroenterology, more recent efforts have begun to address clinical gastroenterology practices both in the outpatient and inpatient settings. Clinical outpatient and inpatient gastroenterology is laden with areas where standardization could benefit patient care. While data and experience in clinical gastroenterology QA is relatively limited, it is clear that inconsistent use of guidelines and practice variations in gastroenterology can lead to lower quality care. In this review, we review a variety of areas in clinical gastroenterology where existing guidelines and published data suggest both the need and practicality of active QA measures. Copyright © 2011 Elsevier Ltd. All rights reserved.

  9. Gastroenterology training in Australia: how much is enough?

    Science.gov (United States)

    Leung, C; De Cruz, P; Jones, A; Sliwka, G; Bell, S J; Hebbard, G S

    2013-04-01

    Advanced training in gastroenterology currently consists of 2 years of core training and 1 elective (non-core) year. We surveyed gastroenterologists 2-7 years following completion of training to determine the strengths and weaknesses of their training. All gastroenterologists were invited to participate in an anonymous online survey. There was a 46% response rate (49/110). Eighty-one per cent were male with most aged 36-45. Respondents felt that the current training programme prepared them well for public practice and endoscopy but less well for private practice, ambulatory care, surgical aspects of gastroenterology and functional gastrointestinal disorders. Most had faced challenges transitioning to consultant practice. The majority (53%) spent more than the standard 3 years to complete training in gastroenterology. The top three subspecialty Fellowships were in endoscopy (45%), inflammatory bowel disease (29%) and hepatology (23%). In their elective year, 42% undertook a predominantly clinical year (registrar-type position in general or subspecialty gastroenterology), 28% engaged in research while 24% trained in another specialty. Seventy-eight per cent were in full-time work, and 36% were supervising trainees. Ninety-eight per cent felt that it was beneficial for trainees to move between hospitals during the core years of their advanced training. The current Australian gastroenterology training programme is generally adequate in preparing trainees for consultant practice but could be improved by increased emphasis on areas such as private practice, ambulatory gastroenterology and functional gastrointestinal diseases. Exposure to a variety of experiences by training in several different hospitals during core training was universally viewed as being important. © 2012 The Authors; Internal Medicine Journal © 2012 Royal Australasian College of Physicians.

  10. Scintigraphy for diagnosis of special problems in gastro-enterology

    International Nuclear Information System (INIS)

    Kempken, K.

    1987-01-01

    Nuclear medical studies have been used for many years in gastro-enterology to search for intrahepatic masses (static scintigram) and to clarify icterus and acute cholecystitis (hepatobiliary function scintigraphy). However, the range of indications for scintigraphic procedures is much broader still, and special questions in gastro-enterology, therefore, may often be answered, too. The methods discussed in the following all are non-invasive and may be applied not only in larger hospitals but also in private practices for nuclear medicine. (orig.) [de

  11. 21 CFR 876.4730 - Manual gastroenterology-urology surgical instrument and accessories.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Manual gastroenterology-urology surgical... OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4730 Manual gastroenterology-urology surgical instrument and accessories. (a) Identification...

  12. Motivation for orthognathic treatment and anticipated satisfaction levels-a two-centre cross-national audit.

    Science.gov (United States)

    Patcas, Raphael; Cunningham, Susan J; Shute, Justin; Lloyd, Timothy; Obwegeser, Joachim A; Arjomand, Lida; Sharma, Sujata

    2017-06-01

    This audit investigated factors which motivate patients to seek orthognathic treatment, assessed how confident patients were that they would be satisfied with the outcome of treatment, and explored possible influencing factors. Questionnaires were distributed to pre-surgical patients at two centres (United Kingdom and Switzerland); questions asked what patients wished to gain from orthognathic treatment and how confident they were that they would be satisfied with treatment outcome. Gender, age and location were recorded as demographic variables, and type of malocclusion was also recorded. A total of 202 questionnaires were returned (UK, n = 149; Switzerland, n = 53). Reported motivating factors focused on improvements in aesthetics (specified and unspecified) (UK vs. Switzerland: 91.3% vs. 83.0%), function (72.5% vs. 66.0%), psychosocial health (51.7% vs. 20.8%), speech (4.0% vs. 7.5%), alleviation of pain (5.4% vs. 17%) and normalization of breathing (1.3% vs. 7.5%). No significant relationships were observed relative to patient age, gender or malocclusion. The anticipated satisfaction levels were generally high (86.5% vs. 89.9%). Although the distribution of motivational factors varied between the two sites, it did not affect the anticipated satisfaction level. Patients were generally confident that they would be satisfied with their treatment outcome and that their reasons for seeking treatment would be addressed. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. All rights reserved.

  13. Editorial | Lesi | Nigerian Journal of Gastroenterology and Hepatology

    African Journals Online (AJOL)

    Nigerian Journal of Gastroenterology and Hepatology. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 6, No 1-2 (2014) >. Log in or Register to get access to full text downloads.

  14. A prospective analysis of gastroenterology out-patient consultations ...

    African Journals Online (AJOL)

    Introduction: The pattern and relative occurrence of gastrointestinal and liver disorders in Nigeria is unclear. The aim of this study was to assess the pattern of gastroenterology referral and consultations as seen in the outpatient department of the Lagos University Teaching Hospital, Lagos, Nigeria. Methods: This was a ...

  15. International gastroenterology research : subject areas, impact, and funding

    NARCIS (Netherlands)

    Lewison, G; Grant, J; Jansen, P

    Aims - To examine the volume and potential impact of gastroenterology research outputs from 1985 to 1998 from 14 developed countries; the overlap with research in cancer, infectious diseases, and genetics; and the funding sources for this research. To determine if countries' research outputs

  16. Side effects are incompletely reported among systematic reviews in gastroenterology.

    Science.gov (United States)

    Mahady, Suzanne E; Schlub, Timothy; Bero, Lisa; Moher, David; Tovey, David; George, Jacob; Craig, Jonathan C

    2015-02-01

    Systematic reviews are an integral component of evidence-based health care. However, little is known on how well they report the potential harms of interventions. We assessed the reporting of harms in recently published systematic reviews of interventions relevant to clinical gastroenterology. We identified all systematic reviews of randomized trials of gastroenterology interventions published from 2008 to 2012 in highly cited gastroenterology and general medical journals. We adapted the Consolidated Standards of Reporting Trials guidelines for harms and assessed qualitative and quantitative parameters of harms reporting. Regression analyses determined predictors of more comprehensive harms reporting. In total, 78 systematic reviews were identified, with 72 published in gastroenterology journals and six in general medical journals. Overall, one in three systematic reviews (26/78, 33%) did not refer to harms of the intervention anywhere in the article. Less than half of the studies included adverse events as an outcome measure, and data on absolute rates of adverse events were only provided in 28%. Most (65%) did not include any figures or tables on adverse event; however, all included these on efficacy outcomes (mean, 3 and range, 1-7). Regression analyses indicated that the use of reporting guidelines was significantly associated with better harms reporting (P = 0.04). The reporting of harms in gastroenterology systematic reviews is largely inadequate and highly asymmetrical compared with the reporting of benefits. We suggest that review authors routinely assess both efficacy and harms outcomes of an intervention and that reporting guidelines specifically targeting harms reporting be developed. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

  17. Global Health Education in Gastroenterology Fellowship: A National Survey.

    Science.gov (United States)

    Jirapinyo, Pichamol; Hunt, Rachel S; Tabak, Ying P; Proctor, Deborah D; Makrauer, Frederick L

    2016-12-01

    Interest in global health (GH) education is increasing across disciplines. To assess exposure to and perception of GH training among gastroenterology fellows and program directors across the USA. Design: Electronic survey study. The questionnaire was circulated to accredited US gastroenterology fellowship programs, with the assistance of the American Gastroenterological Association. Gastroenterology program directors and fellows. The questionnaire was returned by 127 respondents (47 program directors, 78 fellows) from 55 training programs (36 % of all training programs). 61 % of respondents had prior experience in GH. 17 % of programs offered GH curriculum with international elective (13 %), didactic (9 %), and research activity (7 %) being the most common. Fellows had adequate experience managing hepatitis B (93 %), cholangiocarcinoma (84 %), and intrahepatic duct stones (84 %). 74, 69 and 68 % reported having little to no experience managing hepatitis E, tuberculosis mesenteritis, or epidemic infectious enteritis, respectively. Most fellows would participate in an elective in an underserved area locally (81 %) or a 4-week elective abroad (71 %), if available. 44 % of fellows planned on working or volunteering abroad after fellowship. Barriers to establishing GH curriculum included funding (94 %), scheduling (88 %), and a lack of standardized objectives (78 %). Lack of interest, however, was not a concern. Fellows (49 %), more than faculty (29 %) (χ 2  = 21.9; p = 0.03), believed that GH education should be included in fellowship curriculum. Program directors and trainees recognize the importance of GH education. However, only 17 % of ACGME-approved fellowship programs offer the opportunity. Global health curriculum may enhance gastroenterology training.

  18. Current status of endoscopic simulation in gastroenterology fellowship training programs.

    Science.gov (United States)

    Jirapinyo, Pichamol; Thompson, Christopher C

    2015-07-01

    Recent guidelines have encouraged gastroenterology and surgical training programs to integrate simulation into their core endoscopic curricula. However, the role that simulation currently has within training programs is unknown. This study aims to assess the current status of simulation among gastroenterology fellowship programs. This questionnaire study consisted of 38 fields divided into two sections. The first section queried program directors' experience on simulation and assessed the current status of simulation at their institution. The second portion surveyed their opinion on the potential role of simulation on the training curriculum. The study was conducted at the 2013 American Gastroenterological Association Training Directors' Workshop in Phoenix, Arizona. The participants were program directors from Accreditation Council for Graduate Medical Education accredited gastroenterology training programs, who attended the workshop. The questionnaire was returned by 69 of 97 program directors (response rate of 71%). 42% of programs had an endoscopic simulator. Computerized simulators (61.5%) were the most common, followed by mechanical (30.8%) and animal tissue (7.7%) simulators, respectively. Eleven programs (15%) required fellows to use simulation prior to clinical cases. Only one program has a minimum number of hours fellows have to participate in simulation training. Current simulators are deemed as easy to use (76%) and good educational tools (65%). Problems are cost (72%) and accessibility (69%). The majority of program directors believe that there is a need for endoscopic simulator training, with only 8% disagreeing. Additionally, a majority believe there is a role for simulation prior to initiation of clinical cases with 15% disagreeing. Gastroenterology fellowship program directors widely recognize the importance of simulation. Nevertheless, simulation is used by only 42% of programs and only 15% of programs require that trainees use simulation prior to

  19. Canadian pediatric gastroenterology workforce: Current status, concerns and future projections

    Science.gov (United States)

    Morinville, Véronique; Drouin, Éric; Lévesque, Dominique; Espinosa, Victor M; Jacobson, Kevan

    2007-01-01

    BACKGROUND: There is concern that the Canadian pediatric gastroenterology workforce is inadequate to meet health care demands of the pediatric population. The Canadian Association of Gastroenterology Pediatric Committee performed a survey to determine characteristics and future plans of the Canadian pediatric gastroenterology workforce and trainees. METHODS: Estimates of total and pediatric populations were obtained from the 2001 Census of Population, Statistics Canada (with estimates to July 1, 2005). Data on Canadian pediatric gastroenterologists, including clinical full-time equivalents, sex, work interests, opinions on workforce adequacy, retirement plans, fellowship training programs and future employment plans of fellows, were gathered through e-mail surveys and telephone correspondence in 2005 and 2006. RESULTS: Canada had an estimated population of 32,270,507 in 2005 (6,967,853 people aged zero to 17 years). The pediatric gastroenterology workforce was estimated at 9.2 specialists per million children. Women accounted for 50% of the workforce. Physician to pediatric population ratios varied, with Alberta demonstrating the highest and Saskatchewan the lowest ratios (1:69,404 versus 1:240,950, respectively). Between 1998 and 2005, Canadian pediatric gastroenterology fellowship programs trained 65 fellows (65% international trainees). Twenty-two fellows (34%) entered the Canadian workforce. CONCLUSIONS: The survey highlights the variable and overall low numbers of pediatric gastroenterologists across Canada, an increasingly female workforce, a greater percentage of part-time physicians and a small cohort of Canadian trainees. In conjunction with high projected retirement rates, greater demands on the work-force and desires to partake in nonclinical activities, there is concern for an increasing shortage of pediatric gastroenterologists in Canada in future years. PMID:17948136

  20. [Impact of the labour market on vocational retraining centre participants' return to work: a study on employment agencies level].

    Science.gov (United States)

    Hetzel, C; Flach, T; Schmidt, C

    2012-08-01

    This paper is aimed at identifying labour market factors impacting vocational retraining centre participants' return to work on Employment Agencies level and at comparing results to unemployed people's return to work (Social Code Book III). Databases are regional return to work rates of 2006 graduates, selected labour market indicators 2007, and the 2007 labour market classification of the Institute for Employment Research (IAB). The n = 75 Employment Agency districts where 74.5 % of the participants followed-up lived were analyzed using analyses of variance and multiple loglinear regression. Compared to the unemployment context (Social Code Book III), the impact of the labour market is much lower and less complex. In the multiple model, the regional unemployment rate and the regional tertiarization rate (size of the service sector) are found to be significant and superior to the IAB-classification. Hence, participants' return to work is less dependent on labour market conditions than unemployed people's return to work (Social Code Book III). © Georg Thieme Verlag KG Stuttgart · New York.

  1. Stroke survivors’ levels of community reintegration, quality of life, satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area

    Directory of Open Access Journals (Sweden)

    Adrian Kusambiza-Kiingi

    2017-03-01

    Full Text Available Background: Stroke survivors are discharged home before they are functionally independent and return home with activity limitations that would not be manageable without a caregiver. Aim: To determine stroke survivors’ levels of community reintegration, quality of life (QOL, satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area. Method: This was a cross-sectional study using the following outcome measures: Maleka Stroke Community Reintegration Measure, Stroke-specific quality of life scale, Caregiver strain index and Physical therapy patient satisfaction questionnaire. Results: A total of 108 stroke survivors and 45 caregivers participated in this study. The average age of the stroke survivors was 54 years (standard deviation = 12.73 and 58% (n = 62 had moderate to full community reintegration. They were happy with physiotherapy services but not with parking availability and cost of services. The QOL was poor with the lowest scores for energy and highest scores for vision and language domains. Twenty five (55% caregivers were strained. A positive correlation was found between community reintegration and satisfaction with services (r = 0.27, p < 0.0001 and QOL (r = 0.51, p < 0.0001. A negative correlation was found between community reintegration and caregiver strain (r = -0.37, p < 0.0001. Conclusion: Most stroke survivors are reintegrated into their communities except in the areas of work and education and have poor QOL and most of their caregivers are strained; however, they are satisfied with physiotherapy services.

  2. Spatio-temporal factors associated with meningococcal meningitis annual incidence at the health centre level in Niger, 2004-2010.

    Directory of Open Access Journals (Sweden)

    Juliette Paireau

    2014-05-01

    Full Text Available BACKGROUND: Epidemics of meningococcal meningitis (MM recurrently strike the African Meningitis Belt. This study aimed at investigating factors, still poorly understood, that influence annual incidence of MM serogroup A, the main etiologic agent over 2004-2010, at a fine spatial scale in Niger. METHODOLOGY/PRINCIPAL FINDINGS: To take into account data dependencies over space and time and control for unobserved confounding factors, we developed an explanatory Bayesian hierarchical model over 2004-2010 at the health centre catchment area (HCCA level. The multivariate model revealed that both climatic and non-climatic factors were important for explaining spatio-temporal variations in incidence: mean relative humidity during November-June over the study region (posterior mean Incidence Rate Ratio (IRR = 0.656, 95% Credible Interval (CI 0.405-0.949 and occurrence of early rains in March in a HCCA (IRR = 0.353, 95% CI 0.239-0.502 were protective factors; a higher risk was associated with the percentage of neighbouring HCCAs having at least one MM A case during the same year (IRR = 2.365, 95% CI 2.078-2.695, the presence of a road crossing the HCCA (IRR = 1.743, 95% CI 1.173-2.474 and the occurrence of cases before 31 December in a HCCA (IRR = 6.801, 95% CI 4.004-10.910. At the study region level, higher annual incidence correlated with greater geographic spread and, to a lesser extent, with higher intensity of localized outbreaks. CONCLUSIONS: Based on these findings, we hypothesize that spatio-temporal variability of MM A incidence between years and HCCAs result from variations in the intensity or duration of the dry season climatic effects on disease risk, and is further impacted by factors of spatial contacts, representing facilitated pathogen transmission. Additional unexplained factors may contribute to the observed incidence patterns and should be further investigated.

  3. Spatio-temporal factors associated with meningococcal meningitis annual incidence at the health centre level in Niger, 2004-2010.

    Science.gov (United States)

    Paireau, Juliette; Maïnassara, Halima B; Jusot, Jean-François; Collard, Jean-Marc; Idi, Issa; Moulia-Pelat, Jean-Paul; Mueller, Judith E; Fontanet, Arnaud

    2014-05-01

    Epidemics of meningococcal meningitis (MM) recurrently strike the African Meningitis Belt. This study aimed at investigating factors, still poorly understood, that influence annual incidence of MM serogroup A, the main etiologic agent over 2004-2010, at a fine spatial scale in Niger. To take into account data dependencies over space and time and control for unobserved confounding factors, we developed an explanatory Bayesian hierarchical model over 2004-2010 at the health centre catchment area (HCCA) level. The multivariate model revealed that both climatic and non-climatic factors were important for explaining spatio-temporal variations in incidence: mean relative humidity during November-June over the study region (posterior mean Incidence Rate Ratio (IRR) = 0.656, 95% Credible Interval (CI) 0.405-0.949) and occurrence of early rains in March in a HCCA (IRR = 0.353, 95% CI 0.239-0.502) were protective factors; a higher risk was associated with the percentage of neighbouring HCCAs having at least one MM A case during the same year (IRR = 2.365, 95% CI 2.078-2.695), the presence of a road crossing the HCCA (IRR = 1.743, 95% CI 1.173-2.474) and the occurrence of cases before 31 December in a HCCA (IRR = 6.801, 95% CI 4.004-10.910). At the study region level, higher annual incidence correlated with greater geographic spread and, to a lesser extent, with higher intensity of localized outbreaks. Based on these findings, we hypothesize that spatio-temporal variability of MM A incidence between years and HCCAs result from variations in the intensity or duration of the dry season climatic effects on disease risk, and is further impacted by factors of spatial contacts, representing facilitated pathogen transmission. Additional unexplained factors may contribute to the observed incidence patterns and should be further investigated.

  4. Resolved nuclear hyperfine structure of muonium centres in CuCl and GaAs by means of the avoided-level-crossing technique

    International Nuclear Information System (INIS)

    Schneider, J.W.; Keller, H.; Schmid, B.; Boesiger, K.; Kuendig, W.; Odermatt, W.; Patterson, B.D.; Puempin, B.; Simmler, H.; Savic, I.M.; Heming, M.; Reid, I.D.; Roduner, E.; Louwrier, P.W.F.

    1988-01-01

    Avoided-level-crossing resonances from isotropic muonium centres interacting with neighbouring nuclear spins in powdered CuCl are reported. The prominent resonances have a complex multiline structure and are strongly temperature-dependent. In addition, previously unobserved resonances in single-crystal GaAs from anomalous muonium interacting with a 71 Ga neighbour are presented. (orig.)

  5. Women’s Health Training in Gastroenterology Fellowship: A National Survey of Fellows and Program Directors

    Science.gov (United States)

    Roberson, Erica; Richie, Kelly; Lindstrom, Mary J.; Esposti, Silvia Degli; Wald, Arnold

    2013-01-01

    Background and Aims The Gastroenterology Core Curriculum requires training in women’s digestive disorders; however, requirements do not necessarily produce knowledge and competence. Our study goals were: (1) to compare perceptions of education, fellow-reported levels of competence, and attitudes towards training in women’s gastrointestinal (GI) health issues during fellowship between gastroenterology fellows and program directors, and (2) to determine the barriers for meeting training requirements. Methods A national survey assessing four domains of training was conducted. All GI program directors in the United States (n = 153) and a random sample of gastroenterology fellows (n = 769) were mailed surveys. Mixed effects linear modeling was used to estimate all mean scores and to assess differences between the groups. Cronbach’s alpha was used to assess the consistency of the measures which make up the means. Results Responses were received from 61% of program directors and 31% of fellows. Mean scores in perceived didactic education, clinical experiences, and competence in women’s GI health were low and significantly differed between the groups (P < 0.0001). Fellows’ attitudes towards women’s GI health issues were more positive compared to program directors’ (P = 0.004). Barriers to training were: continuity clinic at a Veteran’s Administration hospital, low number of pregnant patients treated, low number of referrals from obstetrics and gynecology, and lack of faculty interest in women’s health. Conclusions (1) Fellows more so than program directors perceive training in women’s GI health issues to be low. (2) Program directors more so than fellows rate fellows to be competent in women’s GI health. (3) Multiple barriers to women’s health training exist. PMID:21267780

  6. Risk factors for nutritional status determination and indications for preventive nutrition therapy in hospitalized gastroenterological patients

    Directory of Open Access Journals (Sweden)

    Roganović Branka

    2007-01-01

    Full Text Available Background/Aim. Risk factors for the intrahospital nutritional status worsening (NSW have not been precisely defined in the literature. The objective was defining thoese factors among gastroenterological patients and defining the risk patients requiring a preventive nutritional therapy. Methods. In 650 gastroenterological patients, NSW was evaluated on the basis of reducing of the six parameters: body weight, body mass index (BMI, triceps skinfold thickness (TSF, midupper arm muscle circumference (MAMC, serum albumin level (ALB, and lymphocyte count (LYM. The influence on NSW was tested for 13 factors concerning characteristics of the patient, disease, and diagnostic procedures. Among the factors influencing significantly the NSW, primary and secondary risk factors were selected. After scoring of risk factors had been performed, the risk-score for NSW (RSNSW was defined. The critical value of RSNSW which required preventive nutritional therapy was also calculated. Results. The incidence of NSW was in the range 29.2%−57.9%. The presence of general complications and severe disease activity were considered as primary risk factors, whereas malignant disease, age above 71, hepato-billiary tract involvement, hospitalization longer than 14 days, and mobility worsening were considered as secondary risk factors. The best predictive value for the NSW was proved for the RSNSW ≥ 6. Because of that, preventive nutritional therapy should be indicated in patients presenting with both primary risk factors or in patients presenting with one primary factor combined with three secondary risk factors at least. Conclusion. There are 7 risk factors for NSW in gastroenterological patients, but they are not of the same importance - two primary and five secondary risk factors can be differentiated. Preventive nutritional therapy is indicated only in patients having both primary risk factors or in those presenting with one primary risk factor combined with three

  7. Environmental monitoring radiological programs for the nuclear centre and the low level radioactive waste facility in Mexico

    International Nuclear Information System (INIS)

    Quintero, E.; Cervantes, L.; Rojas, V.

    2006-01-01

    The National Institute of Nuclear Research of Mexico (ININ) has its Laboratory of Environmental Radiological Monitoring, (LVRA), to assure the critical population and the environment they are not exposed to radiation doses greater than the limits established by the national and international legislation, this laboratory carries out environmental monitoring radiological programs the Nuclear Centre and its surroundings and the Low Level Radioactive Waste Facility (CADER) and its around. In order to carry out these programs the LVRA has rooms for evaporation, drying, grinding, ashing of environmental and food samples, and a laboratory for gamma ray spectrometry, liquid scintillation, alpha-beta gross counting and computer room. Since the year 2000 the (ININ) has tried to implant the quality system ISO 9001:2000 including a its (LVRA). This quality system includes: a Plan of Quality, Quality Manual, programs of technical and administrative document elaboration, technical and administrative procedures, technical and administrative qualification programmes for the laboratory staff, maintenance and calibration programs for measurement systems and finally participation in national and international exercises of intercomparison. The ININ counts with the management of quality assurance to verify these programs, in addition, our Nuclear Regulatory Commission (CNSNS) carries out periodic audits to authorize the of use and handling of radioactive and nuclear material licenses of these facilities. In this work we presented the advances and difficulties found in the implantation of the quality system, also we present the benefits obtained with uses of this system, the samples analyses results, and the calculation of the annual dose to the critical population for the last five years. In addition, we presented the calculation the radionuclides concentration tendencies in different sample types, according to our (CNSNS) requirements. In the same way the results of the calibrations

  8. Endoscopic ultrasound in gastroenterology: from diagnosis to therapeutic implications.

    Science.gov (United States)

    Mekky, Mohamed A; Abbas, Wael A

    2014-06-28

    Since its advent in 1980, the scope of endoscopic ultrasound (EUS) has grown to include a wide range of indications, and it is now being incorporated as an integral part of everyday practice in the field of gastroenterology. Its use is extending from an adjuvant imaging aid to utilization as a therapeutic tool for various gastrointestinal disorders. EUS was first used to visualize remote organs, such as the pancreas and abdominal lymph nodes. When fine needle aspiration was introduced, the indications for EUS expanded to include tissue sampling for diagnostic purposes. At the same time, the needle can be used to convey a potential therapy to the internal organs, allowing access to remote sites. In this review, we aim to highlight the expanding spectrum of EUS indications and uses in the field of gastroenterology.

  9. [The current state and prospect of Chinese medicine gastroenterology].

    Science.gov (United States)

    Zhang, Sheng-Sheng; Zhou, Tao

    2012-03-01

    The progress and existent problems of Chinese medicine (CM) gastroenterology since the National Eleventh Five-Year Plan were discussed in this article in terms of theory innovation, formulation of clinical pathway and diagnosis-treatment consensus, efficacy assessment, formulation of efficacy assessment scale, advantage diseases, and exploration of the syndrome standardization, progress in science research, academic exchange, and the construction of study platform, and so on. Meanwhile, the development of CM gastroenterology was prospected in the following five aspects: to enhance the theory inheritance and innovation, the construction of discipline standardization; to establish scientific clinical efficacy assessment methods and the standard system; to expend treatment technologies and feature therapies; and to clarify the modern scientific connotation of CM theory and treatment.

  10. Diversity in clinical management and protocols for the treatment of major bleeding trauma patients across European level I Trauma Centres

    DEFF Research Database (Denmark)

    Schäfer, Nadine; Driessen, Arne; Fröhlich, Matthias

    2015-01-01

    according to clinical assessment in combination with laboratory signs of achieved haemostasis. The severity of coagulopathy and shock is mostly assessed via standard coagulation tests and partially used extended viscoelastic tests. All centres have implemented the immediate use of tranexamic acid. Initial...

  11. Assessing Quality Outcome Measures in Children with Coeliac Disease—Experience from Two UK Centres

    Science.gov (United States)

    Ross, Alexander; Shelley, Helen; Novell, Kim; Ingham, Elizabeth; Callan, Julia; Heuschkel, Robert; Morris, Mary-Anne; Zilbauer, Matthias

    2013-01-01

    Improved diagnosis of coeliac disease has increased incidence and therefore burden on the health care system. There are no quality outcome measures (QOM) in use nationally to assess hospital management of this condition. This study applied QOM devised by the East of England paediatric gastroenterology network to 99 patients reviewed at two tertiary hospitals in the Network, to assess the quality of care provided by nurse led and doctor led care models. The average performance across all QOM was 96.2% at Addenbrooke’s Hospital (AH), and 98.7% at Norfolk and Norwich Hospital (NNUH), whilst 95% (n = 18) of QOM were met. Patient satisfaction was high at both sites (uptake of questionnaire 53 of 99 patients in the study). The study showed a comparably high level of care delivered by both a nurse and doctor led service. Our quality assessment tools could be applied in the future by other centres to measure standards of care. PMID:24284612

  12. Assessing Quality Outcome Measures in Children with Coeliac Disease—Experience from Two UK Centres

    Directory of Open Access Journals (Sweden)

    Alexander Ross

    2013-11-01

    Full Text Available Improved diagnosis of coeliac disease has increased incidence and therefore burden on the health care system. There are no quality outcome measures (QOM in use nationally to assess hospital management of this condition. This study applied QOM devised by the East of England paediatric gastroenterology network to 99 patients reviewed at two tertiary hospitals in the Network, to assess the quality of care provided by nurse led and doctor led care models. The average performance across all QOM was 96.2% at Addenbrooke’s Hospital (AH, and 98.7% at Norfolk and Norwich Hospital (NNUH, whilst 95% (n = 18 of QOM were met. Patient satisfaction was high at both sites (uptake of questionnaire 53 of 99 patients in the study. The study showed a comparably high level of care delivered by both a nurse and doctor led service. Our quality assessment tools could be applied in the future by other centres to measure standards of care.

  13. Risk of symptomatic heterotopic ossification following plate osteosynthesis in multiple trauma patients: an analysis in a level-1 trauma centre

    Directory of Open Access Journals (Sweden)

    Pape Hans-Christoph

    2009-10-01

    Full Text Available Abstract Background Symptomatic heterotopic ossification (HO in multiple trauma patients may lead to follow up surgery, furthermore the long-term outcome can be restricted. Knowledge of the effect of surgical treatment on formation of symptomatic heterotopic ossification in polytrauma is sparse. Therefore, we test the effects of surgical treatment (plate osteosynthesis or intramedullary nailing on the formation of heterotopic ossification in the multiple trauma patient. Methods We retrospectively analysed prospectively documented data of blunt multiple trauma patients with long bone fractures which were treated at our level-1 trauma centre between 1997 and 2005. Patients were distributed to 2 groups: Patients treated by intramedullary nails (group IMN or plate osteosynthesis (group PLATE were compared. The expression and extension of symptomatic heterotopic ossifications on 3-6 months follow-up x-rays in antero-posterior (ap and lateral views were classified radiologically and the maximum expansion was measured in millimeter (mm. Additionally, ventilation time, prophylactic medication like indomethacine and incidence and correlation of head injuries were analysed. Results 101 patients were included in our study, 79 men and 22 women. The fractures were treated by intramedullary nails (group IMN n = 50 or plate osteosynthesis (group PLATE n = 51. Significantly higher radiologic ossification classes were detected in group PLATE (2.9 ± 1.3 as compared to IMN (2.2 ± 1.1; p = 0.013. HO size in mm ap and lateral showed a tendency towards larger HOs in the PLATE group. Additionally PLATE group showed a higher rate of articular fractures (63% vs. 28% in IMN while IMN demonstrated a higher rate of diaphyseal fractures (72% vs. 37% in PLATE; p = 0.003. Ventilation time, indomethacine and incidence of head injuries showed no significant difference between groups. Conclusion Fracture care with plate osteosynthesis in polytrauma patients is associated with

  14. Alexithymia in Gastroenterology and Hepatology: A Systematic Review.

    Science.gov (United States)

    Carrozzino, Danilo; Porcelli, Piero

    2018-01-01

    Background: Alexithymia is a multifaceted personality construct that represents a deficit in the cognitive processing of emotions and is currently understood to be related to a variety of medical and psychiatric conditions. The present review aims to investigate the relationship of alexithymia with gastrointestinal (GI) disorders as functional gastrointestinal disorders (FGID, as irritable bowel syndrome (IBS) and functional dyspepsia) and inflammatory bowel disease (IBD) [ulcerative colitis (UC) and Crohn's disease (CD)] and liver diseases as chronic hepatitis C (CHC), cirrhosis, and liver transplantation. Methods: The articles were selected from the main electronic databases (PsycInfo, Medline, PubMed, Web of Science, Scopus, Cochrane, and ScienceDirect) using multiple combinations of relevant search terms (defined GI and liver diseases, articles in English, use of the Toronto scales [TAS] for alexithymia). The TAS was selected as inclusion criterion because it is the most widely used measure, thus allowing comparisons across studies. Results: Forty-eight studies met the inclusion criteria, of which 38 focused on GI disorders (27 on FGID and 11 on IBD) and 10 on liver diseases. Most studies ( n = 30, 62%) were cross-sectional. The prevalence of alexithymia was higher in FGID (two third or more) than IBD and liver diseases (from one third to 50% of patients, consistent with other chronic non-GI diseases) than general population (10-15%). In functional disorders, alexithymia may be viewed as a primary driver for higher visceral perception, symptom reporting, health care use, symptom persistence, and negative treatment outcomes. Also, it has been found associated with psychological distress and specific GI-related forms of anxiety in predicting symptom severity as well as post-treatment outcomes and is associated with several psychological factors increasing the burden of disease and impairing levels of quality of life. A number of critical issues (small sample

  15. Systematic review: the applications of nanotechnology in gastroenterology.

    Science.gov (United States)

    Brakmane, G; Winslet, M; Seifalian, A M

    2012-08-01

    Over the past 30 years, nanotechnology has evolved dramatically. It has captured the interest of variety of fields from computing and electronics to biology and medicine. Recent discoveries have made invaluable changes to future prospects in nanomedicine; and introduced the concept of theranostics. This term offers a patient specific 'two in one' modality that comprises of diagnostic and therapeutic tools. Not only nanotechnology has shown great impact on improvements in drug delivery and imaging techniques, but also there have been several ground-breaking discoveries in regenerative medicine. Gastroenterology invites multidisciplinary approach owing to high complexity of gastrointestinal (GI) system; it includes physicians, surgeons, radiologists, pharmacologists and many more. In this article, we concentrate on current developments in nano-gastroenterology. Literature search was performed using Web of Science and Pubmed search engines with terms--nanotechnology, nanomedicine and gastroenterology. Article search was concentrated on developments since 2005. We have described original and innovative approaches in gastrointestinal drug delivery, inflammatory disease and cancer-target treatments. Here, we have reviewed advances in GI imaging using nanoparticles as fluorescent contrast, and their potential for site-specific targeting. This review has also depicted various approaches and novel discoveries in GI regenerative medicine using nanomaterials for scaffold designs and induced pluripotent stem cells as cell source. Developments in nanotechnology have opened new range of possibilities to help our patients. This includes novel drug delivery vehicles, diagnostic tools for early and targeted disease detection and nanocomposite materials for tissue constructs to overcome cosmetic or physical disabilities. © 2012 Blackwell Publishing Ltd.

  16. CIVILIAN GUNSHOT WOUNDS TO THE CHEST: A CLINICOPATHOLOGICAL ANALYSIS OF AN ANNUAL CASELOAD AT A LEVEL 1 TRAUMA CENTRE.

    Science.gov (United States)

    Meijering, V M; Hattam, A T; Navsaria, P H; Nicol, A J; Edu, S

    2017-06-01

    Gunshot wounds (GSW) to the chest are common presentations to trauma centres in South Africa. The clinical management and outcome of GSW to the chest are significantly altered by missile trajectory and the associated anatomical structures injured making them challenging injuries to treat. Currently, the management of GSW chest is based on scant evidence and treatment is typically according to algorithms based largely on the anecdotal experience of high volume institutions and experienced clinicians. Ethical approval was obtained for this study. The Electronic Trauma Health Registry (eTHR) Application of the Trauma Centre at Groote Schuur Hospital in Cape Town was interrogated for the year 2015 for all patients with GSW chest. The data was then analysed using descriptive statistics. A total of 141 patients with GSW to the chest were admitted to the Trauma Centre with a median age of 26 years. More than half of the patients, 53. 2% (n = 75) sustained an isolated GSW to the chest. Overall, 29.1% (n = 41) patients sustained a thoracoabdominal injury, which accounts for a significant higher amount of emergency surgeries compared to patients with non thoracoabdominal injuries (54% vs 15%, p = chest surgery of which 5 patients survived. Overall mortality was 7.1% (n = 10) of which 5 patients died from a thoracic cause. Civilian GSW to the chest are common injuries seen in Cape Town, often with concomitant injuries leading to increased morbidity. Significantly more emergency surgeries were done in patients with thoracoabdominal injury. Overall few patients needed chest-related emergency operative intervention (9.2%) with a survival rate of 38.5%. Overall mortality of patients with GSW chest who reached the hospital was 7.1% of whom 50% died from a thoracic cause.

  17. ANDRA's Centre de l'Aube: Design, construction, operation of a state of the art surface disposal facility for low and intermediate level waste

    International Nuclear Information System (INIS)

    Potier, J.M.

    2001-01-01

    The ANDRA's Centre de I'Aube disposal facility for low and intermediate level radioactive waste may be considered as a state-of-the-art repository. Since its implementation in the early nineties, the French facility has been used as a model by many countries worldwide for the surface disposal of radioactive waste. The disposal concept developed by ANDRA, the French Radioactive Waste Management Agency, consists of a multiple-barrier system designed to isolate radioactivity and provide protection to the public and to the environment. Waste operations at ANDRA's Centre de I'Aube are largely automated to ensure better protection to site workers. The paper reviews all aspects of the repository implementation: siting, design, construction, operation and future closure, and environmental monitoring. (author)

  18. Optical coherence tomography in gastroenterology: a review and future outlook

    Science.gov (United States)

    Tsai, Tsung-Han; Leggett, Cadman L.; Trindade, Arvind J.; Sethi, Amrita; Swager, Anne-Fré; Joshi, Virendra; Bergman, Jacques J.; Mashimo, Hiroshi; Nishioka, Norman S.; Namati, Eman

    2017-12-01

    Optical coherence tomography (OCT) is an imaging technique optically analogous to ultrasound that can generate depth-resolved images with micrometer-scale resolution. Advances in fiber optics and miniaturized actuation technologies allow OCT imaging of the human body and further expand OCT utilization in applications including but not limited to cardiology and gastroenterology. This review article provides an overview of current OCT development and its clinical utility in the gastrointestinal tract, including disease detection/differentiation and endoscopic therapy guidance, as well as a discussion of its future applications.

  19. Changing outcome for infants of birth-weight 500-999 g born outside level 3 centres in Victoria. The Victorian Infant Collaborative Study Group.

    Science.gov (United States)

    1997-08-01

    The aim of this study of extremely low birth-weight (ELBW, birth weight 500-999 g) infants born in Victoria was to determine the changes between 3 distinct eras; 1979-80, 1985-87, and 1991-2, in the proportions who were born outside level 3 perinatal centres (outborn), the proportions of outborn infants who were transferred after birth to a level 3 neonatal unit, the survival rate for outborn infants, and sensorineural impairment and disability rates in outborn survivors. The proportion of ELBW livebirths who were outborn fell significantly over successive eras, from 30.2% (106 of 351) in 1979-80, to 23.0% (129 of 560) in 1985-87, and to 15.6% (67 of 429) in 1991-92. Between 1979-80 and 1985-87, the proportions who were outborn fell predominantly in those of birth-weight from 800-999 g, whereas between 1985-87 and 1991-92 the proportions who were outborn fell predominantly in those of birth weight 500-799 g. The proportions of outborn infants who were transferred after birth to a level 3 neonatal unit were similar in the 3 eras, at 49.1%, 38.0% and 41.2%, respectively. The survival rates for outborn infants were lower in each era than for infants born in a level 3 perinatal centre. Only 1 outborn infant not transferred after birth to a level-3 unit survived in any era. The survival rates for infants transferred after birth were similar in the first 2 eras, but rose significantly in 1991-92 (34.6%, 36.7% and 60.7%, respectively). The rates of sensorineural impairments and disabilities in survivors fell significantly between the first 2 eras, and remained low in the last era. It is pleasing that the proportion of tiny babies who were outborn fell significantly over time, reflecting increased referral of high-risk mothers to level 3 perinatal centres before birth. For ELBW outborn infants, survival prospects free of substantial disability are reasonable, but not as good as for those born in level 3 perinatal centres.

  20. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition syllabus for subspecialty training: moving towards a European standard

    NARCIS (Netherlands)

    D'Antiga, Lorenzo; Nicastro, Emanuele; Papadopoulou, Alexandra; Mearin, Maria L.; Tzivinikos, Christos; Vandenplas, Yvan; van Goudoever, Hans; Baumann, Ulrich; Troncone, Riccardo; Koletzko, Berthold

    2014-01-01

    The requirements for and conditions of subspecialty training in paediatric gastroenterology, hepatology, and nutrition (PGHN) are rather variable across European countries. The European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) agreed on a training syllabus aimed to

  1. 77 FR 18829 - Gastroenterology and Urology Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Science.gov (United States)

    2012-03-28

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-N-0001] Gastroenterology and Urology Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting AGENCY... public. Name of Committee: Gastroenterology and Urology Devices Panel of the Medical Devices Advisory...

  2. Follow-up of participants in the Canadian Association of Gastroenterology Scholars' Program, 2006 to 2012.

    Science.gov (United States)

    Lam, Mindy Ching Wan; Sey, Michael Sl; Gregor, Jamie; Wong, Clarence

    2014-02-01

    The Canadian Association of Gastroenterology (CAG) Scholars' Program (previously known as the Bright Lights Course) is designed to encourage trainees to consider a subspecialty career in gastroenterology. A formal analysis of the Scholars' Program performed in 2007 revealed that 82% of participants invited to the program pursued or were planning to pursue a career in gastroenterology. The positive results are consistent with the CAG's strategic plan of developing "the next generation of gastroenterology clinical practitioners, researchers, educators, and leaders" and to "attract, train, and retain the best and the brightest to gastroenterology". The present study was a follow-up analysis of participants in the Scholars' Program between 2006 and 2012. Although 93.1% of participants had an interest in gastroenterology before attending the Scholars' Program, the majority (68.7%) reported a greater interest in gastroenterology after the program. Similar to the study from 2007, the present study again illustrates the importance and success of the Scholars' Program in generating interest and retaining candidates in gastroenterology.

  3. A Study of an Emerging Occupation: The Gastroenterology Assistant. Interim Report.

    Science.gov (United States)

    Kuritsky, Joel; Goldsmith, Katherine L.

    To determine the need, desirability, and training requirements for a gastroenterology assistant training program, interviews with gastroenterologists, a survey of 15 hospitals, and observations of gastroenterology laboratories were conducted. In addition, a questionnaire to ascertain which laboratory tests the assistant would perform was…

  4. 76 FR 71983 - Gastroenterology and Urology Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Science.gov (United States)

    2011-11-21

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0002] Gastroenterology and Urology Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting AGENCY... public. Name of Committee: Gastroenterology and Urology Devices Panel of the Medical Devices Advisory...

  5. 75 FR 57968 - Gastroenterology and Urology Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Science.gov (United States)

    2010-09-23

    ...] Gastroenterology and Urology Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting AGENCY... public. Name of Committee: Gastroenterology and Urology Devices Panel of the Medical Devices Advisory... committee will discuss, make recommendations, and vote on information related to the PMA for the LAP-BAND...

  6. Retrospective review of injury severity, interventions and outcomes among helicopter and nonhelicopter transport patients at a Level 1 urban trauma centre.

    Science.gov (United States)

    Hannay, R Scott; Wyrzykowski, Amy D; Ball, Chad G; Laupland, Kevin; Feliciano, David V

    2014-02-01

    Air ambulance transport for injured patients is vitally important given increasing patient volumes, the limited number of trauma centres and inadequate subspecialty coverage in nontrauma hospitals. Air ambulance services have been shown to improve patient outcomes compared with ground transport in select circumstances. Our primary goal was to compare injuries, interventions and outcomes in patients transported by helicopter versus nonhelicopter transport. We performed a retrospective 10-year review of 14 440 patients transported to an urban Level 1 trauma centre by helicopter or by other means. We compared injury severity, interventions and mortality between the groups. Patients transported by helicopter had higher median injury severity scores (ISS), regardless of penetrating or blunt injury, and were more likely to have Glasgow Coma Scale scores less than 8, require airway control, receive blood transfusions and require admission to the intensive care unit or operating room than patients transported by other means. Helicopter transport was associated with reduced overall mortality (odds ratio 0.41, 95% confidence interval 0.33-0.39). Patients transported by other methods were more likely to die in the emergency department. The mean ISS, regardless of transport method, rose from 12.3 to 15.1 (p = 0.011) during our study period. Patients transported by helicopter to an urban trauma centre were more severely injured, required more interventions and had improved survival than those arriving by other means of transport.

  7. Endoscopic training: A nationwide survey of French fellows in gastroenterology.

    Science.gov (United States)

    Amiot, Aurélien; Conroy, Guillaume; Le Baleur, Yann; Winkler, Jérôme; Palazzo, Maxime; Treton, Xavier

    2018-04-01

    During their 4 years of training, French fellows in gastroenterology should acquire theoretical and practical competency in gastrointestinal (GI) endoscopy. To evaluate the delivery of endoscopy training to French GI fellows and perception of learning. A nationwide electronic survey was carried out of French GI fellows using an anonymous, 17-item electronic questionnaire. A total of 291 out of 484 (60%) GI fellows responded to the survey. Only 40% of subjects had access to theoretical training and/or virtual simulators. Only 49% and 35% of fourth year fellows had reached the threshold numbers of EGD and colonoscopies recommended by the European section and Board of gastroenterology and hepatology. Sixty-two percent and 57% of trainees reported having insufficient knowledge in interpreting gastric and colic lesions. Access to dedicated endoscopy activity for at least 8 weeks during the year was the only independent factor associated with the achievement of the recommended annual threshold number of procedures. The access of fellows to theoretical training and to preclinical virtual simulators is still insufficient. Personalized support and regular assessment of cognitive and technical acquisition over the 4 years of training seems to be necessary. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  8. Female authorship in major academic gastroenterology journals: a look over 20 years.

    Science.gov (United States)

    Long, Michelle T; Leszczynski, Ania; Thompson, Katherine D; Wasan, Sharmeel K; Calderwood, Audrey H

    2015-01-01

    Authorship in peer-reviewed medical journals is a marker for success in academic medicine. To determine the representation of female physicians among authors of original research in U.S. gastroenterology journals. Retrospective. All first and senior U.S. authors of original research published in the years 1992, 1997, 2002, 2007, and 2012 in the following journals: Gastroenterology, Hepatology, American Journal of Gastroenterology, Clinical Gastroenterology and Hepatology (CGH), and Gastrointestinal Endoscopy (GIE). The percentage of female first and senior authors compared with the percentage of women practicing in academic gastroenterology. We evaluated 6490 articles, of which 2275 original research articles and 455 editorials were eligible for inclusion. Author gender was determined for 98.5% of the 3792 authors. Overall, female first authors increased from 9.1±2.9% in 1992 to 29.3±4.9% in 2012 (Pgender gap. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  9. [Certification of an ambulatory gastroenterologic service fulfilling ISO Law 9001--criteria and national guidelines of the Gastroenterologic Association].

    Science.gov (United States)

    Birkner, B

    2000-09-01

    The objectives of certification and accreditation are the deployment and examination of quality improvement measures in health care services. The quality management system of the ISO 9001 is created to install measures and tools leading to assured and improved quality in health care. Only some experiences with certification fulfilling ISO 9001 criteria exist in the German health care system. Evidence-based clinical guidelines can serve as references for the development of standards in quality measurement. Only little data exists on the implementation strategy of guidelines and evaluation, respectively. A pilot quality management system in consistence with ISO 9001 criteria was developed for ambulatory, gastroenterological services. National guidelines of the German Society of Gastroenterology and Metabolism and the recommendations of the German Association of Physicians for quality assurance of gastrointestinal endoscopy were included in the documentation and internal auditing. This pilot quality management system is suitable for the first steps in the introduction of quality management in ambulatory health care. This system shows validity for accreditation and certification of gastrointestinal health care units as well.

  10. A pragmatic multi-centre randomised controlled trial of fluid loading and level of dependency in high-risk surgical patients undergoing major elective surgery: trial protocol

    Directory of Open Access Journals (Sweden)

    Norrie John

    2010-04-01

    Full Text Available Abstract Background Patients undergoing major elective or urgent surgery are at high risk of death or significant morbidity. Measures to reduce this morbidity and mortality include pre-operative optimisation and use of higher levels of dependency care after surgery. We propose a pragmatic multi-centre randomised controlled trial of level of dependency and pre-operative fluid therapy in high-risk surgical patients undergoing major elective surgery. Methods/Design A multi-centre randomised controlled trial with a 2 * 2 factorial design. The first randomisation is to pre-operative fluid therapy or standard regimen and the second randomisation is to routine intensive care versus high dependency care during the early post-operative period. We intend to recruit 204 patients undergoing major elective and urgent abdominal and thoraco-abdominal surgery who fulfil high-risk surgical criteria. The primary outcome for the comparison of level of care is cost-effectiveness at six months and for the comparison of fluid optimisation is the number of hospital days after surgery. Discussion We believe that the results of this study will be invaluable in determining the future care and clinical resource utilisation for this group of patients and thus will have a major impact on clinical practice. Trial Registration Trial registration number - ISRCTN32188676

  11. Audit of the job satisfaction levels of the UK radiography and physics workforce in UK radiotherapy centres 2012.

    Science.gov (United States)

    Hutton, D; Beardmore, C; Patel, I; Massey, J; Wong, H; Probst, H

    2014-07-01

    Workforce planning reports identify a staff shortfall that jeopardizes the ability of UK radiotherapy centres to meet future demands. Obtaining an understanding of the work experiences of radiotherapy professionals will support the development of strategies to increase job satisfaction, productivity and effectiveness. A quantitative survey assessed job satisfaction, attitudes to incident reporting, stress and burnout, opportunities for professional development, workload, retention and turnover. Clinical oncologists were not included, as the Royal College of Radiologists, London, UK, had recently assessed their members' satisfaction. All questions were taken from validated instruments or adapted from the "UK National Health Service Staff Survey". The survey yielded 658 completed responses (approximately 16% response rate), from public and private sectors. Over a third (36%) of respondents were classified as satisfied for job satisfaction with 11% dissatisfied and the remaining 53% ambivalent. A significant proportion of clinical staff (37.5%) report high emotional exhaustion. Presenteeism was an issue with 42.4% attending work despite feeling unable to fulfil their role. Radiotherapy professionals are prone to the effects of compassion fatigue and burnout. Attention must be paid to workload and its impact on practitioners' job satisfaction. Professional development that is supported and informed by a performance development review is a simple and effective means of enhancing satisfaction. Individuals have a responsibility to themselves and their colleagues as their behaviours and attitudes influence job satisfaction. This work identifies areas for future research to enhance the professional resilience of practitioners, in order to provide high-quality treatments.

  12. Allocation of substance use disorder patients to appropriate levels of care: feasibility of matching guidelines in routine practice in Dutch treatment centres.

    Science.gov (United States)

    Merkx, Maarten J M; Schippers, Gerard M; Koeter, Maarten J W; Vuijk, Pieter Jelle; Oudejans, Suzan; de Vries, Carlijn C Q; van den Brink, Wim

    2007-03-01

    To examine the feasibility of implementing evidence-based guidelines for patient-treatment-matching to levels of care in two Dutch substance abuse treatment centres. Multi-centre observational follow-up study. Two large substance abuse treatment centres (SATCs). All 4394 referrals to the two SATCs in 2003. Baseline patient characteristics needed for treatment allocation according to protocol, treatment allocation according to matching protocol, treatment allocation according to actual level of care (LOC) entered. Comparison of recommended and actual LOC entered. Evaluation of reasons for observed differences between recommended and actual LOC entered. Data needed for treatment allocation according to protocol were available for 2269 (51.6%) patients. Data needed for evaluation of actual LOC entered were available for 1765 (40.2%) patients. Of these patients, 1089 (60.8%) were allocated according to protocol: 48.4% based on the guideline algorithm and 12.4% based on clinically justified deviations from this algorithm. The main reason for deviation was a different appraisal of addiction severity, made by the intake counsellor compared to the protocol. The feasibility of guideline-based treatment allocation is seriously limited due to inadequate data collection of patient characteristics and suboptimal guideline-based treatment allocation. As a consequence, only 24.4% of the patients could be evaluated as being matched properly to the treatment planned. The results indicate several barriers which limit the adequate implementation of patient-treatment-matching guidelines: problems in the infrastructure of data collection and storage and the inertia of intake staff who did not adhere to the guidelines for assessment and matching.

  13. Follow-up of participants in the Canadian Association of Gastroenterology Scholars’ Program, 2006 to 2012

    Science.gov (United States)

    Lam, Mindy CW; Sey, Michael SL; Gregor, Jamie; Wong, Clarence

    2014-01-01

    The Canadian Association of Gastroenterology (CAG) Scholars’ Program (previously known as the Bright Lights Course) is designed to encourage trainees to consider a subspecialty career in gastroenterology. A formal analysis of the Scholars’ Program performed in 2007 revealed that 82% of participants invited to the program pursued or were planning to pursue a career in gastroenterology. The positive results are consistent with the CAG’s strategic plan of developing “the next generation of gastroenterology clinical practitioners, researchers, educators, and leaders” and to “attract, train, and retain the best and the brightest to gastroenterology”. The present study was a follow-up analysis of participants in the Scholars’ Program between 2006 and 2012. Although 93.1% of participants had an interest in gastroenterology before attending the Scholars’ Program, the majority (68.7%) reported a greater interest in gastroenterology after the program. Similar to the study from 2007, the present study again illustrates the importance and success of the Scholars’ Program in generating interest and retaining candidates in gastroenterology. PMID:24288694

  14. What do gastroenterology trainees want: recognition, remuneration or recreation?

    LENUS (Irish Health Repository)

    Harewood, G C

    2010-07-27

    BACKGROUND: Occupational psychologists have identified three factors important in motivating physicians: financial reward, academic recognition, time off. AIM: To assess motivators among gastroenterology (GI) trainees. METHODS: A questionnaire was distributed to GI trainees to assess their motivators: (1) work fewer hours for less lucrative rate, (2) reduction in salary\\/increase in hours for academic protected time, and (3) work longer hours for higher total salary, but less lucrative hourly rate. RESULTS: Overall, 61 trainees responded; 52% of trainees would work shorter hours for less lucrative rate; 60% would accept a disproportionate reduction in salary\\/increase in hours for academic protected time; 54% would work longer hours for more money but less lucrative rate. Most trainees (93%) accepted at least one scenario. CONCLUSIONS: Most GI trainees are willing to modify their job description to align with their personal values. Tailoring job descriptions according to these values can yield economic benefits to GI Divisions.

  15. What do gastroenterology trainees want: recognition, remuneration or recreation?

    LENUS (Irish Health Repository)

    Harewood, G C

    2012-02-01

    BACKGROUND: Occupational psychologists have identified three factors important in motivating physicians: financial reward, academic recognition, time off. AIM: To assess motivators among gastroenterology (GI) trainees. METHODS: A questionnaire was distributed to GI trainees to assess their motivators: (1) work fewer hours for less lucrative rate, (2) reduction in salary\\/increase in hours for academic protected time, and (3) work longer hours for higher total salary, but less lucrative hourly rate. RESULTS: Overall, 61 trainees responded; 52% of trainees would work shorter hours for less lucrative rate; 60% would accept a disproportionate reduction in salary\\/increase in hours for academic protected time; 54% would work longer hours for more money but less lucrative rate. Most trainees (93%) accepted at least one scenario. CONCLUSIONS: Most GI trainees are willing to modify their job description to align with their personal values. Tailoring job descriptions according to these values can yield economic benefits to GI Divisions.

  16. [Notes for the history of pediatric gastroenterology in Peru].

    Science.gov (United States)

    Álvarez Carrasco, Ricardo Iván

    2015-01-01

    The Pediatric Gastroenterology and Nutrition in Peru, is one of the subspecialties of Pediatrics that has experienced one of the most significant growth in recent decades, however, to achieve this seat it should have passed a long way built through the efforts and talent hundreds of doctors for several generations. Its modern history began in 1981 with the creation of the first unit of the specialty in the National Institute of Child Health (INSN), followed by the establishment of the second specialization that contributed to its spread and progress of several hospitals in the country, and many of them now have a doctor of this specialty. Our purpose is to plant the foundations of that story, whose extension go beyond the space that allows us an article.

  17. Epidemiological Study Of Burn Cases And Their Mortality Experiences Amongst Adults From A Tertiary Level Care Centre

    Directory of Open Access Journals (Sweden)

    Kumar P

    1997-01-01

    Full Text Available Research question: How to use hospital statistics in establishing epidemiology of burns amongst adults? Objectives: To identify epidemiological determinants for Ii Various burn injuries and ii their mortality experiences. Study design: Hospital based study carried out for a period of one year (1st January 1991 to 31st December 1991. Settings: Wards of department of Burn & Plastic Surgery, BJ Medical College, Ahmedabad. Participants: 386 adults (20 years and above admitted at the centre for burn injuries during 1991. Study variables: Epidemiological determinants (age, sex, temporal, place, etc. for various burn injuries and the determinants of mortality (type of burn, extent of burn, referral time lag etc. Outcome profile: Common profile of burn victims with relation to the epidemiological factors and other factors responsible for high mortality in burn cases. Statistical analysis: Chi- square and Z tests. Results:Burns occured more in females specially in the age group of 20-24 years. Eighty five percent were flame burns. Flame burns were more in females, while electric burns were more in males. Burns were less during monsoon (27.7% than winter (32.6% and summer (39.6%, but electric burns were twice more common during monsoon. Maximum burns (81.9% were domestic, occurring mainly either in kitchen or living room. They were seen more in late evening. Sixty two percent cases were severe as total burn surface area (TBSA was >40%. Case fatality correlated positively with TBSA and death was almost universal with TBSA >60%. Early referral reduced fatality significantly in less severe burns (TBSA<40% but failed to influence it in severe burns. Appraisal of alleged suicide cases (2.6% and of stove bursting (4.4% revealed that young females carry additional risk of burn injuries.

  18. Assessment of levels of occupational exposure to extremely low frequency electric and magnetic fields in data centres in Greater Accra Region-Ghana

    International Nuclear Information System (INIS)

    Kalognia, Joshua

    2016-07-01

    Data centres use a lot of power, consumed by two main usages: power required to run the actual equipment and power required to cool the equipment. Usage of electricity results in the production of electric and magnetic fields (EMF). Even though electricity is useful in human lives, there have been reported cases of adverse health effects from EMF generated from its use. Because the use of electricity is ubiquitous and plays a vital role in society’s economy, the possibility of harm from EMF to electric utility customers and workers deserves attention.The Electric and Magnetic fields for workers in data center in the Greater Accra Region have been assessed. The fundamental objective was to determine the levels of the electric and magnetic fields and to assess the extent of exposure of workers in the data centre to these fields. The results obtained for the electric field intensities in the data centre ranged from 6.03E-03 ± 7.54E-04 kVm"-"1 to 2.33E-04 ± 8.82E-05 kVm"-"1.The results obtained for the resultant field strength in the data centre ranged from 3.12E-01± 8.77E-03 μT to 6.57E-02 ± 7.38E-03 μT. The results obtained for the magnetic flux density ranged from 3.9E-07 ± 8.77E-03 μT to 7.27E-08 ± 7.31E-03 μT. The results obtained for the induced current density ranged from 2.37E-06 ± 1.50E-02 mA/m"2 to 2.46E-07 ± 9.99E-03 mA/m"2. Data obtained are below the basic restrictions for induced current density and reference levels for electric field and magnetic flux density set by the International. (au)

  19. Wait times for gastroenterology consultation in Canada: The patients’ perspective

    Science.gov (United States)

    Paterson, WG; Barkun, AN; Hopman, WM; Leddin, DJ; Paré, P; Petrunia, DM; Sewitch, MJ; Switzer, C; van Zanten, S Veldhuyzen

    2010-01-01

    Long wait times for health care have become a significant issue in Canada. As part of the Canadian Association of Gastroenterology’s Human Resource initiative, a questionnaire was developed to survey patients regarding wait times for initial gastroenterology consultation and its impact. A total of 916 patients in six cities from across Canada completed the questionnaire at the time of initial consultation. Self-reported wait times varied widely, with 26.8% of respondents reporting waiting less than two weeks, 52.4% less than one month, 77.1% less than three months, 12.5% reported waiting longer than six months and 3.6% longer than one year. One-third of patients believed their wait time was too long, with 9% rating their wait time as ‘far too long’; 96.4% believed that maximal wait time should be less than three months, 78.9% believed it should be less than one month and 40.3% believed it should be less than two weeks. Of those working or attending school, 22.6% reported missing at least one day of work or school because of their symptoms in the month before their appointment, and 9.0% reported missing five or more days in the preceding month. A total of 20.2% of respondents reported being very worried about having a serious disease (ie, scored 6 or higher on 7-point Likert scale), and 17.6% and 14.8%, respectively, reported that their symptoms caused major impairment of social functioning and with the activities of daily living. These data suggest that a significant proportion of Canadians with digestive problems are not satisfied with their wait time for gastroenterology consultation. Furthermore, while awaiting consultation, many patients experience an impaired quality of life because of their gastrointestinal symptoms. PMID:20186353

  20. Endoscopic training in gastroenterology fellowship: adherence to core curriculum guidelines.

    Science.gov (United States)

    Jirapinyo, Pichamol; Imaeda, Avlin B; Thompson, Christopher C

    2015-12-01

    The Gastroenterology Core Curriculum and American Society of Gastrointestinal Endoscopy provide guidelines for endoscopic training. Program adherence to these recommendations is unclear. This study aims to assess endoscopic training experience during fellowship. Questionnaire study. The questionnaire was circulated to US fellowship programs, with the assistance of the American Gastroenterological Association. Graduating third-year fellows. Seventy-three fellows returned the questionnaire. Nearly all fellows met the required numbers for esophagoduodenoscopy (98%) and colonoscopy (100%), with fewer meeting requirements for PEG (73%) and non-variceal hemorrhage (75%). The majority of fellows did not meet minimum numbers for variceal banding (40%), esophageal dilation (43%), capsule endoscopy (42%). Fellows rated training in cognitive aspects of endoscopy as 3.86 [1 (inadequate), 5 (excellent)] and reported greatest emphasis on interpreting endoscopic findings and least on virtual colonography. Quality indicators of endoscopy received little emphasis (rating of 3.04; p = 0.00001), with adenoma detection rate being least emphasized. Fifty-six percent of fellows reported having routine endoscopy conferences. Half of the programs have endoscopic simulators, with 15% of fellows being required to use simulation. Following direct hands-on experience, fellows rated external endoscopy courses (64%) as the next most useful experience. Many fellows do not meet required numbers for several endoscopic procedures, and quality indicators receive little emphasis during training. Most programs do not provide simulation training or hold regular endoscopy conferences. Fellowship programs should perform internal audits and make feasible adjustments. Furthermore, it may be time for professional societies to revisit training guidelines.

  1. The storage center of very-low level radioactive wastes; Le centre de stockage des dechets de tres faible activite

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-07-01

    The low level radioactive wastes have a radioactivity level as same as the natural radioactivity. This wastes category and their storage has been taken into account by the french legislation. This document presents the storage principles of the site, containment, safety and the Center organization. (A.L.B.)

  2. Implementation of baby boomer hepatitis C screening and linking to care in gastroenterology practices: a multi-center pilot study.

    Science.gov (United States)

    Younossi, Zobair M; LaLuna, Louis L; Santoro, John J; Mendes, Flavia; Araya, Victor; Ravendhran, Natarajan; Pedicone, Lisa; Lio, Idania; Nader, Fatema; Hunt, Sharon; Racila, Andrei; Stepanova, Maria

    2016-04-04

    Estimates suggest that only 20 % of HCV-infected patients have been identified and gastroenterology practices in patients previously unscreened for HCV. After obtaining patient informed consent, demographics, clinical and health-related quality of life (HRQOL) data were collected. A blood sample was screened for HCV antibody (HCV AB) using the OraQuick HCV Rapid Antibody Test. HCV AB-positive patients were tested for presence of HCV RNA and, if HCV RNA positive, patients underwent treatment discussions. We screened 2,000 individuals in 5 gastroenterology centers located close to large metropolitan areas on the East Coast (3 Northeast, 1 Mid-Atlantic and 1 Southeast). Of the screened population, 10 individuals (0.5 %) were HCV AB-positive. HCV RNA testing was performed in 90 % (9/10) of HCV AB-positive individuals. Of those, 44.4 % (4/9) were HCV RNA-positive, and all 4 (100 %) were linked to caregiver. Compared to HCV AB negative subjects, HCV AB-positive individuals tended to be black (20.0 vs. 5.2 %, p = 0.09) and reported significantly higher rates of depression: 60.0 vs. 21.5 %, p = 0.009. These individuals also reported a significantly lower HRQOL citing having more fatigue, poorer concentration, and a decreased level of energy (p gastroenterology centers, the linkage to care was very high. The sample of patients used in this study may be biased, so further studies are needed to assess the effectiveness of the CDC screening recommendations. Implementation of the Baby Boomer Screening for HCV requires identifying screening environement with high prevalence of HCV+ individuals as well as an efficient process of linking them to care.

  3. The french low-level waste disposal site 'Centre de l'Aube'. A ten years process, from geological concept to waste deliveries

    International Nuclear Information System (INIS)

    Fernique, J.C.

    1993-01-01

    The 'Centre de la Manche', first French low-level waste disposal site opened in 1969 and will enter the institutional control period around 1994. A creation process for a new disposal was initiated in 1981 when ANDRA prepared a general radioactive waste management Program and presented it to the High Council for Nuclear Safety and Information. After acceptance of the Program, a national site screening was made, based on a conceptual geological model designed from the experience. In 1984, the Minister of Industry announced the pre-selection of 3 counties out of the inventory for preliminary studies that allowed to select l' Aube as a potential site for the new French disposal 'Centre de l'Aube'. The different steps of the process and procedure that brought to the acceptance of the first packages in January 1992 is presented in the paper, as well as the experience recently gained since that date. This additional know-how and expertise is made available by Andra through agreements already existing with various Countries like, among others, Spain, the United States, and Mexico

  4. The HILW-LL (high- and intermediate-level waste, long-lived) disposal project: working toward building the Cigeo Industrial Centre for Geological Disposal; Le projet HA-MAVL: vers la realisation du centre industriel de stockage geologique Cigeo

    Energy Technology Data Exchange (ETDEWEB)

    Labalette, Th. [Agence Nationale pour la Gestion des Dechets Radioactifs - ANDRA, Dir. des Projets, 92 - Chatenay Malabry (France)

    2011-02-15

    The French Act of 28 June 2006 identifies reversible disposal in deep geological facilities as the benchmark solution for long-term management of high-level waste (HLW) and for intermediate-level long-lived waste (ILW-LL). The Act tasks ANDRA (national agency for the management of radioactive wastes) with the pursuit of studies and research on the choice of a site and the design of the repository, with a view to examining the licence application in 2015 and, provided that the licence is granted, to make the facility operational by 2025. At the end of 2009, ANDRA submitted to the Government its proposals regarding the site and the design of the Industrial Centre for Geological Disposal, known as CIGEO. With the definition of a possible area for the construction of underground disposal facilities, one of the key stages in the project has been achieved. The choice of a surface site will be validated following the public consultation scheduled for the end of 2012. The project is now on the point of entering the definition stage (preliminary design). CIGEO will be a nuclear facility unlike any other. It will be built and operated for a period of over 100 years. For it to be successful, the project must meet certain requirements related to its integration in the local area, industrial planning, safety and reversibility, while also controlling costs. Reversibility is a very important concept that will be defined by law. It is ANDRA's responsibility to ensure that a reasonable balance is found between these different concerns. (author)

  5. Knowledge Levels and Attitudes of People Living in the City Centre of Nevşehir on Organ Donation and Transplantation

    Science.gov (United States)

    Yazar, Mehmet Akif; Açıkgöz, Mehmet Barış

    2016-01-01

    Objective The purpose of this descriptive study was to determine the knowledge levels and attitudes of people living in Nevşehir on organ donation (OD) and transplantation. Methods Data were collected using a questionnaire administered to 414 people residing in Nevşehir between February and May 2016. The primary and secondary endpoints of the present study were to determine the attitudes and knowledge levels of participants on OD and transplantation, respectively. Results Four hundred and fourteen people between the ages 20 and 65 years participated. In total, 8.9% of the participants correctly answered the question ‘What is necessary for donating an organ?’ and 31.4% of them correctly answered the question ‘What is brain death?’ Moreover, 53.1% of the participants stated that they wanted to receive reliable information on OD from OD centres. There was a close relationship between high education level and the willingness to donate organs (pdonate organs: 22.9% of them explained that their decision was because of their religious beliefs and 19.6% stated that their families did not allow it. It was observed that people who accepted organs from others were more willing to donate organs to their relatives (p<0.05). Conclusion People living in Nevşehir do not have sufficient knowledge on OD; they had various concerns on the issue and wanted to receive information from OD centres. Exemplification and internalisation methods can be used in educational schedules to increase the OD. PMID:27909606

  6. Cincuentenario de una Escuela de Gastroenterología

    Directory of Open Access Journals (Sweden)

    Arecio Peñalosa Rosas

    2003-08-01

    Full Text Available

    Con motivo de cumplir la Sociedad de Cirugía de Bogotá cien años de haber sido fundada (Julio 22 de 1902 y de haberse iniciado la construcción del Hospital de San José que puso al servicio de la comunidad todas sus instalaciones el 8 de Febrero de 1925, hacemos una reseña histórica del Servicio de Gastroenterología y Endoscopia Digestiva de este Hospital, cuna de una escuela gastroenterológica que ha sido protagónica en la Medicina Colombiana, disciplina médica que se inicia como tal a partir del 24 de Julio de 1947 con la fundación de la “Asociación Nacional de Gastroenterología” por un pequeño grupo de cirujanos que despertó gran interés dentro del cuerpo médico, buscando varios profesionales orientaciones posteriores en Norteamérica y Europa, siendo de resaltar la influencia del Dr. Henry L. Bockus de la Universidad de Pennsylvania y la del Dr. Charles Debray en el Hospital Bichat de París.

    El Dr. Jorge Suárez Hoyos como Jefe del Servicio de Órganos de los Sentidos en el Hospital de San José había constituido una Sección de Broncoesofagología, dotándola de equipo endoscópico rígido de iluminación distal tipo Chevalier-Jackson.

    En el segundo semestre de 1948, a su regreso de Argentina, tras un curso de especialización en el Servicio del Profesor Bonorino Udaondo en el Hospital Rawson y en el Servicio del Profesor Iván Gogni-Moreno en el Hospital Haedo de Buenos Aires, el Dr.Carlos Camacho Rodríguez, habiendo sido aceptado en la Asociación Nacional de Gastroenterología de Colombia el 1o de Julio de 1948 con el trabajo “Estrecheces de esófago. Manejo con dilatación retrógrada” es nombrado Adjunto en el Servicio de Cirugía del Hospital y se vincula como tal al Servicio de Broncoesofagología ; además de las esofagoscopias y rectoscopias con equipo rígido, inicia la práctica de Gastroscopias con el gastroscopio semirígido Schindler y el tipo Benedict de iluminación distal con

  7. Application value of combined measurement of serum sTn, CA242, CA19-9 and CEA in the diagnosis of gastroenterological neoplasm

    International Nuclear Information System (INIS)

    Zhang Wanzhong; Chen Zhizhou; Fan Zhenfu

    2007-01-01

    To determine the application value of four serum tumor markers sTn, CA242, CA 19-9 and CEA in the diagnosis of gastroenterological neoplasm, the serum sTn, CA242, CA19-9 and CEA in 30 normal adult controls and 60 patients with gastroenterological neoplasm were measured by IRMA. The results showed that the serum sTn, CA242, CA19-9 and CEA levels in patients with gastric carcinoma or colorectal carcinoma were much higher than those in control group (P<0.01). The serum CEA, CA19-9 and CA242 levels in patients with colorectal carcinoma were significantly higher than those in patients with gastric carcinoma (P<0.01), but the serum sTn level in the former was markedly lower (P<0.01) than that in the latter. The sensitivity of tumor marker increased with the progress of clinical stages, with a considerably higher sensitivity for stage IV compared with stage I-II (P<0.01). The combined test of four tumor markers could be more sensitive than single test in detecting gastric carcinoma and colorectal carcinoma (P<0.05). Four tumor markers are useful for diagnosing gastroenterological neoplasm, and the combined measurement of 4 tumor markers could increase the sensitivity of detecting gastric carcinoma. (authors)

  8. Validity of randomized clinical trials in gastroenterology from 1964-2000

    DEFF Research Database (Denmark)

    Kjaergard, Lise L; Frederiksen, Sarah L; Gluud, Christian

    2002-01-01

    The internal validity of clinical trials depends on the adequacy of the reported methodological quality. We assessed the methodological quality of all 383 randomized clinical trials published in GASTROENTEROLOGY as original articles from 1964 to 2000.......The internal validity of clinical trials depends on the adequacy of the reported methodological quality. We assessed the methodological quality of all 383 randomized clinical trials published in GASTROENTEROLOGY as original articles from 1964 to 2000....

  9. Volume reduction and conditioning campaigns, upon low level solid waste drums, realised in ENEA centres of Trisaia (ITREC plant) and Saluggia (EUTREX plant)

    International Nuclear Information System (INIS)

    Gili, M.

    1995-09-01

    The volume reduction and conditioning campaigns, upon low level solid waste drums, realized between 1989 and 1993 in the ENEA (Italian Agency for New Technologies, Energy and the Environment) centres of Trisaia (ITREC plant) and Saluggia (EUREX plant), by the mean of supercompactation, and cement immobilization inside over packs, are hereby described. The operational techniques and the equipments used, the whole volume reduction factors obtained and some final considerations over this solid rad wastes treatment procedure are shown. This method, where correctly operated and coupled to an accurate radiological characterization, permits to save space for the waste storage in the short period and to obtain final manufacts, certified suitable for shallow burial disposal, according to italian technical guide n. 26

  10. Influence of Mean Rooftop-Level Estimation Method on Sensible Heat Flux Retrieved from a Large-Aperture Scintillometer Over a City Centre

    Science.gov (United States)

    Zieliński, Mariusz; Fortuniak, Krzysztof; Pawlak, Włodzimierz; Siedlecki, Mariusz

    2017-08-01

    The sensible heat flux ( H) is determined using large-aperture scintillometer (LAS) measurements over a city centre for eight different computation scenarios. The scenarios are based on different approaches of the mean rooftop-level (zH) estimation for the LAS path. Here, zH is determined separately for wind directions perpendicular (two zones) and parallel (one zone) to the optical beam to reflect the variation in topography and building height on both sides of the LAS path. Two methods of zH estimation are analyzed: (1) average building profiles; (2) weighted-average building height within a 250 m radius from points located every 50 m along the optical beam, or the centre of a certain zone (in the case of a wind direction perpendicular to the path). The sensible heat flux is computed separately using the friction velocity determined with the eddy-covariance method and the iterative procedure. The sensitivity of the sensible heat flux and the extent of the scintillometer source area to different computation scenarios are analyzed. Differences reaching up to 7% between heat fluxes computed with different scenarios were found. The mean rooftop-level estimation method has a smaller influence on the sensible heat flux (-4 to 5%) than the area used for the zH computation (-5 to 7%). For the source-area extent, the discrepancies between respective scenarios reached a similar magnitude. The results demonstrate the value of the approach in which zH is estimated separately for wind directions parallel and perpendicular to the LAS optical beam.

  11. ALCOHOL DEPENDENCE IN GASTROENTEROLOG YOUTPATIENT ON A PUBLIC HOSPITAL

    Directory of Open Access Journals (Sweden)

    Mariana de Andrade PRANKE

    2017-09-01

    Full Text Available ABSTRACT BACKGROUND: Alcoholism and alcoholic liver disease are both considered worldwide health problems. OBJECTIVE: The prevalence of alcohol dependence, the associated risk factors and the concordance between the prevalence found and the data collected during the medical visit were evaluated. METHODS: A prospective study evaluating gastroenterology outpatients at a public tertiary hospital was conducted. Two specific questionnaires to assess alcohol dependence were applied: Cut down, Annoyed by criticism, Guilty, Eye-opener (CAGE and The Alcohol Use Disorder Identification Test (AUDIT. Data on comorbidities, clinical diagnosis and assessment of alcohol consumption by the attending physician were collected through medical records. RESULTS: One hundred and seventy eight patients were interviewed, of which 119 (66.9% were women and 59 (33.1% were men, with mean age of 57 years. Thirty-three (18.5% of the 178 patients were considered alcohol-dependent by the CAGE questionnaire. Thirteen (7.3% patients scored 8 points or more on the AUDIT questionnaire. The agreement (kappa between these questionnaires was 0.37 (P<0.001. The most consumed drink was beer. The median daily consumption of dependent patients was 64 g. None of the patients were undergoing treatment in a specific treatment center, and 14/33 (42.4% patients considered themselves alcoholics. Only in 17/33 (51.5% there was information about alcoholism in their respective medical records. In the bivariate analysis, male gender (P<0.001, onset of alcohol consumption before the age of 15 (P=0.003, daily alcohol consumption in the last 12 months (P<0.001 and smoking (P<0.001 were identified as risk factors. After multivariate analysis, only male gender (P=0.009 and smoking (P=0.001 were associated with alcoholism. CONCLUSION: The present study demonstrated a high prevalence of alcohol dependence in the gastroenterology outpatient clinic, being predominantly associated with male gender and

  12. Metabolome analysis for discovering biomarkers of gastroenterological cancer.

    Science.gov (United States)

    Suzuki, Makoto; Nishiumi, Shin; Matsubara, Atsuki; Azuma, Takeshi; Yoshida, Masaru

    2014-09-01

    Improvements in analytical technologies have made it possible to rapidly determine the concentrations of thousands of metabolites in any biological sample, which has resulted in metabolome analysis being applied to various types of research, such as clinical, cell biology, and plant/food science studies. The metabolome represents all of the end products and by-products of the numerous complex metabolic pathways operating in a biological system. Thus, metabolome analysis allows one to survey the global changes in an organism's metabolic profile and gain a holistic understanding of the changes that occur in organisms during various biological processes, e.g., during disease development. In clinical metabolomic studies, there is a strong possibility that differences in the metabolic profiles of human specimens reflect disease-specific states. Recently, metabolome analysis of biofluids, e.g., blood, urine, or saliva, has been increasingly used for biomarker discovery and disease diagnosis. Mass spectrometry-based techniques have been extensively used for metabolome analysis because they exhibit high selectivity and sensitivity during the identification and quantification of metabolites. Here, we describe metabolome analysis using liquid chromatography-mass spectrometry, gas chromatography-mass spectrometry, and capillary electrophoresis-mass spectrometry. Furthermore, the findings of studies that attempted to discover biomarkers of gastroenterological cancer are also outlined. Finally, we discuss metabolome analysis-based disease diagnosis. Copyright © 2014 Elsevier B.V. All rights reserved.

  13. Gastroenterology training in private hospitals: India vs South Africa

    Science.gov (United States)

    Mulder, Chris Jacob Johan; Puri, Amarender Singh; Reddy, Duvvur Nageshwar

    2010-01-01

    In South Africa, nurses and doctors are emigrating in significant numbers. Job satisfaction, safety and ensuring career progression are important in retaining doctors to make a career in Republic of South Africa (RSA). Due to budgetary constraints many hospitals have not been upgraded. Coming home after overseas training seems difficult. In RSA it takes a minimum of 13 years for a young specialist to become registered and 15 years for subspecialists. Career progression, creating more specialist trainees in public and private hospitals and shortening the period of professional training are potential solutions to the problem. India, which has a population of more than 1 billion people, is struggling with similar problems. For the past 10-15 years, private hospitals have assisted in manpower development for medical specialist and subspecialist careers. Currently their private sector trains 60% of their recognised (sub)specialities fellows. A national task force for specialist training in RSA should be instituted. It should discuss, based on the current status and projected specialist and subspecialist personnel requirements, the future structure and logistics of training needs. This is required in all subspecialities including gastroenterology, as has been done in India. It is hoped that as a consequence well-trained doctors, similar to those in India, might move to provincial hospitals in rural areas, upgrading the medical services and keeping medical power in South Africa. South Africa should become a model for Sub-Saharan Africa, as India already is for South-East Asia. PMID:20180232

  14. Computerized tomography - its validity in the diagnosis of gastroenterologic disease

    International Nuclear Information System (INIS)

    Schoppe, W.D.; Jungblut, R.M.

    1982-01-01

    The development of faster CT-machines with scantimes below five seconds and the introduction of different techniques for CT examinations (e.g. application of oral and intravenous contrast material) have influenced diagnostic procedures in medicine. On the other hand there are only a few procedures that have been replaced by CT, e.g. pneumoventriculography, pneumoretroperitoneum. In gastronenterology well established diagnostic methods as ultrasound, ERCP, PTC, barium meal and barium enema are known to have a high accuracy. CT has to be compared with these techniques and therefore its value in the diagnostic spectrum is still under investigation. So far every single method has primary or secondary indications. But it should be the aim of further studies to minimize risk and radiation dose of diagnostic procedures. Using CT this is possible, especially in intraabdominal diseases. From the present knowledge the validity of CT in the diagnosis of gastroenterologic diseases is discussed. The given recommendations might change in the future as result of ongoing investigations, technical improvements, wider distribution of CT machines and broader experiences of physicians. (orig.) [de

  15. Ultrahigh speed endoscopic optical coherence tomography for gastroenterology.

    Science.gov (United States)

    Tsai, Tsung-Han; Lee, Hsiang-Chieh; Ahsen, Osman O; Liang, Kaicheng; Giacomelli, Michael G; Potsaid, Benjamin M; Tao, Yuankai K; Jayaraman, Vijaysekhar; Figueiredo, Marisa; Huang, Qin; Cable, Alex E; Fujimoto, James; Mashimo, Hiroshi

    2014-12-01

    We describe an ultrahigh speed endoscopic swept source optical coherence tomography (OCT) system for clinical gastroenterology using a vertical-cavity surface-emitting laser (VCSEL) and micromotor imaging catheter. The system had a 600 kHz axial scan rate and 8 µm axial resolution in tissue. Imaging was performed with a 3.2 mm diameter imaging catheter at 400 frames per second with a 12 µm spot size. Three-dimensional OCT (3D-OCT) imaging was performed in patients with a cross section of pathologies undergoing upper and lower endoscopy. The use of distally actuated imaging catheters enabled OCT imaging with more flexibility, such as volumetric imaging in the small intestine and the assessment of hiatal hernia using retroflex imaging. The high rotational scanning stability of the micromotor enabled 3D volumetric imaging with micron scale volumetric accuracy for both en face OCT and cross-sectional imaging, as well as OCT angiography (OCTA) for 3D visualization of subsurface microvasculature. The ability to perform both structural and functional 3D OCT imaging in the GI tract with microscopic accuracy should enable a wide range of studies and enhance the sensitivity and specificity of OCT for detecting pathology.

  16. [Gastroenterology in the G-DRG-System 2004].

    Science.gov (United States)

    Bunzemeier, H; Frühmorgen, P; Caspary, W F; Roeder, N

    2003-11-01

    After a year of preliminary voluntarily introduction of casemix funding in hospitals in 2003 nearly every German hospital will be confronted with lump sump payments on the basis of the G-DRG system for their inpatient care starting from January 2004. To analyse weaknesses referring to gastroenterology services within the G-DRG version 1.0 the German Association for Disorders of the Digestive System and Metabolism (DGVS) and the DRG-Research-Group from the University of Muenster conducted a DRG evaluation project. In the analysis patient data from 16 hospitals were included. As a result of the project recommendations for G-DRG adjustments were generated. Those recommendations were implemented in the advancement to G-DRG version 2004. Also the International Classification of Diseases (ICD-10) was modified to ICD-10 German Modification. The classification of procedures OPS-301 was revised. The main adjustments to the G-DRG system and both classifications will be presented in this paper.

  17. The influence of industrial-scale canning on cadmium and lead levels in sardines and anchovies from commercial fishing centres of the Mediterranean Sea.

    Science.gov (United States)

    Galitsopoulou, Augoustina; Georgantelis, Dimitrios; Kontominas, Michael

    2012-01-01

    The current study encompassed a survey on the levels of toxic trace elements in two highly consumed fish species in commercial fishing centres of western, central and eastern Mediterranean Sea. A Zeeman GTA-AAS graphite furnace atomic absorption spectrometry system was used throughout the study. Toxicological evaluation of the samples revealed a low Cd content in the raw samples, ranging between 0.003 and 0.027 mg kg⁻¹. Pb presented significantly higher values, from 0.037 to 0.297 mg kg⁻¹, occasionally reaching the limit of 0.3 mg kg⁻¹. Heavy metal levels were particularly higher in bones, thus raising queries about the safe consumption of fish intended to be eaten as a whole, a very common practice for small fish and canned products. The influence of industrial-scale canning showed that canning enhanced heavy metal levels by 35%-80%. The effect of canning depended on metal type and reduction of moisture loss after the steam-roasting step of the canning procedure.

  18. [Gastroenterology in the former GDR (1975-1990) and the changes after German reunification].

    Science.gov (United States)

    Nilius, R

    2014-06-01

    This short overview sketches the state of Gastroenterology in the GDR (1975 - 1990) from the point of view of an East-German contemporary witness. The "Society for Gastroenterology/GDR" (GfG) has played a decisive role for the development of the Gastroenterology in the GDR. The society promoted medical education and constitutions of gastroenterological centers, fostered gastroenterological research and controlled the standards for the recognition of Gastroenterology as a state-accepted medical sub-discipline. An extensive program of scientific and educative events included two-annual meetings of scientific congresses, the "Berka-Talks", endoscopic workshops" and featured special symposia such as for Hepatology, Pancreatology and gastro-intestinal Microbiology. Temporary working groups developed technical and professional legal advice. Although the GfG was a full member of the respective international organizations (OMGE, ASNEMGE, ESGE), it was almost impossible building up reliable international contacts in a mutual interest. Especially, contacts with colleagues representing the "German Society of Digestion and Metabolic Diseases" (DGVS) were impeded. With the political changes of 1989/1990, an association of the two German Societies for Gastroenterology seemed within reach. At a meeting in Halle (Saale) (March, 22nd, 1990), representatives of DGVS and GfG quickly agreed on modalities to merge the two societies. After the 45th meeting of the DGVS (October 3rd-6th, Essen) more than 600 GDR physicians could join the BRD society under accommodating conditions. The GfG had fulfilled its historical function as a "bridge" during the division of Germany with dignity and was suspended (November, 24nd,1990). © Georg Thieme Verlag KG Stuttgart · New York.

  19. White paper of Italian Gastroenterology: delivery of services for digestive diseases in Italy: weaknesses and strengths.

    Science.gov (United States)

    Buscarini, Elisabetta; Conte, Dario; Cannizzaro, Renato; Bazzoli, Franco; De Boni, Michele; Delle Fave, Gianfranco; Farinati, Fabio; Ravelli, Paolo; Testoni, Pier Alberto; Lisiero, Manola; Spolaore, Paolo

    2014-07-01

    In 2011 the three major Italian gastroenterological scientific societies (AIGO, the Italian Society of Hospital Gastroenterologists and Endoscopists; SIED, the Italian Society of Endoscopy; SIGE, the Italian Society of Gastroenterology) prepared their official document aimed at analysing medical care for digestive diseases in Italy, on the basis of national and regional data (Health Ministry and Lombardia, Veneto, Emilia-Romagna databases) and to make proposals for planning of care. Digestive diseases were the first or second cause of hospitalizations in Italy in 1999-2009, with more than 1,500,000 admissions/year; however only 5-9% of these admissions was in specialized Gastroenterology units. Reported data show a better outcome in Gastroenterology Units than in non-specialized units: shorter average length of stay, in particular for admissions with ICD-9-CM codes proxying for emergency conditions (6.7 days versus 8.4 days); better case mix (higher average diagnosis-related groups weight in Gastroenterology Units: 1 vs 0.97 in Internal Medicine units and 0.76 in Surgery units); lower inappropriateness of admissions (16-25% versus 29-87%); lower in-hospital mortality in urgent admissions (2.2% versus 5.1%); for patients with urgent admissions due to gastrointestinnal haemorrhage, in-hospital mortality was 2.3% in Gastroenterology units versus 4.0% in others. The present document summarizes the scientific societies' official report, which constitutes the "White paper of Italian Gastroenterology". Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  20. An audit of diagnostic reference levels in interventional cardiology and radiology: Are there differences between academic and non-academic centres?

    International Nuclear Information System (INIS)

    Samara, E. T.; Aroua, A.; De palma, R.; Stauffer, J. C.; Schmidt, S.; Trueb, P. R.; Stuessi, A.; Treier, R.; Bochud, F.; Verdun, F. R.

    2012-01-01

    A wide variation in patient exposure has been observed in interventional radiology and cardiology. The purpose of this study was to investigate the patient dose from fluoroscopy-guided procedures performed in non-academic centres when compared with academic centres. Four procedures (coronary angiography, percutaneous coronary intervention, angiography of the lower limbs and percutaneous transluminal angioplasty of the lower limbs) were evaluated. Data on the dose-area product, fluoroscopy time and number of images for 1000 procedures were obtained from 23 non-academic centres and compared with data from 5 academic centres. No differences were found for cardiology procedures performed in non-academic centres versus academic ones. However, significantly lower doses were delivered to patients for procedures of the lower limbs when they were performed in non-academic centres. This may be due to more complex procedures performed in the academic centres. Comparison between the centres showed a great variation in the patient dose for these lower limb procedures. (authors)

  1. Level of consciousness on admission to a Heart Attack Centre is a predictor of survival from out-of-hospital cardiac arrest.

    Science.gov (United States)

    Deakin, Charles D; Fothergill, Rachael; Moore, Fionna; Watson, Lynne; Whitbread, Mark

    2014-07-01

    The relationship between the neurological status at the time of handover from the ambulance crew to a Heart Attack Centre (HAC) in patients who have achieved return of spontaneous circulation (ROSC) and subsequent outcome, in the context of current treatment standards, is unknown. A retrospective review of all patients treated by London Ambulance Service (LAS) from 1(st) April 2011 to 31(st) March 2013 admitted to a HAC in Greater London was undertaken. Neurological status (A - alert; V - responding to voice; P - responding to pain; U - unresponsive) recorded by the ambulance crew on handover was compared with length of hospital stay and survival to hospital discharge. A total of 475 sequential adult cardiac arrests of presumed cardiac origin, achieving ROSC on admission to a HAC were identified. Outcome data was available for 452 patients, of whom 253 (56.0%) survived to discharge. Level of consciousness on admission to the HAC was a predictor of duration of hospital stay (Pa shockable rhythm, 32.3% (120/371) were 'A' or 'V', compared with 9.1% (9/99) of those with non-shockable rhythms (PA or V) compared with those with non-shockable rhythms. Most patients who are conscious on admission to the HAC will survive, compared with approximately half of those who are unconscious (P or U), suggesting that critical care is generally appropriate at all levels of consciousness if ROSC has been achieved. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. The difference of level CO2 emissions from the transportation sector between weekdays and weekend days on the City Centre of Pemalang

    Science.gov (United States)

    Sawitri, E.; Hardiman, G.; Buchori, I.

    2017-06-01

    The high growth of human activity potentially increases the number of vehicles and the use of fossil fuels that contribute the increase of CO2 emissions in atmosphere. Controlling CO2 emission that causes greenhouse effect becomes the main agenda of Indonesian Government. The first step control CO2 emissions is by measuring the level of CO2 emissions, especially CO2 emissions from fossil fuel consumption in the transport sector. This research aims to assess the level of CO2 emissions from transportation sector on the main roads in the city centre of Pemalang both in weekdays and weekend days. The methods applied to calculate CO2 emissions using Intergovernmental Panel on Climate Change (IPCC) 2006 method. For this, a survey on the number of vehicles passing through the main roads using hand tally counter is firstly done. The results, CO2 emissions in working day, i.e. 49,006.95 tons/year compared to weekend i.e. 38,865.50 tons/year.

  3. The practicality of including the systemic inflammatory response syndrome in the definition of polytrauma: experience of a level one trauma centre.

    Science.gov (United States)

    Butcher, Nerida E; Balogh, Zsolt J

    2013-01-01

    The systemic inflammatory response syndrome (SIRS) has been advocated as a significant predictor of outcome in trauma. Recent trauma literature has proposed SIRS as a surrogate for physiological derangements characteristic of polytrauma with some authors recommending its inclusion into the definition of polytrauma. The practicality of daily SIRS collection outside of specifically designed prospective trials is unknown. The purpose of this study was to assess the availability of SIRS variables and its appropriateness for inclusion into a definition of polytrauma. We hypothesised SIRS variables would be readily available and easy to collect, thus represent an appropriate inclusion into the definition of polytrauma. A prospective observational study of all trauma team activation patients over 7-months (August 2009 to February 2010) at a University affiliated level-1 urban trauma centre. SIRS data (temperature>38°C or 90 bpm; RR>20/min or a PaCO(2)12.0×10(9)L(-1), or 10 immature bands) collected from presentation, at 24 h intervals until 72 h post injury. Inclusion criteria were all patients generating a trauma team activation response age >16. 336 patients met inclusion criteria. In 46% (155/336) serial SIRS scores could not be calculated due to missing data. Lowest rates of missing data observed on admission [3% (11/336)]. Stratified by ISS>15 (132/336), in 7% (9/132) serial SIRS scores could not be calculated due to missing data. In 123 patients ISS>15 with complete data, 81% (100/123) developed SIRS. For Abbreviated Injury Scale (AIS)>2 in at least 2 body regions (64/336) in 5% (3/64) serial SIRS scores could not be calculated, with 92% (56/61) of patients with complete data developing SIRS. For Direct ICU admissions [25% (85/336)] 5% (4/85) of patients could not have serial SIRS calculated [mean ISS 15(±11)] and 90% (73/81) developed SIRS at least once over 72 h. Based on the experience of our level-1 trauma centre, the practicability of including SIRS into the

  4. Institutional Support : Centre for Research and Technology ...

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

    year-old science and technology research centre at Maseno University in western Kenya. The Centre focuses on science and technology research to influence both national policies and development practices at the community level. Currently ...

  5. 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.

  6. Disruptive behavior in the workplace: Challenges for gastroenterology fellows.

    Science.gov (United States)

    Srisarajivakul, Nalinee; Lucero, Catherine; Wang, Xiao-Jing; Poles, Michael; Gillespie, Colleen; Zabar, Sondra; Weinshel, Elizabeth; Malter, Lisa

    2017-05-14

    To assess first-year gastroenterology fellows' ability to address difficult interpersonal situations in the workplace using objective structured clinical examinations (OSCE). Two OSCEs ("distracted care team" and "frazzled intern") were created to assess response to disruptive behavior. In case 1, a fellow used a colonoscopy simulator while interacting with a standardized patient (SP), nurse, and attending physician all played by actors. The nurse and attending were instructed to display specific disruptive behavior and disregard the fellow unless requested to stop the disruptive behavior and focus on the patient and procedure. In case 2, the fellow was to calm an intern managing a patient with massive gastrointestinal bleeding. The objective in both scenarios was to assess the fellows' ability to perform their duties while managing the disruptive behavior displayed by the actor. The SPs used checklists to rate fellows' performances. The fellows completed a self-assessment survey. Twelve fellows from four gastrointestinal fellowship training programs participated in the OSCE. In the "distracted care team" case, one-third of the fellows interrupted the conflict and refocused attention to the patient. Half of the fellows were able to display professionalism despite the heated discussion nearby. Fellows scored lowest in the interprofessionalism portion of post-OSCE surveys, measuring their ability to handle the conflict. In the "frazzled intern" case, 68% of fellows were able to establish a calm and professional relationship with the SP. Despite this success, only half of the fellows were successfully communicate a plan to the SP and only a third scored "well done" in a domain that focused on allowing the intern to think through the case with the fellow's guidance. Fellows must receive training on how to approach disruptive behavior. OSCEs are a tool that can assess fellow skills and set a culture for open discussion.

  7. The relationship between workplace violence, perceptions of safety, and Professional Quality of Life among emergency department staff members in a Level 1 Trauma Centre.

    Science.gov (United States)

    Copeland, Darcy; Henry, Melissa

    2018-02-02

    Emergency department staff members are frequently exposed to workplace violence which may have physical, psychological, and workforce related consequences. The purpose of this study was to examine the relationships between exposure to workplace violence, tolerance to violence, expectations of violence, perceptions of workplace safety, and Professional Quality of Life (compassion satisfaction - CS, burnout - BO, secondary traumatic stress - STS) among emergency department staff members. A cross-sectional design was used to survey all emergency department staff members from a suburban Level 1 Trauma Centre in the western United States. All three dimensions of Professional Quality of Life were associated with exposure to non-physical patient violence including: general threats (CS p = .012, BO p = .001, STS p = .035), name calling (CS p = .041, BO p = .021, STS p = .018), and threats of lawsuit (CS p = .001, BO p = .001, STS p = .02). Tolerance to violence was associated with BO (p = .004) and CS (p = .001); perception of safety was associated with BO (p = .018). Exposure to non-physical workplace violence can significantly impact staff members' compassion satisfaction, burnout and secondary traumatic stress. Greater attention should be paid to the effect of non-physical workplace violence. Additionally, addressing tolerance to violence and perceptions of safety in the workplace may impact Professional Quality of Life. Copyright © 2018 Elsevier Ltd. All rights reserved.

  8. [High-Flow Nasal Cannulae (HFNC) in Neonates: A Survey of Current Practice in Level 1 Perinatal Centres in the German State of North Rhine-Westphalia].

    Science.gov (United States)

    Hepping, N; Garbe, W; Schneider, K

    2015-12-01

    High-flow nasal cannulae (HFNC) is a kind of non-invasive respiratory support. In recent years, its application has gained increasing popularity for treating neonates with respiratory failure. Within this study, neonatologists employed at high level perinatal centres within the region of North Rhine-Westphalia, Germany were interviewed. We evaluated their personal experience as well as the underlying indication for using HFNC. We undertook an online survey. 93% of the interviewed participants use HFNC systems in their NICU. The most prominent indications were CPAP-weaning, nasal trauma, and apnoea of prematurity. Both initial flow and maximum and minimum flow rates varied widely. The primary benefit of HFNC vs. conventional CPAP was the improved neonate tolerance, less nasal traumata and ease of application and care. A common disadvantage was the inability to conduct PEEP measurements. The application of the HFNC system is increasing for specific neonatal indications, thereby increasing the data for the evaluation of effectivity and safety. Nevertheless, detailed investigations of the appropriate flow rate settings are still lacking. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Nigerian Journal of Gastroenterology and Hepatology - Vol 1, No 2 ...

    African Journals Online (AJOL)

    Distribution of ABO Blood Groups in a Tertiary Care Centre in North-Eastern, Nigeria · EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. AB Olokoba, SK Tidi, FK Salawu, A Danburam, OO Desalu, J Midala, LH Badung, LB Olokoba, OA Obateru ...

  10. Based on the Materials of IV Scientific Session of the Institute of Gastroenterology of the NAMS of Ukraine «New Technologies in Theoretical and Clinical Gastroenterology»

    Directory of Open Access Journals (Sweden)

    I.Yu. Skyrda

    2016-09-01

    Scientific supervisor of the conference — Yuri M. Stepanov, doctor of Sciences, Professor, honored doctor of Ukraine, Director of SI "Institute gastroenterology of NAMS of Ukraine", head of the Department of gastroenterology and therapy SI "Dnepropetrovsk medical Academy", the Chairman of the Union "Association for the study and treatment of diseases of the digestive system in Ukraine".

  11. Specialty Payment Model Opportunities and Assessment: Gastroenterology and Cardiology Model Design Report.

    Science.gov (United States)

    Mulcahy, Andrew W; Chan, Chris; Hirshman, Samuel; Huckfeldt, Peter J; Kofner, Aaron; Liu, Jodi L; Lovejoy, Susan L; Popescu, Ioana; Timbie, Justin W; Hussey, Peter S

    2015-07-15

    Gastroenterology and cardiology services are common and costly among Medicare beneficiaries. Episode-based payment, which aims to create incentives for high-quality, low-cost care, has been identified as a promising alternative payment model. This article describes research related to the design of episode-based payment models for ambulatory gastroenterology and cardiology services for possible testing by the Center for Medicare and Medicaid Innovation at the Centers for Medicare and Medicaid Services (CMS). The authors analyzed Medicare claims data to describe the frequency and characteristics of gastroenterology and cardiology index procedures, the practices that delivered index procedures, and the patients that received index procedures. The results of these analyses can help inform CMS decisions about the definition of episodes in an episode-based payment model; payment adjustments for service setting, multiple procedures, or other factors; and eligibility for the payment model.

  12. Implementation of preventive strength training in residential geriatric care: a multi-centre study protocol with one year of interventions on multiple levels.

    Science.gov (United States)

    Brach, Michael; Nieder, Frank; Nieder, Ulrike; Mechling, Heinz

    2009-11-24

    There is scientific evidence that preventive physical exercise is effective even in high age. In contrast, there are few opportunities of preventive exercise for highly aged people endangered by or actually in need of care. For example, they would not be able to easily go to training facilities; standard exercises may be too intensive and therefore be harmful to them; orientation disorders like dementia would exacerbate individuals and groups in following instructions and keeping exercises going. In order to develop appropriate interventions, these and other issues were assigned to different levels: the individual-social level (ISL), the organisational-institutional level (OIL) and the political-cultural level (PCL). Consequently, this conceptional framework was utilised for development, implementation and evaluation of a new strength and balance exercise programme for old people endangered by or actually in need of daily care. The present paper contains the development of this programme labeled "fit for 100", and a study protocol of an interventional single-arm multi-centre trial. The intervention consisted of (a) two group training sessions every week over one year, mainly resistance exercises, accompanied by sensorimotor and communicative group exercises and games (ISL), (b) a sustainable implementation concept, starting new groups by instructors belonging to the project, followed by training and supervision of local staff, who stepwise take over the group (OIL), (c) informing and convincing activities in professional, administrative and governmental contexts, public relation activities, and establishing an advisory council with renowned experts and public figures (PCL). Participating institutions of geriatric care were selected through several steps of quality criteria assessment. Primary outcome measures were continuous documentation of individual participation (ISL), number of groups continued without external financial support (at the end of the project, and

  13. Implementation of preventive strength training in residential geriatric care: a multi-centre study protocol with one year of interventions on multiple levels

    Directory of Open Access Journals (Sweden)

    Nieder Ulrike

    2009-11-01

    Full Text Available Abstract Background There is scientific evidence that preventive physical exercise is effective even in high age. In contrast, there are few opportunities of preventive exercise for highly aged people endangered by or actually in need of care. For example, they would not be able to easily go to training facilities; standard exercises may be too intensive and therefore be harmful to them; orientation disorders like dementia would exacerbate individuals and groups in following instructions and keeping exercises going. In order to develop appropriate interventions, these and other issues were assigned to different levels: the individual-social level (ISL, the organisational-institutional level (OIL and the political-cultural level (PCL. Consequently, this conceptional framework was utilised for development, implementation and evaluation of a new strength and balance exercise programme for old people endangered by or actually in need of daily care. The present paper contains the development of this programme labeled "fit for 100", and a study protocol of an interventional single-arm multi-centre trial. Methods The intervention consisted of (a two group training sessions every week over one year, mainly resistance exercises, accompanied by sensorimotor and communicative group exercises and games (ISL, (b a sustainable implementation concept, starting new groups by instructors belonging to the project, followed by training and supervision of local staff, who stepwise take over the group (OIL, (c informing and convincing activities in professional, administrative and governmental contexts, public relation activities, and establishing an advisory council with renowned experts and public figures (PCL. Participating institutions of geriatric care were selected through several steps of quality criteria assessment. Primary outcome measures were continuous documentation of individual participation (ISL, number of groups continued without external financial

  14. The HILW-LL (high- and intermediate-level waste, long-lived) disposal project: working toward building the Cigeo Industrial Centre for Geological Disposal

    International Nuclear Information System (INIS)

    Labalette, Th.

    2011-01-01

    The French Act of 28 June 2006 identifies reversible disposal in deep geological facilities as the benchmark solution for long-term management of high-level waste (HLW) and for intermediate-level long-lived waste (ILW-LL). The Act tasks ANDRA (national agency for the management of radioactive wastes) with the pursuit of studies and research on the choice of a site and the design of the repository, with a view to examining the licence application in 2015 and, provided that the licence is granted, to make the facility operational by 2025. At the end of 2009, ANDRA submitted to the Government its proposals regarding the site and the design of the Industrial Centre for Geological Disposal, known as CIGEO. With the definition of a possible area for the construction of underground disposal facilities, one of the key stages in the project has been achieved. The choice of a surface site will be validated following the public consultation scheduled for the end of 2012. The project is now on the point of entering the definition stage (preliminary design). CIGEO will be a nuclear facility unlike any other. It will be built and operated for a period of over 100 years. For it to be successful, the project must meet certain requirements related to its integration in the local area, industrial planning, safety and reversibility, while also controlling costs. Reversibility is a very important concept that will be defined by law. It is ANDRA's responsibility to ensure that a reasonable balance is found between these different concerns. (author)

  15. Funding source and conflict of interest disclosures by authors and editors in gastroenterology specialty journals revisited.

    Science.gov (United States)

    Qureshi, J; Sud, A; Vakil, N

    2012-03-01

    A survey of journals published in the field of Gastroenterology conducted 5 years ago showed marked variability in reporting of conflicts of interest or funding sources in these journals. To re-examine reporting of conflicts of interest and funding sources for original articles and editorials in Gastroenterology and Hepatology journals. We evaluated all original articles and editorials in 15 leading journals (determined by impact factor-Thomson Reuter Science Citation Index) devoted to Gastroenterology and Hepatology for disclosures of conflicts and for editor's self disclosures. We examined each journal's editorial policy by contacting the journal directly if the information was not revealed on the Web site or print versions of the journal. Of the 1574 articles evaluated, a total of 1207 (77%) reported the presence or absence of a potential conflict of interest and 1047 (67%) reported the presence or absence of funding sources. A total of 3 of the 15 (20%) journals (American Journal of Gastroenterology, Gastroenterology, and Alimentary Pharmacology and Therapeutics reported the presence or absence of funding sources in all their published original articles. Only 5 of 15 (33%) journals (Gut, Gastrointestinal Endoscopy, American Journal of Gastroenterology, Neurogastroenterology & Motility and Alimentary Pharmacology and Therapeutics) publicly disclosed the conflicts of interest of the editors. (i) Funding sources and conflicts of interest are still reported variably in the GI literature. (ii) Editorials and review articles are influential, but have poor reporting of conflicts of interest. (iii) Editors of many journals still do not report their conflicts of interest. © 2012 Blackwell Publishing Ltd.

  16. Quality of colonoscopy performance among gastroenterology and surgical trainees: a need for common training standards for all trainees?

    Science.gov (United States)

    Leyden, J E; Doherty, G A; Hanley, A; McNamara, D A; Shields, C; Leader, M; Murray, F E; Patchett, S E; Harewood, G C

    2011-11-01

    Cecal intubation and polyp detection rates are objective measures of colonoscopy performance. Minimum cecal intubation rates greater than 90% have been endorsed by the American Society for Gastrointestinal Endoscopy (ASGE) and the Joint Advisory Group (JAG) UK. Performance data for medical and surgical trainee endoscopists are limited, and we used endoscopy quality parameters to compare these two groups. Retrospective review of all single-endoscopist colonoscopies done by gastroenterology and surgical trainees ("registrars," equivalent to fellows, postgraduate year 5) with more than two years' endoscopy experience, in 2006 and 2007 at a single academic medical center. Completion rates and polyp detection rates for endoscopists performing more than 50 colonoscopies during the study period were audited. Colonoscopy withdrawal time was prospectively observed in a representative subset of 140 patients. Among 3079 audited single-endoscopist colonoscopies, seven gastroenterology trainees performed 1998 procedures and six surgery trainees performed 1081. The crude completion rate was 82%, 84% for gastroenterology trainees and 78% for surgery trainees (P gastroenterology trainees, and 84% for surgical trainees (P gastroenterology and surgical trainees, respectively (P gastroenterology trainees 14% and surgical trainees 9% (P = 0.0065). In the prospectively audited procedures, median withdrawal time was greater in the gastroenterology trainee group and polyp detection rates correlated closely with withdrawal time (r = 0.99). The observed disparity in endoscopic performance between surgical and gastroenterology trainees suggests the need for a combined or unitary approach to endoscopy training for specialist medical and surgical trainees. © Georg Thieme Verlag KG Stuttgart · New York.

  17. 78 FR 41937 - Joint Meeting of the Gastroenterology-Urology Panel and the Radiological Devices Panel of the...

    Science.gov (United States)

    2013-07-12

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0816] Joint Meeting of the Gastroenterology-Urology Panel and the Radiological Devices Panel of the Medical...: Gastroenterology-Urology Panel and Radiological Devices Panel of the Medical Devices Advisory Committee. General...

  18. Management consensus guideline for hepatocellular carcinoma: 2016 updated by the Taiwan Liver Cancer Association and the Gastroenterological Society of Taiwan

    Directory of Open Access Journals (Sweden)

    Sheng-Nan Lu

    2018-05-01

    Full Text Available Background: Hepatocellular carcinoma (HCC is one of the leading causes of cancer-related mortality in Taiwan. To help clinical physicians to manage patients with HCC, the Taiwan Liver Cancer Association and the Gastroenterological Society of Taiwan produced the management consensus guideline for HCC. Methods: The recommendations focus on nine important issues on management of HCC, including surveillance, diagnosis, staging, surgery, local ablation, transarterial chemoembolization/transarterial radioembolization/hepatic arterial infusion chemotherapy, systemic therapy, radiotherapy, and prevention. Results: The consensus statements were discussed, debated and got consensus in each expert team. And then the statements were sent to all of the experts for further discussion and refinement. Finally, all of the experts were invited to vote for the statements, including the level of evidence and recommendation. Conclusion: With the development of the management consensus guideline, HCC patients could benefit from the optimal therapeutic modality. Keywords: Diagnosis, Hepatocellular carcinoma, Staging, Surveillance, Treatment

  19. Level of information about gynaecological prevention in teenagers at risk from social exclusion, referred by family court rulings to juvenile attendance centres – a pilot study

    Directory of Open Access Journals (Sweden)

    Marcin Bobiński

    2015-09-01

    Full Text Available Introduction and objective. The objective of the study was to present preliminary results of a pilot study concerning the level of knowledge of gynaecological prevention, conducted in teenagers referred by court rulings to a juvenile attendance centre. Materials and method. The instrument was an anonymous survey questionnaire completed by participants in health prevention classes in late 2010 and early 2011. The studied group consisted of teenagers aged 15–17 years (mean age: 15.72 years, median = 16 years, SD = 0.679 who were under probation officers’ supervision in the Zamość region of south-eastern Poland. The sample size was 101 persons – 51 boys (50.50%, 50 girls (49.5%. Results. According to the respondents, the most important reasons for seeing a gynaecologist were: menstrual disorders (70.30%, suspicion of pregnancy (63.37% and pain or burning sensations while urinating (58.42%. The following were regarded as prevalent cancers in women: cancers of the breast (99.01%, cervix (89.1%, and ovaries (62.38%. Over 92% of subjects stated that it was possible to protect oneself from cervical cancer, but only 41.5% of respondents indicated the correct definition of the term ‘cytology’. Statistical analysis focused on differences between genders. A higher self-assessment of mental health was shown in boys. Conclusions. Teenagers of similar background may find it more difficult to gain access to knowledge about health prophylaxis, including gynaecological prevention. Efforts should be intensified in order to ‘equalize health opportunities’ through appropriate preparation of teaching curricula (including health education and philosophy of medicine.

  20. Prospective Controlled Assessment of Impact of Feedback on Gastroenterology Trainees in Outpatient Practice.

    LENUS (Irish Health Repository)

    Harewood, Gavin C

    2011-03-29

    BACKGROUND AND AIMS: Previous studies have demonstrated the value of systematic feedback in enhancing endoscopic procedure performance. It remains unknown whether feedback may play a role in modifying physician performance in outpatient practice. This study aimed to assess the impact of systematic feedback on duration of office visits of gastroenterology (GI) trainees in outpatient practice. METHODS: Patients attending a GI outpatient department in an academic medical center were prospectively followed over 4 months. The duration of office visits for consecutive patients seen by five GI fellows of similar experience level were recorded for 2 months (pre-feedback); confidential feedback was then provided to each fellow on a weekly basis for 2 months detailing their individual consultation times and the comparative, anonymous times of the other fellows (post-feedback). RESULTS: Over the course of the study, 1,647 outpatients were seen by five GI fellows. Pre-feedback consultation durations differed significantly with one fellow taking 2.5 times longer than their colleague. Following feedback, times shortened significantly for all fellows, with the greatest impact observed in those trainees taking longer at baseline. There were no significant differences in satisfaction levels among patients seen by each trainee. CONCLUSIONS: There was a wide disparity in the consultation times among GI fellows. Systematic feedback shortened times among all trainees and enhanced uniformity by having the greatest impact among those fellows taking longer at baseline. Routine provision of feedback may be valuable in enhancing uniformity of outpatient practice although clinicians should ensure that shortening consultation visits does not compromise quality of patient care. Future larger studies of feedback in this setting will be enhanced by incorporating objective measures of quality of care and patient satisfaction.

  1. Prospective controlled assessment of impact of feedback on gastroenterology trainees in outpatient practice.

    LENUS (Irish Health Repository)

    Harewood, Gavin C

    2012-02-01

    BACKGROUND AND AIMS: Previous studies have demonstrated the value of systematic feedback in enhancing endoscopic procedure performance. It remains unknown whether feedback may play a role in modifying physician performance in outpatient practice. This study aimed to assess the impact of systematic feedback on duration of office visits of gastroenterology (GI) trainees in outpatient practice. METHODS: Patients attending a GI outpatient department in an academic medical center were prospectively followed over 4 months. The duration of office visits for consecutive patients seen by five GI fellows of similar experience level were recorded for 2 months (pre-feedback); confidential feedback was then provided to each fellow on a weekly basis for 2 months detailing their individual consultation times and the comparative, anonymous times of the other fellows (post-feedback). RESULTS: Over the course of the study, 1,647 outpatients were seen by five GI fellows. Pre-feedback consultation durations differed significantly with one fellow taking 2.5 times longer than their colleague. Following feedback, times shortened significantly for all fellows, with the greatest impact observed in those trainees taking longer at baseline. There were no significant differences in satisfaction levels among patients seen by each trainee. CONCLUSIONS: There was a wide disparity in the consultation times among GI fellows. Systematic feedback shortened times among all trainees and enhanced uniformity by having the greatest impact among those fellows taking longer at baseline. Routine provision of feedback may be valuable in enhancing uniformity of outpatient practice although clinicians should ensure that shortening consultation visits does not compromise quality of patient care. Future larger studies of feedback in this setting will be enhanced by incorporating objective measures of quality of care and patient satisfaction.

  2. Resident trainees do not affect patient satisfaction in an outpatient gastroenterology clinic: a prospective study conducted in a Canadian gastroenterology clinic.

    Science.gov (United States)

    Brahmania, Mayur; Young, Madison; Muthiah, Chetty; Ilnyckyj, Alexandra; Duerksen, Donald; Moffatt, Dana C

    2015-10-01

    There is little literature regarding how a gastroenterology trainee affects a patient's interpretation of care during outpatient clinic visits. Improving patient satisfaction is desirable and benefits may include enhanced patient compliance as well as providing trainees with areas for improvement. To evaluate patient satisfaction in an outpatient gastroenterology clinic when seen by a trainee and attending physician versus an attending physician alone. The secondary objective was to evaluate physician characteristics that play a role in creating a positive clinical experience. A randomized prospective survey study was conducted over an 11-month period (July 2012 to June 2013) at St Boniface Hospital (Winnipeg, Manitoba). Two gastroenterology fellows (postgraduate year 4 and 5) and nine internal medicine residents (postgraduate year 1 to 3) comprised the 'trainee' role, while three academic clinicians comprised the 'attending' role. Patients included individuals seen for an initial consultation and were >18 years of age. A total of 211 patients comprised the final study group, with 118 in the attending group and 93 in the trainee group. In univariate analysis, patients more often had a very good experience when seen by an attending physician alone versus a trainee and attending physician (73% versus 56%; P=0.016); however, on multivariate analysis, there was no significant difference in patient satisfaction (OR 0.89; P=0.931). Physician factors found to be associated with high patient satisfaction on multivariate analysis included: addressing all patient concerns (OR 27.56; P=0.021); giving the patient a preliminary diagnosis (OR 78.02; P=0.006); and feeling the physician was thorough (OR 72.53; P=0.029). The present study did not reveal a difference in patient satisfaction if a patient sees an attending physician alone or with a trainee. Moreover, to improve patient satisfaction in a gastroenterology clinic, physicians should address all patient concerns, provide a

  3. Nutrition education for pediatric gastroenterology, hepatology, and nutrition fellows: Survey of NASPGHAN fellowship training programs

    Science.gov (United States)

    The aim of the study was to assess the methodology and content of nutrition education during gastroenterology fellowship training and the variability among the different programs. A survey questionnaire was completed by 43 fellowship training directors of 62 active programs affiliated to the North A...

  4. Representativeness and response rates from the Domestic/International Gastroenterology Surveillance Study (DIGEST)

    NARCIS (Netherlands)

    Tijssen, J. G.

    1999-01-01

    BACKGROUND: The Domestic/international Gastroenterology Surveillance Study (DIGEST) examined the prevalence of upper gastrointestinal symptoms among the general population in 10 countries, and the impact of these symptoms on healthcare usage and quality of life. This report discusses the validation

  5. Indications, results, and clinical impact of endoscopic ultrasound (EUS)-guided sampling in gastroenterology

    DEFF Research Database (Denmark)

    Dumonceau, J-M; Polkowski, M; Larghi, A

    2011-01-01

    This article is part of a combined publication that expresses the current view of the European Society of Gastrointestinal Endoscopy (ESGE) about endoscopic ultrasound (EUS)-guided sampling in gastroenterology, including EUS-guided fine needle aspiration (EUS-FNA) and EUS-guided trucut biopsy (EU...

  6. Introducing the PET Centre Prague

    International Nuclear Information System (INIS)

    Belohlavek, O.

    2001-01-01

    The PET Centre Prague (www.homolka.cz/nm) was established in 1999 as the outcome of a joint project of the public Na Homolce Hospital and the Nuclear Research Institute Rez, plc, the Czech radiopharmaceutical producer. Technical and financial assistance was provided by the International Atomic Energy Agency, which perceived the Centre as its model project that could serve as a guide for the development of PET centres in countries sharing a comparable level of development with the Czech Republic. The article maps the history of the project, its design, workplace lay-out and equipment, radiation protection arrangements and spectrum of the first approx. 3000 investigations. (author)

  7. An example of a complete treatment cycle for low- and medium-level waste at the nuclear research centre at Pupspitek-Serpong (Indonesia)

    International Nuclear Information System (INIS)

    Eymeri, M.J.; Gauthey, J.C.

    1993-01-01

    Nuclear power installations and nuclear research laboratories produce large quantities of liquid and solid waste in Indonesia. By controlling the entire waste treatment process from production to storage, TECHNICATOME has been able to set up for BATAN (BADAN TENEGA ATOM NASIONAL) the Indonesian nuclear research centre, a radioactive waste treatment plant on the PUPSPITEK site

  8. Quality of meta-analyses in major leading gastroenterology and hepatology journals: A systematic review.

    Science.gov (United States)

    Liu, Pengfei; Qiu, Yuanyu; Qian, Yuting; Chen, Xiao; Wang, Yiran; Cui, Jin; Zhai, Xiao

    2017-01-01

    To appraise the current reporting methodological quality of meta-analyses in five leading gastroenterology and hepatology journals, and to identify the variables associated with the reporting quality. We systematically searched the literature of meta-analyses in Gastroenterology, Gut, Hepatology, Journal of Hepatology (J HEPATOL) and American Journal of Gastroenterology (AM J GASTROENTEROL) from 2006 to 2008 and from 2012 to 2014. Characteristics were extracted based on the PRISMA statement and the AMSTAR tool. Country, number of patients, funding source were also revealed and descriptively reported. A total of 127 meta-analyses were enrolled in this study and were compared among journals, study years, and other characters. Compliances with the PRISMA statement and the AMSTAR checklist were 20.8 ± 4.2 out of a maximum of 27 and 7.6 ± 2.4 out of a maximum of 11, respectively. Some domains were poorly reported including describing a protocol and/or registration (item 5, 0.0%), describing methods, and giving results of additional analyses (item 16, 45.7% and item 23, 48.0%) for PRISMA and duplicating study selection and data extraction (item 2, 53.5%), and providing a list of included and excluded studies (item 5, 14.2%) for AMSTAR. Publication in recent years showed a significantly better methodological quality than those published in previous years. This study shows that methodological reporting quality of MAs in the major gastroenterology and hepatology journals has improved in recent years after the publication of the developed PRISMA statement, and it can be further improved. © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  9. [Gastroenterology in the new century in Venezuela. A first five years situational diagnosis].

    Science.gov (United States)

    Lizarzábal de Belloso, Maribel

    2007-09-01

    Once the elaboration of CIE-10 Gastroenterology we used two indicators (Health and Management) as quantifiable measurements that reflect the critical success factors in the specialty. HEALTH INDICATORS: 13,21% of main medical complains in primary care concern to Gastroenterology. Four of them rank among the first 25 ("Diarrhea", "Abdominal pain", "Helmintiasis" and "Other Esophagus, Stomach and Bowel diseases"). At the specialty care, Acid-peptic disease ranked as the first main complain according with 56-73.3% of the gastroenterologist consulted (Public and Private care) followed by Gastrointestinal reflux, Irritable bowel, Constipation, Lithiasis, Diverticular disease, Hemorrhages, Jaundice, Cirrhosis, Amibiasis, Pancreatitis, Colon cancer, Polyps, Hepatitis and Colopathy. 11,4% of the total deaths among Venezuelans are by gastrointestinal causes and five of them count among the first 25, with wide regional variability. Trujillo reports major mortality by liver disease (3%) followed by Vargas, District Federal, Tachira (2.8%). Cirrhosis and Fibrosis are more frequent in Táchira (2.3%) Trujillo, Vargas (2,1%) Some regions report mainly infections and diarrheas. Major cancer mortality is in Táchira (6,73% of deaths in the State) followed by Merida and Trujillo. MANAGEMENT INDICATORS: Services Demand. 2,86 consult/habitant/year in internal medicine and 0.77 en specialties. Services Offer. 793 Gastroenterologists (3.4/10.000 habitants). 44.5% concentrated in D.Federal, followed by Táchira (3.9%) Carabobo, Zulia y Mérida. Human Resources Formation. 16 Post-graduated Programs graduate 70 gastroenterologists annually. The Gastroenterology Education Agreement 2006 unified the Venezuelan Gastroenterologist profile and the graduation requirements. The Venezuelan Gastroenterology Society, age 60, has extraordinary national and international projection through its scientific publication (GEN Magazine). This analysis of the present of Gastroenterology in Venezuela allows

  10. Comparison of risk factors for hepatitis b and c in patients visiting a gastroenterology clinic

    International Nuclear Information System (INIS)

    Shazi, L.; Abbas, Z.

    2006-01-01

    Objective: To find out and compare the risk factors for hepatitis Band C infections in patients visiting a gastroenterology clinic. Design: A case-control study. Place and Duration of Study: The Liver Stomach Clinic, Karachi, from July 2004 to September 2004. Patients and Methods: Patients of hepatitis Band C visiting the clinic were interviewed and data were noted on a prescribed form. Patients with dyspeptic symptoms who were negative for both hepatitis Band C were taken as controls. Statistical analysis was done using SPSS package. Results: Total numbers of patients interviewed were 148; 63 with hepatitis C, 41 with hepatitis B and 44 in the control group. These patients hailed from various parts of Pakistan with diverse ethnicity. Comparing hepatitis C with the control group, important risk factors identified were lower level of education, the occupational exposure to the blood and syringes, history of blood transfusions, taking therapeutic injections and intravenous drips, and habit of getting shaved by barbers. Patients of hepatitis B were younger as compared to the control group. Their knowledge about spread of infection was poor. These patients had not received hepatitis B vaccine during childhood. Less number of risk factors could be identified in this group, Shaving from the barber's shop was also found to be a risk factor just like in hepatitis C. Conclusion: There is a need to educate general population about the possible risk factors associated with the spread of hepatitis C and B. Proper screening of blood products and universal precautions against the spread of infections are recommended. Treatment by in drips and getting shaved by barbers should be discouraged. Vaccination against hepatitis B is recommended. (author)

  11. Crawling at High Speeds: Steady Level Locomotion in the Spider Cupiennius salei-Global Kinematics and Implications for Centre of Mass Dynamics.

    Directory of Open Access Journals (Sweden)

    Tom Weihmann

    Full Text Available Spiders are an old yet very successful predatory group of arthropods. Their locomotor system differs from those of most other arthropods by the lack of extensor muscles in two major leg joints. Though specific functional characteristics can be expected regarding the locomotion dynamics of spiders, this aspect of movement physiology has been only scarcely examined so far. This study presents extensive analyses of a large dataset concerning global kinematics and the implications for dynamics of adult female specimens of the large Central American spider Cupiennius salei (Keyserling. The experiments covered the entire speed-range of straight runs at constant speeds. The analyses revealed specific characteristics of velocity dependent changes in the movements of the individual legs, as well as in the translational and rotational degrees of freedom of both the centre of mass and the body. In contrast to many other fast moving arthropods, C. salei avoid vertical fluctuations of their centre of mass during fast locomotion. Accordingly, aerial phases were not observed here. This behaviour is most likely a consequence of optimising energy expenditure with regard to the specific requirements of spiders' leg anatomy. A strong synchronisation of two alternating sets of legs appears to play only a minor role in the locomotion of large spiders. Reduced frequency and low centre of mass amplitudes as well as low angular changes of the body axes, in turn, seems to be the result of relatively low leg coordination.

  12. United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis (HaPanEU)

    NARCIS (Netherlands)

    Löhr, J. Matthias; Dominguez-Munoz, Enrique; Rosendahl, Jonas; Besselink, Marc; Mayerle, Julia; Lerch, Markus M.; Haas, Stephan; Akisik, Fatih; Kartalis, Nikolaos; Iglesias-Garcia, Julio; Keller, Jutta; Boermeester, Marja; Werner, Jens; Dumonceau, Jean-Marc; Fockens, Paul; Drewes, Asbjorn; Ceyhan, Gürlap; Lindkvist, Björn; Drenth, Joost; Ewald, Nils; Hardt, Philip; de Madaria, Enrique; Witt, Heiko; Schneider, Alexander; Manfredi, Riccardo; Brøndum, Frøkjer J.; Rudolf, Sasa; Bollen, Thomas; Bruno, Marco

    2017-01-01

    Background:There have been substantial improvements in the management of chronic pancreatitis, leading to the publication of several national guidelines during recent years. In collaboration with United European Gastroenterology, the working group on Harmonizing diagnosis and treatment of chronic

  13. United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis (HaPanEU)

    NARCIS (Netherlands)

    Lohr, J.M.; Dominguez-Munoz, E.; Rosendahl, J.; Besselink, M.; Mayerle, J.; Lerch, M.M.; Haas, S.; Akisik, F.; Kartalis, N.; Iglesias-Garcia, J.; Keller, J.; Boermeester, M.; Werner, J.; Dumonceau, J.M.; Fockens, P.; Drewes, A.; Ceyhan, G.; Lindkvist, B.; Drenth, J.P.; Ewald, N.; Hardt, P.; Madaria, E. de; Witt, H.; Schneider, A.; Manfredi, R.; Brondum, F.J.; Rudolf, S.; Bollen, T.; Bruno, M.

    2017-01-01

    BACKGROUND: There have been substantial improvements in the management of chronic pancreatitis, leading to the publication of several national guidelines during recent years. In collaboration with United European Gastroenterology, the working group on 'Harmonizing diagnosis and treatment of chronic

  14. Commonly Used Preparations for Colonoscopy: Efficacy, Tolerability and Safety – A Canadian Association of Gastroenterology Position Paper

    Directory of Open Access Journals (Sweden)

    Alan Barkun

    2006-01-01

    Full Text Available INTRODUCTION: The increased demand for colonoscopy, coupled with the introduction of new bowel cleansing preparations and recent caution advisories in Canada, has prompted a review of bowel preparations by the Canadian Association of Gastroenterology.

  15. The past 10 years of gastroenterology and hepatology-reflections and predictions.

    Science.gov (United States)

    Friedman, Scott L; Quigley, Eamonn M M; Sharkey, Keith A; Sung, Joseph J Y; Whitcomb, David C

    2014-11-01

    In November 2004, the very first issue of this journal featured articles on the pathogenesis of ulcerative colitis, mechanisms leading to chronic pancreatitis, and treatment of recurrent Clostridium-difficile-associated diarrhoea. Although those topics might seem familiar, much has changed in the intervening years in our understanding, diagnosis and treatment of many different diseases across the field of gastroenterology and hepatology. Nonetheless, many challenges remain. Here, we have asked five of our Advisory Board members-international experts across different subspecialties in gastroenterology and hepatology-to reflect on the progress and frustrations of the past 10 years. They also comment on where effort and money should be invested now, as well as their predictions for progress in the next 10 years.

  16. Telephone reminders reduced the non-attendance rate in a gastroenterology outpatient clinic

    DEFF Research Database (Denmark)

    Jeppesen, Maja Haunstrup; Ainsworth, Mark Andrew

    2015-01-01

    in a gastroenterology outpatient clinic like ours. METHODS: This was a comparative intervention study with a historical control group in a gastroenterology outpatient clinic. The study lasted six months. Patients with a scheduled appointment in the first three-month period received no reminder (control group, n = 2......,705). Patients in the following three-month period were reminded by telephone one weekday in advance of their appointment, when possible (intervention group, n = 2,479). Non-attending patients in the intervention group received a questionnaire. Based on the results, a financial cost-benefit analysis was made......-attendees. The most common explanation for non-attendance in the intervention group was forgetfulness (39%). The reminder telephone call was cost-effective. CONCLUSION: In this outpatient clinic, telephone reminders were cost-effective and significantly reduced the non-attendance rate by 43%....

  17. Ordinary tales from endoscopic odysseys: fiction, ethics, and the gastroenterological journey.

    Science.gov (United States)

    Meulenberg, Frans; de Beaufort, Inez D

    2014-04-01

    Fiction (i.e. novels, short stories, and movies) provides an opportunity for imaginative moral reflection and can serve as a basis for moral argument. Narratives play a role in moral reasoning because they are exemplars as well as tests. Those who care for sick people, should be interested in patient's and literary stories. Exploring the representation of gastroenterological ailments in fiction gives insight in the experience of undergoing colonoscopy, farting, pain, the borders of intimacy, hygiene and the lack of it, taboos and the doctor-patient-relationship. Included authors are, among others: Michel Faber, Alan Bennett, Charles Bukowski, Charlotte Roche and James Joyce. Several movies are discussed as well. Though in general gastroenterological problems don't seem often at foreground in fiction, in some cases they are represented in a more symbolic way, and touch upon some fundamental aspects of the human condition. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Graduate medical education in humanism and professionalism: a needs assessment survey of pediatric gastroenterology fellows.

    Science.gov (United States)

    Garvey, Katharine C; Kesselheim, Jennifer C; Herrick, Daniel B; Woolf, Alan D; Leichtner, Alan M

    2014-01-01

    The deterioration of humanism and professionalism during graduate medical training is an acknowledged concern, and programs are required to provide professionalism education for pediatric fellows. We conducted a needs assessment survey in a national sample of 138 first- and second-year gastroenterology fellows (82% response rate). Most believed that present humanism and professionalism education met their needs, but this education was largely informal (eg, role modeling). Areas for formal education desired by >70% included competing demands of clinical practice versus research, difficult doctor-patient relationships, depression/burnout, angry parents, medical errors, work-life balance, and the patient illness experience. These results may guide curricula to formalize humanism and professionalism education in pediatric gastroenterology fellowships.

  19. Efficacy of the Treatment for Anxiety-Depressive Disorders in Patients with Gastroenterological Diseases

    Directory of Open Access Journals (Sweden)

    S.V. Kosynska

    2015-02-01

    Full Text Available The article deals with problem of the treatment of anxiety-depressive disorders in patients with gastroenterological disease and persistent symptoms of abdominal pain and dyspepsia. For objectification of psychoemotional disorders and choice of their correction, we have applied HADS scale. We have detected a high incidence of anxiety — in 93.75 % of such patients, depression — in 81.25 %, their combination — in 78.1 %. Gidazepam efficacy was evaluated in anxiety disorders and escitalopram one — in depressive disorders. It is shown that the use of psychocorrection enables to reverse gastroenterological symptoms: abdominal pain has completely gone in 71.9 % of patients, dyspeptic complaints — in 86.9 %, as well as to reduce anxiety-depressive symptoms.

  20. Development of gastroenterology and hepatology in Iran: Part II- advances in research and therapeutic modalities.

    Science.gov (United States)

    Saberifiroozi, Mehdi; Mir-Madjlessi, Seid-Hossein

    2009-09-01

    Following the establishment of Gastroenterology and Hepatology Fellowship Programs in 1987, significant developments in research and health care delivery have been achieved. The number of published articles has increased significantly and now more than 10 approved research centers are involved in several longitudinal and population based studies in GI epidemiology, viral hepatitis and GI oncology around the country. Before 1987 less than 50 gastroenterologists were working in the country, but now more than 300 gastroenterologists are involved in public and private health care delivery systems. Advanced diagnostic and therapeutic endoscopic procedures and complex surgical procedures such as liver transplantation are a routine now. These achievements are indicative of hard work and determination of dedicated physicians after the Islamic Revolution, and the support of governmental and non-governmental sectors. The future prospect of development in the discipline of gastroenterology and hepatology in Iran seems to be very encouraging.

  1. Advances in gastroenterology--opportunities and challenges for the dental practitioner.

    Science.gov (United States)

    Nolan, Anita

    2012-04-01

    As the oral cavity marks the beginning of the gastrointestinal tract (GIT), it is not surprising that it frequently mirrors disease that occurs lower in the GIT. Increasingly, clinical signs in the oral cavity are recognized as future predictors and prognostic indicators of GIT and, indeed, other systemic disease. This paper discusses recent advances in the overlap area of Oral Medicine and Gastroenterology and the significant role of the dental practitioner in the management of these patients.

  2. Utilization and efficacy of internet-based eHealth technology in gastroenterology: a systematic review.

    Science.gov (United States)

    Knowles, Simon R; Mikocka-Walus, Antonina

    2014-04-01

    While there have been several reviews exploring the outcomes of various eHealth studies, none have been gastroenterology-specific. This paper aims to evaluate the research conducted within gastroenterology which utilizes internet-based eHealth technology to promote physical and psychological well-being. A systematic literature review of internet-based eHealth interventions involving gastroenterological cohorts was conducted. Searched databases included: EbSCOhost Medline, CINAHL, and PsycINFO. Inclusion criteria were studies reporting on eHealth interventions (both to manage mental health problems and somatic symptoms) in gastroenterology, with no time restrictions. Exclusion criteria were non-experimental studies, or studies using only email as primary eHealth method, and studies in language other than English. A total of 17 papers were identified; seven studies evaluated the efficacy of a psychologically oriented intervention (additional two provided follow-up analyses exploring the original published data) and eight studies evaluated disease management programs for patients with either irritable bowel syndrome, inflammatory bowel disease (IBD) or celiac disease. Overall, psychological eHealth interventions were associated with significant reductions in bowel symptoms and improvement in quality of life (QoL) that tended to continue up to 12 months follow up. The eHealth disease management was shown to generally improve QoL, adherence, knowledge about the disease, and reduce healthcare costs in IBD, although the studies were associated with various methodological problems, and thus, this observation should be confirmed in well-designed interventional studies. Based on the evidence to date, eHealth internet-based technology is a promising tool that can be utilized to both promote and enhance gastrointestinal disease management and mental health.

  3. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease

    DEFF Research Database (Denmark)

    Husby, S; Koletzko, S; Korponay-Szabó, I R

    2012-01-01

    Diagnostic criteria for coeliac disease (CD) from the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) were published in 1990. Since then, the autoantigen in CD, tissue transglutaminase, has been identified; the perception of CD has changed from that of a rather...... uncommon enteropathy to a common multiorgan disease strongly dependent on the haplotypes human leukocyte antigen (HLA)-DQ2 and HLA-DQ8; and CD-specific antibody tests have improved....

  4. World Gastroenterology Organization Practice Guidelines for the diagnosis and management of IBD in 2010

    DEFF Research Database (Denmark)

    Bernstein, Charles N; Fried, Michael; Krabshuis, J H

    2010-01-01

    have, in the past, been most evident in the developed world, their prevalence in the developing world has been gradually increasing in recent decades. This poses unique issues in diagnosis and management which have been scarcely addressed in the literature or in extant guidelines. Depending...... resources. The World Gastroenterology Organization has, accordingly, developed guidelines for diagnosing and treating IBD using a cascade approach to account for variability in resources in countries around the world....

  5. Methodology and application of 13C breath test in gastroenterology practice

    International Nuclear Information System (INIS)

    Yan Weili; Jiang Yibin

    2002-01-01

    13 C breath test has been widely used in research of nutrition, pharmacology and gastroenterology for its properties such as safety, non-invasion and so on. The author describes the principle, methodology of 13 C breath test and its application in detection to Helico-bacteria pylori infection in stomach and small bowl bacterial overgrowth, measurement of gastric emptying, pancreatic exocrine function and liver function with various substrates

  6. Training centres - organization and management

    International Nuclear Information System (INIS)

    Kovar, P.

    1986-01-01

    In the lecture 'Training centres - organization and management' some principles and requirements which influence the organization, management and activity pattern of nuclear training centres, are briefly introduced. It is demonstrated, step by step, how these general principles are implemented in the development of the Czechoslovak nuclear power programme, it means, how the training of the NPP personnel proceeds in Czechoslovak nuclear training centres. General principles which are selected: a connection between the capacity of the training centre and the scope and needs of the nuclear power programme, a position of the training center within the institutional set-up, a structure and organization of the training system which complies with the system of NPP construction, reflect the pattern and the activity of the nuclear training centre and nuclear power technical level, a research group of workers in the nuclear training centre, main tasks and technical facilities, management of the training process and a transfer of knowledge and research results into the training process. The lecture is supplemented by pictures and slides. (orig.)

  7. RTEMS Centre - Support and Maintenance Centre to RTEMS Operating System

    Science.gov (United States)

    Silva, H.; Constantino, A.; Freitas, D.; Coutinho, M.; Faustino, S.; Mota, M.; Colaço, P.; Sousa, J.; Dias, L.; Damjanovic, B.; Zulianello, M.; Rufino, J.

    2009-05-01

    RTEMS CENTRE - Support and Maintenance Centre to RTEMS Operating System is a joint ESA/Portuguese Task Force initiative to develop a support and maintenance centre to the Real-Time Executive for Multiprocessor Systems (RTEMS). This paper gives a high level visibility of the progress, the results obtained and the future work in the RTEMS CENTRE [6] and in the RTEMS Improvement [7] projects. RTEMS CENTRE started officially in November 2006, with the RTEMS 4.6.99.2 version. A full analysis of RTEMS operating system was produced. The architecture was analysed in terms of conceptual, organizational and operational concepts. The original objectives [1] of the centre were primarily to create and maintain technical expertise and competences in this RTOS, to develop a website to provide the European Space Community an entry point for obtaining support (http://rtemscentre.edisoft.pt), to design, develop, maintain and integrate some RTEMS support tools (Timeline Tool, Configuration and Management Tools), to maintain flight libraries and Board Support Packages, to develop a strong relationship with the World RTEMS Community and finally to produce some considerations in ARINC-653, DO-178B and ECSS E-40 standards. RTEMS Improvement is the continuation of the RTEMS CENTRE. Currently the RTEMS, version 4.8.0, is being facilitated for a future qualification. In this work, the validation material is being produced following the Galileo Software Standards Development Assurance Level B [5]. RTEMS is being completely tested, errors analysed, dead and deactivated code removed and tests produced to achieve 100% statement and decision coverage of source code [2]. The SW to exploit the LEON Memory Management Unit (MMU) hardware will be also added. A brief description of the expected implementations will be given.

  8. Increasing Complexity of Clinical Research in Gastroenterology: Implications for Training Clinician-Scientists

    Science.gov (United States)

    Scott, Frank I.; McConnell, Ryan A.; Lewis, Matthew E.; Lewis, James D.

    2014-01-01

    Background Significant advances have been made in clinical and epidemiologic research methods over the past 30 years. We sought to demonstrate the impact of these advances on published research in gastroenterology from 1980 to 2010. Methods Three journals (Gastroenterology, Gut, and American Journal of Gastroenterology) were selected for evaluation given their continuous publication during the study period. Twenty original clinical articles were randomly selected from each journal from 1980, 1990, 2000, and 2010. Each article was assessed for topic studied, whether the outcome was clinical or physiologic, study design, sample size, number of authors and centers collaborating, and reporting of statistical methods such as sample size calculations, p-values, confidence intervals, and advanced techniques such as bioinformatics or multivariate modeling. Research support with external funding was also recorded. Results A total of 240 articles were included in the study. From 1980 to 2010, there was a significant increase in analytic studies (pgastroenterology and hepatology over the last three decades. This increase highlights the need for advanced training of clinical investigators to conduct future research. PMID:22475957

  9. European Society for Pediatric Gastroenterology Hepatology and Nutrition's Educational Offer and the Training Syllabus.

    Science.gov (United States)

    Maglione, Marco; Finizio, Daniela; Veres, Gabor; Pop, Tudor L; Continisio, Grazia I; Papadopoulou, Alexandra; Guarino, Alfredo

    2017-11-01

    The basic knowledge necessary for a European pediatric gastroenterologist/hepatologist/nutritionist is set-out in the training syllabus (TS) of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN). We retrospectively compared the topics covered in ESPGHAN's training events between 2013 and 2016 with the basic knowledge TS items. Thirty-six initiatives including e-learning were identified. Twelve (33%) courses focused on gastroenterology, 9 (25%) on hepatology, and 10 (28%) on nutrition. Five (14%) courses covered >1 field and were classified "General." The initiatives covered 12 of 57 (21%) TS items; 31 of 57 items (54%) were partially covered; and 14 of 57 (25%) not covered. Five of 9 e-learning courses covered gastroenterology topics, whereas none covered hepatology topics. ESPGHAN's 3-year educational offer partially met the training needs listed in the TS. A coordinated educational program covering all TS items would harmonize training within Europe and would provide trainees with a professional portfolio for employment purposes.

  10. Management of Helicobacter Pylori in the United States: Results from a national survey of gastroenterology physicians.

    Science.gov (United States)

    Murakami, Traci T; Scranton, Rebecca A; Brown, Heidi E; Harris, Robin B; Chen, Zhao; Musuku, Sunitha; Oren, Eyal

    2017-07-01

    We sought to determine current knowledge and practices among gastroenterology physicians and assess adherence to current guidelines for H. pylori management. Online surveys were distributed in 2014 to practicing gastroenterology physicians for information related to the diagnosis and treatment of H. pylori infection. A total of 582 completed surveys were reviewed. The H. pylori screening test used "almost always" was gastric biopsy obtained during endoscopy (histology) (59%) followed by stool antigen test (20%). Standard triple therapy for 14days was commonly prescribed by 53% of respondents. The stool antigen test was most frequently chosen to confirm H. pylori eradication (51%), although only 58% of physicians checked for eradication in patients who underwent treatment. Adherence to current American College of Gastroenterology guidelines is low. Although more physicians treat patients with a positive H. pylori test, only half ensure eradication after treatment. Improving knowledge of the resistance patterns of H. pylori may be critical to ensure successful eradication. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. A Longitudinal Study of Adenoma Detection Rate in Gastroenterology Fellowship Training.

    Science.gov (United States)

    Gianotti, Robert J; Oza, Sveta Shah; Tapper, Elliot B; Kothari, Darshan; Sheth, Sunil G

    2016-10-01

    Current guidelines suggest that a gastroenterology fellow in training needs to perform 140 colonoscopies to achieve competency. Data are limited regarding adenoma detection rate (ADR) in fellowship. To assess how fellow ADR correlates with number of colonoscopies performed. We performed a retrospective study examining consecutive colonoscopies performed by gastroenterology fellows. Fellow ADR before and after the 140 procedure benchmark was compared to colonoscopies performed by attending only with whom these fellows trained. A threshold for ideal procedure count was performed using ROC analysis. We analyzed 2021 average-risk colonoscopies performed by 10 gastroenterology fellows under the supervision of an attending physician. When fellows had performed 140 colonoscopies under attending supervision (p = 0.02). The ADR of fellows who had performed >140 colonoscopies under attending supervision was greater than that of attending-only colonoscopies (36 vs. 25 %, p 325 (male patients) and 539 (female patients) colonoscopies was determined to be ideal for achieving adequate ADR based on ROC analysis. Our data suggest that ADR increases after fellows perform >140 colonoscopies under attending supervision, and thereafter surpasses the ADR of attending-only colonoscopies. Some of the differences may be driven by detection of small adenomas. The findings of this study suggest that a higher threshold for number of colonoscopies performed under attending supervision may be needed to achieve adequate ADR during fellowship prior to independent practice.

  12. Undernutrition, risk of malnutrition and obesity in gastroenterological patients: A multicenter study

    Institute of Scientific and Technical Information of China (English)

    Massimiliano Rizzi; Silvia Mazzuoli; Nunzia Regano; Rosa Inguaggiato; Margherita Bianco; Gioacchino Leandro; Elisabetta Bugianesi; Donatella Noè; Nicoletta Orzes; Paolo Pallini; Maria Letizia Petroni; Gianni Testino; Francesco William Guglielmi

    2016-01-01

    AIM: To investigate the prevalence of undernutrition, risk of malnutrition and obesity in the Italian gastroenterological population. METHODS: The Italian Hospital Gastroenterology Association conducted an observational, cross-sectional multicenter study. Weight, weight loss, and body mass index were evaluated. Undernutrition was defined as unintentional weight loss > 10% in the last threesix months. Values of Malnutrition Universal Screening Tool(MUST) > 2, NRS-2002 > 3, and Mini Nutritional Assessment(MNA) from 17 to 25 identified risk of malnutrition in outpatients, inpatients and elderly patients, respectively. A body mass index ≥ 30 indicated obesity. Gastrointestinal pathologies were categorized into acute, chronic and neoplastic diseases. RESULTS: A total of 513 patients participated in the study. The prevalence of undernutrition was 4.6% in outpatients and 19.6% in inpatients. Moreover, undernutrition was present in 4.3% of the gastrointestinal patients with chronic disease, 11.0% of those with acute disease, and 17.6% of those with cancer. The risk of malnutrition increased progressively and significantly in chronic, acute and neoplastic gastrointestinal diseases in inpatients and the elderly population. Logistical regression analysis confirmed that cancer was a risk factor for undernutrition(OR = 2.7; 95%CI: 1.2-6.44, P = 0.02). Obesity and overweight were more frequent in outpatients. CONCLUSION: More than 63% of outpatients and 80% of inpatients in gastroenterological centers suffered from significant changes in body composition and required specific nutritional competence and treatment.

  13. The 1993 Canadian Association of Gastroenterology Strategic Plan: Excellence in Achievement

    Directory of Open Access Journals (Sweden)

    Richard Fedorak

    2003-01-01

    Full Text Available By the summer of 1990, the Canadian Association of Gastroenterology (CAG had been in existence as Canada’s premier gastroenterology society for nearly thirty years. The specialty of gastroenterology was in an exponential growth phase and many changes were on the horizon, including discussions as to whether the CAG should continue to conduct its annual meeting in conjunction with the Royal College meeting. In 1990, the CAG Governing Board and then president Dr Eldon Shaffer initiated a membership needs analysis (with technical assistance provided through the Strategic Planning Group at Searle Canada Inc to provide a foundation for a strategic planning process that was to carry forward over the next several years and ultimately produce the CAG’s first strategic planning document. After substantial review and assessment, the 1991/1992 and 1992/1993 CAG Governing Boards approved the 1993 CAG Strategic Plan. This strategic plan served the organization well over the past decade and has provided the cornerstone upon which the CAG advanced many progressive initiatives.

  14. Comparative analysis of disease activity in patients of chronic hepatitis B virus, with and without super infection with hepatitis D virus; an experience at tertiary care centre

    International Nuclear Information System (INIS)

    Hassan, K.D.; Mahmood, T.; Farooq, M.U.

    2008-01-01

    The hepatitis D virus super-infection contributes significantly to the morbidity and mortality of hepatitis B virus infection. The objectives were to describe the incidence of Hepatitis D virus and comparative analysis of disease activity in patients of chronic hepatitis B virus, with and without super-infection of hepatitis D virus. This Cross-sectional comparative study was conducted at Department of Medicine and Gastroenterology Clinic Jinnah Postgraduate Medical Centre, Karachi, Pakistan from February 2007 to July 2007. HBsAg positive patients who attended our Gastroenterology clinic were selected for the study. After screening for Anti-HDV these patients were segregated in to Anti-HDV positive and negative groups. Data was analyzed on SPSS 12. Eighty-four patients were selected. Seventy-three patients who fulfilled the inclusion criteria were enrolled in to the study. Anti-HDV was positive in 23 (31.5%) patients. Among these 23 anti-HDV positive, HDV-RNA was detected in 15 (75%) patients. The differences of age, gender, marital status and area of residence whether rural or urban were not significant between the two groups. HBV-DNA was significantly suppressed in majority of anti- HDV positive patients (p=0.019). Mean serum ALT levels were significantly higher in patients who had HDV infection (p=0.014). HDV infection was common in this series of patients with a frequency of 31.5%. All patients of chronic HBV should be screened for HDV whether they are asymptomatic HBV carriers or have chronic active hepatitis particularly when they have raised serum ALT. (author)

  15. [Exposure to limited resources in the gastroenterology - results of a survey of hospital physicians].

    Science.gov (United States)

    Kerkemeyer, L; Reifferscheid, A; Pomorin, N; Wasem, J

    2016-11-01

    Background and research question: The hospital sector is currently characterized by a high economic pressure. As well the DRG system as the investment financing by the federal states imply financial limitations. Hospitals react to this situation by trying to reduce costs and to increase case volume. It is questionable whether and to what extent patient care and the working conditions of the physicians are affected by these circumstances. Especially, gastroenterological patients were considered to be insufficiently covered by the DRG system in the past. Therefore, this study focuses on the gastroenterology. Method: Based on prior studies and several semi-structured interviews with gastroenterologists working in hospitals a discipline-specific questionnaire was developed. Three versions of the questionnaire were differentiated to correspond to the respective experiences of the target population (chief physician, senior physician, assistant physician). All in all, 1751 members of the "Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten" (DGVS) were addressed. The questionnaire was answered by 642 participants resulting in a response rate of 36.7 %. The answers were interpreted by using descriptive and multivariate analyses. Results: A significant economic pressure is perceived by the participating gastroenterologists. This pressure manifests itself primary in perceived deficits in nursing care and human attention towards the patients. Moreover, the work satisfaction is negatively affected. Identified difficulties in the personnel recruitment can only be partially attributed to economic reasons. However, rationing of services is relatively seldom. Also, a financially-oriented overprovision is not perceived as a primary concern. In general, assistant physicians were a bit more skeptical about the situation in the gastroenterology, e. g. patient care, than the chief physicians. Conclusions: In total, the situation in the

  16. Human-centred Governance

    DEFF Research Database (Denmark)

    Bason, Christian

    2017-01-01

    Design approaches are now being applied all over the world as a powerful approach to innovating public policies and services. Christian Bason, author of Leading public design: Discovering human-centred governance, argues that by bringing design methods into play, public managers can lead change...... with citizens at the centre, and discover a new model for steering public organisations: human-centred governance....

  17. The Search for Centre

    Science.gov (United States)

    Nunes, April

    2006-01-01

    This paper acknowledges the importance of a dancer's centre but likewise highlights the problematic nature of the communication of this concept from dance teacher to student. After a brief introduction of orthodox approaches in finding centre, this paper suggests a method of locating centre through the ancient somatic technique.

  18. Mochovce waste treatment centre

    International Nuclear Information System (INIS)

    Sedliak, D.; Endrody, J.

    2000-01-01

    The first unit of the Mochovce NPP (WWER 440 MW) was put in a test operation in October 1998. The second unit with the same power output was put in the test operation in March 2000. The Nuclear Regulatory Authority of the Slovak Republic in its Decision No. 318/98 of 28 October 1998, by which an agreement with the operation of the Unit 1 of the Mochovce. Nuclear Power Plant was issued, requires to start the construction of the Liquid Radioactive Waste Treatment Centre until January 2004. The subject of this presentation is a system description of the Liquid Radioactive Waste (LRW) management in the Mochovce NPP. The initial part is dedicated to a short description of the radioactive waste management legislation requirements. Then the presentation continues with an information about the LRW production in the Mochovce NPP, LRW sources, chemical and radiochemical attributes, description of storage. The presentation also provides real values of its production in a comparison with the design data. The LRW production minimization principles are also mentioned there. Another part deals with the basic requirements for the technology proposal of the liquid RW treatment, especially concerning the acceptance criteria at the Republic RW Repository Mochovce. The final part is devoted to a short description of the investment procedure principles - design preparation levels and a proposed construction schedule of the centre. (authors)

  19. Commonly used preparations for colonoscopy: Efficacy, tolerability and safety – A Canadian Association of Gastroenterology position paper

    Science.gov (United States)

    Barkun, Alan; Chiba, Naoki; Enns, Robert; Marcon, Margaret; Natsheh, Susan; Pham, Co; Sadowski, Dan; Vanner, Stephen

    2006-01-01

    INTRODUCTION: The increased demand for colonoscopy, coupled with the introduction of new bowel cleansing preparations and recent caution advisories in Canada, has prompted a review of bowel preparations by the Canadian Association of Gastroenterology. METHODS: The present review was conducted by the Clinical Affairs group of committees including the endoscopy, hepatobiliary/transplant, liaison, pediatrics, practice affairs and regional representation committees, along with the assistance of Canadian experts in the field. An effort was made to systematically assess randomized prospective trials evaluating commonly used bowel cleansing preparations in Canada. RESULTS: Polyethylene glycol (PEG)-; sodium phosphate (NaP)-; magnesium citrate (Mg-citrate)-; and sodium picosulphate, citric acid and magnesium oxide (PSMC)-containing preparations were reviewed. Regimens of PEG 2 L with bisacodyl (10 mg to 20 mg) or Mg-citrate (296 mL) are as effective as standard PEG 4 L regimens, but are better tolerated. NaP preparations appear more effective and better tolerated than standard PEG solutions. PSMC has good efficacy and tolerability but head-to-head trials with NaP solutions remain few, and conclusions equivocal. Adequate hydration during preparation and up to the time of colonoscopy is critical in minimizing side effects and improving bowel cleansing in patients receiving NaP and PSMC preparations. All preparations may cause adverse events, including rare, serious outcomes. NaP should not be used in patients with cardiac or renal dysfunction (PEG solution is preferable in these patients), bowel obstruction or ascites, and caution should be exercised when used in patients with pre-existing electrolyte disturbances, those taking medications that may affect electrolyte levels and elderly or debilitated patients. Health Canada’s recommended NaP dosing for most patients is two 45 mL doses 24 h apart. However, both safety and efficacy data on this dosing schedule are lacking

  20. CMS Centre at CERN

    CERN Multimedia

    2007-01-01

    A new "CMS Centre" is being established on the CERN Meyrin site by the CMS collaboration. It will be a focal point for communications, where physicists will work together on data quality monitoring, detector calibration, offline analysis of physics events, and CMS computing operations. Construction of the CMS Centre begins in the historic Proton Synchrotron (PS) control room. The historic Proton Synchrotron (PS) control room, Opened by Niels Bohr in 1960, will be reused by CMS to built its control centre. TThe LHC@FNAL Centre, in operation at Fermilab in the US, will work very closely with the CMS Centre, as well as the CERN Control Centre. (Photo Fermilab)The historic Proton Synchrotron (PS) control room is about to start a new life. Opened by Niels Bohr in 1960, the room will be reused by CMS to built its control centre. When finished, it will resemble the CERN Contro...

  1. World Health Organization 2006 Child Growth Standards and 2007 Growth Reference Charts: A Discussion Paper by the Committee on Nutrition of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition

    DEFF Research Database (Denmark)

    Turck, Dominique; Michaelsen, Kim F.; Shamir, Raanan

    2013-01-01

    Growth charts are essential for evaluating children’s health including their nutrition; however, the evaluation of child growth trajectories and consequently the decision to intervene are highly dependent on the growth charts used. The aim of this discussion paper of the European Society for Paed......Growth charts are essential for evaluating children’s health including their nutrition; however, the evaluation of child growth trajectories and consequently the decision to intervene are highly dependent on the growth charts used. The aim of this discussion paper of the European Society...... for Paediatric Gastroenterology, Hepatology, and Nutrition Committee on Nutrition is to provide information on the background and rationale of the World Health Organization (WHO) 2006 child growth standards and WHO 2007 growth reference charts, describe their development, outline their main innovative aspects...... between different countries and ethnic groups. WHO 2007 growth reference charts (5–19 years) are based mainly on a re-analysis of National Centre for Health Statistics data from 1977, without information on feeding. European Society for Paediatric Gastroenterology, Hepatology, and Nutrition Committee...

  2. Attitudes and Usage of the Food and Drug Administration Adverse Event Reporting System Among Gastroenterology Nurse Practitioners and Physician Assistants.

    Science.gov (United States)

    Salk, Allison; Ehrenpreis, Eli D

    2016-01-01

    The Food and Drug Administration Adverse Event Reporting System (FAERS) is used for postmarketing pharmacovigilance. Our study sought to assess attitudes and usage of the FAERS among gastroenterology nurse practitioners (NPs) and physician assistants (PAs). A survey was administered at the August 2012 Principles of Gastroenterology for the Nurse Practitioner and Physician Assistant course, held in Chicago, IL. Of the 128 respondents, 123 (96%) reported a specialty in gastroenterology or hepatology and were included in analysis. Eighty-nine participants were NPs and 32 PAs, whereas 2 did not report their profession. Although 119 (98%) agreed or strongly agreed with the statement that accurately reporting adverse drug reactions is an important process to optimize patient safety, the majority of participants (54% NPs and 81% PAs) were unfamiliar with the FAERS. In addition, only 20% of NPs and 9% of PAs reported learning about the FAERS in NP or PA schooling. Our study shows enthusiasm among gastroenterology NPs and PAs for the reporting of adverse drug reactions, coupled with a lack of familiarity with the FAERS. This presents an opportunity for enhanced education about reporting of adverse drug reactions for gastroenterology NPs and PAs.

  3. Gastroenterology training and career choices: a prospective longitudinal study of the impact of gender and of managed care.

    Science.gov (United States)

    Arlow, Freda L; Raymond, Patricia L; Karlstadt, Robyn G; Croitoru, Raquel; Rybicki, Benjamin A; Sastri, Suriya V

    2002-02-01

    We aimed to determine if gender differences exist in the selection and training of female and male gastroenterology fellows. One hundred seventy-six of 218 training program directors returned an 18-question survey about their programs, including leave policies, training, and prevalence of female faculty. Two cohorts of graduating trainees from 1993 and 1995 (N = 393) returned anonymous surveys regarding their training program experiences, demographics, and business training. Female gastroenterology trainees are more likely to choose programs according to parental leave policies (p family reasons" (p family planning because of training program restrictions (20% vs 7%, p gender discrimination (39%) and sexual harassment (19%) during gastroenterology training. Trainees of both sexes had mentorship during training (65% vs 71%, ns); female trainees were more likely to have an opposite sex mentor (71% vs 3.4%) despite an almost 50% prevalence of female full-time and clinical faculty. Female trainees were apt to be less trained in advanced endoscopy (p gender felt adequately prepared for the business aspects of gastroenterology. Alterations in gastroenterology training are needed to attract qualified female applicants. New graduates of both sexes lack practice management education.

  4. Progress in pediatrics in 2011. Choices in endocrinology, gastroenterology, hemato-oncology, infectious diseases, otolaryngology, pharmacotherapy and respiratory tract illnesses

    Directory of Open Access Journals (Sweden)

    Caffarelli Carlo

    2012-06-01

    Full Text Available Abstract Main progresses in endocrinology, gastroenterology, hemato-oncology, infectious diseases, otolaryngology, pharmacotherapy, and respiratory tract illnesses selected from articles published in The Italian Journal of Pediatrics in 2011 were reviewed. Risk factors for gastroenteritis and appendicitis in developing countries may be useful in improving our understanding of these diseases. Childhood hearing impairment is a world-wide problem which continues to have an high prevalence in newborns. Among the mechanisms of diseases, obese children often have asthma and high hepcidin levels that may reduce serum iron concentrations. In cystic fibrosis, 18q distal deletion has been described as a novel mutation. Hypothyroidism in children with central nervous system infections may increase mortality rates. Infrared tympanic thermometer (IRTT in oral mode for the measurement of body temperature may be useful in fever screening in a busy setup. In newborns, the transmission of CMV infection through breast milk may be prevented through freezing or pasteurization. Recent advances in treatment of constipation, urinary tract infections, leukemia, pain in children with cancer, neonates with sepsis or difficult weaning from mechanical ventilation will likely contribute towards optimizing management of these common disorders. The work of the Family Pediatricians Medicines for Children Research Network aims to develop competence, infrastructure, networking and education for pediatric clinical trials.

  5. Bibliometric analysis of the top-cited gastroenterology and hepatology articles

    Science.gov (United States)

    Azer, Samy A; Azer, Sarah

    2016-01-01

    Objective To identify the top-cited articles in gastroenterology and hepatology, and analyse their characteristics. Methods Two searches were conducted in the Science Citation Index Expanded database; a search of 69 journals under the category ‘Gastroenterology and Hepatology’ (list A) and a keyword search of all journals (list B). The search results were analysed and the inter-rater coefficient of agreement between evaluators was measured using Cohen κ. Results The number of citations varied from 1049 to 2959 in list A and from 1929 to 5500 in list B. In both lists, the majority of articles were research papers. No significant correlations were found between the number of citations and the number of years since publication (R2=0.00992, p=0.473 and R2=0.00202, p=0.757, respectively). However, the mean number of citations of papers published before the year 2000 was lower than those published after 2000 (36.70±19.31 vs 106.03±39.22). No correlation was found between number of authors and the number of citations (R2=0.04352, p=0.130), but strong correlations were found between the number of institutes involved or number of countries and the number of citations (R2=0.275, particles were not only published in highly ranked journals specialising in Gastroenterology and Hepatology but also in 14 journals not specialised in this field. The number of citations correlated with the number of institutes and the number of countries involved but not with the number of grants received or the number of authors. Females were under-represented in the authorship. PMID:26857105

  6. Failure to Thrive: A Prospective Study in a Pediatric Gastroenterology Clinic.

    Science.gov (United States)

    Larson-Nath, Catherine M; Goday, Praveen S

    2016-06-01

    We aimed to describe the clinical characteristics, diagnostic work-up, interventions, and outcomes of children referred to a pediatric gastroenterology clinic with the diagnosis of failure to thrive (FTT). We prospectively enrolled 110 children seen for the first time in our pediatric gastroenterology clinic for FTT. Standard demographic information, history, and anthropometric data were collected at initial and follow-up visits. We also obtained data about diagnostic workup, therapeutic interventions, and growth outcomes. Seventy patients (63.6%) were boys with a median age of 0.79 years (interquartile range 0.36-1.98). Of the 91 children with follow-up data, 81 (89%) were found to have nonorganic etiologies of their FTT. The majority of children (56.4%) underwent laboratory evaluation. Imaging and endoscopic evaluations were performed in fewer patients (29.6 and 10.2%, respectively). Endoscopic intervention yielded a diagnosis in 16.7% of patients while the positive result rates for laboratory testing and imaging were 3.2% and 3.1%, respectively. The most common therapeutic interventions included increasing calories (71.8%), avoiding grazing (71.8%), and structuring meals and snacks (67.3%). Compared with nonadherent children, children who were adherent with standard behavioral and nutritional interventions showed a higher positive change in z scores for weight (0.36 vs -0.01, P = 0.001) and body mass index (0.58 vs -0.18, P = 0.031). The majority of children in a pediatric gastroenterology clinic with FTT have nonorganic etiologies of their failure to thrive. Laboratory, imaging, and endoscopic evaluation are rarely positive and should be judiciously performed. Adherence to standardized interventions leads to improved growth.

  7. North American Pediatric Gastroenterology Fellowship Needs Assessment in Inflammatory Bowel Disease: Trainee and Program Director Perspectives.

    Science.gov (United States)

    Dotson, Jennifer L; Falaiye, Tolulope; Bricker, Josh B; Strople, Jennifer; Rosh, Joel

    2016-07-01

    Pediatric inflammatory bowel disease (IBD) care is complex and rapidly evolving. The Crohn's and Colitis Foundation of America and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition cosponsored a needs assessment survey of pediatric gastroenterology trainees and program directors (PDs) to inform on educational programming. A Web-based, self-completed survey was provided to North American trainees and PDs during the 2013-2014 academic year. Standard descriptive statistics summarized demographics and responses. One hundred sixty-six of 326 (51%) trainees (62% female) and 37 of 74 (50%) PDs responded. Median trainees per program = 5 and median total faculty = 10 (3 IBD experts); 15% of programs did not have a self-identified "IBD expert" faculty member. Sixty-nine percent of trainees were confident/somewhat confident in their IBD inpatient training, whereas 54% were confident/somewhat confident in their outpatient training. Trainees identified activities that would most improve their education, including didactics (55%), interaction with national experts (50%), trainee-centered IBD Web resources (42%), and increased patient exposure (42%). Trainees were most confident in managing inpatient active Crohn's disease/ulcerative colitis, phenotype classification, managing biological therapies, and using clinical disease activity indices. They were least confident in managing J-pouch complications, performing pouchoscopy, managing extraintestinal manifestations, and ostomy-related complications. Eighty-five percent would like an IBD-focused training elective. Most directors (86%) would allow trainees to do electives at other institutions. This IBD needs assessment survey of pediatric gastroenterology trainees and PDs demonstrated a strong resource commitment to IBD training and clinical care. Areas for educational enrichment emerged, including pouch and ostomy complications.

  8. Bibliometric analysis of the top-cited gastroenterology and hepatology articles.

    Science.gov (United States)

    Azer, Samy A; Azer, Sarah

    2016-02-08

    To identify the top-cited articles in gastroenterology and hepatology, and analyse their characteristics. Two searches were conducted in the Science Citation Index Expanded database; a search of 69 journals under the category 'Gastroenterology and Hepatology' (list A) and a keyword search of all journals (list B). The search results were analysed and the inter-rater coefficient of agreement between evaluators was measured using Cohen κ. The number of citations varied from 1049 to 2959 in list A and from 1929 to 5500 in list B. In both lists, the majority of articles were research papers. No significant correlations were found between the number of citations and the number of years since publication (R(2)=0.00992, p=0.473 and R(2)=0.00202, p=0.757, respectively). However, the mean number of citations of papers published before the year 2000 was lower than those published after 2000 (36.70 ± 19.31 vs 106.03 ± 39.22). No correlation was found between number of authors and the number of citations (R(2)=0.04352, p=0.130), but strong correlations were found between the number of institutes involved or number of countries and the number of citations (R(2)=0.275, pGastroenterology and Hepatology but also in 14 journals not specialised in this field. The number of citations correlated with the number of institutes and the number of countries involved but not with the number of grants received or the number of authors. Females were under-represented in the authorship. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. Incidence and prevalence of inflammatory bowel diseases in gastroenterology primary care setting.

    Science.gov (United States)

    Tursi, Antonio; Elisei, Walter; Picchio, Marcello

    2013-12-01

    The incidence of inflammatory bowel diseases (IBDs) has markedly increased over the last years, but no epidemiological study has been performed in gastroenterology primary care setting. We describe the epidemiology of IBD in a gastroenterology primary care unit using its records as the primary data source. Case finding used predefined read codes to systematically search computer diagnostic and prescribing records from January 2009 to December 2012. A specialist diagnosis of Ulcerative colitis (UC), Crohn's disease (CD), inflammatory bowel disease unclassified (IBDU) or segmental colitis associated with diverticulosis (SCAD), based on clinical, histological or radiological findings, was a prerequisite for the inclusion in the study. Secondary, infective and apparent acute self-limiting colitis were excluded. We identified 176 patients with IBD in a population of 94,000 with a prevalence 187.2/100,000 (95% CI: 160.6-217.0). Between 2009 and 2012 there were 61 new cases. In particular, there were 23 new cases of UC, 19 new cases of CD, 15 new cases of SCAD, and 4 new cases of IBDU. The incidence of IBD was 16.2/100,000 (95% CI 12.5-20.7) per year. The incidence per year was 6/100,000 (95% CI 3.8 to 8.9) for UC, 5/100,000 (95% CI 3.0-7.7) for CD, 4/100,000 (95% CI 2.3-6.5) for SCAD, and 1/100,000 (95% CI 0.3-2.6) for IBDU. We assessed for the first time which is the prevalence and incidence of IBD in a gastroenterology primary care unit. This confirms that specialist primary care unit is a key factor in providing early diagnosis of chronic diseases. Copyright © 2013 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  10. First quality score for referral letters in gastroenterology-a validation study.

    Science.gov (United States)

    Eskeland, Sigrun Losada; Brunborg, Cathrine; Seip, Birgitte; Wiencke, Kristine; Hovde, Øistein; Owen, Tanja; Skogestad, Erik; Huppertz-Hauss, Gert; Halvorsen, Fred-Arne; Garborg, Kjetil; Aabakken, Lars; de Lange, Thomas

    2016-10-08

    To create and validate an objective and reliable score to assess referral quality in gastroenterology. An observational multicentre study. 25 gastroenterologists participated in selecting variables for a Thirty Point Score (TPS) for quality assessment of referrals to gastroenterology specialist healthcare for 9 common indications. From May to September 2014, 7 hospitals from the South-Eastern Norway Regional Health Authority participated in collecting and scoring 327 referrals to a gastroenterologist. Correlation between the TPS and a visual analogue scale (VAS) for referral quality. The 327 referrals had an average TPS of 13.2 (range 1-25) and an average VAS of 4.7 (range 0.2-9.5). The reliability of the score was excellent, with an intra-rater intraclass correlation coefficient (ICC) of 0.87 and inter-rater ICC of 0.91. The overall correlation between the TPS and the VAS was moderate (r=0.42), and ranged from fair to substantial for the various indications. Mean agreement was good (ICC=0.47, 95% CI (0.34 to 0.57)), ranging from poor to good. The TPS is reliable, objective and shows good agreement with the subjective VAS. The score may be a useful tool for assessing referral quality in gastroenterology, particularly important when evaluating the effect of interventions to improve referral quality. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  11. Gastroenterology training in a resource-limited setting: Zambia, Southern Africa.

    Science.gov (United States)

    Asombang, Akwi W; Turner-Moss, Eleanor; Seetharam, Anil; Kelly, Paul

    2013-07-07

    To evaluate need for and efficacy of a structured gastroenterology didactic session in expanding awareness and understanding of digestive disorders. A four-day symposium was developed with didactic sessions (days 1, 2) and practical endoscopy (days 3, 4). Didactic sessions included case presentations highlighting pathophysiology and management. One nurse and four practicing gastroenterologists from the United Kingdom led lectures and supervised workshops with audience participation. Practical endoscopy focused on diagnostic and therapeutic procedures and their application to diagnosis and treatment of ailments of the gastrointestinal tract. Pre- and post-workshop questionnaires were distributed to participants during didactic sessions. A pre-workshop questionnaire gauged expectations and identified objectives to be met at the symposium. Post-workshop questionnaires were administered to assess efficacy of each session. Participants graded sessions from 1 (poor) to 5 (excellent) on quality of case presentations, knowledge, clarity and mode of presentation. We assessed if time allotted to each topic was sufficient, value of sessions, impact on practice and interest in future symposiums. There were 46 attendees on day 1: 41% undergraduates, 41% residents, 11% consultants and 4% unspecified. Day 2 (a Saturday) had 24 participants: 17% undergraduates, 71% residents, 9% consultants, 4% unspecified. Primary pre-workshop symposium expectation was to gain knowledge in: general gastroenterology (55.5%), practical endoscopy (13.8%), pediatric gastroenterology (5%), epidemiology of gastrointestinal disorders specific to Zambia (6%), and interaction with international speakers (6%). The post-symposium questionnaire was answered by 19 participants, of whom 95% felt specific aims were met; all would attend future conferences and recommend to others. The beneficial effect of a structured symposium in developing countries warrants further attention as a mechanism to improve disease

  12. Conceptualization and treatment of chronic abdominal pain in pediatric gastroenterology practice.

    Science.gov (United States)

    Schurman, Jennifer V; Hunter, Heather L; Friesen, Craig A

    2010-01-01

    The aim of this study was to examine how children with abdominal pain presently are viewed, assessed, and treated by pediatric gastroenterologists across North America, as well as how perspectives have changed since initial release of the Rome criteria for functional gastrointestinal disorders approximately 15 years ago. One hundred seventy-four full members of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition completed a pediatric gastroenterology practice survey designed by the authors in 2006. The responses were examined for practice patterns and specific knowledge/use of the Rome criteria. The responses were also compared with historical data from 151 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition members who completed a similar survey in 1992. There were few changes in the evaluation, treatment, or outcomes for children with abdominal pain for the past 15 years. Knowledge of the Rome criteria was common, but use in practice was not; several specific problems with the criteria were identified. A mismatch also appeared between belief in the importance of psychological factors in the creation/maintenance of pediatric abdominal pain and integration of these factors as part of standard evaluation and treatment. Finally, controversy emerged regarding both the term "functional" and the importance of histologic inflammation in the pathophysiology of pediatric abdominal pain. The evolution and dissemination of the Rome criteria for the past 15 years have not substantially changed evaluation or treatment practices for children with abdominal pain. Many areas of inconsistency and controversy remain. More focused research is needed to better understand this common pain condition and to establish an effective treatment program that can be disseminated across practitioners.

  13. Skill accreditation system for laparoscopic gastroenterologic surgeons in Japan.

    Science.gov (United States)

    Mori, Toshiyuki; Kimura, Taizo; Kitajima, Masaki

    2010-01-01

    The Japan Society for Endoscopic Surgery (JSES) has established an Endoscopic Surgical Skill Qualification System and started examination in 2004. Non-edited videotapes were assessed by two judges in a double-blinded fashion with strict criteria. Two kinds of criteria, namely common and procedure-specific, were prepared. The common criteria were designed to evaluate set-ups, autonomy of the operator, display of the surgical field, recognition of surgical anatomy, co-operation of the surgical team. The procedure-specific criteria were made to assess the operation in a step-by-step fashion. In total, out of 1.114 surgeons who were assessed by this qualification system over a period of four years, 537 (48.2%) have been accredited. The qualification rate in each surgical field has remained at the same level of 40 to 50% to date. Inter-rater agreement of two judges was low at 0.31 in the first year, but improved with revision of the criteria and consensus meetings. Surgeons assessed by this system as qualified experienced less frequent complications when compared to those who failed. This system has impacted on the improvement and standardization of laparoscopic surgery in Japan.

  14. [MODERN PROKINETICS AND THEIR ROLE IN THE TREATMENT OF GASTROENTEROLOGICAL PATHOLOGY].

    Science.gov (United States)

    Sheptulin, A A; Belousova, I B

    2016-01-01

    The importance of prokinetics (drugs stimulating motor function of the gastrointestinal tract) arises from the high prevalence of gastroenterological pathology associated with primary or secondary disturbances of this function in esophagus, stomach, and intestines. The main groups of prokinetics are beta-blockers of dopamine receptors, inhibitors of acetylcholine esterase (or their combination with dopamine receptor blockers), 5-HT4-receptor agonists. They find wide application for the treatment of gastroesophgeal reflux disease, functional dyspepsia and constipation, obstipational form of irritable bowel syndrome, and other conditions accompanied by motor function disorders of the gastrointestinal tract.

  15. Interprofessional Collaboration with Immune Checkpoint Inhibitor Therapy: the Roles of Gastroenterology, Endocrinology and Neurology.

    Science.gov (United States)

    Seery, Virginia

    2017-11-01

    To discuss immune checkpoint inhibitor therapy and identify opportunities for interprofessional collaboration in the management of toxicities in the areas of gastroenterology, endocrinology, and neurology. Published research and education articles in oncology, nursing, and various specialties. The use of immune checkpoint inhibitors is expanding; timely management of toxicity is critical for positive patient outcomes. There are many opportunities for interprofessional collaboration in the diagnosis and treatment of immune-related adverse events. Nurses play key roles in recognizing immune-related adverse events, providing patient education, and helping to facilitate interprofessional collaboration. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Gastroenterology – Guidelines on Parenteral Nutrition, Chapter 15

    Directory of Open Access Journals (Sweden)

    Schulz, R. J.

    2009-11-01

    Full Text Available In patients with Crohn's disease and ulcerative colitis parenteral nutrition (PN is indicated when enteral nutrition is not possible or should be avoided for medical reasons. In Crohn's patients PN is indicated when there are signs/symptoms of ileus or subileus in the small intestine, scars or intestinal fistulae. PN requires no specific compounding for chronic inflammatory bowel diseases. In both diseases it should be composed of 55–60% carbohydrates, 25–30% lipids and 10–15% amino acids. PN helps in the correction of malnutrition, particularly the intake of energy, minerals, trace elements, deficiency of calcium, vitamin D, folic acid, vitamin B12, and zinc. Enteral nutrition is clearly superior to PN in severe, acute pancreatitis. An intolerance to enteral nutrition results in an indication for total PN in complications such as pseudocysts, intestinal and pancreatic fistulae, and pancreatic abscesses or pancreatic ascites. If enteral nutrition is not possible, PN is recommended, at the earliest, 5 days after admission to the hospital. TPN should not be routinely administered in mild acute pancreatitis or nil by moth status <7 days, due to high costs and an increased risk of infection. The energy requirements are between 25 and 35 kcal/kg body weight/day. A standard solution including lipids (monitoring triglyceride levels! can be administered in acute pancreatitis. Glucose (max. 4–5 g/kg body weight/day and amino acids (about 1.2–1.5 g/kg body weight/day should be administered and the additional enrichment of TPN with glutamine should be considered in severe, progressive forms of pancreatitis.

  17. SAP Nuclear Competence Centre

    International Nuclear Information System (INIS)

    Andrlova, Z.

    2009-01-01

    In this issue we continue and introduce the SAP Nuclear Competence Centre and its head Mr. Igor Dzama. SAP Nuclear Competence Centrum is one of the fi rst competence centres outside ENEL headquarters. It should operate in Slovakia and should have competencies within the whole Enel group. We are currently dealing with the issues of organisation and funding. We are trying to balance the accountability to the NPP directors and to the management of the competence centres at Enel headquarters; we are looking at the relations between the competence centres within the group and defining the services that we will provide for the NPPs. author)

  18. Canadian Irradiation Centre

    International Nuclear Information System (INIS)

    1987-05-01

    The Canadian Irradiation Centre is a non-profit cooperative project between Atomic Energy of Canada Limited, Radiochemical Company and Universite du Quebec, Institut Armand-Frappier, Centre for Applied Research in Food Science. The Centre's objectives are to develop, demonstrate and promote Canada's radiation processing technology and its applications by conducting applied research; training technical, professional and scientific personnel; educating industry and government; demonstrating operational and scientific procedures; developing processing procedures and standards, and performing product and market acceptance trials. This pamphlet outlines the history of radoation technology and the services offered by the Canadian Irradiation Centre

  19. Frequent attenders without organic disease in a gastroenterology clinic. Patient characteristics and health care use.

    Science.gov (United States)

    Bass, C; Bond, A; Gill, D; Sharpe, M

    1999-01-01

    We used a hospital computer to identify 50 patients (35 women, 15 men) satisfying research criteria for "frequent attenders" at a gastroenterology outpatient clinic (four or more visits to a general hospital clinic in the previous 12 months). Their mean duration of symptoms was 5 years, and 80% reported fatigue as a significant complaint. Thirteen (37%) of the women were also consulting a gynecologist, and in nine of these their status was normal. Seven (21%) of the 35 women who were interviewed had a history of childhood sexual abuse, and these patients reported significantly more lifetime somatic symptoms (9.7, SD = 3.8) than those without such a history (5.4, SD = 3.5, p = 12 visits over the previous 12 months), and the patients reported a mean number of 5.7 (SD = 2.1) specialist appointments in the previous year. There may be a case for using the hospital computer to identify frequent attenders proactively at an earlier stage of their hospital visits so that appropriate management can be instituted. If such patients can be identified in this way, their assessment and management might be more appropriately supervised in designated clinics by more experienced gastroenterology staff.

  20. Dysphagia referrals to a district general hospital gastroenterology unit: hard to swallow.

    Science.gov (United States)

    Melleney, Elizabeth Mary-Ann; Subhani, Javaid Mohammed; Willoughby, Charles Peter

    2004-01-01

    The aim of our study was to audit dysphagia referrals received by a specialist gastroenterology unit during an entire year. We used a prospective audit carried out over a 12-month period at the District General Hospital gastroenterology unit. The audit included 396 consecutive patients who were referred with swallowing difficulties. We found that 60 referrals (15.2%) were inaccurate and the patients had no swallowing problem. Of the 336 patients with genuine dysphagia, only 29 (8.6%) were new cancer cases. The large majority of subjects had benign disease mostly related to acid reflux. Weight loss was significantly associated with malignancy but also occurred in one third of patients with reflux alone. The temporal pattern of dysphagia was not significantly predictive of cancer. All the cancer patients were above the age of 50 years. Although patients were in general assessed rapidly after hospital referral, the productivity, in terms of early tumor diagnosis, was extremely low. We conclude that there is a substantial rate of inaccurate referrals of dysphagia patients. Most true cases of swallowing difficulty relate to benign disease. Even the devotion of considerable resources to the early diagnosis of esophago gastric malignancy in an attempt to conform with best practice guidelines results in a very low success rate in terms of the detection of potentially curable tumors.

  1. Telephone reminders reduced the non-attendance rate in a gastroenterology outpatient clinic.

    Science.gov (United States)

    Jeppesen, Maja Haunstrup; Ainsworth, Mark Andrew

    2015-06-01

    Non-attendance is a global health-care problem. The aim of the present study was 1) to investigate if a telephone reminder could reduce the non-attendance rate, 2) to study reasons for non-attendance and 3) to evaluate if a permanent implementation would be economically advantageous in a gastroenterology outpatient clinic like ours. This was a comparative intervention study with a historical control group in a gastroenterology outpatient clinic. The study lasted six months. Patients with a scheduled appointment in the first three-month period received no reminder (control group, n = 2,705). Patients in the following three-month period were reminded by telephone one weekday in advance of their appointment, when possible (intervention group, n = 2,479). Non-attending patients in the intervention group received a questionnaire. Based on the results, a financial cost-benefit analysis was made. In the intervention group, 1,577 (64%) patients answered the reminder telephone call. The non-attendance rate was significantly lower in the intervention group (6.1%) than in the control group (10.5%) (p < 0.00001). Only 1.3% of the patients who answered the reminder turned out to be non-attendees. The most common explanation for non-attendance in the intervention group was forgetfulness (39%). The reminder telephone call was cost-effective. In this outpatient clinic, telephone reminders were cost-effective and significantly reduced the non-attendance rate by 43%.

  2. Temporal trends and variability of colonoscopy performance in a gastroenterology practice.

    Science.gov (United States)

    le Clercq, Chantal M C; Mooi, Rick J; Winkens, Bjorn; Salden, Bouke N H; Bakker, C Minke; van Nunen, Annick B; Keulen, Eric P T; de Ridder, Rogier J; Masclee, Ad A M; Sanduleanu, Silvia

    2016-03-01

    Quality measures for colonoscopy are operator dependent and vary. It is unclear whether quality measures change over time. In this study, time-dependent variation in colonoscopy performance was examined in a gastroenterology practice. Colonoscopy and histopathology records that were collected at three hospitals (one university and two non-university hospitals) over three time periods (2007, 2010, and 2013) were reviewed. Data from colonoscopists performing at least 100 procedures per year were analyzed. Inter-colonoscopist variation in performance (i. e. adjusted cecal intubation rate [aCIR], adenoma detection rate [ADR], advanced ADR, mean adenomas per procedure [MAP], proximal ADR, nonpolypoid ADR, and serrated polyp detection rate) were examined using coefficients of variation. Logistic regression analyses were also performed, adjusting for covariates. A total of 23 colonoscopists performing 6400 procedures were included. Overall, the mean aCIR, ADR, MAP, and proximal ADR improved significantly over time, from 91.9 %, 22.5 %, 0.37, and 10.2 % in 2007 to 95.3 %, 25.8 %, 0.45, and 13.4 %, respectively, in 2013 (P gastroenterology clinical practice. Core quality measures improved over time, mainly through improvement of the lower performers. Measurement of inter-colonoscopist variation in performance helps to identify factors that stimulate or hinder performance, and forms the basis for interventions. http://www.trialregister.nl. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Evaluation of funding gastroenterology research in Canada illustrates the beneficial role of partnerships

    Science.gov (United States)

    Sherman, Philip M; Hart, Kimberly Banks; Rose, Keeley; Bosompra, Kwadwo; Manuel, Christopher; Belanger, Paul; Daniels, Sandra; Sinclair, Paul; Vanner, Stephen; Buret, André G

    2013-01-01

    BACKGROUND: Funders of health research in Canada seek to determine how their funding programs impact research capacity and knowledge creation. OBJECTIVE: To evaluate the impact of a focused grants and award program that was cofunded by the Canadian Institutes of Health Research Institute of Nutrition, Metabolism and Diabetes, and the Canadian Association of Gastroenterology; and to measure the impact of the Program on the career paths of funded researchers and assess the outcomes of research supported through the Program. METHODS: A survey of the recipients of grants and awards from 2000 to 2008 was conducted in 2012. The CIHR Funding Decisions database was searched to determine subsequent funding; a bibliometric citation analysis of publications arising from the Program was performed. RESULTS: Of 160 grant and award recipients, 147 (92%) completed the survey. With >$17.4 million in research funding, support was provided for 131 fellowship awards, seven career transition awards, and 22 operating grants. More than three-quarters of grant and award recipients continue to work or train in a research-related position. Combined research outputs included 545 research articles, 130 review articles, 33 book chapters and 11 patents. Comparative analyses indicate that publications supported by the funding program had a greater impact than other Canadian and international comparators. CONCLUSIONS: Continuity in support of a long-term health research funding partnership strengthened the career development of gastroenterology researchers in Canada, and enhanced the creation and dissemination of new knowledge in the discipline. PMID:24340317

  4. The utility and yield of endoscopic ultrasonography for suspected choledocholithiasis in common gastroenterology practice.

    Science.gov (United States)

    Quispel, Rutger; van Driel, Lydi M W J; Veldt, Bart J; van Haard, Paul M M; Bruno, Marco J

    2016-12-01

    Endoscopic ultrasonography (EUS) is an established diagnostic modality for diagnosing common bile duct (CBD) stones. Its use has led to a reduction in the number of endoscopic retrograde cholangiopancreatography (ERCP) procedures performed for suspected choledocholithiasis. We aimed to explore the role of EUS in detecting CBD stones and/or sludge in common gastroenterology practice. We reviewed case records of 268 consecutive patients who underwent (EUS) procedures performed to confirm or rule out the presence of CBD stones and/or sludge between November 2006 and January 2011 in the Reinier de Graaf Hospital, Delft, The Netherlands, which is a nonacademic community hospital. On the basis of EUS findings, 169 of 268 (63%) patients did not undergo ERCP and were therefore not exposed to its risk of complications. Patients with positive findings on EUS (n=99) all underwent ERCP and endoscopic sphincterotomy. Only 57 of 99 (58%) had positive findings at ERCP. The main contributing factors to this finding seem to be time interval between EUS and ERCP and the type of CBD content (i.e. sludge, one CBD stone or more than one CBD stone) described. In our common gastroenterology practice, EUS plays an important role in selecting patients suspected to have CBD stones or sludge for ERCP. Much is to be learned about the probability of spontaneous passage of CBD stones and sludge into the duodenum.

  5. Current Status of and Recommendations for Nutrition Education in Gastroenterology Fellowship Training in Canada.

    Science.gov (United States)

    Hu, Jing; Raman, Maitreyi; Gramlich, Leah

    2018-04-01

    Knowledge and skill in the area of nutrition are a key competency for the gastroenterologist. However, standards for nutrition education for gastroenterology fellows in Canada do not exist, and gastroenterologists in training and in practice do not feel confident in their knowledge or skill as it relates to nutrition. This study was undertaken to identify the current status of nutrition education in gastroenterology (GI) fellowship training programs in Canada and to provide insight into the development of nutrition educational goals, processes, and evaluation. Using mixed methods, we did a survey of current and recent graduates and program directors of GI fellowship programs in Canada. We undertook a focus group with program directors and fellows to corroborate findings of the survey and to identify strategies to advance nutrition education, knowledge, and skill of trainees. In total, 89.3% of the respondents perceived that the nutrition education was important for GI training, and 82.1% of the respondents perceived nutrition care would be part of their practice. However, only 50% of respondents had a formal rotation in their program, and it was mandatory only 36% of the time. Of the respondents, 95% felt that nutrition education should be standardized within GI fellowship training. Significant gaps in nutrition education exist with GI fellowship programs in Canada. The creation of standards for nutrition education would be valued by training programs, and such a nutrition curriculum for GI fellowship training in Canada is proposed. © 2017 American Society for Parenteral and Enteral Nutrition.

  6. United European Gastroenterology Week scientific abstracts and their progression to full publication.

    Science.gov (United States)

    Raju, Suneil A; Sanders, David S; Akram, Rahim; Glover, Rebecca; Al-Rifaie, Ammar; Peever, Elise; Purves, Josh; Scanu, Emily; Kurien, Matthew

    2017-10-01

    Abstracts presentations at scientific meetings enable rapid dissemination of novel research. The percentage of abstracts that proceed to full publication from differing medical specialties is highly variable. This study aims to evaluate the outcomes of abstracts presented at the United European Gastroenterology Week (UEGW). All abstracts presented at UEGW between 2009 and 2011 were assessed. Cross-referencing of the first author, senior author and at least one keyword of the abstract was performed using PubMed and EMBASE databases. Abstracts and possible resultant full publications were then examined in tandem to ensure that they represented the same study. Data were also collected on lag time to publication, journal impact factors, country of the author and factors influencing subsequent publication. A total of 6785 abstracts (1438 oral and 5347 poster presentations) were presented during the period assessed. Of these, 2099 (30.9%) proceeded to full publication in indexed journals. Oral abstract presentations were most likely to proceed to full publication compared with poster presentations (odds ratio: 1.38, 95% confidence interval: 1.22-1.56) and were more likely to achieve publication in higher impact journals (median impact factor 4.78 vs. 2.89, PEuropean Gastroenterology abstract conversion rate to full publication (46.8%). This is the first study to assess the publication rates of UEGW. Findings are favourable with similar studies from other societies.

  7. The stress concept in gastroenterology: from Selye to today [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Sigrid Elsenbruch

    2017-12-01

    Full Text Available More than eighty years after Hans Selye (1907–1982 first developed a concept describing how different types of environmental stressors affect physiological functions and promote disease development (called the “general adaptation syndrome” in 1936, we herein review advances in theoretical, mechanistic, and clinical knowledge in stress research, especially in the area of gastroenterology, and summarize progress and future perspectives arising from an interdisciplinary psychoneurobiological framework in which genetics, epigenetics, and other advanced (omics technologies in the last decade continue to refine knowledge about how stress affects the brain-gut axis in health and gastrointestinal disease. We demonstrate that neurobiological stress research continues to be a driving force for scientific progress in gastroenterology and related clinical areas, inspiring translational research from animal models to clinical applications, while highlighting some areas that remain incompletely understood, such as the roles of sex/gender and gut microbiota in health and disease. Future directions of research should include not only the genetics of the stress response and resilience but also epigenetic contributions.

  8. Avoidance-oriented students' development in motivation for maths, self-regulated learning behaviour and achievement: a person-centred study in the lowest level of secondary education

    NARCIS (Netherlands)

    Peetsma, T.; van der Veen, I.

    2013-01-01

    Performance-avoidance orientation has been found to undermine students’ academic motivation and achievement. Recognising groups of students with different levels and developments of performance-avoidance orientation makes it possible to try to intervene early in their school careers. In this study,

  9. The storage center of short life low and intermediate level radioactive wastes; Le centre de stockage des dechets de faible et moyenne activite a vie courte

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-07-01

    Situated at 50 km of Troyes, the Aube Center was opened in 1992 in order to take over from the Manche Center, for the surface storage of low life low and intermediate level radioactive wastes. It offers an answer to manage safely theses wastes at an industrial scale during 50 years. (A.L.B.)

  10. Client Centred Desing

    DEFF Research Database (Denmark)

    Ørngreen, Rikke; Nielsen, Janni; Levinsen, Karin

    2008-01-01

    In this paper we argue for the use of Client Centred preparation phases when designing complex systems. Through Client Centred Design human computer interaction can extend the focus on end-users to alse encompass the client's needs, context and resources....

  11. Pediatric gastroenterology

    International Nuclear Information System (INIS)

    Heyman, S.

    1988-01-01

    Recent advances in diagnostic techniques have significantly improved understanding of gastrointestinal disease in children. Ultrasonography, computed tomography, and nuclear medicine have all contributed to improved diagnosis and complemented conventional radiographic procedures. While nuclear medicine studies lack the high spatial resolution of the other modalities, they provide important functional information. Computer acquisition allows for quantitation of the data. These studies are all relatively noninvasive, unlike angiography, endoscopy, or percutaneous transhepatic cholangiography. The latter studies should be used more selectively. The role of magnetic resonance imaging is currently being evaluated. This chapter considers only the applications of radionuclide liver-spleen imaging and upper gastrointestinal studies in infants and children. The latter include an evaluation of esophageal motility, gastroesophageal reflux, and gastric emptying. Other relevant studies, such as hepatobiliary, gastrointestinal bleeding (including Meckel's diverticulum), and gallium imaging re covered elsewhere in this volume

  12. Formaldehyde in the Galactic Centre

    International Nuclear Information System (INIS)

    Cohen, R.J.; Few, R.W.

    1981-01-01

    Formaldehyde 6-cm absorption in the direction of the Galactic Centre has been surveyed using the Jodrell Bank MK II radio telescope (beam-width 10 x 9 arcmin). The observations sample the region - 2 0 = 0 and - 0 0 .5 = 0 .5, with a velocity range of 620 km s -1 , a velocity resolution of 2.1 km s -1 and an rms noise level of approximately 0.03 K. The data are presented as contour maps showing line temperature as a function of latitude and velocity (b-V maps) and as a function of longitude and velocity (l-V maps). Similar maps of the line-to-continuum ratio are also presented. The radial distribution of formaldehyde (H 2 CO) in the Galactic Centre region is derived using two different kinematic models which give similar results. Formaldehyde is strongly concentrated in the Galactic Centre in a layer of latitude extent approximately 0 0 .5 and longitude extent approximately 4 0 which contains one quarter of all the H 2 CO in the Galaxy. The distribution is centred on l approximately 1 0 . The individual H 2 CO features are described in detail. (author)

  13. Inversion of spin levels in Ni sup 2 sup + : Zn(BF sub 4) sub 2 centre dot 6H sub 2 O at all -round compression and effect of transition coincidence

    CERN Document Server

    Krygin, I M; Nejlo, G N; Prokhorov, A D

    2001-01-01

    The study of the EPR spectrum of the Ni sup 2 sup + ion, replacing Zn sup 2 sup + in the Zn(BF sub 4) centre dot 6H sub 2 O crystals in the wide temperature range by the all-round compression in the X- and Q-ranges is carried out. The basic changes by varying temperature and pressure occur with the D parameter, characterizing the initial splitting by practically unchanged g-factor. The increase in the temperature is accompanied by the D nonlinear growth. The all-round compression linearly changes the initial splitting and leads to the change in the D-sign, signifying the spin levels inversion by 3.5 kbar. Coincidence of EPR lines, relative to different transitions, leads to the crevasse appearance in the outline of this one, that is connected with cross-relaxation inside the spin system

  14. Inter-observer variability in diagnosing radiological features of aneurysmal subarachnoid hemorrhage; a preliminary single centre study comparing observers from different specialties and levels of training.

    Science.gov (United States)

    Siddiqui, Usman T; Khan, Anjum F; Shamim, Muhammad Shahzad; Hamid, Rana Shoaib; Alam, Muhammad Mehboob; Emaduddin, Muhammad

    2014-01-01

    A noncontrast computed tomography (CT) scan remains the initial radiological investigation of choice for a patient with suspected aneurysmal subarachnoid hemorrhage (aSAH). This initial scan may be used to derive key information about the underlying aneurysm which may aid in further management. The interpretation, however, is subject to the skill and experience of the interpreting individual. The authors here evaluate the interpretation of such CT scans by different individuals at different levels of training, and in two different specialties (Radiology and Neurosurgery). Initial nonontrast CT scan of 35 patients with aSAH was evaluated independently by four different observers. The observers selected for the study included two from Radiology and two from Neurosurgery at different levels of training; a resident currently in mid training and a resident who had recently graduated from training of each specialty. Measured variables included interpreter's suspicion of presence of subarachnoid blood, side of the subarachnoid hemorrhage, location of the aneurysm, the aneurysm's proximity to vessel bifurcation, number of aneurysm(s), contour of aneurysm(s), presence of intraventricular hemorrhage (IVH), intracerebral hemorrhage (ICH), infarction, hydrocephalus and midline shift. To determine the inter-observer variability (IOV), weighted kappa values were calculated. There was moderate agreement on most of the CT scan findings among all observers. Substantial agreement was found amongst all observers for hydrocephalus, IVH, and ICH. Lowest agreement rates were seen in the location of aneurysm being supra or infra tentorial. There were, however, some noteworthy exceptions. There was substantial to almost perfect agreement between the radiology graduate and radiology resident on most CT findings. The lowest agreement was found between the neurosurgery graduate and the radiology graduate. Our study suggests that although agreements were seen in the interpretation of some of

  15. Commissioning of the very low level radioactive waste disposal facility; Mise en service du Centre de stockage de dechets de tres faible activite

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2003-08-01

    This press kit presents the solution retained by the French national agency of radioactive wastes (ANDRA) for the management of very low level radioactive wastes. These wastes mainly come from the dismantling of decommissioned nuclear facilities and also from other industries (chemical, metal and other industries). The storage concept is a sub-surface disposal facility (Morvilliers center, Aube) with a clay barrier and a synthetic membrane system. The regulatory framework, and the details of the licensing, of the commissioning and of the environment monitoring are recalled. The detailed planing of the project and some exploitation data are given. (J.S.)

  16. Large-scale fuel cycle centres

    International Nuclear Information System (INIS)

    Smiley, S.H.; Black, K.M.

    1977-01-01

    The US Nuclear Regulatory Commission (NRC) has considered the nuclear energy centre concept for fuel cycle plants in the Nuclear Energy Centre Site Survey 1975 (NECSS-75) Rep. No. NUREG-0001, an important study mandated by the US Congress in the Energy Reorganization Act of 1974 which created the NRC. For this study, the NRC defined fuel cycle centres as consisting of fuel reprocessing and mixed-oxide fuel fabrication plants, and optional high-level waste and transuranic waste management facilities. A range of fuel cycle centre sizes corresponded to the fuel throughput of power plants with a total capacity of 50,000-300,000MW(e). The types of fuel cycle facilities located at the fuel cycle centre permit the assessment of the role of fuel cycle centres in enhancing the safeguard of strategic special nuclear materials - plutonium and mixed oxides. Siting fuel cycle centres presents a smaller problem than siting reactors. A single reprocessing plant of the scale projected for use in the USA (1500-2000t/a) can reprocess fuel from reactors producing 50,000-65,000MW(e). Only two or three fuel cycle centres of the upper limit size considered in the NECSS-75 would be required in the USA by the year 2000. The NECSS-75 fuel cycle centre evaluation showed that large-scale fuel cycle centres present no real technical siting difficulties from a radiological effluent and safety standpoint. Some construction economies may be achievable with fuel cycle centres, which offer opportunities to improve waste-management systems. Combined centres consisting of reactors and fuel reprocessing and mixed-oxide fuel fabrication plants were also studied in the NECSS. Such centres can eliminate shipment not only of Pu but also mixed-oxide fuel. Increased fuel cycle costs result from implementation of combined centres unless the fuel reprocessing plants are commercial-sized. Development of Pu-burning reactors could reduce any economic penalties of combined centres. The need for effective fissile

  17. What Are We Going to Do with You? Gastroenterology Service Providers’ Perception of ‘Difficult to Manage’ IBD Patients

    Directory of Open Access Journals (Sweden)

    T Michael Vallis

    2002-01-01

    Full Text Available BACKGROUND: This paper reports the results of a systematic survey of members of a clinical gastroenterology service to determine their perceptions of patients with inflammatory bowel disease (IBD who were deemed to function poorly and were difficult to manage clinically.

  18. Paediatric gastroenterology evaluation of overweight and obese children referred from primary care for suspected non-alcoholic fatty liver disease

    Science.gov (United States)

    Schwimmer, J B; Newton, K P; Awai, H I; Choi, L J; Garcia, M A; Ellis, L L; Vanderwall, K; Fontanesi, J

    2013-01-01

    Background Screening overweight and obese children for non-alcoholic fatty liver disease (NAFLD) is recommended by paediatric and endocrinology societies. However, gastroenterology societies have called for more data before making a formal recommendation. Aim To determine whether the detection of suspected NAFLD in overweight and obese children through screening in primary care and referral to paediatric gastroenterology resulted in a correct diagnosis of NAFLD. Methods Information generated in the clinical evaluation of 347 children identified with suspected NAFLD through screening in primary care and referral to paediatric gastroenterology was captured prospectively. Diagnostic outcomes were reported. The diagnostic performance of two times the upper limit of normal (ULN) for alanine aminotransferase (ALT) was assessed. Results Non-alcoholic fatty liver disease was diagnosed in 55% of children identified by screening and referral. Liver disease other than NAFLD was present in 18% of those referred. Autoimmune hepatitis was the most common alternative diagnosis. Children with NAFLD had significantly (P gastroenterology has the potential to identify clinically relevant liver pathology. Consensus is needed on how to value the risk and rewards of screening and referral, to identify children with liver disease in the most appropriate manner. PMID:24117728

  19. At the ethical crossroads: how a gastroenterology procedure unit negotiated a solution for a reoccurring ethical dilemma.

    Science.gov (United States)

    Gair, Jonathan

    2013-01-01

    The gastroenterology procedures environment has proven to be fertile ground for the realization of moral distress as it relates to the practice of nursing. Specifically, nurses are expected to fulfill their duty as advocates for their clients at all times and within all contexts; however, their ability to discharge this essential function has been complicated by such influential factors as sedating medications, competing ethical motivations, discordant conclusions of moral reasoning and action, as well as competing institutional factors. This article begins with a fictional case study to introduce readers to the contextual essence of the moral distress that a group of gastroenterology nurses was collectively experiencing. Subsequently, the aim of this article was to explicate how one department, with the aid of an ethics committee, negotiated a process similar to the case study to develop a pragmatic policy and identify an educational primer that encourages nurses to reexamine and value the tangible realities inherent and expected of an advocate in the dynamically complex environment that characterizes all gastroenterology procedure environments where gastroenterology nurses practice.

  20. RTEMS CENTRE- RTEMS Improvement

    Science.gov (United States)

    Silva, Helder; Constantino, Alexandre; Freitas, Daniel; Coutinho, Manuel; Faustino, Sergio; Sousa, Jose; Dias, Luis; Zulianello, Marco

    2010-08-01

    During the last two years, EDISOFT's RTEMS CENTRE team [1], jointly with the European Space Agency and with the support of the worldwide RTEMS community [2], have been developing an activity to facilitate the qualification of the real-time operating system RTEMS (Real-Time Operating System for Multiprocessor Systems). This paper intends to give a high level visibility of the progress and the results obtained in the RTEMS Improvement [3] activity. The primary objective [4] of the project is to improve the RTEMS product, its documentation and to facilitate the qualification of RTEMS for future space missions, taking into consideration the specific operational requirements. The sections below provide a brief overview of the RTEMS operating system and the activities performed in the RTEMS Improvement project, which includes the selection of API managers to be qualified, the tailoring process, the requirements analysis, the reverse engineering and design of the RTEMS, the quality assurance process, the ISVV activities, the test campaign, the results obtained, the criticality analysis and the facilitation of qualification process.

  1. Integration of microbiology and infectious disease teaching courses in an interdisciplinary training programme (Master level) centred on the 'One world, one health' WHO concept.

    Science.gov (United States)

    Eveillard, Matthieu; Ruvoen, Nathalie; Lepelletier, Didier; Fradet, Stéphanie; Couvreur, Sébastien; Krempf, Michel; Magras, Catherine

    2016-05-01

    This report describes the integration of the microbiology and infectious diseases teaching courses in an international Master's level interdisciplinary programme based on the 'One world, one health' WHO concept, and reports the students and teachers' evaluation related to their feelings of about this innovative programme. The integration was evaluated by recording the positioning of these two topics in the five teaching units constituting the programme, and by identifying their contribution in the interactions between the different teaching units. The satisfaction of students was assessed by a quantitative survey, whereas the feelings of students and teachers were assessed by interviews. The study demonstrated that microbiology and infectious diseases were widely involved in interactions between the teaching units, constituting a kind of cement for the programme. The students assigned a mean score of 3.7 to the topics dealing with microbiology and infectious diseases. According to the qualitative data, students and teachers considered that the interdisciplinary approach provided new insights but reported problems of communication, probably inherent to the multiculturalism of the class. © FEMS 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. Satisfação do paciente em uma unidade de gastroenterologia Satisfacción del paciente en una unidad de gastroenterología Patient satisfaction in a gastroenterology unit

    Directory of Open Access Journals (Sweden)

    Gisele Hespanhol Dorigan

    2010-01-01

    planificar la asistencia para atender las necesidades de la clientela.OBJECTIVES: To assess patient satisfaction with nursing care received and verify if there are differences in relation to variables studied. METHODS: This is a descriptive study of quantitative approach in a conventional sample of 63 patients conducted in the gastroenterology unit of a teaching hospital in the interior of Sao Paulo state. To collect the data was used the Patient Satisfaction Instrument (PSI. RESULTS: The patients reported high satisfaction with all items and domains of the ISP, resulting in a satisfactory internal consistency in all domains. The variables gender, educational level and length of stay in the unit, had a positive impact on patient satisfaction. CONCLUSION: It is highlight the importance of knowing the patient satisfaction related to nursing care, which allows assessing and planning the care for the purposes of meeting the needs of nursing customers.

  3. Interview from anywhere: feasibility and utility of web-based videoconference interviews in the gastroenterology fellowship selection process.

    Science.gov (United States)

    Daram, Sumanth R; Wu, Ruonan; Tang, Shou-Jiang

    2014-02-01

    Traditional personal interviews are subject to limitations imposed by geographic, financial, and scheduling constraints. Web-based videoconferencing (WVC) has the potential to simplify the interview process. This study was intended to evaluate the feasibility and utility of WVC using standard tablets/computers with videoconferencing capability in gastroenterology (GI) fellowship interviews. At a single institution, 16 GI fellowship applicants participated in WVC with one interviewer, who was present at a remote location 750 miles away. In addition, each of the candidates underwent traditional interviews with four faculty members at the program site. All study interviewees used an iPad2 (Apple, iOS 5.1; Apple) with a videoconferencing application (Facetime). The interviewer (SRD) used Facetime on a MacBook Pro (Apple, Mac OS X 10.7.3). Each candidate completed a voluntary paper survey after completion of all assigned faculty interviews. The average age of the candidates was 30 years (range, 27-37 years). Fourteen candidates were native English speakers. Candidates expressed a high level of satisfaction, with 13 candidates (81%) stating that their WVC experience met or exceeded their expectations, and 87% of candidates stating that WVC should be an option in fellowship interviews. In addition, 25% of candidates felt that their WVC experience was equivalent to or better than their traditional interview experience on the same day. WVC can be an effective and useful tool in the fellowship interview process. It affords candidates increased flexibility, cost saving, convenience, and provides an option for participating in the selection process at more programs. For the programs and faculty, WVC has a potential to be an effective screening tool, can help minimize loss of clinical revenue and can also be an acceptable alternative to in-person interviews.

  4. Nuclear Power Plant Temelin Technical Support Centre

    International Nuclear Information System (INIS)

    Krizek, K.

    2000-01-01

    The erection of the Technical Support Centre for the Nuclear Power Plant Temelin has been a relatively sophisticated and costly issue. It was by proper use of the existing systems, as e.g. I and C, ISE and other systems, that a robust system has been created that is able to meet any requirements laid on the performance of the Technical Support Centre. The decision of the utility CEZ, a.s. that made it possible to establish the Technical Support Centre at the Nuclear Power Plant Temelin has been a right step which shows the level of safety culture within the utility. (author)

  5. Conceptual design and equipment of visitor centres

    International Nuclear Information System (INIS)

    Huettinger, K.

    1993-01-01

    Discussing the needs to be met by a visitor centre, the author develops the strategies to be adopted and defines the items to be included in the information program. The procedure in preparing the layout and design are explained and the media available to provide various levels of information are listed. Principles of selecting and mixing the media are discussed and the functions of the various sections of the centre described. Also included are examples of the costs and time requirements for the establishment of a typical centre. The importance of regular maintenance and updating is emphasized. (author)

  6. [Evaluation of hospitalizations in the gastroenterology service of Gabriel Toure Hospital, Mali].

    Science.gov (United States)

    Diarra, M; Konate, A; Demble Doumbia, A; Kalle, A; Maiga, M Y

    2006-01-01

    The goal of this study was to appreciate principal affections and mortality and in gastroenterology service of Gabriel Touré Hospital. It is about a survey longitudinal that has permit to analyze patients who have been care. During study, 766 patients were unregistered. Mean age of patient was 45.17 years and a sex ratio (M/F) = 1.10. The rate of reference was 13.85%. The morbidity was dominated by HIV infection (29.90%) followed by Hepato-cellular Carcinoma (7.83%) and cirrhosis (4.05%). Mortality (18.41%) was dominated by the VIH infection, HCC and Cirrhosis. The precocious recourse to cares, the improvement of work conditions, the sensitization, the infectious illness prevention is factors that will permit a reduction of morbidity and hospital mortality.

  7. Canadian Association of Gastroenterology policy on the application for, and implementation of, clinical practice guidelines

    Science.gov (United States)

    Singh, Harminder; Leontiadis, Grigorios I; Hookey, Lawrence; Enns, Robert; Bistritz, Lana; Rioux, Louis-Charles; Hope, Louise; Sinclair, Paul

    2014-01-01

    An important mandate of the Canadian Association of Gastroenterology (CAG), as documented in the Association’s governance policies, is to optimize the care of patients with digestive disorders. Clinical practice guidelines are one means of achieving this goal. The benefits of timely, high-quality and evidenced-based recommendations include: Enhancing the professional development of clinical members through education and dissemination of synthesized clinical research;Improving patient care provided by members by providing focus on quality and evidence;Creating legislative environments that favour effective clinical practice;Enhancing the clinical care provided to patients with digestive disease by nongastroenterologists; andIdentifying areas that require further information or research to improve clinical care.The present document provides the foundation required to ensure that clinical practice guidelines produced by the CAG are necessary, appropriate, credible and applicable. These recommendations should be adhered to as closely as possible to obtain CAG endorsement. PMID:25314352

  8. [Gastroenterology 2.0: useful resources for the gastroenterologist available on the Web 2.0].

    Science.gov (United States)

    Curioso, Walter H; Proaño, Alvaro; Ruiz, Eloy F

    2011-01-01

    The term Web 2.0 refers to the use of Internet applications which enable the users to share, participate and collaborate together on information. The objective of this study is to check different applications that use Web 2.0, which could help the gastroenterologist in his daily practice. The applications that will be checked include: blogs, microblogging, RSS, podcasts, wikis and social networks. "Gastroenterology 2.0" represents the applications, services, and tools based on Web 2.0, which are of easy use and easily accessible - to consumers, patients, gastroenterologists and other health professionals, as well as researchers. Although several studies have shown the benefits these technologies have on the medical practice, it is necessary to conduct further studies to demonstrate the use of these applications on improving health.

  9. World Gastroenterology Organization Practice Guidelines for the diagnosis and management of IBD in 2010.

    Science.gov (United States)

    Bernstein, Charles N; Fried, Michael; Krabshuis, J H; Cohen, Henry; Eliakim, R; Fedail, Suleiman; Gearry, Richard; Goh, K L; Hamid, Saheed; Khan, Aamir Ghafor; LeMair, A W; Malfertheiner; Ouyang, Qin; Rey, J F; Sood, Ajit; Steinwurz, Flavio; Thomsen, Ole O; Thomson, Alan; Watermeyer, Gillian

    2010-01-01

    Inflammatory bowel disease (IBD) represents a group of idiopathic, chronic, inflammatory intestinal conditions. Its two main disease categories are: Crohn's disease (CD) and ulcerative colitis (UC), which feature both overlapping and distinct clinical and pathological features. While these diseases have, in the past, been most evident in the developed world, their prevalence in the developing world has been gradually increasing in recent decades. This poses unique issues in diagnosis and management which have been scarcely addressed in the literature or in extant guidelines. Depending on the nature of the complaints, investigations to diagnose either form of IBD or to assess disease activity will vary and will also be influenced by geographic variations in other conditions that might mimic IBD. Similarly, therapy varies depending on the phenotype of the disease being treated and available resources. The World Gastroenterology Organization has, accordingly, developed guidelines for diagnosing and treating IBD using a cascade approach to account for variability in resources in countries around the world.

  10. World Gastroenterology Organization Practice Guidelines for the diagnosis and management of IBD in 2010

    DEFF Research Database (Denmark)

    Bernstein, Charles N; Fried, Michael; Krabshuis, J H

    2010-01-01

    have, in the past, been most evident in the developed world, their prevalence in the developing world has been gradually increasing in recent decades. This poses unique issues in diagnosis and management which have been scarcely addressed in the literature or in extant guidelines. Depending...... on the nature of the complaints, investigations to diagnose either form of IBD or to assess disease activity will vary and will also be influenced by geographic variations in other conditions that might mimic IBD. Similarly, therapy varies depending on the phenotype of the disease being treated and available...... resources. The World Gastroenterology Organization has, accordingly, developed guidelines for diagnosing and treating IBD using a cascade approach to account for variability in resources in countries around the world....

  11. Diagnosis and management of adult coeliac disease: guidelines from the British Society of Gastroenterology.

    Science.gov (United States)

    Ludvigsson, Jonas F; Bai, Julio C; Biagi, Federico; Card, Timothy R; Ciacci, Carolina; Ciclitira, Paul J; Green, Peter H R; Hadjivassiliou, Marios; Holdoway, Anne; van Heel, David A; Kaukinen, Katri; Leffler, Daniel A; Leonard, Jonathan N; Lundin, Knut E A; McGough, Norma; Davidson, Mike; Murray, Joseph A; Swift, Gillian L; Walker, Marjorie M; Zingone, Fabiana; Sanders, David S

    2014-08-01

    A multidisciplinary panel of 18 physicians and 3 non-physicians from eight countries (Sweden, UK, Argentina, Australia, Italy, Finland, Norway and the USA) reviewed the literature on diagnosis and management of adult coeliac disease (CD). This paper presents the recommendations of the British Society of Gastroenterology. Areas of controversies were explored through phone meetings and web surveys. Nine working groups examined the following areas of CD diagnosis and management: classification of CD; genetics and immunology; diagnostics; serology and endoscopy; follow-up; gluten-free diet; refractory CD and malignancies; quality of life; novel treatments; patient support; and screening for CD. 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.

  12. Communication of alcohol and smoking lifestyle advice to the gastroenterological patient.

    Science.gov (United States)

    Spence, Andrew D; Khasawneh, Mais; Allen, Patrick B; Addley, Jennifer

    2017-10-01

    Effective communication between healthcare staff and patients is central to development of the patient-professional relationship. Many barriers influence this communication, often resulting in patients' lack of understanding and retention of information, particularly affecting advice regarding lifestyle habits, such as alcohol consumption and smoking. Alcohol and smoking misuse are potentially modifiable risk factors known to adversely affect a variety of gastroenterological conditions and improvements in communication with patients regarding this is an important management component. This review discusses the clinical impact of these factors and how healthcare professionals can improve communication. We discuss how enhancing verbal communication skills through medical training leads to greater outcomes in patient satisfaction and adherence to treatment and advice. In addition, with the rapid digitalisation of society, platforms such as social media and smartphone applications may be considered as adjuncts to traditional forms of communication. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. The Bruce Energy Centre

    International Nuclear Information System (INIS)

    Jones, R.I.

    1982-06-01

    The Bruce Energy Centre Development Corporation is a joint venture of the Ontario Energy Corporation and 6 private companies formed to market surplus steam from the Bruce Nuclear Power Development. The corporation will also sell or lease land near Bruce NPD. The Bruce Energy Centre has an energy output of 900 BTU per day per dollar invested. Potential customers include greenhouse operators, aquaculturalists, food and beverage manufacturers, and traditional manufacturers

  14. The Aube centre

    International Nuclear Information System (INIS)

    1996-07-01

    This educational booklet is devoted to a general presentation of the Aube radioactive wastes storage centre. After a short presentation of the Andra, the French national agency for the management of radioactive wastes, it gives some general information about radioactive wastes (origin, classification), containers (quality assurance and different types), wastes transportation (planning, safety), and about the Aube centre itself: description, treatment and conditioning of drums (compacting and injection), storage facilities, geological situation of the site, and environmental controls. (J.S.)

  15. CENTRE FOR GEOMETRICAL METROLOGY

    DEFF Research Database (Denmark)

    De Chiffre, Leonardo

    The objective of this Annual Report is to give a general introduction to CGM as well as to give an account of the tasks carried out using the facilities of CGM's Instrument Centre during 1998 and 1999.......The objective of this Annual Report is to give a general introduction to CGM as well as to give an account of the tasks carried out using the facilities of CGM's Instrument Centre during 1998 and 1999....

  16. A 25-year analysis of the American College of Gastroenterology Research Grant Program:

    Science.gov (United States)

    Crockett, Seth D.; Dellon, Evan S.; Bright, Stephanie D.; Shaheen, Nicholas J.

    2011-01-01

    Introduction The American College of Gastroenterology (ACG) has awarded research grants for 25 years. We assessed the characteristics of grant recipients, their current academic status, and the likelihood of publication resulting from the grant. Methods Demographic data, year and amount of award, title of project, and recipient’s institution were extracted from ACG databases. Using ACG reports and medical literature search engines, we assessed publication based on grant-funded research, as well as career publication record. We also determined the current position of awardees. Similar analysis was performed for recipients of junior investigator awards. Results A total of 396 clinical research awards totaling $5,374,497 ($6,867,937 in 2008 dollars) were awarded to 341 recipients in the 25 years between 1983 and 2008. The most commonly funded areas of research were endoscopy (22% of awards) and motility/functional disorders (21%). At least one peer-reviewed publication based on grant-funded research occurred in 255 of the awards (69%). Higher award value was associated with subsequent publication. Of 341 past awardees, 195 (62%) are currently in academic positions. Factors associated with staying in academics included higher award value (pacademics. Overall, the mean cost in grant dollars per published paper based on the research was $14,875. Conclusion The majority of ACG grant recipients published the results of their research and remained in academics. Higher amount of award, holding an advanced degree, and publication were associated with careers in academics. The ACG research grant award program is an important engine of investigation, publications, and academic career development in the field of gastroenterology. PMID:19319125

  17. Practice Audit in Gastroenterology (PAGE) program: A novel approach to continuing professional development

    Science.gov (United States)

    Armstrong, David; Hollingworth, Roger; Gardiner, Tara; Klassen, Michael; Smith, Wendy; Hunt, Richard H; Barkun, Alan; Gould, Michael; Leddin, Desmond

    2006-01-01

    BACKGROUND: Practice audit is an important component of continuing professional development that may more readily be undertaken if it were less complex. This qualitative study assessed the use of personal digital assistants to facilitate data collection and review. METHODS: Personal digital assistants programmed with standard questionnaires related to upper gastrointestinal endoscopies (Practice Audit in Gastroenterology-Endoscopy [‘PAGE-Endo’]) and colonoscopies (PAGE-Colonoscopy [‘PAGE-Colo’]) were provided to Canadian gastroenterologists, surgeons and internists. Over a three-week audit period, participants recorded indications, and the expected (E) and reported (R) findings for each procedure. Thereafter, participants recorded compliance with reporting, the ease of use and value of the PAGE program, and their willingness to perform another audit. RESULTS: Over 15 to 18 months, 173 participants completed PAGE-Endo (6168 procedures) and 111 completed PAGE-Colo (4776 procedures). Most respondents noted that PAGE was easy to use (99%), beneficial (88% to 95%), and that they were willing undertake another audit (92% to 95%). In PAGE-Endo, alarm features were prevalent (55%), but major reported findings were less common than expected: esophagitis (E 29.9%, R 14.8%), esophageal stricture (E 8.3%, R 3.6%), gastric ulcer (E 17.0%, R 4.7%), gastric cancer (E 4.3%, R 1.0%) and duodenal ulcer (E 11.5%, R 5.7%). In PAGE-Colo, more colonoscopies were performed for symptom investigation (55%) than for screening (25%) or surveillance (20%). There were marked interprovincial variations with respect to sedation, biopsies and technical aspects of colonoscopy. CONCLUSION: Secure, real-time data entry with review of aggregate and individual data in the PAGE program provided an acceptable, straightforward methodology for accredited practice audit activities. PAGE has considerable potential for continuing professional development in gastroenterology and other specialties

  18. Establishing an integrated gastroenterology service between a medical center and the community.

    Science.gov (United States)

    Niv, Yaron; Dickman, Ram; Levi, Zohar; Neumann, Gadi; Ehrlich, Dorit; Bitterman, Haim; Dreiher, Jacob; Cohen, Arnon; Comaneshter, Doron; Halpern, Eyran

    2015-02-21

    To combine community and hospital services in order to enable improvements in patient management, an integrated gastroenterology service (IGS) was established. Referral patterns to specialist clinics were optimized; open access route for endoscopic procedures (including esophago-gastro-duodenoscopy, sigmoidoscopy and colonoscopy) was established; family physicians' knowledge and confidence were enhanced; direct communication lines between experts and primary care physicians were opened. Continuing education, guidelines and agreed instructions for referral were promoted by the IGS. Six quality indicators were developed by the Delphi method, rigorously designed and regularly monitored. Improvement was assessed by comparing 2010, 2011 and 2012 indicators. An integrated delivery system in a specific medical field may provide a solution to a fragmented healthcare system impaired by a lack of coordination. In this paper we describe a new integrated gastroenterology service established in April 2010. Waiting time for procedures decreased: 3 mo in April 30th 2010 to 3 wk in April 30th 2011 and stayed between 1-3 wk till December 30th 2012. Average cost for patient's visit decreased from 691 to 638 NIS (a decrease of 7.6%). Six health indicators were improved significantly comparing 2010 to 2012, 2.5% to 67.5%: Bone densitometry for patients with inflammatory bowel disease, preventive medications for high risk patients on aspirin/NSAIDs, colonoscopy following positive fecal occult blood test, gastroscopy in Barrett's esophagus, documentation of family history of colorectal cancer, and colonoscopy in patients with a family history of colorectal cancer. Establishment of an IGS was found to effectively improve quality of care, while being cost-effective.

  19. Shifting Away From Fee-For-Service: Alternative Approaches to Payment in Gastroenterology.

    Science.gov (United States)

    Patel, Kavita; Presser, Elise; George, Meaghan; McClellan, Mark

    2016-04-01

    Fee-for-service payments encourage high-volume services rather than high-quality care. Alternative payment models (APMs) aim to realign financing to support high-value services. The 2 main components of gastroenterologic care, procedures and chronic care management, call for a range of APMs. The first step for gastroenterologists is to identify the most important conditions and opportunities to improve care and reduce waste that do not require financial support. We describe examples of delivery reforms and emerging APMs to accomplish these care improvements. A bundled payment for an episode of care, in which a provider is given a lump sum payment to cover the cost of services provided during the defined episode, can support better care for a discrete procedure such as a colonoscopy. Improved management of chronic conditions can be supported through a per-member, per-month (PMPM) payment to offer extended services and care coordination. For complex chronic conditions such as inflammatory bowel disease, in which the gastroenterologist is the principal care coordinator, the PMPM payment could be given to a gastroenterology medical home. For conditions in which the gastroenterologist acts primarily as a consultant for primary care, such as noncomplex gastroesophageal reflux or hepatitis C, a PMPM payment can support effective care coordination in a medical neighborhood delivery model. Each APM can be supplemented with a shared savings component. Gastroenterologists must engage with and be early leaders of these redesign discussions to be prepared for a time when APMs may be more prevalent and no longer voluntary. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

  20. Prevalence and correlates of achieving recommended physical activity levels among children living in rural South Asia—A multi-centre study

    Directory of Open Access Journals (Sweden)

    Krithiga Shridhar

    2016-08-01

    Full Text Available Abstract Background We report the prevalence of recommended physical activity levels (RPALs and examine the correlates of achieving RPALs in rural South Asian children and analyse its association with anthropometric outcomes. Methods This analysis on rural South Asian children aged 5–14 years (n = 564 is a part of the Chronic Disease Risk Factor study conducted at three sites in India (Chennai n = 146; Goa n = 218 and Bangladesh (Matlab; n = 200. Data on socio-demographic and lifestyle factors (physical activity (PA; diet were collected using an interviewer-administered questionnaires, along with objective anthropometric measurements. Multivariate logistic regression models were used to examine whether RPALs (active travel to school (yes/no; leisure-time PA ≥ 1 h/day; sedentary-activity ≤ 2 h/day were associated with socio-demographic factors, diet and other forms of PA. Multivariate linear regression models were used to investigate associations between RPALs and anthropometrics (BMI- and waist z-scores. Results The majority of children (71.8 % belonged to households where a parent had at least a secondary education. Two-thirds (66.7 % actively travelled to school; 74.6 % reported ≥1 h/day of leisure-time PA and 55.7 % had ≤2 h/day of sedentary-activity; 25.2 % of children reported RPALs in all three dimensions. Older (10–14 years, OR = 2.0; 95 % CI: 1.3, 3.0 and female (OR = 1.7; 95 % CI: 1.1, 2.5 children were more likely to travel actively to school. Leisure-time PA ≥ 1 h/day was more common among boys (OR = 2.5; 95 % CI: 1.5, 4.0, children in Matlab, Bangladesh (OR = 3.0; 95 % CI: 1.6, 5.5, and those with higher processed-food consumption (OR = 2.3; 95 % CI: 1.2, 4.1. Sedentary activity ≤ 2 h/day was associated with younger children (5–9 years, OR = 1.6; 95 % CI: 1.1, 2.4, children of Goa (OR = 3.5; 95 % CI: 2.1, 6.1 and Chennai (OR = 2.5; 95

  1. Prevalence and correlates of achieving recommended physical activity levels among children living in rural South Asia-A multi-centre study.

    Science.gov (United States)

    Shridhar, Krithiga; Millett, Christopher; Laverty, Anthony A; Alam, Dewan; Dias, Amit; Williams, Joseph; Dhillon, Preet K

    2016-08-02

    We report the prevalence of recommended physical activity levels (RPALs) and examine the correlates of achieving RPALs in rural South Asian children and analyse its association with anthropometric outcomes. This analysis on rural South Asian children aged 5-14 years (n = 564) is a part of the Chronic Disease Risk Factor study conducted at three sites in India (Chennai n = 146; Goa n = 218) and Bangladesh (Matlab; n = 200). Data on socio-demographic and lifestyle factors (physical activity (PA); diet) were collected using an interviewer-administered questionnaires, along with objective anthropometric measurements. Multivariate logistic regression models were used to examine whether RPALs (active travel to school (yes/no); leisure-time PA ≥ 1 h/day; sedentary-activity ≤ 2 h/day) were associated with socio-demographic factors, diet and other forms of PA. Multivariate linear regression models were used to investigate associations between RPALs and anthropometrics (BMI- and waist z-scores). The majority of children (71.8 %) belonged to households where a parent had at least a secondary education. Two-thirds (66.7 %) actively travelled to school; 74.6 % reported ≥1 h/day of leisure-time PA and 55.7 % had ≤2 h/day of sedentary-activity; 25.2 % of children reported RPALs in all three dimensions. Older (10-14 years, OR = 2.0; 95 % CI: 1.3, 3.0) and female (OR = 1.7; 95 % CI: 1.1, 2.5) children were more likely to travel actively to school. Leisure-time PA ≥ 1 h/day was more common among boys (OR = 2.5; 95 % CI: 1.5, 4.0), children in Matlab, Bangladesh (OR = 3.0; 95 % CI: 1.6, 5.5), and those with higher processed-food consumption (OR = 2.3; 95 % CI: 1.2, 4.1). Sedentary activity ≤ 2 h/day was associated with younger children (5-9 years, OR = 1.6; 95 % CI: 1.1, 2.4), children of Goa (OR = 3.5; 95 % CI: 2.1, 6.1) and Chennai (OR = 2.5; 95 % CI: 1.5, 4.3) and low household education

  2. Nuclear research centres - The Egyptian experiment

    International Nuclear Information System (INIS)

    Abdelrazek, I.D.

    2001-01-01

    The Atomic Energy Authority of Egypt has four research centres located at two sites. Its research reactors are devoted to the production of isotopes, neutron beam experiments, activation analysis and materials research. The accelerators are devoted to the production of short lived isotopes for medical applications and materials R and D. Irradiation technology is used for sterilization of medical supplies and food preservation. High level of expertise in those centres is also useful for other developmental activities in Egypt. (author)

  3. RTEMS CENTRE- Support and Maintenance CENTRE to RTEMS Operating System

    Science.gov (United States)

    Silva, H.; Constantino, A.; Coutunho, M.; Freitas, D.; Faustino, S.; Mota, M.; Colaço, P.; Zulianello, M.

    2008-08-01

    RTEMS stands for Real-Time Operating System for Multiprocessor Systems. It is a full featured Real Time Operating System that supports a variety of open APIs and interface standards. It provides a high performance environment for embedded applications, including a fixed-priority preemptive/non-preemptive scheduler, a comprehensive set of multitasking operations and a large range of supported architectures. Support and maintenance CENTRE to RTEMS operating system (RTEMS CENTRE) is a joint initiative of ESA-Portugal Task force, aiming to build a strong technical competence in the space flight (on- board) software, to offer support, maintenance and improvements to RTEMS. This paper provides a high level description of the current and future activities of the RTEMS CENTRE. It presents a brief description of the RTEMS operating system, a description of the tools developed and distributed to the community [1] and the improvements to be made to the operating system, including facilitation for the qualification of RTEMS (4.8.0) [2] for the space missions.

  4. OBESITY LEVELS OF ADULT WOMEN AND MEN IN CITY CENTRE OF SİVAS / SİVAS İL MERKEZİNDE YETİŞKİN KADIN VE ERKEKLERDE OBEZİTE DEĞERLERİ

    Directory of Open Access Journals (Sweden)

    Dr. Gülüşan ÖZGÜN BAŞIBÜYÜK

    2007-11-01

    obesity and disease. Consequently, it was determined that interaction of environmental conditions as socioeconomic structure, education level, climate and nutritional factors are affected by anthropometric characters at different levels. Also, we can say that anthropometric measurements of our individuals living city centre of Sivas differ from other region’s people.

  5. Energy centre microgrid model

    Energy Technology Data Exchange (ETDEWEB)

    Pasonen, R.

    2011-09-15

    A simulation model of Energy centre microgrid made with PSCAD simulation software version 4.2.1 has been built in SGEM Smart Grids and Energy Markets (SGEM) work package 6.6. Microgrid is an autonomous electric power system which can operate separate from common distribution system. The idea of energy centre microgrid concept was considered in Master of Science thesis 'Community Microgrid - A Building block of Finnish Smart Grid'. The name of energy centre microgrid comes from a fact that production and storage units are concentrated into a single location, an energy centre. This centre feeds the loads which can be households or industrial loads. Power direction flow on the demand side remains same compared to the current distribution system and allows to the use of standard fuse protection in the system. The model consists of photovoltaic solar array, battery unit, variable frequency boost converter, inverter, isolation transformer and demand side (load) model. The model is capable to automatically switch to islanded mode when there is a fault in outside grid and back to parallel operation mode when fault is removed. The modelled system responses well to load changes and total harmonic distortion related to 50Hz base frequency is kept under 1.5% while operating and feeding passive load. (orig.)

  6. The ideal Atomic Centre

    International Nuclear Information System (INIS)

    Mas, R.

    1965-01-01

    The author presents considerations which should prove to be of interest to all those who have to design, to construct and to operate a nuclear research centre. A large number of the ideas presented can also be applied to non-nuclear scientific research centres. In his report the author reviews: various problems with which the constructor is faced: ground-plan, infrastructure, buildings and the large units of scientific equipment in the centre, and those problems facing the director: maintenance, production, supplies, security. The author stresses the relationship which ought to exist between the research workers and the management. With this aim in view he proposes the creation of National School for Administration in Research which would train administrative executives for public or private organisations; they would be specialised in the fields of fundamental or applied research. (author) [fr

  7. The DIY Digital Medical Centre.

    Science.gov (United States)

    Timmis, James Kenneth; Timmis, Kenneth

    2017-09-01

    Healthcare systems worldwide are confronted with major economic, organizational and logistical challenges. Historic evolution of health care has led to significant healthcare sector fragmentation, resulting in systemic inefficiencies and suboptimal resource exploitation. To attain a sustainable healthcare model, fundamental, system-wide improvements that effectively network, and ensure fulfilment of potential synergies between sectors, and include and facilitate coherent strategic planning and organisation of healthcare infrastructure are needed. Critically, they must be specifically designed to sustainably achieve peak performance within the current policy environment for cost-control, and efficiency and quality improvement for service delivery. We propose creation of a new healthcare cluster, to be embedded in existing healthcare systems. It consists of (i) local 24/7 walk-in virtually autonomous do-it-yourself Digital Medical Centres performing routine diagnosis, monitoring, prevention, treatment and standardized documentation and health outcome assessment/reporting, which are online interfaced with (ii) regional 24/7 eClinician Centres providing on-demand clinical supervision/assistance to Digital Medical Centre patients. Both of these are, in turn, online interfaced with (iii) the National Clinical Informatics Centre, which houses the national patient data centre (cloud) and data analysis units that conduct patient- and population-level, personalized and predictive(-medicine) intervention optimization analyses. The National Clinical Informatics Centre also interfaces with biomedical research and prioritizes and accelerates the translation of new discoveries into clinical practice. The associated Health Policy Innovation and Evaluation Centre rapidly integrates new findings with health policy/regulatory discussions. This new cluster would synergistically link all health system components in a circular format, enable not only access by all arms of the health

  8. World Health Organization 2006 child growth standards and 2007 growth reference charts: A discussion paper by the committee on Nutrition of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

    Science.gov (United States)

    Turck, Dominique; Michaelsen, Kim F; Shamir, Raanan; Braegger, Christian; Campoy, Cristina; Colomb, Virginie; Decsi, Tamás; Domellöf, Magnus; Fewtrell, Mary; Kolacek, Sanja; Mihatsch, Walter; Moreno, Luis A; van Goudoever, Johannes

    2013-08-01

    Growth charts are essential for evaluating children's health including their nutrition; however, the evaluation of child growth trajectories and consequently the decision to intervene are highly dependent on the growth charts used. The aim of this discussion paper of the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition Committee on Nutrition is to provide information on the background and rationale of the World Health Organization (WHO) 2006 child growth standards and WHO 2007 growth reference charts, describe their development, outline their main innovative aspects, discuss potential limitations, and make recommendations. WHO 2006 child growth standards (0-5 years) are based on prospectively collected data describing the growth of healthy infants who were breast-fed according to WHO recommendations, showing a pattern of linear growth, which is remarkably consistent between different countries and ethnic groups. WHO 2007 growth reference charts (5-19 years) are based mainly on a re-analysis of National Centre for Health Statistics data from 1977, without information on feeding. European Society for Paediatric Gastroenterology, Hepatology, and Nutrition Committee on Nutrition recommends that WHO child growth standards should be used to monitor growth in all children in the age range 0 to 2 years in Europe, whether breast- or formula-fed, and that they should be considered to be used in the age range 2 to 5 years. Implementation of the WHO child growth standards should be preceded by evaluation of the implication of their use on national healthcare policies. Health professionals should be guided on their use and interpretation and an adequate communication strategy should be available locally to ensure that parents receive clear and consistent advice. The decision on whether to implement the WHO growth references (5-19 years) should be made by national bodies because the growth pattern during the 5- to 19-year period differs between

  9. Netherlands Reactor Centre

    International Nuclear Information System (INIS)

    Anon.

    1976-01-01

    Briefly reviews the last year's work of the twenty year old Netherlands Reactor Centre (RCN) in the fields of reactor safety, fissile material, nuclear fission, non-nuclear energy systems and overseas co-operation. The annual report thus summarised is the last one to appear under the name of RCN. The terms of reference of the organisation having been broadened to include research into energy supply in general, it is to be known in future as the Netherlands Energy Research Centre (ECN). (D.J.B.)

  10. The Structural Integrity Centre

    International Nuclear Information System (INIS)

    Tomkins, B.

    1987-01-01

    The paper concerns the development and work of the Structural Integrity Centre (SIC) at Risley Nuclear Laboratories, United Kingdom. The centre was set up to provide authoritative advice to plant designers and operators on the integrity and life assessment of structures and components across the reactor projects in the United Kingdom. A description is given of the structure and role of the SIC, as well as the Structural Integrity Assessment work. The assessment methods are described for thermally loaded structures and welded structures. Finally, defect significance assessment and environmental effects are outlined. (U.K.)

  11. Environmental monitoring of the Cea Valduc centre

    International Nuclear Information System (INIS)

    Guetat, Ph.; Jaskula, L.

    2010-01-01

    This paper describes the main features of the environmental control in the vicinity of the CEA Valduc centre, explains the site specific characteristics, the surveillance policy, and some historical elements about tritium atmospheric release. Some levels of activities are given, corresponding to an exposure level below 0.02% of natural irradiation. (author)

  12. International research centre launched

    International Nuclear Information System (INIS)

    1965-01-01

    Full text: The first scientific research and educational institution to be set up on a completely international basis was officially inaugurated in Trieste on 5 October 1964 by the Director General of IAEA, Dr. Sigvard Eklund, when he opened the first seminar of the International Centre for Theoretical Physics. As evidence of the international nature of the institution he noted that the scientists who would work and teach there during the first year represented sixteen different countries. By the end of 1964, the Centre building was nearing completion and three of the five floors were occupied. A successful symposium had been held on the subject of plasma physics, and a score of professors and fellows were at work, from Bulgaria, Czechoslovakia, Greece, India, Japan, Jordan, the Netherlands, Norway, Pakistan, Poland, the United Kingdom, and the United States. A dozen scientific papers had been issued as preprints. The main purpose of the Centre is to foster the advancement of theoretical physics through training and research; at first the chief subject will be high-energy and elementary particle physics. Plasma physics, low energy physics and solid-state physics will also be dealt with. Special attention is paid to the needs of the developing countries. Of the 25 fellows selected for the academic year 1964-65, more than half are from South America, Africa and Asia. In conjunction with the Research Centre, there is an Advanced School for theoretical Physics to provide graduate training for fellows who need such preparation before they embark upon research. The Centre works under the guidance of a Scientific Council comprising the president, Prof. M. Sandoval-Vallarta (Nuclear Energy Commission of Mexico); Prof. A. Abragam (Saclay, France); Prof. R. Oppenheimer (Institute for Advanced Study, Princeton, USA); Dr. V. Soloviev (Dubna, USSR); Prof V.F. Weiskopf (Director General, CERN) ; Prof Abdus Salam (Imperial College, London) ; Prof. P. Budini (University of Trieste

  13. Access to specialist gastroenterology care in Canada: Comparison of wait times and consensus targets

    Science.gov (United States)

    Leddin, Desmond; Armstrong, David; Barkun, Alan NG; Chen, Ying; Daniels, Sandra; Hollingworth, Roger; Hunt, Richard H; Paterson, William G

    2008-01-01

    BACKGROUND: Monitoring wait times and defining targets for care have been advocated to improve health care delivery related to cancer, heart, diagnostic imaging, joint replacements and sight restoration. There are few data on access to care for digestive diseases, although they pose a greater economic burden than cancer or heart disease in Canada. The present study compared wait times for specialist gastroenterology care with recent, evidence-based, consensus-defined benchmark wait times for a range of digestive diseases. METHODS: Total wait times from primary care referral to investigation were measured for seven digestive disease indications by using the Practice Audit in Gastroenterology program, and were benchmarked against consensus recommendations. RESULTS: Total wait times for 1903 patients who were undergoing investigation exceeded targets for those with probable cancer (median 26 days [25th to 75th percentiles eight to 56 days] versus target of two weeks); probable inflammatory bowel disease (101 days [35 to 209 days] versus two weeks); documented iron deficiency anemia (71 days [19 to 142 days] versus two months); positive fecal occult blood test (73 days [36 to 148 days] versus two months); dyspepsia with alarm symptoms (60 days [23 to 140 days] versus two months); refractory dyspepsia without alarm symptoms (126 days [42 to 225 days] versus two months); and chronic constipation and diarrhea (141 days [68 to 264 days] versus two months). A minority of patients were seen within target times: probable cancer (33% [95% CI 20% to 47%]); probable inflammatory bowel disease (12% [95% CI 1% to 23%]); iron deficiency anemia (46% [95% CI 37% to 55%]); positive occult blood test (41% [95% CI 28% to 54%]); dyspepsia with alarm symptoms (51% [95% CI 41% to 60%]); refractory dyspepsia without alarm symptoms (33% [95% CI 19% to 47%]); and chronic constipation and diarrhea (21% [95% CI 14% to 29%]). DISCUSSION: Total wait times for the seven indications exceeded the

  14. Assessing the educational needs of Canadian gastroenterologists and gastroenterology nurses: Challenges to optimal care in Crohn’s disease

    Science.gov (United States)

    Dupuis, Martin; Marshall, John K; Hayes, Sean M; Cytryn, Kayla; Murray, Suzanne

    2009-01-01

    OBJECTIVE: A national needs assessment of Canadian gastroenterologists and gastroenterology nurses was undertaken to determine the perceived and unperceived educational and performance barriers to caring for patients with Crohn’s disease (CD). METHODS: A triangulated, mixed-method approach (qualitative and quantitative) was used to determine the nature and extent of knowledge gaps and barriers in the care of patients with CD. RESULTS: Qualitative interviews were conducted with nine gastroenterologists, four gastroenterology nurses and nine patients with CD. Based on this exploratory research, a survey was designed and launched nationally (37 gastroenterologists, 36 gastroenterology nurses). Findings indicated that Canadian gastroenterologists and gastroenterology nurses lacked clarity regarding their roles and responsibilities across the continuum of CD care, and face communication gaps within the health care team, undermining their effectiveness. Gastroenterologists identified challenges in optimal diagnosis due to unclear testing and diagnostic criteria. They recognized knowledge gaps when treating patient subgroups and in prescribing biological therapies. Furthermore, gastroenterologists self-identified gaps in skill, knowledge, and confidence in monitoring disease progression and effectively assessing response to therapy. When managing patients with CD, gastroenterologists expressed challenges with patient issues outside their domain of medical expertise, particularly with the skills needed to facilitate effective patient communication and education that would enhance adherence to recommended treatments. CONCLUSIONS: Educational initiatives should address diagnostic and treatment guidelines, as well as enhancement of clinical performance gaps in health care team processes and the patient-professional therapeutic relationship. To impact care and patient outcomes, these initiatives must be relevant to clinical practice settings and applicable to the practice

  15. Centre for Political and

    African Journals Online (AJOL)

    user

    and definitions will be published and the data translated into the official ... The Centre provides a terminological and subject-related service to lecturers and ... postgraduate students in international politics, political studies and .... obtain financial contributions (cf. .... making of authoritative and enforceable rules (laws) for.

  16. Implementing Responsibility Centre Budgeting

    Science.gov (United States)

    Vonasek, Joseph

    2011-01-01

    Recently, institutes of higher education (universities) have shown a renewed interest in organisational structures and operating methodologies that generate productivity and innovation; responsibility centre budgeting (RCB) is one such process. This paper describes the underlying principles constituting RCB, its origin and structural elements, and…

  17. Fuel cycle centres

    International Nuclear Information System (INIS)

    Hagen, M.

    1977-01-01

    The concept of co-locating and integrating fuel cycle facilities at one site is discussed. This concept offers considerable advantages, especially in minimizing the amount of radioactive material to be transported on public roads. Safeguards and physical protection as relating to such an integrated system of facilities are analysed in detail, also industrial and commercial questions. An overall risk-benefit evaluation turns out to be in favour of fuel cycle centres. These centres seem to be specifically attractive with regard to the back end of the fuel cycle, including on-site disposal of radioactive wastes. The respective German approach is presented as an example. Special emphasis is given to the site selection procedures in this case. Time scale and cost for the implementation of this concept are important factors to be looked at. Since participation of governmental institutions in these centres seems to be indispensable their respective roles as compared to industry must be clearly defined. The idea of adjusting fuel cycle centres to regional rather than national use might be an attractive option, depending on the specific parameters in the region, though results of existing multinational ventures are inconclusive in this respect. Major difficulties might be expected e.g. because of different national safety regulations and standards as well as commercial conditions among partner countries. Public acceptance in the host country seems to be another stumbling block for the realization of this type of multinational facilities

  18. Budapest Training Technology Centre.

    Science.gov (United States)

    Budapest Training Technology Centre (Hungary).

    The Budapest Training Technology Centre (BTTC) grew out of a 1990 agreement calling for Great Britain to help Hungary develop and implement open and flexible training methods and technology-based training to support the labor force development and vocational training needs resulting from Hungary's transition to a market economy. The BTTC would be…

  19. Official Centre Hospitality

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

    Sylvain Dufour

    Approved by the Management Executive Committee. - 1 -. Version 3.1.0 effective 2017-06-28. Official Centre Hospitality. 1. Objective. 2. Application. 3. Definitions. 4. Roles and Responsibilities. 5. Authorization. 6. Consultants and Contractors. 7. Reimbursement. 1. Objective. To define the circumstances under which ...

  20. Academic Drug Discovery Centres

    DEFF Research Database (Denmark)

    Kirkegaard, Henriette Schultz; Valentin, Finn

    2014-01-01

    Academic drug discovery centres (ADDCs) are seen as one of the solutions to fill the innovation gap in early drug discovery, which has proven challenging for previous organisational models. Prior studies of ADDCs have identified the need to analyse them from the angle of their economic...

  1. ATLAS Visitors Centre

    CERN Multimedia

    claudia Marcelloni

    2009-01-01

    ATLAS Visitors Centre has opened its shiny new doors to the public. Officially launched on Monday February 23rd, 2009, the permanent exhibition at Point 1 was conceived as a tour resource for ATLAS guides, and as a way to preserve the public’s opportunity to get a close-up look at the experiment in action when the cavern is sealed.

  2. Non-English speakers attend gastroenterology clinic appointments at higher rates than English speakers in a vulnerable patient population

    Science.gov (United States)

    Sewell, Justin L.; Kushel, Margot B.; Inadomi, John M.; Yee, Hal F.

    2009-01-01

    Goals We sought to identify factors associated with gastroenterology clinic attendance in an urban safety net healthcare system. Background Missed clinic appointments reduce the efficiency and availability of healthcare, but subspecialty clinic attendance among patients with established healthcare access has not been studied. Study We performed an observational study using secondary data from administrative sources to study patients referred to, and scheduled for an appointment in, the adult gastroenterology clinic serving the safety net healthcare system of San Francisco, California. Our dependent variable was whether subjects attended or missed a scheduled appointment. Analysis included multivariable logistic regression and classification tree analysis. 1,833 patients were referred and scheduled for an appointment between 05/2005 and 08/2006. Prisoners were excluded. All patients had a primary care provider. Results 683 patients (37.3%) missed their appointment; 1,150 (62.7%) attended. Language was highly associated with attendance in the logistic regression; non-English speakers were less likely than English speakers to miss an appointment (adjusted odds ratio 0.42 [0.28,0.63] for Spanish, 0.56 [0.38,0.82] for Asian language, p gastroenterology clinic appointment, not speaking English was most strongly associated with higher attendance rates. Patient related factors associated with not speaking English likely influence subspecialty clinic attendance rates, and these factors may differ from those affecting general healthcare access. PMID:19169147

  3. New European initiatives in colorectal cancer screening: Budapest Declaration. Official appeal during the Hungarian Presidency of the Council of the European Union under the Auspices of the United European Gastroenterology Federation, the European Association for Gastroenterology and Endoscopy and the Hungarian Society of Gastroenterology.

    Science.gov (United States)

    Wittmann, Tibor; Stockbrugger, Reinhold; Herszényi, László; Jonkers, Daisy; Molnár, Béla; Saurin, Jean-Christophe; Regula, Jaroslaw; Malesci, Alberto; Laghi, Luigi; Pintér, Tamás; Teleky, Béla; Dítě, Petr; Tulassay, Zsolt

    2012-01-01

    Colorectal cancer (CRC) is the second most common newly diagnosed cancer and the second most common cause of death in the European Union (EU). CRC is an enormous health and economic burden. Early detection and prevention have the possibility of reducing this burden significantly. Many cancer-associated deaths can be avoided through early detection by high-quality colorectal screening programs followed by appropriate treatment. Under the auspices of the United European Gastroenterology Federation (UEGF), the European Association for Gastroenterology and Endoscopy, the Hungarian Society of Gastroenterology and the Hungarian College of Gastroenterology, the 'Budapest Declaration' (2011) was an accepted official scientific program during the Hungarian Presidency of the Council of the European Union. The Budapest Declaration follows the Munich Declaration (2001), the Brussels Declaration (2007), the Transatlantic Declaration (2009), the Barcelona Declaration (2010), the written declaration of CRC screening, a joint initiative with European Parliamentarians coordinated by the UEGF, and finally, the 'European Guidelines for Quality Assurance in Colorectal Cancer Screening and Diagnosis'. The 'Budapest Declaration' together with previous declarations aims to urge the national and supranational healthcare decision makers to launch new Europe-wide initiatives to establish high-quality CRC programs to achieve optimal efficiency in CRC screening. In case of implementation of the proposals, actions and conditions recommended, we can achieve that one of the basic principles of the EU - the chance of equal access - be realized in member states with respect to the prevention of CRC and reduction of cancer-related mortality. To better achieve this goal, we propose to establish an UEGF joint committee, with one participant representing each EU member state to coordinate and supervise the implementation of CRC screening. Copyright © 2012 S. Karger AG, Basel.

  4. Management of Nonceliac Gluten Sensitivity by Gastroenterology Specialists: Data from an Italian Survey

    Directory of Open Access Journals (Sweden)

    Federica Branchi

    2015-01-01

    Full Text Available Background and Aim. Nonceliac gluten sensitivity is syndrome characterized by symptoms disappearing after a gluten-free diet. Its existence is still argument of discussion among specialists. Our aim was to evaluate the knowledge about nonceliac gluten sensitivity among gastroenterology specialists. Methods. During October 2013 a questionnaire was sent through a medical newsletter to Italian gastroenterologists. Twelve questions investigated their knowledge on nonceliac gluten sensitivity, including their diagnostic and therapeutic approach. Results. A total of 212 gastroenterologists filled in the questionnaire. The 98.6% were aware of the existence of a syndrome called “nonceliac gluten sensitivity” and 77% believe in its existence. However, only 56% gave a correct definition of the term. The majority of specialists diagnosed gluten sensitive patients and the number of diagnoses was not statistically different from that of celiac disease. Moreover, a gluten-free diet was prescribed by 64% of the specialists and among them the 73% noted an increase of gluten sensitive patients attending their outpatient services. Conclusions. Our study indicated that most of the specialists recognize nonceliac gluten sensitivity and prescribe gluten-free diet, although 44% of the specialists are not able to give its correct definition; underlining the necessity of medical education on this topic is needed.

  5. Molecular imaging for theranostics in gastroenterology: one stone to kill two birds.

    Science.gov (United States)

    Ko, Kwang Hyun; Kown, Chang-Il; Park, Jong Min; Lee, Hoo Geun; Han, Na Young; Hahm, Ki Baik

    2014-09-01

    Molecular imaging in gastroenterology has become more feasible with recent advances in imaging technology, molecular genetics, and next-generation biochemistry, in addition to advances in endoscopic imaging techniques including magnified high-resolution endoscopy, narrow band imaging or autofluorescence imaging, flexible spectral imaging color enhancement, and confocal laser endomicroscopy. These developments have the potential to serve as "red flag" techniques enabling the earlier and accurate detection of mucosal abnormalities (such as precancerous lesions) beyond biomarkers, virtual histology of detected lesions, and molecular targeted therapy-the strategy of "one stone to kill two or three birds"; however, more effort should be done to be "blue ocean" benefit. This review deals with the introduction of Raman spectroscopy endoscopy, imaging mass spectroscopy, and nanomolecule development for theranostics. Imaging of molecular pathological changes in cells/tissues/organs might open the "royal road" to either convincing diagnosis of diseases that otherwise would only be detected in the advanced stages or novel therapeutic methods targeted to personalized medicine.

  6. Patient Electronic Health Records as a Means to Approach Genetic Research in Gastroenterology.

    Science.gov (United States)

    Ananthakrishnan, Ashwin N; Lieberman, David

    2015-10-01

    Electronic health records (EHRs) are being increasingly utilized and form a unique source of extensive data gathered during routine clinical care. Through use of codified and free text concepts identified using clinical informatics tools, disease labels can be assigned with a high degree of accuracy. Analysis linking such EHR-assigned disease labels to a biospecimen repository has demonstrated that genetic associations identified in prospective cohorts can be replicated with adequate statistical power and novel phenotypic associations identified. In addition, genetic discovery research can be performed utilizing clinical, laboratory, and procedure data obtained during care. Challenges with such research include the need to tackle variability in quality and quantity of EHR data and importance of maintaining patient privacy and data security. With appropriate safeguards, this novel and emerging field of research offers considerable promise and potential to further scientific research in gastroenterology efficiently, cost-effectively, and with engagement of patients and communities. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

  7. Improving access in gastroenterology: The single point of entry model for referrals

    Science.gov (United States)

    Novak, Kerri L; Van Zanten, Sander Veldhuyzen; Pendharkar, Sachin R

    2013-01-01

    In 2005, a group of academic gastroenterologists in Calgary (Alberta) adopted a centralized referral intake system known as central triage. This system provided a single point of entry model (SEM) for referrals rather than the traditional system of individual practitioners managing their own referrals and queues. The goal of central triage was to improve wait times and referral management. In 2008, a similar system was developed in Edmonton at the University of Alberta Hospital (Edmonton, Alberta). SEMs have subsequently been adopted by numerous subspecialties throughout Alberta. There are many benefits of SEMs including improved access and reduced wait times. Understanding and measuring complex patient flow systems is key to improving access, and centralized intake systems provide an opportunity to better understand total demand and system bottlenecks. This knowledge is particularly important for specialties such as gastroenterology (GI), in which demand exceeds supply. While it is anticipated that SEMs will reduce wait times for GI care in Canada, the lack of sufficient resources to meet the demand for GI care necessitates additional strategies. PMID:24040629

  8. Multisensor fusion in gastroenterology domain through video and echo endoscopic image combination: a challenge

    Science.gov (United States)

    Debon, Renaud; Le Guillou, Clara; Cauvin, Jean-Michel; Solaiman, Basel; Roux, Christian

    2001-08-01

    Medical domain makes intensive use of information fusion. In particular, the gastro-enterology is a discipline where physicians have the choice between several imagery modalities that offer complementary advantages. Among all existing systems, videoendoscopy (based on a CCD sensor) and echoendoscopy (based on an ultrasound sensor) are the most efficient. The use of each system corresponds to a given step in the physician diagnostic elaboration. Nowadays, several works aim to achieve automatic interpretation of videoendoscopic sequences. These systems can quantify color and superficial textures of the digestive tube. Unfortunately the relief information, which is important for the diagnostic, is very difficult to retrieve. On the other hand, some studies have proved that 3D information can be easily quantified using echoendoscopy image sequences. That is why the idea to combine these information, acquired from two very different points of view, can be considered as a real challenge for the medical image fusion topic. In this paper, after a review of actual works concerning numerical exploitation of videoendoscopy and echoendoscopy, the following question will be discussed: how can the use of complementary aspects of the different systems ease the automatic exploitation of videoendoscopy ? In a second time, we will evaluate the feasibility of the achievement of a realistic 3D reconstruction based both on information given by echoendoscopy (relief) and videoendoscopy (texture). Enumeration of potential applications of such a fusion system will then follow. Further discussions and perspectives will conclude this first study.

  9. The more publication, the higher impact factor: citation analysis of top nine gastroenterology and hepatology journals.

    Science.gov (United States)

    Karimi Elizee, Pegah; Karimzadeh Ghassab, Romina; Raoofi, Azam; Miri, Seyyed Mohammad

    2012-12-01

    The impact factor (IF), as the most important criterion for journal's quality measurement, is affected by the self-citation and number of publications in each journal. To find out the relationship between the number of publications and self-citations in a journal, and their correlations with IF. Self-citations and impact factors of nine top gastroenterology and hepatology journals were assessed during the seven recent years (2005-2011) through Journal Citation Reports (JCR, ISI Thomson Reuters). Although impact factors of all journals increased during the study, five out of nine journals increased the number of publications from 2005 to 2011. There was an increase in self-citation only in the journal of HEPATOLOGY (499 in 2005 vs. 707 in 2011). Impact factors of journals (6.5 ± 3.5) were positively correlated with total number of publications (248.6 ± 91.7) (R: 0.688, P citation rate (238.73 ± 195.317) was highly correlated with total number of publications in each journal (248.6 ± 91.7) (R: 0.861, P citation (6.08 ± 3.3) had a correlation (R: 0.672, P citation have definite effects on IF of a journal and because IF is the most prominent criterion for journal's quality measurement, it would be a good idea to consider factors affecting on IF such as self-citation.

  10. Explaining the Learning Experiences of Clinical Procedures of the Internal Medicine Residents at Department of Gastroenterology

    Directory of Open Access Journals (Sweden)

    Mansoureh Taghavinia

    2012-07-01

    Full Text Available Introduction: the method and way of learning and teaching are effective in acquiring clinical skills, and identifying the shortcomings of learning and teaching will lead to better planning. The purpose of this study was to explain the experiences of the learning clinical procedures of the internal medicine residents in gastroenterology department. Methods: qualitative study using content thematic analysis was done. Six fourth-year residents were selected and interviewed considering purposive sampling. The data of the interviews were transcribed and analyzed after rereading. Results: the collected data are divided into three categories: learning and experience with the following four categories (learning time and experiencing, leaning and experiencing times, learning and experiencing opportunities, training and the lack of the training of some procedures. These categories are explained by using some quotes derived from the data. Conclusion: the results of this study suggest that the administrative management of internal residency is poor and should get seriously in implementation and application of intended instructions existing in the prepared program of Medical Education and Specialized Council of internal residency period. The attending physicians and residents must be aware of the content of education program at the beginning of the residency periods and the trainers must try to supervise the residents’ education.

  11. Improving Access in Gastroenterology: The Single Point of Entry Model for Referrals

    Directory of Open Access Journals (Sweden)

    Kerri L Novak

    2013-01-01

    Full Text Available In 2005, a group of academic gastroenterologists in Calgary (Alberta adopted a centralized referral intake system known as central triage. This system provided a single point of entry model (SEM for referrals rather than the traditional system of individual practitioners managing their own referrals and queues. The goal of central triage was to improve wait times and referral management. In 2008, a similar system was developed in Edmonton at the University of Alberta Hospital (Edmonton, Alberta. SEMs have subsequently been adopted by numerous subspecialties throughout Alberta. There are many benefits of SEMs including improved access and reduced wait times. Understanding and measuring complex patient flow systems is key to improving access, and centralized intake systems provide an opportunity to better understand total demand and system bottlenecks. This knowledge is particularly important for specialties such as gastroenterology (GI, in which demand exceeds supply. While it is anticipated that SEMs will reduce wait times for GI care in Canada, the lack of sufficient resources to meet the demand for GI care necessitates additional strategies.

  12. Improving access in gastroenterology: the single point of entry model for referrals.

    Science.gov (United States)

    Novak, Kerri; Veldhuyzen Van Zanten, Sander; Pendharkar, Sachin R

    2013-11-01

    In 2005, a group of academic gastroenterologists in Calgary (Alberta) adopted a centralized referral intake system known as central triage. This system provided a single point of entry model (SEM) for referrals rather than the traditional system of individual practitioners managing their own referrals and queues. The goal of central triage was to improve wait times and referral management. In 2008, a similar system was developed in Edmonton at the University of Alberta Hospital (Edmonton, Alberta). SEMs have subsequently been adopted by numerous subspecialties throughout Alberta. There are many benefits of SEMs including improved access and reduced wait times. Understanding and measuring complex patient flow systems is key to improving access, and centralized intake systems provide an opportunity to better understand total demand and system bottlenecks. This knowledge is particularly important for specialties such as gastroenterology (GI), in which demand exceeds supply. While it is anticipated that SEMs will reduce wait times for GI care in Canada, the lack of sufficient resources to meet the demand for GI care necessitates additional strategies.

  13. HISTORIC CENTRE(S OF BARCELONA: PRACTICAL AND SYMBOLIC ELEMENTS IN TRADITIONAL URBAN SPACE

    Directory of Open Access Journals (Sweden)

    Verónica Martínez Robles

    2007-09-01

    The model of compact city that Barcelona aims, has required the renewal of its historical areas, and in order to improve their level of centrality, taking into account, that in addition of its historical centre “Ciutat Vella”, Barcelona contains diverse traditional neighborhoods each of them having their own historical centre. The difference centre‐periphery should also be perceived among these other historical centers. Integration should not be confused with standardization, neither differentiation with segregation.

  14. Elderly Care Centre

    Science.gov (United States)

    Wagiman, Aliani; Haja Bava Mohidin, Hazrina; Ismail, Alice Sabrina

    2016-02-01

    The demand for elderly centre has increased tremendously abreast with the world demographic change as the number of senior citizens rose in the 21st century. This has become one of the most crucial problems of today's era. As the world progress into modernity, more and more people are occupied with daily work causing the senior citizens to lose the care that they actually need. This paper seeks to elucidate the best possible design of an elderly care centre with new approach in order to provide the best service for them by analysing their needs and suitable activities that could elevate their quality of life. All these findings will then be incorporated into design solutions so as to enhance the living environment for the elderly especially in Malaysian context.

  15. International Data Centre (IDC)

    International Nuclear Information System (INIS)

    Johansson, P.

    2002-01-01

    The presentation outlines the International Data Centre (Indc) mission, objective and historical background. The Indc progressive commissioning and organizational plans are presented on charts. The IMS stations providing data to Indc operations and the global communication infrastructure are plotted on world maps. The various types of IMS data are thus listed as seismic, hydroacoustic, infrasound and radionuclide. Finally Indc products and services together with its main achievements are listed

  16. Historical centres: changing definitions

    Directory of Open Access Journals (Sweden)

    Roberta Lazzarotti

    2014-02-01

    Full Text Available Since the end of the Second World War, the architectural and planning culture has been showing a fluctuating attention to the theme of historical centres and their enhancement. First of all this uneven progress explains the difficulty to reach a homogeneous definition and this is still lacking. During a long phase of this period, the historical parts of the town were considered as objects to be preserved in an integral way, as urban monuments. This is mostly due to the high symbolic value of these settlements, that represent fundamental landmarks. Identity building and empowerment of local communities are indispensable conditions for any development programme, especially in the case of centres or other historic environments at risk of abandonment. The progressive evolution of this concept brings awareness of the impossibility of separating – either in analytical or in planning terms ­ historical centres from their urban and territorial contexts, which are linked by mutual, deep relationships. This article attempts to retrace the steps signaled by the publication of international documents and conventions, from the Charter of Gubbio (1960 to the Charter of Krakow and the European Landscape Convention (2000; they obviously represent particular points of view, not exhaustive of the richness of the positions in the debate, but extremely significant in terms of diffusion and consensus.

  17. Prevalence of Barrett's esophagus: An observational study from a gastroenterology clinic

    Directory of Open Access Journals (Sweden)

    J.L. Herrera Elizondo

    2017-10-01

    Full Text Available Introduction and aims: Barrett's esophagus is a condition that predisposes to esophageal adenocarcinoma. Our aim was to establish the prevalence of Barrett's esophagus at our center, as well as determine its associated factors. Materials and methods: We retrospectively assessed the endoscopic reports of 500 outpatients seen at our Gastroenterology Service from November 2014 to April 2016. We determined the prevalence of Barrett's esophagus and analyzed the demographic, clinical, and endoscopic findings associated with that pathology. Results: The prevalence of Barrett's esophagus was 1.8%. The mean age of the patients with Barrett's esophagus was 58.7 years (range: 45-70 and there was a predominance of men (66%. In the subgroup of patients with symptoms of gastroesophageal reflux (n = 125, Barrett's esophagus prevalence was 7.2%. In the multivariate analysis, the factors that were independently associated with Barrett's esophagus were gastroesophageal reflux (P=.005 and hiatal hernia (P=.006. Conclusions: The overall prevalence of Barrett's esophagus was 1.8% in our population, with a prevalence of 7.2% in patients that had symptoms of gastroesophageal reflux. Resumen: Introducción y objetivos: El esófago de Barrett es una condición que predispone al adenocarcinoma esofágico. Nuestro objetivo fue establecer la prevalencia de esófago de Barrett en nuestro centro, así como los factores asociados a esta condición. Material y métodos: Evaluamos retrospectivamente los reportes de 500 endoscopias superiores de pacientes ambulatorios de nuestro Servicio de Gastroenterología entre noviembre del 2014 y abril del 2016. Se determinó la prevalencia de esófago de Barrett y se analizaron los datos demográficos, clínicos y endoscópicos asociados a esta patología. Resultados: La prevalencia de esófago de Barrett fue del 1.8%. La edad media en los pacientes con esófago de Barrett fue de 58.7 años (rango: 45-70, con predominancia del sexo

  18. Prevalence of DSM-5 avoidant/restrictive food intake disorder in a pediatric gastroenterology healthcare network.

    Science.gov (United States)

    Eddy, Kamryn T; Thomas, Jennifer J; Hastings, Elizabeth; Edkins, Katherine; Lamont, Evan; Nevins, Caitlin M; Patterson, Rebecca M; Murray, Helen B; Bryant-Waugh, Rachel; Becker, Anne E

    2015-07-01

    Few published studies have evaluated the clinical utility of new diagnostic criteria for avoidant/restrictive food intake disorder (ARFID), a DSM-5 reformulation of feeding and eating disorder of infancy or early childhood. We examined the prevalence of ARFID and inter-rater reliability of its diagnostic criteria in a pediatric gastrointestinal sample. We conducted a retrospective chart review of 2,231 consecutive new referrals (ages 8-18 years) to 19 Boston-area pediatric gastroenterology clinics for evidence of DSM-5 ARFID. We identified 33 (1.5%) ARFID cases; 22 of whom (67%) were male. Most were characterized by insufficient intake/little interest in feeding (n = 19) or limited diet due to sensory features of the food (n = 7). An additional 54 cases (2.4%) met one or more ARFID criteria but there was insufficient information in the medical record to confer or exclude the diagnosis. Diagnostic agreement between coders was adequate (κ = 0.72). Common challenges were (i) distinguishing between diagnoses of ARFID and anorexia nervosa or anxiety disorders; (ii) determination of whether the severity of the eating/feeding disturbance was sufficient to warrant diagnosis in the presence of another medical or psychiatric disorder; and (iii) assessment of psychosocial impairment related to eating/feeding problems. In a pediatric treatment-seeking sample where ARFID features were common, cases meeting full criteria were rare, suggesting that the diagnosis is not over-inclusive even in a population where eating/feeding difficulties are expected. © 2014 Wiley Periodicals, Inc.

  19. Employment prospects and trends for gastroenterology trainees in Canada: A nationwide survey

    Science.gov (United States)

    Razik, Roshan; Cino, Maria; Nguyen, Geoffrey C

    2013-01-01

    BACKGROUND: Many gastroenterology (GI) trainees face a variety of barriers to stable employment and are finding it increasingly difficult to secure employment in their chosen field. OBJECTIVE: To elucidate factors that contribute to the burden of unemployment and underemployment, and to examine solutions that may remedy this growing problem in the field of GI. METHODS: A nationwide survey of current, incoming and recently graduated individuals of GI training programs in Canada was conducted. Trainees in pediatric GI programs and those enrolled in sub-specialty programs within GI were also included. RESULTS: The response rate was 62%, with 93% of respondents enrolled in an adult GI training program. Many (73%) respondents planned to pursue further subspecialty training and the majority (53%) reported concerns regarding job security after graduation as contributory factors. Only 35% of respondents were confident that they would secure employment within six months of completing their training. Regarding barriers to employment, the most cited perceived reasons were lack of funding (both from hospitals and provincial governments) and senior physicians who continue to practice beyond retirement years. Sixty-nine per cent perceived a greater need for career guidance and 49% believed there were too many GI trainees relative to the current job market in their area. Most residents had a contingency plan if they remained unemployed >18 months, which often included moving to another province or to the United States. CONCLUSION: GI trainees throughout Canada reported substantial concerns about securing employment, citing national retirement trends and lack of funding as primary barriers to employment. Although these issues are not easily modifiable, certain problems should be targeted including optimizing training quotas, tailoring career guidance to the needs of the population, and emphasizing credentialing and quality control in endoscopy. PMID:24199210

  20. Perceptions of the Inpatient Training Experience: A Nationwide Survey of Gastroenterology Program Directors and Fellows.

    Science.gov (United States)

    Kumar, Navin L; Perencevich, Molly L; Trier, Jerry S

    2017-10-01

    Inpatient training is a key component of gastroenterology (GI) fellowship programs nationwide, yet little is known about perceptions of the inpatient training experience. To compare the content, objectives and quality of the inpatient training experience as perceived by program directors (PD) and fellows in US ACGME-accredited GI fellowship programs. We conducted a nationwide, online-based survey of GI PDs and fellows at the conclusion of the 2016 academic year. We queried participants about (1) the current models of inpatient training, (2) the content, objectives, and quality of the inpatient training experience, and (3) the frequency and quality of educational activities on the inpatient service. We analyzed five-point Likert items and rank assessments as continuous variables by an independent t test and compared proportions using the Chi-square test. Survey response rate was 48.4% (75/155) for PDs and a total of 194 fellows completed the survey, with both groups reporting the general GI consult team (>90%) as the primary model of inpatient training. PDs and fellows agreed on the ranking of all queried responsibilities of the inpatient fellow to develop during the inpatient service. However, fellows indicated that attendings spent less time teaching and provided less formal feedback than that perceived by PDs (p < 0.0001). PDs rated the overall quality of the inpatient training experience (p < 0.0001) and education on the wards (p = 0.0003) as better than overall ratings by fellows. Although GI fellows and PDs agree on the importance of specific fellow responsibilities on the inpatient service, fellows report experiencing less teaching and feedback from attendings than that perceived by PDs. Committing more time to education and assessment may improve fellows' perceptions of the inpatient training experience.

  1. Antimicrobial stewardship in a Gastroenterology Department: Impact on antimicrobial consumption, antimicrobial resistance and clinical outcome.

    Science.gov (United States)

    Bedini, Andrea; De Maria, Nicola; Del Buono, Mariagrazia; Bianchini, Marcello; Mancini, Mauro; Binda, Cecilia; Brasacchio, Andrea; Orlando, Gabriella; Franceschini, Erica; Meschiari, Marianna; Sartini, Alessandro; Zona, Stefano; Paioli, Serena; Villa, Erica; Gyssens, Inge C; Mussini, Cristina

    2016-10-01

    A major cause of the increase in antimicrobial resistance is the inappropriate use of antimicrobials. To evaluate the impact on antimicrobial consumption and clinical outcome of an antimicrobial stewardship program in an Italian Gastroenterology Department. Between October 2014 and September 2015 (period B), a specialist in infectious diseases (ID) controlled all antimicrobial prescriptions and decided about the therapy in agreement with gastroenterologists. The defined daily doses of antimicrobials (DDDs), incidence of MDR-infections, mean length of stay and overall in-hospital mortality rate were compared with those of the same period in the previous 12-months (period A). During period B, the ID specialist performed 304 consultations: antimicrobials were continued in 44.4% of the cases, discontinued in 13.8%, not recommended in 12.1%, de-escalated 9.9%, escalated in 7.9%, and started in 4.0%. Comparing the 2 periods, we observed a decreased of antibiotics consumption (from 109.81 to 78.45 DDDs/100 patient-days, p=0.0005), antifungals (from 41.28 to 24.75 DDDs/100pd, p=0.0004), carbapenems (from 15.99 to 6.80 DDDsx100pd, p=0.0032), quinolones (from 35.79 to 17.82 DDDsx100pd, p=0.0079). No differences were observed in incidence of MDR-infections, length of hospital stay (LOS), and mortality rate. ASP program had a positive impact on reducing the consumption of antimicrobials, without an increase in LOS and mortality. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  2. Outcomes From Pediatric Gastroenterology Maintenance of Certification Using Web-based Modules.

    Science.gov (United States)

    Sheu, Josephine; Chun, Stanford; O'Day, Emily; Cheung, Sara; Cruz, Rusvelda; Lightdale, Jenifer R; Fishman, Douglas S; Bousvaros, Athos; Huang, Jeannie S

    2017-05-01

    Beginning in 2013, the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) sponsored and developed subspecialty field-specific quality improvement (QI) activities to provide Part 4 Maintenance of Certification (MOC) credit for ongoing certification of pediatric gastroenterologists by the American Board of Pediatrics. Each activity was a Web-based module that measured clinical practice data repeatedly over at least 3 months as participants implemented rapid cycle change. Here, we examine existing variations in clinical practice among participating pediatric gastroenterologists and determine whether completion of Web-based MOC activities improves patient care processes and outcomes. We performed a cross-sectional and prospective analysis of physician and parent-reported clinical practice data abstracted from Web-based MOC modules on the topics of upper endoscopy, colonoscopy, and informed consent collected from pediatric gastroenterologists from North America from 2013 to 2016. Among 134 participating pediatric gastroenterologists, 56% practitioners practiced at an academic institution and most (94%) were NASPGHAN members. Participating physicians reported data from 6300 procedures. At baseline, notable practice variation across measured activities was demonstrated. Much of the rapid cycle changes implemented by participants involved individual behaviors, rather than system/team-based improvement activities. Participants demonstrated significant improvements on most targeted process and quality care outcomes. Pediatric gastroenterologists and parents reported baseline practice variation, and improvement in care processes and outcomes measured during NASPGHAN-sponsored Web-based MOC QI activities. Subspecialty-oriented Web-based MOC QI activities can reveal targets for reducing unwarranted variation in clinical pediatric practice, and can effectively improve care and patient outcomes.

  3. Probiotics as therapy in gastroenterology: a study of physician opinions and recommendations.

    Science.gov (United States)

    Williams, Michael D; Ha, Christina Y; Ciorba, Matthew A

    2010-10-01

    The objective of this study was to determine how gastroenterologists perceive and use probiotic-based therapies in practice. In the United States, there has been a recent increase in research investigating the therapeutic capacities of probiotics in human disease and an accompanying increase in product availability and marketing. How medical care providers have interpreted the available literature and incorporated it into their practice has not been earlier assessed. A 16-question survey (see Survey, Supplemental Digital Content 1, http://links.lww.com/JCG/A14) was distributed to practicing gastroenterologists and physicians with a specific interest in GI disorders within a large metropolitan area. All physicians responded that they believed probiotics to be safe for most patients and 98% responded that probiotics have a role in treating gastrointestinal illnesses or symptoms. Currently 93% of physicians have patients taking probiotics most often for irritable bowel syndrome. Commonly used probiotics included yogurt-based products, Bifidobacterium infantis 35624 (Align), and VSL#3. Most surveyed physicians recommended probiotics for irritable bowel syndrome, antibiotic, and Clostridium difficile-associated diarrhea because they believed that the literature supports their usage for these conditions. However, physician practice patterns did not consistently correlate with published, expert-panel-generated recommendations for evidence-based probiotic use. This study suggests most gastrointestinal disease specialists recognize a role for and have used probiotics as part of their therapeutic armamentarium; however, the effective implementation of this practice will benefit from additional supporting studies and the eventual development of clinical practice guidelines supported by the major gastroenterology societies.

  4. British Society of Gastroenterology position statement on serrated polyps in the colon and rectum.

    Science.gov (United States)

    East, James E; Atkin, Wendy S; Bateman, Adrian C; Clark, Susan K; Dolwani, Sunil; Ket, Shara N; Leedham, Simon J; Phull, Perminder S; Rutter, Matt D; Shepherd, Neil A; Tomlinson, Ian; Rees, Colin J

    2017-07-01

    Serrated polyps have been recognised in the last decade as important premalignant lesions accounting for between 15% and 30% of colorectal cancers. There is therefore a clinical need for guidance on how to manage these lesions; however, the evidence base is limited. A working group was commission by the British Society of Gastroenterology (BSG) Endoscopy section to review the available evidence and develop a position statement to provide clinical guidance until the evidence becomes available to support a formal guideline. The scope of the position statement was wide-ranging and included: evidence that serrated lesions have premalignant potential; detection and resection of serrated lesions; surveillance strategies after detection of serrated lesions; special situations-serrated polyposis syndrome (including surgery) and serrated lesions in colitis; education, audit and benchmarks and research questions. Statements on these issues were proposed where the evidence was deemed sufficient, and re-evaluated modified via a Delphi process until >80% agreement was reached. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool was used to assess the strength of evidence and strength of recommendation for finalised statements. Key recommendation : we suggest that until further evidence on the efficacy or otherwise of surveillance are published, patients with sessile serrated lesions (SSLs) that appear associated with a higher risk of future neoplasia or colorectal cancer (SSLs ≥10 mm or serrated lesions harbouring dysplasia including traditional serrated adenomas) should be offered a one-off colonoscopic surveillance examination at 3 years ( weak recommendation, low quality evidence, 90% agreement ). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  5. Employment prospects and trends for gastroenterology trainees in Canada: a nationwide survey.

    Science.gov (United States)

    Razik, Roshan; Cino, Maria; Nguyen, Geoffrey C

    2013-11-01

    Many gastroenterology (GI) trainees face a variety of barriers to stable employment and are finding it increasingly difficult to secure employment in their chosen field. To elucidate factors that contribute to the burden of unemployment and underemployment, and to examine solutions that may remedy this growing problem in the field of GI. A nationwide survey of current, incoming and recently graduated individuals of GI training programs in Canada was conducted. Trainees in pediatric GI programs and those enrolled in subspecialty programs within GI were also included. The response rate was 62%, with 93% of respondents enrolled in an adult GI training program. Many (73%) respondents planned to pursue further subspecialty training and the majority (53%) reported concerns regarding job security after graduation as contributory factors. Only 35% of respondents were confident that they would secure employment within six months of completing their training. Regarding barriers to employment, the most cited perceived reasons were lack of funding (both from hospitals and provincial governments) and senior physicians who continue to practice beyond retirement years. Sixty-nine per cent perceived a greater need for career guidance and 49% believed there were too many GI trainees relative to the current job market in their area. Most residents had a contingency plan if they remained unemployed >18 months, which often included moving to another province or to the United States. GI trainees throughout Canada reported substantial concerns about securing employment, citing national retirement trends and lack of funding as primary barriers to employment. Although these issues are not easily modifiable, certain problems should be targeted including optimizing training quotas, tailoring career guidance to the needs of the population, and emphasizing credentialing and quality control in endoscopy.

  6. Do gender disparities persist in gastroenterology after 10 years of practice?

    Science.gov (United States)

    Singh, Aparajita; Burke, Carol A; Larive, Brett; Sastri, Suriya V

    2008-07-01

    Cross-sectional studies confirm gender disparity in many aspects of the practice of medicine and surgery. Some data suggest the disparities diminish after 10 yr of practice. This study aims to examine gender discrepancies in income, social, and professional status of gastroenterologists after 10 yr of practice. Prospective, observational, cohort study of gastroenterologists incepted upon graduation from a U.S. GI fellowship program in 1993 and 1995. A 36-item questionnaire was sent to the cohort at 3, 5, and 10 yr after graduation from GI fellowship training. The following are the results of the final, 10th year survey. A total of 168 men and 25 women (mean age 45.5 yr) responded. Men and women were equally likely to be board certified and married, however, women had fewer children. Men earned a mean annual gross income of $375,000 versus$245,000 for women (P= 0.001). After adjusting for practice setting, work hours, practice-ownership, free endoscopy center practice, and vacation time, female gastroenterologists earned $82,000 (22%) less per year than their male colleagues (95% CI $34,000-130,000, P= 0.001). Women were more frequently in academic practice (38%vs 17%), but were less likely to hold the most advanced academic positions. After 10 yr of practice, significant economic, professional, and social disparities persist between male and female gastroenterologists in this cohort. Women were more likely to practice in a setting with flexible work hours, a family leave provision, and in a practice with other women. Initiatives to equalize pay and ensure opportunities for professional advancement for women may diminish the significant practice disparities incurred by women in gastroenterology.

  7. Pediatric gastrointestinal bleeding: Perspectives from the Italian Society of Pediatric Gastroenterology

    Science.gov (United States)

    Romano, Claudio; Oliva, Salvatore; Martellossi, Stefano; Miele, Erasmo; Arrigo, Serena; Graziani, Maria Giovanna; Cardile, Sabrina; Gaiani, Federica; de’Angelis, Gian Luigi; Torroni, Filippo

    2017-01-01

    There are many causes of gastrointestinal bleeding (GIB) in children, and this condition is not rare, having a reported incidence of 6.4%. Causes vary with age, but show considerable overlap; moreover, while many of the causes in the pediatric population are similar to those in adults, some lesions are unique to children. The diagnostic approach for pediatric GIB includes definition of the etiology, localization of the bleeding site and determination of the severity of bleeding; timely and accurate diagnosis is necessary to reduce morbidity and mortality. To assist medical care providers in the evaluation and management of children with GIB, the “Gastro-Ped Bleed Team” of the Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition (SIGENP) carried out a systematic search on MEDLINE via PubMed (http://www.ncbi.nlm.nih.gov/pubmed/) to identify all articles published in English from January 1990 to 2016; the following key words were used to conduct the electronic search: “upper GIB” and “pediatric” [all fields]; “lower GIB” and “pediatric” [all fields]; “obscure GIB” and “pediatric” [all fields]; “GIB” and “endoscopy” [all fields]; “GIB” and “therapy” [all fields]. The identified publications included articles describing randomized controlled trials, reviews, case reports, cohort studies, case-control studies and observational studies. References from the pertinent articles were also reviewed. This paper expresses a position statement of SIGENP that can have an immediate impact on clinical practice and for which sufficient evidence is not available in literature. The experts participating in this effort were selected according to their expertise and professional qualifications. PMID:28293079

  8. Use of Complementary and Alternative Medicine: A survey in Turkish Gastroenterology Patients

    Directory of Open Access Journals (Sweden)

    Kav Taylan

    2009-10-01

    Full Text Available Abstract Background The study examined complementary and alternative medicine (CAM usage by patients attending a Turkish gastroenterology outpatient clinic. Methods The survey was conducted on 216 patients presenting with gastrointestinal problems during their first visit to the clinic using a 31 item, self-report questionnaire between May and October 2005. Data included information on patient demographics and their gastrointestinal symptoms, as well as items to identify CAM use and patient satisfaction with these therapies. Results Seventy-nine patients (36.6% reported using one or more forms of CAM. The most commonly used therapy was herbal therapy, usually taken as a tea or infusion. These were used by 27 people (29% in this subgroup. Common indicators for their use were epigastric pain, constipation, bloating and dyspepsia or indigestion. CAM use among upper GI patients was marginally higher than lower GI patients (41.8% versus 41.2%, but the highest usage was amongst patients with liver disease where 53.8% reported using one or more CAM therapy. About half of the patients learned about CAM from their relatives or friends, with more women than men using the therapies (p Conclusion CAM usage in our sample of gastrointestinal patients was lower than that described in other countries and other chronic disease groups. This could be due to their low perceived efficacy, or the relatively transient duration of symptoms experienced by the sample. Healthcare professionals need however, to be aware of CAM usage in order to educate patients appropriately about possible adverse effects or drug-interactions.

  9. Motivation to change drinking behavior: the differences between alcohol users from an outpatient gastroenterology clinic and a specialist alcohol treatment service

    Directory of Open Access Journals (Sweden)

    Neliana Buzi Figlie

    Full Text Available CONTEXT AND OBJECTIVE: For some patients who have developed significant alcohol-related physical disease, total abstinence from alcohol may offer the best chance of survival. The aim of this study was to investigate motivation for treatment in two groups of alcohol users: outpatients from the gastroenterology clinic and outpatients from the specialist alcohol treatment service. DESIGN AND SETTING: Cross-sectional study, at a federally funded public teaching hospital. METHODS: The sample studied was 151 outpatients from the gastroenterology clinic and 175 from the specialist alcohol treatment service. The interview was conducted in the outpatient clinics at the first appointment, and consisted of demographic questions and scales for measuring quality of life, alcohol dependence, pattern of alcohol, motivation for treatment and consequences of alcohol consumption. RESULTS: The results suggested that outpatients from the gastroenterology clinic were less dependent on alcohol, had suffered fewer consequences from alcohol and had fewer emotional and mental health problems than did the outpatients from the alcohol treatment service. In relation to their stages of change, the gastroenterology outpatients presented high precontemplation scores at the beginning of treatment while outpatients of alcohol treatment service showed higher scores in contemplation, action and maintenance. CONCLUSION: The medical treatment may be a reason for the temporary alcohol abstinence behavior among the gastroenterology outpatients.

  10. Comparison of alcohol-dependent patients at a gastroenterological and a psychiatric ward according to the Lesch alcoholism typology: implications for treatment.

    Science.gov (United States)

    Vyssoki, Benjamin; Steindl-Munda, Petra; Ferenci, Peter; Walter, Henriette; Höfer, Peter; Blüml, Victor; Friedrich, Fabian; Kogoj, Dagmar; Lesch, Otto M

    2010-01-01

    To assess the clinical and biological status of alcohol-dependent patients admitted to a psychiatric or a gastroenterological ward, assessing and comparing dimensions important for prescribing treatment for withdrawal and relapse prevention. Eighty patients, alcohol-dependent according to international classification of diseases tenth revision and diagnostic and statistical manual, text revised, version IV, admitted to the Vienna General Hospital between January 2005 and  November 2006, were examined, of whom 44 were admitted to the psychiatric ward and 36 to the gastroenterological ward. Dimensions of alcohol dependence were assessed using a computerized structured interview, the Lesch alcoholism typology (LAT). Biological markers and the model for end-stage liver disease (MELD) score defined the severity of alcohol-related physical disturbances. As might be expected, gastroenterological patients had more advanced physical diseases than psychiatric patients, and affective disorders and suicidal tendencies were significantly commoner among the psychiatric patients. Thus, LAT Type II patients were overrepresented at the gastroenterological ward and LAT Type III patients at the psychiatric ward. The severity of somatic diseases and psychiatric disorders as well as the distribution of the four types according to Lesch differ between alcohol-dependent patients admitted to a psychiatric ward or a gastroenterological ward. Regarding the positive long-term outcome, different evidence-based medical treatment approaches for withdrawal and relapse prevention are needed for these patients.

  11. DGNB certified Healthcare Centres

    DEFF Research Database (Denmark)

    Brunsgaard, Camilla; Larsen, Tine Steen

    2015-01-01

    for sustainability and wants a certification. This research investigates the decision‐making and design process (DMaDP) behind four DGNB certified Healthcare Centres (HCC) in Northern Jutland in Denmark. In general, knowledge about the DMaDP is important. However it is important to know what part DGNB plays...... a dialog about DGNB and energy concept is important even before anyone start sketching. Experiences with the different approaches will be further outlined in the paper.Future research has the intention to collect further knowledge about DGNB and DMaDP in practise. This project was limited to Healthcare...

  12. Town Centre Redevelopment Strategies

    DEFF Research Database (Denmark)

    Vagnby, Bo Hellisen

    After many years of urban growth Danish downtowns are facing some important choices. Shall the stake one-sidedly be on the town centres as driving forces for growth and 'city marketing', or do they still have a role to play in a broader socio-economic context? In the paper we look back on eight...... as slum clearence and urban renewal. To a certain extent parallels are drawn to international experiences, especially where these are of such a nature that they can be assumed transferred to Danish connctions. Conclusively, the strategies are discussed in the light of the turn of Danish urban planning...

  13. Pediatric Chronic Intestinal Failure in Italy: Report from the 2016 Survey on Behalf of Italian Society for Gastroenterology, Hepatology and Nutrition (SIGENP

    Directory of Open Access Journals (Sweden)

    Antonella Diamanti

    2017-11-01

    Full Text Available Background: Intestinal failure (IF is the reduction in functioning gut mass below the minimal level necessary for adequate digestion and absorption of nutrients and fluids for weight maintenance in adults or for growth in children. There is a paucity of epidemiologic data on pediatric IF. The purpose of this study was to determine the prevalence, incidence, regional distribution and underlying diagnosis of pediatric chronic IF (CIF requiring home parenteral nutrition (HPN in Italy. Methods: Local investigators were selected in 19 Italian centers either of reference for pediatric HPN or having pediatric gastroenterologists or surgeons on staff and already collaborating with the Italian Society for Pediatric Gastroenterology, Hepatology and Nutrition with regard to IF. Data requested in this survey for children at home on Parenteral Nutrition (PN on 1 December 2016 included patient initials, year of birth, gender, family’s place of residence and underlying diagnosis determining IF. Results: We recorded 145 CIF patients on HPN aged ≤19 years. The overall prevalence was 14.12/million inhabitants (95% CI: 9.20–18.93; the overall incidence was 1.41/million inhabitant years (95% CI: 0.53–2.20. Conclusion: Our survey provides new epidemiological data on pediatric CIF in Italy; these data may be quantitatively useful in developing IF care strategy plans in all developed countries.

  14. Visits to Tier-1 Computing Centres

    CERN Multimedia

    Dario Barberis

    At the beginning of 2007 it became clear that an enhanced level of communication is needed between the ATLAS computing organisation and the Tier-1 centres. Most usual meetings are ATLAS-centric and cannot address the issues of each Tier-1; therefore we decided to organise a series of visits to the Tier-1 centres and focus on site issues. For us, ATLAS computing management, it is most useful to realize how each Tier-1 centre is organised, and its relation to the associated Tier-2s; indeed their presence at these visits is also very useful. We hope it is also useful for sites... at least, we are told so! The usual participation includes, from the ATLAS side: computing management, operations, data placement, resources, accounting and database deployment coordinators; and from the Tier-1 side: computer centre management, system managers, Grid infrastructure people, network, storage and database experts, local ATLAS liaison people and representatives of the associated Tier-2s. Visiting Tier-1 centres (1-4). ...

  15. A reference regional nuclear fuel centre

    International Nuclear Information System (INIS)

    1978-01-01

    A nuclear fuel centre groups the facilities for spent fuel reprocessing, plutonium fuel fabrication, waste conditioning, and interim storage on a single site. The technical aspects of safety and protection, and the socio-economic consequences of two types of centre have been studied. The reference centre has an initial reprocessing capacity of 1500 tonnes. This capacity is quadrupled by the construction of two new units in 15 years. The other centre considered is a quarter of this size. A description is given of the processes used, the personal and capital requirements for construction and operation of the plant, the transport of radioactive waste and products, and the quantities involved. The local radiological impact is low and could be further reduced to a level well below that of natural radioactivity. The resulting increase in economic activity, employment, income redistribution and the new infrastructure requirements are estimated for a rural or semi-rural region. Measures to prevent tension are proposed. The impact of the host country's balance of payments, finances, employment situation and technological knowhow is evaluated. The original centre is compared with equivalent facilities scattered geographically

  16. Electrically active sodium-related defect centres in silicon

    DEFF Research Database (Denmark)

    Dahl, Espen; Madsbøll, J.; Søiland, A.-K.

    2013-01-01

    Electrically active defect centres related to sodium in silicon have been examined with deep level transient spectroscopy, and their recombination potential analysed with the microwave photoconductive decay technique. In order to investigate the entire silicon band gap for defect centres, both p-...

  17. United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis (HaPanEU).

    Science.gov (United States)

    Löhr, J Matthias; Dominguez-Munoz, Enrique; Rosendahl, Jonas; Besselink, Marc; Mayerle, Julia; Lerch, Markus M; Haas, Stephan; Akisik, Fatih; Kartalis, Nikolaos; Iglesias-Garcia, Julio; Keller, Jutta; Boermeester, Marja; Werner, Jens; Dumonceau, Jean-Marc; Fockens, Paul; Drewes, Asbjorn; Ceyhan, Gürlap; Lindkvist, Björn; Drenth, Joost; Ewald, Nils; Hardt, Philip; de Madaria, Enrique; Witt, Heiko; Schneider, Alexander; Manfredi, Riccardo; Brøndum, Frøkjer J; Rudolf, Sasa; Bollen, Thomas; Bruno, Marco

    2017-03-01

    There have been substantial improvements in the management of chronic pancreatitis, leading to the publication of several national guidelines during recent years. In collaboration with United European Gastroenterology, the working group on 'Harmonizing diagnosis and treatment of chronic pancreatitis across Europe' (HaPanEU) developed these European guidelines using an evidence-based approach. Twelve multidisciplinary review groups performed systematic literature reviews to answer 101 predefined clinical questions. Recommendations were graded using the Grading of Recommendations Assessment, Development and Evaluation system and the answers were assessed by the entire group in a Delphi process online. The review groups presented their recommendations during the 2015 annual meeting of United European Gastroenterology. At this one-day, interactive conference, relevant remarks were voiced and overall agreement on each recommendation was quantified using plenary voting (Test and Evaluation Directorate). After a final round of adjustments based on these comments, a draft version was sent out to external reviewers. The 101 recommendations covered 12 topics related to the clinical management of chronic pancreatitis: aetiology (working party (WP)1), diagnosis of chronic pancreatitis with imaging (WP2 and WP3), diagnosis of pancreatic exocrine insufficiency (WP4), surgery in chronic pancreatitis (WP5), medical therapy (WP6), endoscopic therapy (WP7), treatment of pancreatic pseudocysts (WP8), pancreatic pain (WP9), nutrition and malnutrition (WP10), diabetes mellitus (WP11) and the natural course of the disease and quality of life (WP12). Using the Grading of Recommendations Assessment, Development and Evaluation system, 70 of the 101 (70%) recommendations were rated as 'strong' and plenary voting revealed 'strong agreement' for 99 (98%) recommendations. The 2016 HaPanEU/United European Gastroenterology guidelines provide evidence-based recommendations concerning key aspects

  18. The effect of new biosimilars in rheumatology and gastroenterology specialities on UK healthcare budgets: Results of a budget impact analysis.

    Science.gov (United States)

    Aladul, Mohammed I; Fitzpatrick, Raymond W; Chapman, Stephen R

    2018-05-15

    The approval of new biosimilars of infliximab, etanercept and adalimumab by the European Medicines Agency is expected to produce further cost savings to the healthcare system budget. This study aimed to estimate the budget impact of the introduction of new biosimilars Flixabi ® , Erelzi ® , Solymbic ® , Amgevita ® and Imraldi ® in rheumatology and gastroenterology specialities in the UK. A published budget impact model was adapted to estimate the expected cost savings following the entry of new biosimilars Flixabi ® , Erelzi ® , Solymbic ® , Amgevita ® and Imraldi ® in the UK over three-year time horizon. This model was based on retrospective market shares of biologics used in rheumatology and gastroenterology which were derived from DEFINE Software and healthcare professional perspectives. The model predicted that infliximab and etanercept biosimilars would replace their corresponding reference agents by 2020. Adalimumab biosimilars were predicted to achieve 19% of the rheumatology and gastroenterology market by 2020. Without the introduction of further biosimilars, the model predicted a reduction in expenditure of £44 million on biologics over the next three years. With the entry of Flixabi ® , Erelzi ® , Solymbic ® , Amgevita ® and Imraldi ® the model estimates cumulative savings of £285 million by 2020. The introduction of new infliximab, etanercept and adalimumab biosimilars will be associated with considerable cost savings and have a substantial favourable impact on the UK NHS budget. The number of biosimilars and time of entry of is critical to create competition which will result in maximum cost savings. Copyright © 2018 Elsevier Inc. All rights reserved.

  19. Advice for a career in academic gastroenterology: from fellowship application through job selection and contract negotiations to research and promotion.

    Science.gov (United States)

    Cappell, M S

    2009-03-01

    This study aims to describe a comprehensive strategy for success in academic gastroenterology by reporting common sense, but mostly previously unpublished, recommendations. The recommendation are based on expert opinion from personal experience mentoring 125 gastroenterology fellows and residents as a program director for nine years and from mentoring research while publishing more than 160 articles in peer-reviewed journals and editing 11 books during a 23-year academic career. Primary criteria for fellowship applicant selection include board scores, clinical performance, interview performance, clinical training, and research productivity. For optimal chances, select the subspecialty of gastroenterology early during residency, consult a mentor, and develop a well-planned strategy. Faculty advancement depends upon publications, grants, national recognition, interpersonal skills, and recommendations. Article categories from highest-to-lowest in prestige are original investigations, review articles, book chapters, case reports, and letters/abstracts. Articles are judged by the prestige of the journal of publication. Resubmit rejected articles to successively less prestigious journals until accepted for publication. Articles in journals without peer-review have negligible career impact. Grant support creates protected time. Institutional reputation is important in academics. Do not accept a job without a written contract. Have a lawyer review your contract. An outside offer strengthens a negotiating position. Be sociable and nonconfrontational at work. Network with colleagues. Seek a mentor. Meet your supervisor regularly for feedback. Never express anger at your boss or patients. Avoid litigation with employers. Sub-subspecialize to develop expertise in one area. Focus on this area in your research and clinical practice. In conclusion, a well-planned strategy can help you achieve a senior academic position early and efficiently.

  20. Cost-effectiveness analysis of 3-D computerized tomography colonography versus optical colonoscopy for imaging symptomatic gastroenterology patients.

    Science.gov (United States)

    Gomes, Manuel; Aldridge, Robert W; Wylie, Peter; Bell, James; Epstein, Owen

    2013-04-01

    When symptomatic gastroenterology patients have an indication for colonic imaging, clinicians have a choice between optical colonoscopy (OC) and computerized tomography colonography with three-dimensional reconstruction (3-D CTC). 3-D CTC provides a minimally invasive and rapid evaluation of the entire colon, and it can be an efficient modality for diagnosing symptoms. It allows for a more targeted use of OC, which is associated with a higher risk of major adverse events and higher procedural costs. A case can be made for 3-D CTC as a primary test for colonic imaging followed if necessary by targeted therapeutic OC; however, the relative long-term costs and benefits of introducing 3-D CTC as a first-line investigation are unknown. The aim of this study was to assess the cost effectiveness of 3-D CTC versus OC for colonic imaging of symptomatic gastroenterology patients in the UK NHS. We used a Markov model to follow a cohort of 100,000 symptomatic gastroenterology patients, aged 50 years or older, and estimate the expected lifetime outcomes, life years (LYs) and quality-adjusted life years (QALYs), and costs (£, 2010-2011) associated with 3-D CTC and OC. Sensitivity analyses were performed to assess the robustness of the base-case cost-effectiveness results to variation in input parameters and methodological assumptions. 3D-CTC provided a similar number of LYs (7.737 vs 7.739) and QALYs (7.013 vs 7.018) per individual compared with OC, and it was associated with substantially lower mean costs per patient (£467 vs £583), leading to a positive incremental net benefit. After accounting for the overall uncertainty, the probability of 3-D CTC being cost effective was around 60 %, at typical willingness-to-pay values of £20,000-£30,000 per QALY gained. 3-D CTC is a cost-saving and cost-effective option for colonic imaging of symptomatic gastroenterology patients compared with OC.

  1. Slovenian society for gastroenterology and hepatology guidelines on the management of Helicobacter pylori infection

    Directory of Open Access Journals (Sweden)

    Bojan Tepeš

    2011-09-01

    Full Text Available Infection with Helicobacter pylori (Hp is the most common infecion in the world. Half of the world population is infected. The prevalence of infection is declining in the developed world and also in Slovenia, because of better sanitation and eradication therapies. The prevalence of infection with Hp in Slovenia is 25.1 %. Only 20 % of the infected will develop a duodenal or gastric ulcer, ALT lymphoma or cancer in their lifetime. Hp infection is a risk factor for ulcer bleeding in patients on nonsteroidal antiinflammatory drugs and salicylates. Gastoenterologists diagnose the infection with Hp and prescribe therapy. A general practitioner can diagnose the infection by urea breath test or Hp stool test and prescribe therapy in cases of patients with a proven ulcer disease or in patients with first- degree relatives with gastric cancer. The guidelines on the management of Hp infection, published by the Slovenian Society for Gastroenterology and Hepatology (SZGH in 2010, recommend one week therapy with proton pump inhibitor (PPI bid, clarithromycin 500 mg bid and amoxiclline 1000 mg bid in patients without prior therapy with clarithromycin. In the case of prior therapy with macrolides, clarithromycin must be changed for metronidazole 400 mg bid. In the case of therapeutic failure second-line therapy should last 10 days. Secondline therapy can be based on Hp culture and bacterial resistance. The other possibility is PPI bid, colloidal bismuth subcitrate 120 mg qid, oxytetracycline 250 mg qid, metronidazole 400 mg qid; sequential therapy: PI bid 10 days, amoxicillin 1000 mg bid for first 5 days, clarithromycin 500 mg bid and metronidazole 400 mg bid for second 5 days; or PPI bid, amoxicilline 1000 mg bid and levofloxacin 500 mg bid. Hp is a group I human carcinogen responsible for 65 % of all gastric cancers. National screening for Hp infection in younger population without precancerous lesions in the stomach can reduce the incidence of gastric

  2. Influence of Peri-Operative Hypothermia on Surgical Site Infection in Prolonged Gastroenterological Surgery.

    Science.gov (United States)

    Tsuchida, Toshie; Takesue, Yoshio; Ichiki, Kaoru; Uede, Takashi; Nakajima, Kazuhiko; Ikeuchi, Hiroki; Uchino, Motoi

    2016-10-01

    There have been several recent studies on the correlation between intra-operative hypothermia and the occurrence of surgical site infection (SSI). Differences in the depth and timing of hypothermia and the surgical procedure may have led to conflicting results. Patients undergoing gastroenterologic surgery with a duration of >3 h were analyzed. Hypothermia was defined as a core temperature <36°C and was classified as mild (35.5-35.9°C), moderate (35.0-35.4°C), or severe (<35.0°C). Hypothermia also was classified as early-nadir (<36°C within two h of anesthesia induction) and late-nadir (after that time). Risk factors for SSIs were analyzed according to these classifications. Among 1,409 patients, 528 (37.5%) had hypothermia, which was classified as mild in 358, moderate in 137, and severe in 33. Early-nadir and late-nadir hypothermia was found in 23.7% and 13.8%, respectively. There was no significant difference in the incidence of SSIs between patients with and without hypothermia (relative risk 1.00; 95% confidence interval [CI] 0.80-1.25; p = 0.997). However, there was a significantly greater incidence of SSIs in patients with severe hypothermia (33.3%) than in those with normothermia (19.2%; p = 0.045) or mild hypothermia (17.0%; p = 0.021). The incidence of SSIs also was significantly greater in patients with late-nadir than in those with early-nadir hypothermia (23.7% vs. 16.5%; p = 0.041). The incidence of organ/space SSIs was significantly greater in patients with late-nadir hypothermia (19.6%) than in patients with normothermia (12.7%; p = 0.012). In multivariable analysis, neither severe hypothermia (odds ratio 1.24; 95% CI 0.56-2.77] nor late-nadir hypothermia (OR 0.71; 95% CI 0.46-1.01) was an independent risk factor for SSIs. Severe and late-nadir hypothermia were associated with a greater incidence of SSIs and organ/space SSIs. However, neither of these patterns was identified as an independent risk factor for SSIs, possibly

  3. Clinical features and prevalence of gastroesophageal reflux disease in infants attending a pediatric gastroenterology reference service.

    Science.gov (United States)

    Koda, Yu Kar Ling; Ozaki, Marcos J; Murasca, Kelly; Vidolin, Eliana

    2010-01-01

    In infants, it is not always easy to distinguish between pathological and physiological gastroesophageal reflux based only on clinical criteria. In Brazil, studies about gastroesophageal reflux disease in infants are few and are even rare those that used prolonged esophageal pH monitoring for its evaluation. To describe the clinical features of gastroesophageal reflux disease and to determine its prevalence in infants with gastroesophageal reflux attending a tertiary Pediatric Gastroenterology Service and submitted to esophageal pH monitoring for investigation. Descriptive study in 307 infants in whom esophageal pH monitoring (Mark III Digitrapper, Synectics Medical AB, Sweden) was performed during the period December, 1998-December, 2008. The clinical features studied were age group (1-12 months and 13-24 months), and clinical manifestations that motivated the indication of pH monitoring. One hundred twenty-four (40.4%) were female and 183 (59.6%) male with mean age 12.2 +/- 6.2 months (1-23 months). The prevalence of gastroesophageal reflux disease was 18.2% (56/307). One hundred forty-eight (48.2%) were 1-12 months old and 159 (51.8%), 13-24 months. No significant difference was found between the prevalence of these two age groups (P = 0.3006). Gastroesophageal reflux disease was more frequent in those with digestive manifestations (24.2%), crisis of cyanosis/apnea (23.8%) and mixed manifestations (21.5%). Respiratory manifestations were the most frequent indication (39.1%) of pH monitoring. However, the prevalence of gastroesophageal reflux disease was lower (12.5%) in this group compared with in those with digestive manifestations (P = 0.0574), crisis of cyanosis/apnea (P = 0.0882) and mixed manifestations (P = 0.1377). All infants that presented clinical manifestations as crisis of cyanosis/apnea and abnormal pH-metry were Service, the prevalence of gastroesophageal reflux disease associated with acid reflux in infants revealed elevated. Infants with crisis

  4. Call Centre- Computer Telephone Integration

    Directory of Open Access Journals (Sweden)

    Dražen Kovačević

    2012-10-01

    Full Text Available Call centre largely came into being as a result of consumerneeds converging with enabling technology- and by the companiesrecognising the revenue opportunities generated by meetingthose needs thereby increasing customer satisfaction. Regardlessof the specific application or activity of a Call centre, customersatisfaction with the interaction is critical to the revenuegenerated or protected by the Call centre. Physical(v, Call centreset up is a place that includes computer, telephone and supervisorstation. Call centre can be available 24 hours a day - whenthe customer wants to make a purchase, needs information, orsimply wishes to register a complaint.

  5. Analysis of the publication rate of the abstracts presented at a national gastroenterology meeting after 6 years

    Science.gov (United States)

    Gandhi, Divyangkumar; Mclean, Richard W.; Laiyemo, Adeyinka O.

    2017-01-01

    Background/Aims Abstract presentations at scientific meetings provide an opportunity to convey the results of important research. Unfortunately, many abstracts are not eventually published as full manuscripts. We evaluated factors associated with publication of abstracts as manuscripts up to 6.5 years after presentation at the 73rd scientific meeting of the American College of Gastroenterology in 2008. Methods All abstracts, excluding case reports, presented at the meeting were evaluated. We systematically searched for matching manuscripts indexed in PubMed or EMBASE up till May 2015. We used logistic regression models to determine factors associated with manuscript publication and calculated odds ratios (OR) and 95% confidence intervals (CI). Results Of included 791 abstracts, 249 (31.5%) were published as manuscripts within 6.5 years. Oral presentation (OR=2.11; 95%CI: 1.15-3.87), multicenter studies (OR=2.67; 95%CI: 1.44-4.95), abstracts by University-based authors (OR=1.80; 95%CI: 1.20-2.72), and funded research (OR=2.15; 95%CI: 1.43-3.23) were more likely to be published. Winning an award at the meeting was not associated with manuscript publication (OR=1.09; 95%CI: 0.57-2.06). Conclusions There is an urgent need to improve dissemination of scientific knowledge through publication of abstracts presented at gastroenterology meetings as manuscripts. Mentors should endeavor to encourage their mentees to complete this final stage of their scholarly activities. PMID:27931019

  6. Council celebrates CERN Control Centre

    CERN Multimedia

    2006-01-01

    With the unveiling of its new sign, the CERN Control Centre was officially inaugurated on Thursday 16 March. To celebrate its startup, CERN Council members visited the sleek centre, a futuristic-looking room filled with a multitude of monitoring screens.

  7. The Aube centre. 1997 statement

    International Nuclear Information System (INIS)

    1998-09-01

    Since January 1992 the Aube centre ensures the storage of 90% of the short life radioactive wastes produced in France. This educational booklet describes the organization of the activities in the centre from the storage of wastes to the radioactivity surveillance of the environment (air, surface and ground waters, river sediments, plants and milk). (J.S.)

  8. CANDU 9 Control Centre Mockup

    International Nuclear Information System (INIS)

    Webster, A.; Macbeth, M.J.

    1996-01-01

    This paper provides a summary of the design process being followed, the benefits of applying a systematic design using human factors engineering, presents an overview of the CANDU 9 control centre mockup facility, illustrates the control centre mockup with photographs of the 3D CADD model and the full scale mockup, and provides an update on the current status of the project. (author)

  9. Thailand's nuclear research centre

    International Nuclear Information System (INIS)

    Yamkate, P.

    2001-01-01

    The Office of Atomic Energy for Peace, Thailand, is charged with three main tasks, namely, Nuclear Energy development Plan, Utilization of Nuclear Based technology Plan and Science and Technology Plan. Its activities are centred around the research reactor TRR-1/M1. The main areas of contribution include improvement in agricultural production, nuclear medicine and nuclear oncology, health care and nutrition, increasing industrial productivity and efficiency and, development of cadre competent in nuclear science and technology. The office also has the responsibility of ensuring nuclear safety, radiation safety and nuclear waste management. The office has started a new project in 1997 under which a 10 MWt research reactor, an isotope production facility and a waste processing and storage facility would be set up by General Atomic of USA. OAEP has a strong linkage with the IAEA and has been an active participant in RCA programmes. In the future OAEP will enhance its present capabilities in the use of radioisotopes and radiation and look into the possibility of using nuclear energy as an alternative energy resource. (author)

  10. The Adult Education Centre

    Directory of Open Access Journals (Sweden)

    Olga Drofenik

    1997-01-01

    Full Text Available The Adult Education Centre has drafted the professional foundations for the Master Plan for Adult Education which, according to the provisions stipulated in the Adult Education Act, will be adopted by the Parliament. The Master Plan specifies the goals, priority target groups, priority areas and a draft financial projection. The professional foundations include the ratings of adult education in studies about adult education trends in Slovenia and abroad. The paper presents research results relevant to the Master Plan and documents issued by international organizations, including research into the Decisive Global Factors of EC Development after 1992, the Report of Ministers of the OECD, and the Economic Development Strategy of Slovenia . All the above-mentioned documents emphasize the importance of life­long learning in achieving a more fulfilling personal life, faster economic growth and maintenance of social ties. In principle, the same views are shared in Slovenia. However, in practice the "multi-dimensional" nature of adult education often gives way to "education for production". This is why we especially stress the importance of adult education in the social and cultural context.

  11. Centre-level variation in outcomes and treatment for otitis media with effusion and hearing loss and the association of hearing loss with developmental outcomes at ages 5 and 7 years in children with non-syndromic unilateral cleft lip and palate: The Cleft Care UK study. Part 2.

    Science.gov (United States)

    Hall, A; Wills, A K; Mahmoud, O; Sell, D; Waylen, A; Grewal, S; Sandy, J R; Ness, A R

    2017-06-01

    To explore centre-level variation in otitis media with effusion (OME), hearing loss and treatments in children in Cleft Care UK (CCUK) and to examine the association between OME, hearing loss and developmental outcomes at 5 and 7 years. Two hundred and sixty-eight 5-year-old British children with non-syndromic unilateral cleft lip and palate (UCLP) recruited to CCUK. Children had air and bone conduction audiometry at age 5. Information on grommet and hearing aid treatment was obtained from parental questionnaire and medical notes. Hearing loss at age 5 was defined as >20 dB in the better ear and history of OME and hearing loss was determined from past treatment. Children with sensorineural hearing loss were excluded. Associations were examined with speech, behaviour and self-confidence at age 5 and educational attainment at age 7. Centre variation was examined using hierarchical models and associations between hearing variables and developmental outcomes were examined using logistic regression. There was centre-level variation in early grommet placement (variance partition coefficient (VPC) 18%, P=.001) and fitting of hearing aids (VPC 8%, P=.03). A history of OME and hearing loss was associated with poor intelligibility of speech (adjusted odds ratio=2.87, 95% CI 1.42-5.77) and aspects of educational attainment. Hearing loss is an important determinant of poor speech and treatment variation across centres suggest management of OME and hearing loss could be improved. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Canadian Association of Gastroenterology Clinical Practice Guidelines: The Use of Tumour Necrosis Factor-Alpha Antagonist Therapy in Crohn’s Disease

    Directory of Open Access Journals (Sweden)

    Daniel C Sadowski

    2009-01-01

    Full Text Available BACKGROUND: Guidelines regarding the use of infliximab in Crohn’s disease were previously published by the Canadian Association of Gastroenterology in 2004. However, recent clinical findings and drug developments warrant a review and update of these guidelines.

  13. Patient-centred outcomes research: perspectives of patient stakeholders.

    Science.gov (United States)

    Chhatre, Sumedha; Gallo, Joseph J; Wittink, Marsha; Schwartz, J Sanford; Jayadevappa, Ravishankar

    2017-11-01

    To elicit patient stakeholders' experience and perspectives about patient-centred care. Qualitative. A large urban healthcare system. Four patient stakeholders who are prostate cancer survivors. Experience and perspectives of patient stakeholders regarding patient-centred care and treatment decisions. Our patient stakeholders represented a diverse socio-demographic group. The patient stakeholders identified engagement and dialogue with physicians as crucial elements of patient-centred care model. The degree of patient-centred care was observed to be dependent on the situations. High severity conditions warranted a higher level of patient involvement, compared to mild conditions. They agreed that patient-centred care should not mean that patients can demand inappropriate treatments. An important attribute of patient-centred outcomes research model is the involvement of stakeholders. However, we have limited knowledge about the experience of patient stakeholders in patient-centred outcomes research. Our study indicates that patient stakeholders offer a unique perspective as researchers and policy-makers aim to precisely define patient-centred research and care.

  14. The job demands-resources model of work engagement in South African call centres

    OpenAIRE

    Yolandi Janse van Rensburg; Billy Boonzaier; Michèle Boonzaier

    2013-01-01

    Orientation: A ‘sacrificial human resource strategy’ is practised in call centres, resulting in poor employee occupational health. Consequently, questions are posed in terms of the consequences of call centre work and which salient antecedent variables impact the engagement and wellbeing of call centre representatives. Research purpose: Firstly, to gauge the level of employee engagement amongst a sample of call centre representatives in South Africa and, secondly, to track the paths throu...

  15. Evaluation of gastroenterology and hepatology articles on Wikipedia: are they suitable as learning resources for medical students?

    Science.gov (United States)

    Azer, Samy A

    2014-02-01

    With the changes introduced to medical curricula, medical students use learning resources on the Internet such as Wikipedia. However, the credibility of the medical content of Wikipedia has been questioned and there is no evidence to respond to these concerns. The aim of this paper was to critically evaluate the accuracy and reliability of the gastroenterology and hepatology information that medical students retrieve from Wikipedia. The Wikipedia website was searched for articles on gastroenterology and hepatology on 28 May 2013. Copies of these articles were evaluated by three assessors independently using an appraisal form modified from the DISCERN instrument. The articles were scored for accuracy of content, readability, frequency of updating, and quality of references. A total of 39 articles were evaluated. Although the articles appeared to be well cited and reviewed regularly, several problems were identified with regard to depth of discussion of mechanisms and pathogenesis of diseases, as well as poor elaboration on different investigations. Analysis of the content showed a score ranging from 15.6±0.6 to 43.6±3.2 (mean±SD). The total number of references in all articles was 1233, and the number of references varied from 4 to 144 (mean±SD, 31.6±27.3). The number of citations from peer-reviewed journals published in the last 5 years was 242 (28%); however, several problems were identified in the list of references and citations made. The readability of articles was in the range of -8.0±55.7 to 44.4±1.4; for all articles the readability was 26±9.0 (mean±SD). The concordance between the assessors on applying the criteria had mean κ scores in the range of 0.61 to 0.79. Wikipedia is not a reliable source of information for medical students searching for gastroenterology and hepatology articles. Several limitations, deficiencies, and scientific errors have been identified in the articles examined.

  16. Issues associated with the emergence of coeliac disease in the Asia–Pacific region: a working party report of the World Gastroenterology Organization and the Asian Pacific Association of Gastroenterology.

    Science.gov (United States)

    Makharia, Govind K; Mulder, Chris J J; Goh, Khean Lee; Ahuja, Vineet; Bai, Julio C; Catassi, Carlo; Green, Peter H R; Gupta, Siddhartha Datta; Lundin, Knut E A; Ramakrishna, Balakrishnan Siddartha; Rawat, Ramakant; Sharma, Hanish; Sood, Ajit; Watanabe, Chikako; Gibson, Peter R

    2014-04-01

    Once thought to be uncommon in Asia, coeliac disease (CD) is now being increasingly recognized in Asia–Pacific region. In many Asian nations, CD is still considered to be either nonexistent or very rare. In recognition of such heterogeneity of knowledge and awareness, the World Gastroenterology Organization and the Asian Pacific Association of Gastroenterology commissioned a working party to address the key issues in emergence of CD in Asia. A working group consisting of members from Asia–Pacific region, Europe, North America, and South America reviewed relevant existing literature with focus on those issues specific to Asia–Pacific region both in terms of what exists and what needs to be done. The working group identified the gaps in epidemiology, diagnosis, and management of CD in Asian–Pacific region and recommended the following: to establish prevalence of CD across region, increase in awareness about CD among physicians and patients, and recognition of atypical manifestations of CD. The challenges such as variability in performance of serological tests, lack of population-specific cut-offs values for a positive test, need for expert dietitians for proper counseling and supervision of patients, need for gluten-free infrastructure in food supply and creation of patient advocacy organizations were also emphasized. Although absolute number of patients with CD at present is not very large, this number is expected to increase over the next few years or decades. It is thus appropriate that medical community across the Asia–Pacific region define extent of problem and get prepared to handle impending epidemic of CD.

  17. The Aube centre; Le Centre de l`Aube

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-07-01

    This educational booklet is devoted to a general presentation of the Aube radioactive wastes storage centre. After a short presentation of the Andra, the French national agency for the management of radioactive wastes, it gives some general information about radioactive wastes (origin, classification), containers (quality assurance and different types), wastes transportation (planning, safety), and about the Aube centre itself: description, treatment and conditioning of drums (compacting and injection), storage facilities, geological situation of the site, and environmental controls. (J.S.)

  18. CAPTURING REALITY AT CENTRE BLOCK

    Directory of Open Access Journals (Sweden)

    C. Boulanger

    2017-08-01

    Full Text Available The Centre Block of Canada’s Parliament buildings, National Historic Site of Canada is set to undergo a major rehabilitation project that will take approximately 10 years to complete. In preparation for this work, Heritage Conservation Services (HCS of Public Services and Procurement Canada has been completing heritage documentation of the entire site which includes laser scanning of all interior rooms and accessible confined spaces such as attics and other similar areas. Other documentation completed includes detailed photogrammetric documentation of rooms and areas of high heritage value. Some of these high heritage value spaces present certain challenges such as accessibility due to the height and the size of the spaces. Another challenge is the poor lighting conditions, requiring the use of flash or strobe lighting to either compliment or completely eliminate the available ambient lighting. All the spaces captured at this higher level of detail were also captured with laser scanning. This allowed the team to validate the information and conduct a quality review of the photogrammetric data. As a result of this exercise, the team realized that in most, if not all cases, the photogrammetric data was more detailed and at a higher quality then the terrestrial laser scanning data. The purpose and motivation of this paper is to present these findings, as well provide the advantages and disadvantages of the two methods and data sets.

  19. Capturing Reality at Centre Block

    Science.gov (United States)

    Boulanger, C.; Ouimet, C.; Yeomans, N.

    2017-08-01

    The Centre Block of Canada's Parliament buildings, National Historic Site of Canada is set to undergo a major rehabilitation project that will take approximately 10 years to complete. In preparation for this work, Heritage Conservation Services (HCS) of Public Services and Procurement Canada has been completing heritage documentation of the entire site which includes laser scanning of all interior rooms and accessible confined spaces such as attics and other similar areas. Other documentation completed includes detailed photogrammetric documentation of rooms and areas of high heritage value. Some of these high heritage value spaces present certain challenges such as accessibility due to the height and the size of the spaces. Another challenge is the poor lighting conditions, requiring the use of flash or strobe lighting to either compliment or completely eliminate the available ambient lighting. All the spaces captured at this higher level of detail were also captured with laser scanning. This allowed the team to validate the information and conduct a quality review of the photogrammetric data. As a result of this exercise, the team realized that in most, if not all cases, the photogrammetric data was more detailed and at a higher quality then the terrestrial laser scanning data. The purpose and motivation of this paper is to present these findings, as well provide the advantages and disadvantages of the two methods and data sets.

  20. The Centres for Environment-friendly Energy Research (FME)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    public administration and various types of organisations. Uniting the strongest players within a specific area under the aegis of a single centre gives each centre a very high level of overall expertise. The FME centres do not comprise an institution in a single geographic location but rather represent a grouping of entities with unique competencies in relevant areas. Adequate funding is critical to the centres success and further development. The centres each receive NOK 8-20 million annually for a five-year period, with the potential for a three-year extension. The Research Council will evaluate each centre individually and determine whether to grant further funding beyond the initial five-year period. The FME centres are expected to keep on boosting Norwegian energy-related expertise well into the future, with the benefits of their activities extending far beyond the actual lifecycle of the centres themselves. Individually and together, the FME centres will help to provide a secure energy future for Norway and the world at large.(Author)

  1. Methodological reporting of randomized controlled trials in major hepato-gastroenterology journals in 2008 and 1998: a comparative study

    Science.gov (United States)

    2011-01-01

    Background It was still unclear whether the methodological reporting quality of randomized controlled trials (RCTs) in major hepato-gastroenterology journals improved after the Consolidated Standards of Reporting Trials (CONSORT) Statement was revised in 2001. Methods RCTs in five major hepato-gastroenterology journals published in 1998 or 2008 were retrieved from MEDLINE using a high sensitivity search method and their reporting quality of methodological details were evaluated based on the CONSORT Statement and Cochrane Handbook for Systematic Reviews of interventions. Changes of the methodological reporting quality between 2008 and 1998 were calculated by risk ratios with 95% confidence intervals. Results A total of 107 RCTs published in 2008 and 99 RCTs published in 1998 were found. Compared to those in 1998, the proportion of RCTs that reported sequence generation (RR, 5.70; 95%CI 3.11-10.42), allocation concealment (RR, 4.08; 95%CI 2.25-7.39), sample size calculation (RR, 3.83; 95%CI 2.10-6.98), incomplete outecome data addressed (RR, 1.81; 95%CI, 1.03-3.17), intention-to-treat analyses (RR, 3.04; 95%CI 1.72-5.39) increased in 2008. Blinding and intent-to-treat analysis were reported better in multi-center trials than in single-center trials. The reporting of allocation concealment and blinding were better in industry-sponsored trials than in public-funded trials. Compared with historical studies, the methodological reporting quality improved with time. Conclusion Although the reporting of several important methodological aspects improved in 2008 compared with those published in 1998, which may indicate the researchers had increased awareness of and compliance with the revised CONSORT statement, some items were still reported badly. There is much room for future improvement. PMID:21801429

  2. Effect of a health system's medical error disclosure program on gastroenterology-related claims rates and costs.

    Science.gov (United States)

    Adams, Megan A; Elmunzer, B Joseph; Scheiman, James M

    2014-04-01

    In 2001, the University of Michigan Health System (UMHS) implemented a novel medical error disclosure program. This study analyzes the effect of this program on gastroenterology (GI)-related claims and costs. This was a review of claims in the UMHS Risk Management Database (1990-2010), naming a gastroenterologist. Claims were classified according to pre-determined categories. Claims data, including incident date, date of resolution, and total liability dollars, were reviewed. Mean total liability incurred per claim in the pre- and post-implementation eras was compared. Patient encounter data from the Division of Gastroenterology was also reviewed in order to benchmark claims data with changes in clinical volume. There were 238,911 GI encounters in the pre-implementation era and 411,944 in the post-implementation era. A total of 66 encounters resulted in claims: 38 in the pre-implementation era and 28 in the post-implementation era. Of the total number of claims, 15.2% alleged delay in diagnosis/misdiagnosis, 42.4% related to a procedure, and 42.4% involved improper management, treatment, or monitoring. The reduction in the proportion of encounters resulting in claims was statistically significant (P=0.001), as was the reduction in time to claim resolution (1,000 vs. 460 days) (P<0.0001). There was also a reduction in the mean total liability per claim ($167,309 pre vs. $81,107 post, 95% confidence interval: 33682.5-300936.2 pre vs. 1687.8-160526.7 post). Implementation of a novel medical error disclosure program, promoting transparency and quality improvement, not only decreased the number of GI-related claims per patient encounter, but also dramatically shortened the time to claim resolution.

  3. Topicality of identification of free fatty acids pattern in biologic substrates in the diagnosis of gastroenterological diseases

    Directory of Open Access Journals (Sweden)

    V.I. Didenko

    2017-04-01

    Full Text Available The article shows the role of free fatty acids in the pathogenesis of metabolic and gastroenterological disorders. An expediency of gas chromatography method for determination of free fatty acids pattern in biologic samples (blood serum, urine, feces and other was substantiated. The role of free fatty acids in the cell structure components formation, energetic homeostasis and signal molecules or their precursor production was shown. So, disorders of regulation of free fatty acids metabolism lead to systemic fails of insulin action, such as glucose metabolism in adipocytes, muscles and liver. Increase in several fractions of lipid pattern takes place in different pathologic states. These changes occur earlier than changes of enzymes activity or other protein markers. For example, short chain fatty acids can be used for identification of syndrome of bacterial overgrowth in the intestines. Increasе in polyunsaturated fatty acid fraction activates inflammation process, immune reactions, blood hypercoagulation, activation of lipid peroxidation. Also, arachidonic (C20:0, dodecanoic (C12:0 and linoleic (C18:3 acids are markers of inflammation processes. In addition, deficiency of free fatty acids is very important aspect of diagnois. It can’t be uncertified by standard laboratory methods. Proven fact is that essential fatty acids can be a cause of metabolic syndrome, non-alcoholic fatty liver disease formation such as other diseases associated with metabolism. So, only chromatography today is a method for determination fatty acid pattern. The advantages of gas chromatography are rapid realization and high accuracy. Thus, identification of trace concentrations (about 10–12 mole is possible. Implementation of this method into the clinical practice of gastroenterology specialists allows the early diagnosis of pathologies and choice of correct treatment.

  4. Remote transmission of live endoscopy over the Internet: Report from the 87th Congress of the Japan Gastroenterological Endoscopy Society.

    Science.gov (United States)

    Shimizu, Shuji; Ohtsuka, Takao; Takahata, Shunichi; Nagai, Eishi; Nakashima, Naoki; Tanaka, Masao

    2016-01-01

    Live demonstration of endoscopy is one of the most attractive and useful methods for education and is often organized locally in hospitals. However, problems have been apparent in terms of cost, preparation, and potential risks to patients. Our aim was to evaluate a new approach to live endoscopy whereby remote hospitals are connected by the Internet for live endoscopic demonstrations. Live endoscopy was transmitted to the Congress of the Japan Gastroenterological Endoscopic Society by 13 domestic and international hospitals. Patients with upper and lower gastrointestinal diseases and with pancreatobiliary disorders were the subjects of a live demonstration. Questionnaires were distributed to the audience and were sent to the demonstrators. Questions concerned the quality of transmitted images and sound, cost, preparations, programs, preference of style, and adverse events. Of the audience, 91.2% (249/273) answered favorably regarding the transmitted image quality and 93.8% (259/276) regarding the sound quality. All demonstrators answered favorably regarding image quality and 93% (13/14) regarding sound quality. Preparations were completed without any outsourcing at 11 sites (79%) and were evaluated as 'very easy' or 'easy' at all but one site (92.3%). Preparation cost was judged as 'very cheap' or 'cheap' at 12 sites (86%). Live endoscopy connecting multiple international centers was satisfactory in image and sound quality for both audience and demonstrators, with easy and inexpensive preparation. The remote transmission of live endoscopy from demonstrators' own hospitals was preferred to the conventional style of locally organized live endoscopy. © 2015 The Authors Digestive Endoscopy © 2015 Japan Gastroenterological Endoscopy Society.

  5. IAEA To Launch Centre On Ocean Acidification

    International Nuclear Information System (INIS)

    2012-01-01

    Full text: The International Atomic Energy Agency (IAEA) is to launch a new centre this summer to address the growing problem of ocean acidification. Operated by the Agency's Monaco Environmental Laboratories, the Ocean Acidification International Coordination Centre will serve the scientific community - as well as policymakers, universities, media and the general public - by facilitating, promoting and communicating global actions on ocean acidification. Growing amounts of carbon dioxide in the Earth's atmosphere are being absorbed in the planet's oceans which increases their acidity. According to the experts, ocean acidification may render most regions of the ocean inhospitable to coral reefs by 2050 if atmospheric carbon dioxide levels continue to increase. This could lead to substantial changes in commercial fish stocks, threatening food security for millions of people as well as the multi-billion dollar fishing industry. International scientists have been studying the effect and possible responses, and the new centre will help coordinate their efforts. ''During the past five years, numerous multinational and national research projects on ocean acidification have emerged and significant research advances have been made,'' said Daud bin Mohamad, IAEA Deputy Director General for Nuclear Sciences and Applications. ''The time is now ripe to provide international coordination to gain the greatest value from national efforts and research investments.'' The centre will be supported by several IAEA Member States and through the Peaceful Uses Initiative, and it will be overseen by an Advisory Board consisting of leading institutions, including the U.N. Intergovernmental Oceanographic Commission, the U.S. National Oceanic and Atmospheric Administration, the U.N. Food and Agriculture Organization, the Fondation Prince Albert II de Monaco, the OA-Reference User Group, as well as leading scientists and economists in the field. The new centre will focus on international

  6. Discharged of the nuclear wastes by health service centres

    International Nuclear Information System (INIS)

    Mazur, G.; Jednorog, S.

    1993-01-01

    In this paper Polish national regulation in radiation protection on nuclear medical domain was discussed. The method of utilized nuclear wastes in medical and science centres was deliberate. From many years activity of wastes from Nuclear Medicine Department of Central Clinical Hospital Armed Forces Medical Academy and Radiation Protection Department of Armed Forces Institute of Hygiene and Epidemiology was measured. In debate centres radiation monitoring was performed. In this purpose the beta global activity and gamma spectrometry measurement of discharged wastes occurred. From last year in discussed centres wastes activity do not increased permissible levels. (author). 3 refs, 5 tabs

  7. Upper gastrointestinal bleeding: Five-year experience from one centre

    Directory of Open Access Journals (Sweden)

    Jovanović Ivan

    2008-01-01

    Full Text Available Introduction Acute upper gastrointestinal bleeding is the commonest emergency managed by gastroenterologists. Objective To assess the frequency of erosive gastropathy and duodenal ulcer as a cause of upper gastrointestinal (GI bleeding as well as its relation to age, gender and known risk factors. METHOD We conducted retrospective observational analysis of emergency endoscopy reports from the records of the Emergency Department of Clinic for Gastroenterology and Hepatology, Clinical Centre of Serbia, during the period from 2000 to 2005. Data consisted of patients' demographics, endoscopic findings and potential risk factors. Results During the period 2000-2005, three thousand nine hundred and fifty four emergency upper endoscopies were performed for acute bleeding. In one quarter of cases, acute gastric erosions were the actual cause of bleeding. One half of them were associated with excessive consumption of salicylates and NSAIDs. In most of the examined cases, bleeding stopped spontaneously, while 7.6% of the cases required endoscopic intervention. Duodenal ulcer was detected as a source of bleeding in 1320 (33.4% patients and was significantly associated with a male gender (71.8% and salicylate or NSAID abuse (59.1% (χ2-test; p=0.007. Conclusion Erosive gastropathy and duodenal ulcer represent a significant cause of upper gastrointestinal bleeding accounting for up to 60% of all cases that required emergency endoscopy during the 5- year period. Consumption of NSAIDs and salicylates was associated more frequently with bleeding from a duodenal ulcer than with erosive gastropathy leading to a conclusion that we must explore other causes of erosive gastropathy more thoroughly. .

  8. Reducing cooling energy consumption in data centres and critical facilities

    Science.gov (United States)

    Cross, Gareth

    Given the rise of our everyday reliance on computers in all walks of life, from checking the train times to paying our credit card bills online, the need for computational power is ever increasing. Other than the ever-increasing performance of home Personal Computers (PC's) this reliance has given rise to a new phenomenon in the last 10 years ago. The data centre. Data centres contain vast arrays of IT cabinets loaded with servers that perform millions of computational equations every second. It is these data centres that allow us to continue with our reliance on the internet and the PC. As more and more data centres become necessary due to the increase in computing processing power required for the everyday activities we all take for granted so the energy consumed by these data centres rises. Not only are more and more data centres being constructed daily, but operators are also looking at ways to squeeze more processing from their existing data centres. This in turn leads to greater heat outputs and therefore requires more cooling. Cooling data centres requires a sizeable energy input, indeed to many megawatts per data centre site. Given the large amounts of money dependant on the successful operation of data centres, in particular for data centres operated by financial institutions, the onus is predominantly on ensuring the data centres operate with no technical glitches rather than in an energy conscious fashion. This report aims to investigate the ways and means of reducing energy consumption within data centres without compromising the technology the data centres are designed to house. As well as discussing the individual merits of the technologies and their implementation technical calculations will be undertaken where necessary to determine the levels of energy saving, if any, from each proposal. To enable comparison between each proposal any design calculations within this report will be undertaken against a notional data facility. This data facility will

  9. The centre of the action

    CERN Multimedia

    2008-01-01

    The CERN Control Centre (CCC) has all the ingredients of an action movie control room: hundreds of screens, technicians buzzing in and out, huge floor-to-ceiling windows revealing the looming vista of a mountain range, flashing lights, microphones… This is the place where not just the LHC, but the whole of CERN’s accelerator complex and technical support is based - truly the centre of the action at CERN.

  10. FUNCTIONS OF A NEUROMUSCULAR CENTRE

    Directory of Open Access Journals (Sweden)

    Janez Zidar

    2004-12-01

    Full Text Available Main functions of a neuromuscular (NM centre are making diagnosis, treatment and counselling. Some other functions, e. g. forming a register and epidemiological endeavours, could be added. All these activities are expected to be achieved by multidisciplinary approach with the idea that members use the same guidelines and share the same knowledge.NM diseases affect lower levels of the nervous system that is motor units (motor cells in the brainstem and spinal cord, nerve roots, cranial and peripheral nerves, neuromuscular junction, and muscles. There are many such diseases; a few are more common others are rare.Rational approach in making a diagnosis can be divided into several steps. The process begins with a person with clinical symptoms and signs which raise the suspicion of NM disease. The first step is the description of the predominant pattern of muscular wasting and weakness (e. g. limb-girdle, distal, ocular, facio-scapulo-humeral. Each of these syndromes require a differential diagnosis within the motor unit territory what is achieved by means of EMG and muscle biopsy. The latter is even more important to define the nature of the abnormality. Disease nature can also be determined biochemically and, as NM disorders are commonly genetically determined, at the molecular genetic level. Treatment modalities include drugs (causative and symptomatic and other measures such as promoting and maintaining good general health, preventing skeletal deformities, physiotherapy, orthoses, surgery, and prevention of respiratory and cardiac functions. Counselling is mainly by social workers that focus on the practical aspects of coping with illness and disability and by genetic counsellors who gave advise on family planning.

  11. IDRANAP - European Centre of Excellence

    International Nuclear Information System (INIS)

    Buzatu, Florin D.

    2003-01-01

    Selected by the European Commission (EC) experts out of 185 proposals from 11 countries, IDRANAP (Inter-Disciplinary Research and Applications based on Nuclear and Atomic Physics) is the only EC Centre of Excellence in nuclear physics. The project, initiated and developed by a remarkable team from our institute, researchers with a recognized international scientific level, has as main objectives: - promotion in Romania and in the region of modern applications derived from basic and applied research in nuclear and atomic physics; - disciplinary research in ecology, health, biology, science of materials; - specific nuclear and atomic physics research aimed to open new possibilities for applications; - to ensure stimulative conditions for PhD students from Romania and other EC candidate countries to improve their knowledge and experience by joining scientific activities in the region, a fact that might counteract their tendency to migrate to Western countries. The high scientific level of researchers, their access to national and international facilities as well as the link with prestigious laboratories abroad and the socio-economic demand motivated the development of the project. Among expected results, we mention: improving and spreading the scientific knowledge by publications; producing new facilities, devices and instruments; application of nuclear methods in industry, health-care and environment protection, and training of young researchers. The project consists of 18 workpackages structured in 5 distinct areas: - Determining environmental pollution; - Nuclear methods in biology and medicine; - Radionuclide metrology; - Analysis and characterization of materials; - Nuclei far from stability, decay modes, cosmic rays, and facilities.We make an up-to-date presentation of obtained results and activities performed within IDRANAP project, as well as a short overview of our institute. (author)

  12. Redundancy and Reliability for an HPC Data Centre

    OpenAIRE

    Erhan Yılmaz

    2012-01-01

    Defining a level of redundancy is a strategic question when planning a new data centre, as it will directly impact the entire design of the building as well as the construction and operational costs. It will also affect how to integrate future extension plans into the design. Redundancy is also a key strategic issue when upgrading or retrofitting an existing facility. Redundancy is a central strategic question to any business that relies on data centres for its operation. In th...

  13. Information centres: hyper-qualitative tool of Cogema's communication policy

    International Nuclear Information System (INIS)

    Chadeyron, P.

    1993-01-01

    The information centres are an indispensable link in the chain of Cogema's communication policy. They enable a complete adaptation to each visitor's different level of understanding and thus improve the quality of the transmission of information to a reduced, but totally sensitive, target. The information centres therefore represent ''quality'' tools which are complementary to other means of communication. Moreover, they emphasize Cogema's resolution to communicate and formalize its communication policy. (author)

  14. DALI: Defining Antibiotic Levels in Intensive care unit patients: a multi-centre point of prevalence study to determine whether contemporary antibiotic dosing for critically ill patients is therapeutic.

    Science.gov (United States)

    Roberts, Jason A; De Waele, Jan J; Dimopoulos, George; Koulenti, Despoina; Martin, Claude; Montravers, Philippe; Rello, Jordi; Rhodes, Andrew; Starr, Therese; Wallis, Steven C; Lipman, Jeffrey

    2012-07-06

    The clinical effects of varying pharmacokinetic exposures of antibiotics (antibacterials and antifungals) on outcome in infected critically ill patients are poorly described. A large-scale multi-centre study (DALI Study) is currently underway describing the clinical outcomes of patients achieving pre-defined antibiotic exposures. This report describes the protocol. DALI will recruit over 500 patients administered a wide range of either beta-lactam or glycopeptide antibiotics or triazole or echinocandin antifungals in a pharmacokinetic point-prevalence study. It is anticipated that over 60 European intensive care units (ICUs) will participate. The primary aim will be to determine whether contemporary antibiotic dosing for critically ill patients achieves plasma concentrations associated with maximal activity. Secondary aims will compare antibiotic pharmacokinetic exposures with patient outcome and will describe the population pharmacokinetics of the antibiotics included. Various subgroup analyses will be conducted to determine patient groups that may be at risk of very low or very high concentrations of antibiotics. The DALI study should inform clinicians of the potential clinical advantages of achieving certain antibiotic pharmacokinetic exposures in infected critically ill patients.

  15. DALI: Defining Antibiotic Levels in Intensive care unit patients: a multi-centre point of prevalence study to determine whether contemporary antibiotic dosing for critically ill patients is therapeutic

    Directory of Open Access Journals (Sweden)

    Roberts Jason A

    2012-07-01

    Full Text Available Abstract Background The clinical effects of varying pharmacokinetic exposures of antibiotics (antibacterials and antifungals on outcome in infected critically ill patients are poorly described. A large-scale multi-centre study (DALI Study is currently underway describing the clinical outcomes of patients achieving pre-defined antibiotic exposures. This report describes the protocol. Methods DALI will recruit over 500 patients administered a wide range of either beta-lactam or glycopeptide antibiotics or triazole or echinocandin antifungals in a pharmacokinetic point-prevalence study. It is anticipated that over 60 European intensive care units (ICUs will participate. The primary aim will be to determine whether contemporary antibiotic dosing for critically ill patients achieves plasma concentrations associated with maximal activity. Secondary aims will compare antibiotic pharmacokinetic exposures with patient outcome and will describe the population pharmacokinetics of the antibiotics included. Various subgroup analyses will be conducted to determine patient groups that may be at risk of very low or very high concentrations of antibiotics. Discussion The DALI study should inform clinicians of the potential clinical advantages of achieving certain antibiotic pharmacokinetic exposures in infected critically ill patients.

  16. The ideal Atomic Centre; Le Centre Atomique ideal

    Energy Technology Data Exchange (ETDEWEB)

    Mas, R [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1965-07-01

    The author presents considerations which should prove to be of interest to all those who have to design, to construct and to operate a nuclear research centre. A large number of the ideas presented can also be applied to non-nuclear scientific research centres. In his report the author reviews: various problems with which the constructor is faced: ground-plan, infrastructure, buildings and the large units of scientific equipment in the centre, and those problems facing the director: maintenance, production, supplies, security. The author stresses the relationship which ought to exist between the research workers and the management. With this aim in view he proposes the creation of National School for Administration in Research which would train administrative executives for public or private organisations; they would be specialised in the fields of fundamental or applied research. (author) [French] L'auteur propose une base de reflexions a tous ceux qui doivent concevoir, realiser et faire vivre un Centre d'Etudes Nucleaires. Un grand nombre des idees exprimees peut d'ailleurs s'appliquer a un Centre d'Etudes Scientifiques non nucleaires. Dans son ouvrage, l'auteur passe en revue les differents problemes qui se posent au constructeur: plan, masse, infrastructure, batiments et grands appareils du Centre, et ceux qu'a a resoudre le directeur: entretien, fabrication, approvisionnements, securite. L'auteur insiste sur l'aspect des rapports qui doivent exister entre les chercheurs et ceux qui les administrent. Il propose a cette fin la creation d'une Ecole Nationale d'Administration de la Recherche qui formerait des cadres administratifs pour les organismes publics ou prives, specialises dans la Recherche fondamentale ou appliquee. (auteur)

  17. The Belgian nuclear research centre

    International Nuclear Information System (INIS)

    Moons, F.

    2001-01-01

    The Belgian Nuclear Research Centre is almost exclusively devoted to nuclear R and D and services and is able to generate 50% of its resources (out of 75 million Euro) by contract work and services. The main areas of research include nuclear reactor safety, radioactive waste management, radiation protection and safeguards. The high flux reactor BR2 is extensively used to test fuel and structural materials. PWR-plant BR3 is devoted to the scientific analysis of decommissioning problems. The Centre has a strong programme on the applications of radioisotopes and radiation in medicine and industry. The centre has plans to develop an accelerator driven spallation neutron source for various applications. It has initiated programmes to disseminate correct information on issues of nuclear energy production and non-energy nuclear applications to different target groups. It has strong linkages with the IAEA, OECD-NEA and the Euratom. (author)

  18. Technical support and emergency centre

    International Nuclear Information System (INIS)

    Bohun, L.; Kapisovsk y, M.

    1997-01-01

    This paper presents technical support and emergency management center which will be on two places: Mochovce NPP Emergency Centre (Technical support center and Support working center) and Reserve Emergency Centre in Levice (Reserve emergency center and Environmental Evaluation Center). The main aims of the emergency management centers are: the management and coordination of all persons and organisations; provision of the all information needed to evaluation of the accident and its mitigation; continuous evaluation of the potential or real radiological consequences; taking measure for an early notification of the governmental bodies and the organizations, warning and protection of the public; and other aims. In the next part the data for technical support and emergency centre are discussed

  19. Presentation of TVO's visitor's centre

    International Nuclear Information System (INIS)

    Aemmaelae, V.M.

    1993-01-01

    There are four nuclear power plant units in Finland, two of which are PWR's owned by Imatran Voima Oy. The two BWR units are located at Olkiluoto and owned by Teollisuuden Voima Oy. This presentation tells about TVO's concept of informing the visitors at Olkiluoto. At the site there are located, in addition to the two nuclear power plant units, the intermediate storage for spent fuel, the repository for low and medium-active waste as well as the training centre. At the Olkiluoto Visitor's Centre all the activities of the company are presented using varied audio-visual aids. The centre has several exhibits and there are also different installations to show how the plant works. (author)

  20. International Development Research Centre Act Loi sur le Centre de ...

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

    1 juin 2009 ... research includes any scientific or technical inquiry or experimentation that is .... data centres and facilities for research and other activ- ities;. (b) initiate and ..... Loi sur la pension de la fonction publique ne s'applique pas aux ...

  1. Scheduling participants of Assessment Centres

    DEFF Research Database (Denmark)

    Lysgaard, Jens; Løber, Janni

      Assessment Centres are used as a tool for psychologists and coaches to observe a number of dimensions in a person's behaviour and test his/her potential within a number of chosen focus areas. This is done in an intense course, with a number of different exercises which expose each participant...... Centres usually last two days and involve 3-6 psychologists or trained coaches as assessors. An entire course is composed of a number of rounds, with each round having its individual duration. In each round, the participants are divided into a number of groups with prespecifed pairing of group sizes...

  2. Training centres in Latin America

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1959-04-15

    Early 1958 the Brazilian representative on the Board of Governors of the International Atomic Energy Agency - supported by the Governors from Argentina and Guatemala -proposed that a study should be made of the possibility of setting up one or more atomic energy training centres in Latin America. On the Board's recommendation, the Director General of the Agency appointed a fact-finding team to make anon-the-spot study. In drafting this report the team was invited to consider the following points: (a) The need for establishing one or more regional training centres; (b) Existing facilities that are being or could be used for training, together with technical data concerning them; (c) The general scientific technological and industrial conditions of the countries visited insofar as they have a bearing on their training needs and capabilities. The authors of the report conclude that 'a training centre in radio-botany should provide vitally needed knowledge and vitally needed specialists to all the agricultural installations in Latin America. A training centre like this might provide an excellent model upon which to base training centres in other areas'. The report recommends that: 1. The Agency should meet the requests of Latin American universities by, for example, supplying equipment and sending experts; 2. At least one specialized training centre should be established as soon as possible. Taking as an example the field of radio-botany, such a centre would provide trained specialists in radio-botany to agricultural institutions throughout Latin America and also provide basic research results vital to agriculture. The cost of new facilities might be of the order of $7 500 000, with an annual budget of approximately $650 000. Staff required: 40 scientists and 175 employees; 3. Whenever it appears feasible to gather necessary staff of high creative ability and established productivity and when funds can be made available for facilities, equipment and operating costs, at

  3. Training centres in Latin America

    International Nuclear Information System (INIS)

    1959-01-01

    Early 1958 the Brazilian representative on the Board of Governors of the International Atomic Energy Agency - supported by the Governors from Argentina and Guatemala -proposed that a study should be made of the possibility of setting up one or more atomic energy training centres in Latin America. On the Board's recommendation, the Director General of the Agency appointed a fact-finding team to make anon-the-spot study. In drafting this report the team was invited to consider the following points: (a) The need for establishing one or more regional training centres; (b) Existing facilities that are being or could be used for training, together with technical data concerning them; (c) The general scientific technological and industrial conditions of the countries visited insofar as they have a bearing on their training needs and capabilities. The authors of the report conclude that 'a training centre in radio-botany should provide vitally needed knowledge and vitally needed specialists to all the agricultural installations in Latin America. A training centre like this might provide an excellent model upon which to base training centres in other areas'. The report recommends that: 1. The Agency should meet the requests of Latin American universities by, for example, supplying equipment and sending experts; 2. At least one specialized training centre should be established as soon as possible. Taking as an example the field of radio-botany, such a centre would provide trained specialists in radio-botany to agricultural institutions throughout Latin America and also provide basic research results vital to agriculture. The cost of new facilities might be of the order of $7 500 000, with an annual budget of approximately $650 000. Staff required: 40 scientists and 175 employees; 3. Whenever it appears feasible to gather necessary staff of high creative ability and established productivity and when funds can be made available for facilities, equipment and operating costs, at

  4. Logistics centres development in Latvia

    Directory of Open Access Journals (Sweden)

    I. Kabashkin

    2007-12-01

    Full Text Available In the situation where a large increase in trade and freight transport volumes in the Baltic Sea region (BSR is expected and in which the BSR is facing a major economic restructuring, eff orts to achieve more integrated and sustainable transport and communication links within the BSR are needed. One of these eff orts is the development of logistics centres (LCs and their networking, which will continue to have an impact on improving communication links, spatial planning practices and approaches, logistics chain development and the promotion of sustainable transport modes. These factors will refl ect on logistics processes both in major gateway cities and in remote BSR areas. The importance of logistics systems as a whole is not seen clearly enough. Logistics actors see that logistics operations are not appreciated as much as other fi elds of activity. In addition, logistics centres and the importance of logistics activities to the business life of areas and the employment rate should be brought up better. In the paper main goal and tasks of national approach to LCs development are discussed. Strategic focus of new activities in this area is on the integration of various networks within and between logistics centres in order to improve and develop the quality of logistics networks as well as to spatially widen the networking activities. The key objectives are to integrate the links between logistics centres, ports and other logistics operators in a functional and sustainable way, to promote spatial integration by creating sustainable and integrated approaches to spatial planning of logistics centres and transport infrastructure, to improve ICT-based networking and communication practices of the fi elds of transport and logistics and to increase the competence of logistics centres and associated actors by organising educational and training events. The current activities include, for example, the creation of measures for transport networking and

  5. A disposal centre for immobilized nuclear waste

    International Nuclear Information System (INIS)

    1980-02-01

    This report describes a conceptual design of a disposal centre for immobilized nuclear waste. The surface facilities consist of plants for the preparation of steel cylinders containing nuclear waste immobilized in glass, shaft headframe buildings and all necessary support facilities. The underground disposal vault is located on one level at a depth of 1000 m. The waste cylinders are emplaced into boreholes in the tunnel floors. All surface and subsurface facilities are described, operations and schedules are summarized, and cost estimates and manpower requirements are given. (auth)

  6. The Fate of Abstracts Presented at the 2013 and 2014 Annual Meetings of the Romanian Society of Gastroenterology and Hepatology.

    Science.gov (United States)

    Trifan, Anca; Chihaia, Catalin-Alexandru; Tanase, Oana; Lungu, Cristina-Maria; Stanciu, Carol

    2016-12-01

    Oral and poster presentations at annual national meetings of the Romanian Society of Gastroenterology and Hepatology (RSGH) provide a forum for education, communication and discussion of new research. However, for the wide-spread dissemination of the new research work, each presentation should be subsequently published as a full-text article in peer-reviewed, indexed journals. to evaluate the publication rate of full-text articles in peer-reviewed journals after being first presented as abstracts at two consecutive RSGH annual meetings. A retrospective review of all abstracts presented at the annual meetings in 2013 and 2014 was performed. PubMed and Google Scholar were searched using abstract titles, first author's name and affiliation, and key words from the title to identify whether an abstract resulted in a peer-reviewed publication. Abstracts published in full-text were subsequently assessed for study type, study center, topics, publication year, journals and their impact factors (IFs). We chose the 2013 and 2014 meetings to ensure a minimum two-year follow-up period since the last meeting for the publication as full-length articles. A total of 562 abstracts were presented (275 in 2013, 287 in 2014). There were 150 oral presentations (93 in 2013, 57 in 2014) and 412 poster presentations (182 in 2013, 230 in 2014). Fifty seven of them (10.1%) were published as full-text articles, among them 26 (17.3%) after oral presentations and 31 (7.5%) after poster presentations (P=0.001). University affiliation and original research work were most likely to be published. The average IFs of the journals which published the articles were 2.42 in 2013 and 1.87 in 2014. The publication rate for the annual RSGH meetings abstracts as full-text articles in peer-reviewed journals is very low compared to the analyses performed in gastroenterology or other medical specialities from other countries. It is not clear yet what are the factors responsible for the failure of publication.

  7. TFA'Expo Exhibition on the next low level radioactive wastes storage center Andra - Aube Center. January - june 2003; TFA'Expo exposition sur le futur Centre de stockage de dechets de tres faible activite Andra - Centre de l'Aube. Janvier - Juin 2003

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2003-07-01

    In order to inform the public on the nuclear installations, the Andra this document on the next storage Center of the Aube, for the low level radioactive wastes. The six parts present, the wastes characteristics, the wastes management, the choice of the site, the organization of the TFA (very low activity wastes), the environmental impacts and the economical impacts. (A.L.B.)

  8. Adding Postal Follow-Up to a Web-Based Survey of Primary Care and Gastroenterology Clinic Physician Chiefs Improved Response Rates but not Response Quality or Representativeness.

    Science.gov (United States)

    Partin, Melissa R; Powell, Adam A; Burgess, Diana J; Haggstrom, David A; Gravely, Amy A; Halek, Krysten; Bangerter, Ann; Shaukat, Aasma; Nelson, David B

    2015-09-01

    This study assessed whether postal follow-up to a web-based physician survey improves response rates, response quality, and representativeness. We recruited primary care and gastroenterology chiefs at 125 Veterans Affairs medical facilities to complete a 10-min web-based survey on colorectal cancer screening and diagnostic practices in 2010. We compared response rates, response errors, and representativeness in the primary care and gastroenterology samples before and after adding postal follow-up. Adding postal follow-up increased response rates by 20-25 percentage points; markedly greater increases than predicted from a third e-mail reminder. In the gastroenterology sample, the mean number of response errors made by web responders (0.25) was significantly smaller than the mean number made by postal responders (2.18), and web responders provided significantly longer responses to open-ended questions. There were no significant differences in these outcomes in the primary care sample. Adequate representativeness was achieved before postal follow-up in both samples, as indicated by the lack of significant differences between web responders and the recruitment population on facility characteristics. We conclude adding postal follow-up to this web-based physician leader survey improved response rates but not response quality or representativeness. © The Author(s) 2013.

  9. IAEA establishes International Seismic Safety Centre

    International Nuclear Information System (INIS)

    2008-01-01

    Full text: The IAEA today officially inaugurated an international centre to coordinate efforts for protecting nuclear installations against the effects of earthquakes. The International Seismic Safety Centre (ISSC), which has been established within the IAEA's Department of Nuclear Safety and Security, will serve as a focal point on seismic safety for nuclear installations worldwide. ISSC will assist countries on the assessment of seismic hazards of nuclear facilities to mitigate the consequences of strong earthquakes. 'With safety as our first priority, it is vital that we pool all expert knowledge available worldwide to assist nuclear operators and regulators to be well prepared for coping with major seismic events,' said Antonio Godoy, Acting Head of the IAEA's Engineering Safety Section and leader of the ISSC. 'The creation of the ISSC represents the culmination of three decades of the IAEA's active and recognized involvement in this matter through the development of an updated set of safety standards and the assistance to Member States for their application.' To further seismic safety at nuclear installations worldwide, the ISSC will: - Promote knowledge sharing among the international community in order to avoid or mitigate the consequences of extreme seismic events on nuclear installations; - Support countries through advisory services and training courses; and - Enhance seismic safety by utilizing experience gained from previous seismic events in member states. The centre is supported by a scientific committee of high-level experts from academic, industrial and nuclear safety authorities that will advise the ISSC on implementation of its programme. Experts have been nominated from seven specialized areas, including geology and tectonics, seismology, seismic hazard, geotechnical engineering, structural engineering, equipment, and seismic risk. Japan and the United States have both contributed initial funds for creation of the centre, which will be based at

  10. The DEMETER Science Mission Centre

    Czech Academy of Sciences Publication Activity Database

    Lagoutte, D.; Brochot, J.; Y.; de Carvalho, D.; Elie, F.; Harivelo, F.; Hobara, Y.; Madrias, L.; Parrot, M.; Pincon, J. L.; Berthelier, J. J.; Peschard, D.; Seran, E.; Gangloff, M.; Sauvaud, J. A.; Lebreton, J. P.; Štverák, Štěpán; Trávníček, Pavel M.; Grygorczuk, J.; Slominski, J.; Wronowski, R.; Barbier, S.; Bernard, P.; Gaboriaud, A.; Wallut, J. M.

    2006-01-01

    Roč. 54, č. 5 (2006), s. 428-440 ISSN 0032-0633 Institutional research plan: CEZ:AV0Z30420517 Keywords : Mission Centre * Data processing Subject RIV: BN - Astronomy, Celestial Mechanics, Astrophysics Impact factor: 1.509, year: 2006

  11. CENTRE OF THE MAIN INTERESTS

    Directory of Open Access Journals (Sweden)

    DIANA DELEANU

    2013-05-01

    Full Text Available The centre of the main interests of the debtor is a legal tool meant to settle conflicts that can arise between jurisdictions in cross-border insolvencies, based on the principles of mutual recognition and co-operation.

  12. Does gender affect career satisfaction and advancement in gastroenterology? Results of an AGA institute-sponsored survey.

    Science.gov (United States)

    Gerson, Lauren B; Twomey, Kay; Hecht, Gail; Lee, Linda; McQuaid, Ken; Pizarro, Theresa T; Street, Sarah; Yoshida, Cynthia; Early, Dayna

    2007-04-01

    Women comprise 19% of the American Gastroenterological Association (AGA) membership. We performed a prospective study to determine whether female gastroenterologists were less likely to achieve career advancement and satisfaction. We administered an online survey to AGA members from 2004-2006. The survey contained questions regarding effects of gender on career advancement, satisfaction with career, promotional policies, and integration of family and career. A total of 457 individuals (response rate 9% after 2 major invitations) completed the survey, including 262 (57%) women (20% in private practice, 53% in academic careers, and 27% trainees) and 195 men (23% in private practice, 58% in academic careers, and 19% trainees). The male gastroenterologists were significantly older (P careers for significantly more years (P = .002). There were no significant differences with respect to marital status, number of children, or number of hours worked between the genders. Men were more likely to achieve the rank of full professor (P = .035), and significantly more women reported that gender affected their career advancement (47% vs 9%; P careers reported less satisfaction with their careers (P = .01) and perceived more difficulty in achieving promotion and tenure. Women were more likely to choose private practice careers because of part-time options (P = .025). Equal numbers of men and women in practice reported difficulty balancing work and family life. Significantly more female than male gastroenterologists perceive that gender has affected their career advancement. Female academic gastroenterologists reported less overall career satisfaction and promotion than male academic gastroenterologists.

  13. Progress in pediatrics in 2013: choices in allergology, endocrinology, gastroenterology, hypertension, infectious diseases, neonatology, neurology, nutrition and respiratory tract illnesses.

    Science.gov (United States)

    Caffarelli, Carlo; Santamaria, Francesca; Vottero, Alessandra; Dascola, Carlotta Povesi; Mirra, Virginia; Sperli, Francesco; Bernasconi, Sergio

    2014-07-12

    This review will provide new information related to pathophysiology and management of specific diseases that have been addressed by selected articles published in the Italian Journal of Pediatrics in 2013, focusing on allergology, endocrinology, gastroenterology, hypertension, infectious diseases, neonatology, neurology, nutrition and respiratory tract illnesses in children. Recommendations for interpretation of skin prick test to foods in atopic eczema, management of allergic conjunctivitis, hypertension and breastfeeding in women treated with antiepileptic drugs and healthy breakfast have been reported. Epidemiological studies have given emphasis to high incidence of autoimmune disorders in patients with Turner syndrome, increasing prevalence of celiac disease, frequency of hypertension in adolescents, incidence and risk factor for retinopathy of prematurity. Advances in prevention include elucidation of the role of probiotics in reducing occurrence of allergies and feeding intolerance, and events of foetal life that influence later onset of diseases. Mechanistic studies suggested a role for vitamin D deficiency in asthma and type 1 diabetes and for reactivation of Varicella-Zoster virus in aseptic meningitis. Regarding diagnosis, a new mean for the diagnosis of hyperbilirubinaemia in newborns, a score for recognition of impaired nutritional status and growth and criteria for early Dyke-Davidoff-Masson Syndrome have been suggested. New therapeutic approaches consist of use of etanercept for reducing insulin dose in type 1 diabetes, probiotics in atopic eczema, and melatonin in viral infections.

  14. Intermodal Logistics Centres and Freight Corridors – Concepts and Trends

    Directory of Open Access Journals (Sweden)

    Norbert Wagener

    2017-09-01

    Full Text Available . Background: The development of international freight corridors, as the Trans European Network and new rail and inland shipping corridors in Asia and Africa, require efficient logistics centres along these corridors which serve as intermodal interfaces and provide a variety of different logistics service functions. The definition of the term logistics centre differs between countries and implies different functionalities. Locations are often selected randomly and business models are opportunity driven, especially in highly dynamic and less regulated new emerging economies. In particular Freight Villages as a special form of logistics centres have a high impact on regional development and serve as cargo generator for freight corridors. Consideration of general principles how to establish Freight Villages could improve the effectiveness of these logistics centres along freight corridors. Methods: Based on a literature review a comprehensive and hierarchical definition of logistics centres will be discussed and applied. From experiences in the development of logistics centres in several countries, especially in Germany and Lithuania, challenges and concepts concerning regulatory framework, determination of location and business and financing models are discussed. Results: Concerning the definition of logistics centres a hierarchical definition is applied which comprises different levels of logistics centres depending on the scope of the value adding and the functionality. As general principles for the development of Freight Villages the active role of the state, master planning, objective location finding, participation and co-operation of different stakeholders in the business model and a stepwise scheme for financing are introduced. Major trends for the future development of Freight Villages are the digitalization of supply chains, the application of new intermodal technologies and of innovative telematics systems, solutions for low emission and

  15. The CCCB is a cultural centre, not a tourist centre

    Directory of Open Access Journals (Sweden)

    Elena Xirau

    2004-04-01

    Full Text Available Last February, Barcelona's Centre of Contemporary Culture (CCCB celebrated its first ten years in existence. During this time, this institution has looked to be a showcase to the most modern and innovative cultural expressions focused on reflecting on the concept of the city. In this interview, Josep Ramoneda offers his personal view, as the CCCB's director. He talks of how this cultural project was born, of how the concept of the institution took shape in the CCCB, of its relations with Barcelona's Strategic Plan, of how the project has evolved, of the architectural remodelling of the Casa de la Caritat building for its conversion into a cultural centre, of the relations with other institutions and its future.

  16. Gestion du Centre | CRDI - Centre de recherches pour le ...

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

    Le Comité de gestion du Centre (CGC) est composé des membres de la haute direction du CRDI, notamment les directeurs de nos quatre bureaux régionaux et de nos principaux secteurs de programme. Le CGC travaille en collaboration avec le président afin de soutenir la recherche pour le développement, lui fournissant ...

  17. Human-centred approaches in slipperiness measurement

    Science.gov (United States)

    Grönqvist, Raoul; Abeysekera, John; Gard, Gunvor; Hsiang, Simon M.; Leamon, Tom B.; Newman, Dava J.; Gielo-Perczak, Krystyna; Lockhart, Thurmon E.; Pai, Clive Y.-C.

    2010-01-01

    A number of human-centred methodologies—subjective, objective, and combined—are used for slipperiness measurement. They comprise a variety of approaches from biomechanically-oriented experiments to psychophysical tests and subjective evaluations. The objective of this paper is to review some of the research done in the field, including such topics as awareness and perception of slipperiness, postural and balance control, rating scales for balance, adaptation to slippery conditions, measurement of unexpected movements, kinematics of slipping, and protective movements during falling. The role of human factors in slips and falls will be discussed. Strengths and weaknesses of human-centred approaches in relation to mechanical slip test methodologies are considered. Current friction-based criteria and thresholds for walking without slipping are reviewed for a number of work tasks. These include activities such as walking on a level or an inclined surface, running, stopping and jumping, as well as stair ascent and descent, manual exertion (pushing and pulling, load carrying, lifting) and particular concerns of the elderly and mobility disabled persons. Some future directions for slipperiness measurement and research in the field of slips and falls are outlined. Human-centred approaches for slipperiness measurement do have many applications. First, they are utilized to develop research hypotheses and models to predict workplace risks caused by slipping. Second, they are important alternatives to apparatus-based friction measurements and are used to validate such methodologies. Third, they are used as practical tools for evaluating and monitoring slip resistance properties of foot wear, anti-skid devices and floor surfaces. PMID:11794763

  18. Neighbourhood Centres – Organisation, Management and Finance

    DEFF Research Database (Denmark)

    Larsen, Jacob Norvig

    to identify different financial models and analyse economic sustainability. As regards organisational and management models data were collected through documentary sources and by means of personal interviews and field visits to ten centres. Even within the analysed limited population of centres economic...... public subsidy. Some of the centres have high number of users on a daily basis, whereas others are only rarely used. It is explored how organisation, management and financial set-up differs among the centres. Quantitative data on financial issues and annual accounts of fifteen centres were analysed...... and institutional sustainability varies significantly. In organisational terms centres range from fully-integrated in the municipal administration to independent voluntary managed centres. In terms of financial, or economic, models variation is less pronounced as all centres to some degree are dependent on current...

  19. Japanese maintenance centres strive for greater realism

    International Nuclear Information System (INIS)

    Nedderman, J.

    1987-01-01

    Japanese utilities have devoted considerable efforts to ensuring that realistic plant conditions are simulated at their maintenance centres. In some centres, eg that of Kansai Electric Power Co, realism extends to difficult access, limited lighting and restricted ventilation. (author)

  20. Report: Cultural Research Centre (CRC)

    OpenAIRE

    Cross-Cultural Foundation of Uganda

    2010-01-01

    This report arises from research carried out in Iganga and Namutumba districts in late 2006/early 2007 by the Cultural Research Centre (CRC), based in Jinja. Our research focus was to gauge the impact of using Lusoga as a medium of instruction (since 2005 in "pilot" lower primary classes) within and outside the classroom. This initiative was in response to a new set of circumstances in the education sector in Uganda, especially the introduction by Government of teaching in local languages in ...

  1. Radwaste Treatment Centre Jaslovske Bohunice

    International Nuclear Information System (INIS)

    2000-01-01

    In this leaflet the Bohunice Radwaste Treatment Centre (BSC RAO) is presented. BSC RAO is designed to process and treat liquid and solid radwaste, arising from the NPP A-1 decommissioning, from NPPs V-1, V-2, and Mochovce operations, as well as institutional radwaste of diverse institutional (hospitals, research institutes) in the Slovak Republic. Transport, sorting, incineration, compacting, concentration and cementation of radwaste as well as monitoring of emission are described

  2. Family-centred care delivery

    Science.gov (United States)

    Mayo-Bruinsma, Liesha; Hogg, William; Taljaard, Monica; Dahrouge, Simone

    2013-01-01

    Abstract Objective To determine whether models of primary care service delivery differ in their provision of family-centred care (FCC) and to identify practice characteristics associated with FCC. Design Cross-sectional study. Setting Primary care practices in Ontario (ie, 35 salaried community health centres, 35 fee-for-service practices, 32 capitation-based health service organizations, and 35 blended remuneration family health networks) that belong to 4 models of primary care service delivery. Participants A total of 137 practices, 363 providers, and 5144 patients. Main outcome measures Measures of FCC in patient and provider surveys were based on the Primary Care Assessment Tool. Statistical analyses were conducted using linear mixed regression models and generalized estimating equations. Results Patient-reported FCC scores were high and did not vary significantly by primary care model. Larger panel size in a practice was associated with lower odds of patients reporting FCC. Provider-reported FCC scores were significantly higher in community health centres than in family health networks (P = .035). A larger number of nurse practitioners and clinical services on-site were both associated with higher FCC scores, while scores decreased as the number of family physicians in a practice increased and if practices were more rural. Conclusion Based on provider and patient reports, primary care reform strategies that encourage larger practices and more patients per family physician might compromise the provision of FCC, while strategies that encourage multidisciplinary practices and a range of services might increase FCC. PMID:24235195

  3. The Aube storage centre: Annual report 2010

    International Nuclear Information System (INIS)

    2011-01-01

    After a presentation of the Aube storage centre, a storage centre for low and intermediate activity nuclear wastes, this report gives an overview of measures related to nuclear security, to radioprotection and to nuclear safety. It indicates the incidents and accidents which occurred in 2010, describes how the centre's wastes are managed, and indicates the actions performed in terms of public information

  4. Two centre problems in relativistic atomic physics

    Energy Technology Data Exchange (ETDEWEB)

    McConnell, Sean R.

    2013-01-09

    The work contained within this thesis is concerned with the explanation and usage of a set of theoretical procedures for the study of static and dynamic two-centre problems in the relativistic framework of Dirac's equation. Two distinctly different theories for handling time-dependent atomic interactions are reviewed, namely semi-classical perturbation theory and a non-perturbative numerical technique based on the coupled channel equation to directly solve the time-dependent, two-centre Dirac equation. The non-perturbative numerical technique has been developed independently and the calculations performed with it are entirely new. Calculations for ionisation cross sections and state occupancies are conducted for both these methods. The non-perturbative technique for relativistic two-centre problems is extensively explained and, given its novelty, a probity test is conducted between this technique and that of the well established perturbation theory in calculating K-and L-shell ionisation cross sections for the alpha decay of initially Hydrogen-like Polonium. To that end, an in depth outline of the perturbative technique is also made for both collision and decay processes. As well as the comparison test mentioned, this technique is also applied to the analysis of cross sections of the promotion of a single electron into the positive continuum from either a K- or L-shell due to the alpha decay of heavy, neutral nuclei (Gadolinium, Polonium and Thorium). Dirac-Coulomb eigenfunctions centred on the parent nucleus of the decay pair are taken as the basis for use in the cross section calculations utilising first order, semi-classical pertubation theory. The excellent congruence between both techniques justifies the usage of the non-perturbative algorithms in the subsequent analysis of collisions between very heavy, highly charged ions. As such, a set of calculations are performed examining the bound and continuum state occupancy of the electronic levels during a

  5. Anesthesia Service Use During Outpatient Gastroenterology Procedures Continued to Increase From 2010 to 2013 and Potentially Discretionary Spending Remained High.

    Science.gov (United States)

    Predmore, Zachary; Nie, Xiaoyu; Main, Regan; Mattke, Soeren; Liu, Hangsheng

    2017-02-01

    Previous studies have identified an increasing number of gastroenterology (GI) procedures using anesthesia services to provide sedation, with a majority of these services delivered to low-risk patients. The aim of this study was to update these trends with the most recent years of data. We used Medicare and commercial claims data from 2010 to 2013 to identify GI procedures and anesthesia services based on CPT codes, which were linked together using patient identifiers and dates of service. We defined low-risk patients as those who were classified as ASA (American Society of Anesthesiologists) physical status class I or II. For those patients without an ASA class listed on the claim, we used a prediction algorithm to impute an ASA physical status. Over 6.6 million patients in our sample had a GI procedure between 2010 and 2013. GI procedures involving anesthesia service accounted for 33.7% in 2010 and 47.6% in 2013 in Medicare patients, and 38.3% in 2010 and 53.0% in 2013 in commercially insured patients. Overall, as more patients used anesthesia services, total anesthesia service use in low-risk patients increased 14%, from 27,191 to 33,181 per million Medicare enrollees. Similarly, we observed a nearly identical uptick in commercially insured patients from 15,871 to 22,247 per million, an increase of almost 15%. During 2010-2013, spending associated with anesthesia services in low-risk patients increased from US$3.14 million to US$3.45 million per million Medicare enrollees and from US$7.69 million to US$10.66 million per million commercially insured patients. During 2010 to 2013, anesthesia service use in GI procedures continued to increase and the proportion of these services rendered for low-risk patients remained high.

  6. Abdominal pain-related functional gastrointestinal disorders based on Rome III criteria in a pediatric gastroenterology clinic.

    Science.gov (United States)

    Talachian, Elham; Bidari, Ali; Zahmatkesh, Hamed

    2015-01-01

    Functional gastrointestinal disorders (FGIDs) entail several distinct conditions that collectively account for a sizeable proportion of patients complaining of abdominal pain. Physicians' awareness is fundamental to avoid unnecessary evaluations and to alleviate stress-related problems. This study aimed to assess the relative frequencies of FGIDs and related categories in a selected Iranian population. We conducted this cross-sectional study in a gastroenterology clinic of a tertiary care pediatric hospital in Iran. Children and adolescents between the age of 4 and 18 years referred to the clinic from October 2011 to February 2013 were enrolled if they were diagnosed with FGID according to the Rome III criteria. A structured questionnaire was used to collect data on demographic characteristics, pain location, duration and frequency, associated symptoms, and pertinent family history. We used descriptive analyses to show mean (±SD) and relative frequencies of categories of FGIDs. We diagnosed 183 (114 female) with FGIDs out of 1307 children and adolescents who were visited in the clinic. There was history of psychiatric disorders in 42 (22.9%) participants, and migraine headaches and gastrointestinal disorders were at least in one of the parents in 21 (11.5%) and 64 (34.9%) participants, respectively. We defined 84 (46%) patients under Irritable Bowel Syndrome (IBS) category, 38 (21%) under Abdominal Migraine, 26 (14%) under Functional Abdominal Pain, 21 (11%) under Functional Dyspepsia, and 7 (4%) under Functional Abdominal Pain Syndrome. Seven children (4%) had no defining feature for FGID categories and therefore labeled as unclassified. FGID was a prevalent diagnosis among children and adolescents with abdominal pain. IBS was the largest category. Only a minority were unclassifiable under the Rome III criteria, indicating improved differentiation characteristics of Rome III criteria compared to the Rome II version.

  7. Integration of Ambulatory Clinical Pharmacy Services in a Gastroenterology Clinic for Management of Hepatitis C Infection: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Erika Bower

    2017-05-01

    Full Text Available Purpose: The purpose of this study is to describe implementation of comprehensive medication management (CMM services in a gastroenterology (GI clinic for HCV patients on direct acting antivirals (DAAs, and to evaluate services in terms of identification of medication related problems (MRPs, patient satisfaction, and provider satisfaction. Methods: Six months of visit data was retrospectively collected to determine demographic data and to analyze pharmacist’s identification of MRPs. Patient satisfaction surveys were collected using a thirteen question validated pharmacist-satisfaction survey. After pilot completion, a twelve-question survey was sent to all GI clinic staff members to evaluate overall staff satisfaction with services. Results: Ninety-four CMM visits were completed. A total of 246 MRPs were identified with an average of 2.6 MRPs per visit. Seventy-eight MRPs were related to appropriate indication, 27 to efficacy, 30 to safety, and 109 to adherence. Forty MRPs were related to drug-drug interactions. Patient satisfaction surveys revealed that 86% of respondents rated the quality of care and services from the clinical pharmacist as "Excellent". Patients better understood and felt confident with therapy. All staff satisfaction survey respondents strongly agreed or agreed that the pharmacist made valuable contributions to the clinic and patient care. All also strongly agreed that pharmacy’s CMM services were an essential component to the management of HCV. Conclusion: Data supports continued involvement of clinical pharmacists within the clinic to promote safety and efficacy of DAAs. Patient and staff satisfaction survey results further illustrate the importance and value that CMM provided by clinical pharmacists can provide. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including

  8. Enhancing Communication in an Egyptian Research Centre

    International Nuclear Information System (INIS)

    Morsy, S.W.

    2013-01-01

    This paper is a proposed attempt to enhance communication in a research centre in Egypt. The currently Nuclear and Radiological Regulatory Authority (NRRA) which formerly was the National Centre for Nuclear Safety and Radiation Control (NCNSRC) is housed in a nine-storey building with a straight double loaded corridor architectural plan. Syntactic axial analysis showed high integration for each floor plan individually which means that the floor plan is not to be blamed for lack of communication among floor inhabitants; other means must be attempted. But global axial integration (for the whole building) proved to be poor. A problem of communication among floors was identified. Means for enhancing communication were introduced: The lecture hall, the cafe and meeting rooms can play an important role in enhancing global communication among NRRA inhabitants. Besides a questionnaire was designed and distributed on all inhabitants and its feedback came up with ideas which if implemented could result in enhancing the level of communication between the inhabitants of the building thus overcoming spatial hindrances.

  9. Staff Development Strategies for School Library and Media Centres ...

    African Journals Online (AJOL)

    Staff Development is a sine-qua non to the provision of efficient library services at any level. The study sets to investigate staff development strategies in school libraries and Information centres in Owerri, Imo State Nigeria. Selfdesigned questionnaires were used in eliciting data for the study. Ten schools were used with 10 ...

  10. City profile: Transformation and injustice in Mumbai | CRDI - Centre ...

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

    13 déc. 2016 ... In this 2014 profile, researchers with the Tata Institute of Social Sciences Centre for Urban Policy and Governance provide a foundation for understanding the many faces of Mumbai, and how its relatively low levels of public crime mask the many ways in which residents experience violence in their daily ...

  11. Building an Immersive CERN Data Centre Virtual Visit System

    CERN Multimedia

    CERN. Geneva; VALSAN, Liviu

    2015-01-01

    Interested in working on building an immersive, panoramic virtual visit of the CERN Data Centre? We'll show the system used during CERN Open Days, its limitations and plans on how to take it to the next level as a permanent installation to be used by visitors from around the world.

  12. Processing of LLRW arising from AECL nuclear research centres

    International Nuclear Information System (INIS)

    Buckley, L.P.; Le, V.T.; Beamer, N.V.; Brown, W.P.; Helbrecht, R.A.

    1988-11-01

    Operation of nuclear research reactors and laboratories results in the generation of a wide variety of solid and liquid radioactive wastes. This paper describes practical experience with processing of low-level radioactive wastes at two major nuclear research centres in Canada

  13. Openness--A Way Forward: Development Education Research Centre

    Science.gov (United States)

    Hare-Heremia, Mahora

    2014-01-01

    Education is a vital aspect in the lives of humankind. It contributes and shapes our future as citizens of the world. To understand it is to discover the many hidden talents the world has in store for all. The Development Education Research Centre (DERC) holds many resources that aid in the development of education at a global level. With the…

  14. The industrial centre of gathering, warehousing and storage

    International Nuclear Information System (INIS)

    2014-06-01

    This publication proposes an overview of the Cires (industrial centre for the gathering, warehousing and storage), a storage centre classified for the protection of the environment and operated by the ANDRA for the storage of very-low-level wastes. The activities and missions of this centre are briefly indicated, as well as some key figures (storage and warehousing surfaces), a definition of radioactive wastes and an indication of their origins (electronuclear, research, defence, industry, or medicine), an indication of the different categories of wastes with respect to their activity level and lifetime. It briefly describes the technical solution adopted for the storage of these very-low-level wastes, and comments their origins, indicates their average radioactivity level, and their quantity in France. The choice for storage is briefly explained. The pathway followed by a waste is briefly described: production, parcel preparation, parcel delivery at the Cires, controls performed at their arrival, processing and re-packaging of some parcels before storage. The gathering and warehousing functions of the centre for non electronuclear wastes are presented: functions of the specific buildings, concerned wastes. The path followed by these non electronuclear wastes is described with respect with the different types of wastes: sorting, gathering, processing, warehousing, storage. Actions related to the control of the environment and to the control of the storage area after closure are indicated

  15. Staff development strategies for school library media centres: a case ...

    African Journals Online (AJOL)

    Staff development is a sine-qua non to the provision of efficient library services at any level. The study sets to investigate staff development strategies in school libraries and Information centres in Owerri, Imo State Nigeria. Self-designed questionnaires were used in eliciting data for the study. Ten schools were used with 10 ...

  16. Sellafield visitor centre: techniques for bringing technology to the community

    International Nuclear Information System (INIS)

    Jackson, D.

    1993-01-01

    British Nuclear Fuels plc undertakes a full range of fuel cycle services and is committed to an open-door policy in explaining its operations of the public; for which its Visitor's Centre at Sellafield is the flagship. The existing Centre was opened in 1988 and replaced an earlier, smaller, facility. In total, more than 1 000 000 visitors have been welcomed to Sellafield and the Site is now recognized as the largest tourist attraction in the region. This creates a high level of responsibility to the local area, to which Sellafield responds through its many community and education based projects. (author)

  17. Discussion on 'Centres of excellence' in Africa

    International Nuclear Information System (INIS)

    Riad, S.

    1999-01-01

    In Africa, Centres of Excellence should be oriented to build up scientific and technological capacity in the four topics of international Monitoring System related technologies, namely, seismic monitoring, hydro acoustic monitoring, infrasound monitoring and radionuclides monitoring. Training programs on these topics should be a major objective. A network of such centres should be established in a number of African countries. Centres should be equipped with means and materials for on-line course dispatch to interested training centres or research institutions. African centres should develop strong relationship among themselves through information and data exchange and sharing, harmonization of training programs. National data centres may be established as a component of the African Centre of Excellence. States Signatories may authorize the establishment of a specific fund to support the activities of the African center

  18. Gender-specific differences in depression and anxiety symptoms and help-seeking behavior among gastroenterology patients in Riyadh, Saudi Arabia.

    Science.gov (United States)

    Alosaimi, Fahad D; Al-Sultan, Omar A; Alghamdi, Qusay A; Almohaimeed, Ibrahim K; Alqannas, Sulaiman I

    2014-07-01

    To evaluate the gender-specific difference in the prevalence of depression and anxiety and the help-seeking behavior among gastroenterology outpatients. A cross-sectional study was carried out in gastroenterology clinics in 4 hospitals in Riyadh, Saudi Arabia between February and September 2013. A self-administrated questionnaire was developed and administered to patients. The Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) questionnaires were used to identify depression and anxiety. A total of 438 patients completed the study questionnaire; 135 (31%) females, and 303 (69%) males. Compared with males, females had more depression symptoms (44% versus 32%, p=0.012), anxiety symptoms (34% versus 24%, p=0.036), anxiety-associated difficulty (65% versus 52%, p=0.012), but similar suicidal thoughts (14% versus 11%, p=0.347). Females had similar gastrointestinal complaints but longer duration of symptoms. In both females and males, the most common first interventions were using medications (63% versus 69%), and undergoing endoscopy (19% versus 15%), while very few patients initially used herbs or Islamic incantation `Roquia` (7% versus 8%). Compared with males, females were more likely to subsequently seek help at private clinics (23% versus 14%, p=0.014), or with a Quran therapist (11% versus 5%, p=0.012). There are clear gender-specific differences in depression and anxiety symptoms and associated perceived difficulty, but modest differences in help-seeking behavior. Female patients at the gastroenterology clinic may deserve more psychological attention to diagnose depression and anxiety and to alleviate their impact.

  19. The emergence of urban centres

    DEFF Research Database (Denmark)

    Lazaro, Evelyn; Agergaard, Jytte; Larsen, Marianne Nylandsted

    by Tanzanian market liberalizations and its long term effects on private enterprise. The paper is based on a study of four EUCs in Tanzania (Ilula, Igowole, Madizini and Kibaigwa) and seeks to answer three research questions: 1) What economic and spatial trends, including national policies, have formed...... the pathway for rural transformation and early densification towards the emergence of urban centres in Tanzania? 2) What characterize the relationship between value chain dynamics and rural densification? 3) How do migration and investments contribute to the consolidation of EUCs as places of attraction...

  20. F-centre luminescence in nanocrystalline CeO2

    International Nuclear Information System (INIS)

    Aškrabić, S; Dohčević-Mitrović, Z D; Araújo, V D; Ionita, G; De Lima, M M Jr; Cantarero, A

    2013-01-01

    Nanocrystalline CeO 2 powders were synthesized by two cost-effective methods: the self-propagating room temperature (SPRT) method and the precipitation method. Differently prepared samples exhibited different temperature-dependent photoluminescence (PL) in the ultraviolet and visible regions. The PL signals originated from different kinds of oxygen-deficient defect centres with or without trapped electrons (F 0 , F + or F ++ centres). The temperature-dependent PL spectra were measured using different excitation lines, below (457, 488 and 514 nm) or comparable (325 nm) to the ceria optical band gap energy, in order to investigate the positions of intragap localized defect states. Evidence for the presence of F + centres was supported by the signals observed in electron paramagnetic resonance (EPR) measurements. Based on PL and EPR measurements it was shown that F + centres dominate in the CeO 2 sample synthesized by the SPRT method, whereas F 0 centres are the major defects in the CeO 2 sample synthesized by the precipitation method. The luminescence from F ++ states, as shallow trap states, was registered in both samples. Energy level positions of these defect states in the ceria band gap were proposed. (paper)

  1. F-centre luminescence in nanocrystalline CeO2

    Science.gov (United States)

    Aškrabić, S.; Dohčević-Mitrović, Z. D.; Araújo, V. D.; Ionita, G.; de Lima, M. M., Jr.; Cantarero, A.

    2013-12-01

    Nanocrystalline CeO2 powders were synthesized by two cost-effective methods: the self-propagating room temperature (SPRT) method and the precipitation method. Differently prepared samples exhibited different temperature-dependent photoluminescence (PL) in the ultraviolet and visible regions. The PL signals originated from different kinds of oxygen-deficient defect centres with or without trapped electrons (F0, F+ or F++ centres). The temperature-dependent PL spectra were measured using different excitation lines, below (457, 488 and 514 nm) or comparable (325 nm) to the ceria optical band gap energy, in order to investigate the positions of intragap localized defect states. Evidence for the presence of F+ centres was supported by the signals observed in electron paramagnetic resonance (EPR) measurements. Based on PL and EPR measurements it was shown that F+ centres dominate in the CeO2 sample synthesized by the SPRT method, whereas F0 centres are the major defects in the CeO2 sample synthesized by the precipitation method. The luminescence from F++ states, as shallow trap states, was registered in both samples. Energy level positions of these defect states in the ceria band gap were proposed.

  2. Assessment of ART centres in India: client perspectives.

    Science.gov (United States)

    Sogarwal, Ruchi; Bachani, Damodar

    2009-05-01

    Drug adherence and quality of antiretroviral therapy (ART) services are the keys for the successful ART programme. Hence, an attempt has been made to assess ART centres in India from client perspectives that are receiving services from the centres. Data were gathered through exit interviews with 1366 clients from 27 ART centres that were selected on the basis of drug adherence and client load. Analyses revealed that more than 80 per cent of the clients reported overall satisfaction with the services availed from the centre and 60 per cent reported that the quality of life has improved to a great extent after getting ART. Most of the clients strongly demanded to open ART centre in each district for better access as that will increase drug adherence and eventually control the HIV progression. It has been found that as many as 14% of respondents, ever been on ART, reported non-adherence and 70% of them cited distance and economic factors as the reasons for non-adherence. Study concludes that while majority of the clients were satisfied with ART services, shortage of staff, high level of non-drug adherence, long distances and poor referring system are the weak areas requiring attention.

  3. Centre for nuclear engineering University of Toronto annual report 1984

    International Nuclear Information System (INIS)

    1984-12-01

    The annual report of the Centre for Nuclear Engineering, University of Toronto covers the following subjects: message from the Dean; Chairman's message; origins of the centre; formation of the centre; new nuclear appointments; and activities of the centre, 1984

  4. Personal dosimetry in the PET Centre Prague

    International Nuclear Information System (INIS)

    Janeba, D.; Belohlavek, O.; Hermanska, J.

    2001-01-01

    This work is focused on radiation protection in the PET Centre Prague. The personal year dose equivalents of physicians, technologists and labtechnologists in the period 1997-2000 are presented. Dose equivalents are listed for each group as collective, mean and maximum dose equivalents and number of people in the evaluated group. There is an increase in the dose equivalents in 1999 when the PET scanner was installed. Later on, when personnel was trained and better local shielding was used, the increase is not much higher even though the number of patients investigated per day doubled. The radiation field measurements showed that the radiation dose equivalent rate outside the controlled area is on the background level of about 0.17-0.18 mSv/hour. (author)

  5. Achieving competences in patient-centred care

    DEFF Research Database (Denmark)

    Lomborg, Kirsten; Nielsen, Else Skånning; Jensen, Annesofie Lunde

    2011-01-01

    Aim: To document the efficacy of a training programme in patient-centred care in which the nursing staff was trained to involve chronic obstructive pulmonary patients in assisted personal body care (APBC). The objectives were to describe the programme and uncover the outcomes. Background: Chronic....... In order to achieve such competences in nursing staff, we developed, implemented and evaluated a training programme. Design: A qualitative outcome analysis was conducted in order to explore the dynamics of the training programme process and the outcome. patients to be more active, as was common practice...... prior to the training. According to the staff, there was no actual change in the patients’ level of activity. The training was time-consuming. Methods: Seven nurses and six nursing assistants from three hospital units were divided into two groups in which training and evaluation took place. The content...

  6. The new AMS control centre

    CERN Multimedia

    Anaïs Schaeffer

    2011-01-01

    Construction work for the future AMS control room began in November 2010 and should be finished this June. The new building, which will have been completed in record time thanks to the professionalism of the project team, will soon be ready to receive the initial data from the AMS experiment.     Luigi Scibile and Michael Poehler, from the GS department, at the AMS control centre construction site.   The Alpha Magnetic Spectrometer (AMS) is due to wing its way towards the International Space Station (ISS) on board the shuttle Discovery in April. Mainly intended for research on antimatter and dark matter, the data collected by AMS will be sent to Houston in the United States and then directly to CERN’s new Building 946. Construction work for the AMS control centre building on the Route Gentner at CERN’s Prévessin site started in November 2010 and must be completed in time to receive the first data from the spectrometer in June. “It normall...

  7. Communications Centre Model in Insurance Business

    Directory of Open Access Journals (Sweden)

    Danijel Bara

    2013-07-01

    Full Text Available The aim of this paper is to define a communications centre model in an insurance company that essentially has two objectives. The first objective is focused on providing quality support with the sales process thereby creating a strategic advantage over the competition while the second objective is focused on improving the link between internal organizational units whose behaviour can often render decision-making at all levels difficult. The function of sales is fundamental for an insurance company. Whether an insurance company will fulfil its basic function, which is transfer of risk from the insured party to the insurer who agrees tonreimburse incidental damages to the damaged party and distribute them among all members of the risk group on the principles of reciprocity and solidarity, depends on successful sales and billing (Andrijašević & Petranović, 1999. For an insurance company to operate successfully in a demanding market, it is necessary to meet the needs of potential clients who then must be at the centre of all the activities of the insurer. A satisfied policy holder, who is respected by the insurer as a partner, is a guarantee that the sales of insurance services will be successful and that the insured party will come back to the same insurance company. In the era of globalization and all-pervading new technologies and modes of communication, policy holders need to be able to communicate with insurance company employees. Quality communication is a good foundation for a sales conversation. A fast flow of all types of information within an organisation using a single communication module makes decision-making at all levels quicker and easier.

  8. [Acute states in gastroenterology: spontaneous bacterial peritonitis and the acute intestinal pseudoobstruction syndrome].

    Science.gov (United States)

    Lukás, K

    2001-07-19

    Our article concentrates on two acute states, which develop less dramatically but their after-effects may be very serious: Spontaneous bacterial peritonitis and Ogilvie's syndrome. Spontaneous bacterial peritonitis is a bacterial infection of the ascitic fluid without any intraperitoneal source of infection. Ascites is a condition of the disease but need not be clinically manifested. Spontaneous bacterial peritonitis comes usually during heavy hepatic impairment. Diagnosis can be set according: 1. Positive cultivation of ascitic fluid, 2. PMN levels higher than 250/mm3, 3. No infection, which may require a surgical intervention is apparent. Liver disease, which brings about the spontaneous bacterial peritonitis can be: 1. Chronic (e.g. alcoholic cirrhosis), 2. Subacute (e.g. alcoholic hepatitis), 3. Acute (e.g. fulminant hepatic failure). Mortality of this form of peritonitis can reach up to 46%. The most frequent etiological factor is alcohol and viral hepatitis, the most frequent agents are E. coli and Klebsiella pneumoniae. The disease is most effectively cured by cefalosporins of the third generation. With inadequate treatment, prognosis may be poor. Intestinal pseudoobstruction syndrome has clinical symptomatology of a serious impairment with ileus without signs of any mechanical intestinal obstruction. Syndrome can be classified according to its development: 1. Acute form--acute intestinal pseudoobstruction syndrome--Ogilvie's syndrome, 2. Chronic form--chronic intestinal pseudoobstruction syndrome. Pathogenic mechanism of the syndrome is not known. The disease is related to immobility, administration of some drugs, electrolyte imbalance and concomitant diseases (most frequently malignant tumors). Clinical symptomatology dominates nausea, vomiting, diffuse abdominal pain, constipation or diarrhoea. For diagnostics the first step should be termination of all medication, which could have causing affects, then taking native abdominal X-ray picture where gaseous

  9. Progress in Pediatrics in 2012: choices in allergy, endocrinology, gastroenterology, hematology, infectious diseases, neurology, nutrition and respiratory tract illnesses.

    Science.gov (United States)

    Caffarelli, Carlo; Santamaria, Francesca; Vottero, Alessandra; Bernasconi, Sergio

    2013-05-08

    In this review, we summarize the progresses in allergy, endocrinology, gastroenterology, hematology, infectious diseases, neurology, nutrition and respiratory tract illnesses that have been published in The Italian Journal of Pediatrics in 2012. The induction of Treg activity by probiotics might be effective for promoting tolerance towards food allergens. Nasal cytology is useful in patients with rhinitis for diagnosing chronic non-allergic non-infectious diseases. Atopic eczema is associated both with an aberrant skin matrix and impaired systemic immune response. Therefore, isolated topical treatment may have suboptimal effect. Diagnostic work-up of exercise-induced anaphylaxis, including exercise challenge test, is necessary to reach a diagnosis. Studies may support a role for nutrition on prevention of asthma and cardiovascular diseases. Clinicians need to early identify adolescent menstrual abnormalities to minimize sequelae, and to promote health information. In Multiple Endocrine Neoplasia type 2B investigations include acetylcholinesterase study of rectal mucosa followed by the molecular analysis of RET mutation. Low adherence to gluten-free diet and osteopenia are common problems in children with diabetes mellitus type 1 and celiac disease. In infantile colic, laboratory tests are usually unnecessary and the treatment is based on reassurance. Prevalence of obesity and stunting is elucidated by several studies. Evidences are growing that dietetic measures are needed to prevent obesity in children with acute leukemia. Treatment studies for infectious diseases show promise for probiotics along with standard triple therapy in children with Helicobacter pilori infection, while zinc has no effect on pneumonia. Educational programs about the proper management of the febrile child are warranted. A new hour-specific total serum bilirubin nomogram has been shown to be able to predict newborns without hyperbilirubinemia after 48 to 72 hours of life. Newborns with

  10. Nuclear technology centre. Preserving and developing competence and resources

    International Nuclear Information System (INIS)

    Tiren, I.

    1995-01-01

    The Royal Institute of Technology in Stockholm provides one third of Sweden's capacity for engineering studies and technical research at the post-high-school level. Altogether, the institute includes about 8000 students and 900 active postgraduate students and has a staff of nearly 2500. The research activities cover a broad spectrum of the natural sciences and technology, as well as architecture, industrial economics, urban planning, work science and environmental technology. In 1993, a Nuclear Technology Centre was established at the institute. The purpose of this Centre is to stimulate education and research in nuclear technology in order to contribute to the preservation and development of competence in the nuclear field. The formation of the Centre should be regarded as one of several recent initiatives aimed at maintaining a high level of safety and reliability in the operation of nuclear power plants at a time when there are political manoeuvres to phase out nuclear energy in Sweden. The paper summarizes the motives that led to the formation of the Centre, its goals and organization, and its initial activities and results. The paper may be of interest to similar organizations in other countries which are also faced with uncertainties regarding the future of existing nuclear power plants or of current programmes, and which consider that co-operation between the industry and universities is an important factor in ensuring the quality of technological development. (author). 4 refs

  11. First results of the Nordic and Baltic GNSS Analysis Centre

    Science.gov (United States)

    Lahtinen, Sonja; Pasi, Häkli; Jivall, Lotti; Kempe, Christina; Kollo, Karin; Kosenko, Ksenija; Pihlak, Priit; Prizginiene, Dalia; Tangen, Oddvar; Weber, Mette; Paršeliūnas, Eimuntas; Baniulis, Rimvydas; Galinauskas, Karolis

    2018-03-01

    The Nordic Geodetic Commission (NKG) has launched a joint NKG GNSS Analysis Centre that aims to routinely produce high qualityGNSS solutions for the common needs of the NKG and the Nordic and Baltic countries. A consistent and densified velocity field is needed for the constraining of the gla-cial isostatic adjustment (GIA) modelling that is a key component of maintaining the national reference frame realisations in the area. We described the methods of the NKG GNSS Analysis Centre including the defined processing setup for the local analysis centres (LAC) and for the combination centres.We analysed the results of the first 2.5 years (2014.5-2016). The results showed that different subnets were consistent with the combined solution within 1-2 mm level. We observed the so called network effect affecting our reference frame alignment. However, the accuracy of the reference frame alignment was on a few millimetre level in the area of the main interest (Nordic and Baltic Countries). TheNKGGNSS AC was declared fully operational in April 2017.

  12. Smart work centres in rural areas

    DEFF Research Database (Denmark)

    Lorentzen, Anne Birte

    This paper discusses the establishment of telework centres as an element in local development strategies in rural areas, with a particular view to two new telework centres in region North Denmark. The paper argues that telework centres do not represent an easy solution to problems of local...... development and environmental sustainability, and further, that technology may not even be the most important feature needed to make them function as such....

  13. Elm Farm Organic Research Centre December 2006

    OpenAIRE

    Sanders, Richard; Whiltley, Andrew; Haigh, Zoe; Clarke, Sarah; Hitchings, Roger; O'Brien, Josie

    2006-01-01

    The Organic Research Centre. Elm Farm Research Centre Bulletin with Technical Updates from The Organic Advisory Service is a regular publication from The Organic Research Centre. The current issue covers: Report from 2006 Cirencester Conference; Quest for more home produced organic food; in a world where bread matters; Improving wheat with plenty of parents; Unlocking the secrets of the ancient (cereal varieties); Brain food- a good read; Not to late to protect the future: The organic...

  14. Powering the Future Data Centre

    DEFF Research Database (Denmark)

    Zhang, Zhe

    2010-01-01

    of the characteristics of these two power sources: long warm-up stage and low dynamics for fuel cell, and variable terminal voltage for supercapacitors. The motivation for this project was to find ways which can overcome those limitations to integrate fuel cells and supercapcitors to the system with high efficiency......The extended run Uninterruptible Power Supply system (UPSs) which powered by fuel cells and supercapcitors, is a promising solution for future data centre to obtain environmentfriendly energy efficient and cost effective. There are many challenges in power electronic interface circuits, because......: • Optimized design method for dual active bridge (DAB) converter and its derived circuits; • A novel hybrid dc-dc converter and its corresponding optimal design method are proposed; • An improved dual input current-fed DC-DC converter with bidirectional power conversion ability is investigated; • Extend...

  15. Selected Abstracts of the 6th International Congress of UENPS; Valencia (Spain; November 23rd-25th 2016; Session “Gut, gastroenterology and nutrition”

    Directory of Open Access Journals (Sweden)

    --- Various Authors

    2016-11-01

    Full Text Available Selected Abstracts of the 6th International Congress of UENPS; Valencia (Spain; November 23rd-25th 2016; Session “Gut, gastroenterology and nutrition”ABS 1. MATERNAL FACTORS ASSOCIATED WITH EARLY POSTNATAL WEIGHT LOSS IN EXCLUSIVELY BREASTFED NEONATES • C.J. Lee, T.H. Liu, J.Y. Liou, Y.C. Chen, P.N. TsaoABS 2. USE OF INSULIN ON PRETERM NEONATES: A GOOD IDEA? • D. Panjwani, G. HoldenABS 3. RISK FACTORS OF DELAYED ONSET OF LACTATION ASSOCIATED NEONATAL TO HYPERBILIRUBINEMIA • C. Kuok, T. Liu, J. Liou, Y. Chen, P. TsaoABS 4. NUTRITIONAL MANAGEMENT PRACTICE AND POSTNATAL GROWTH OF PRETERM INFANTS • S. Heljic, S. Terzic, H. Maksic, A. HalilovicABS 5. BREAST MILK EXPRESSION AT THE NICU: EXPERIENCES OF MOTHERS EXPRESSING AT THEIR PRETERM INFANT’S BEDSIDE OR IN A BREAST MILK EXPRESSION ROOM • M. Héon, L. Bell, R. Flacking, C. CatelinABS 6. RELIABILITY OF THE OM-6050 OSMOMETER STATION TO ANALYSE THE OSMOLARITY OF FORTIFIED BREAST MILK • A. Herranz Barbero, N. Rico Santana, J. Figueras Aloy, F. Botet Mussons, M.D. Salvia RoigésABS 7. MICROBIOTA OF TERM INFANTS DELIVERED VAGINALLY VS. CESAREAN SECTION – INFLUENCE OF HOME ENVIRONMENT • A. Bartnicka, M. Gałęcka, J. MazelaABS 8. FACTORS INFLUENCING BREASTFEEDING OF PREMATURE NEWBORNS • N. Skorobogatova, D. Stoniene, J. Ribeliene, E. Meškelevičiūtė, R. Penkauskaitė, R. TamelieneABS 9. RISK FACTORS REGARDING SUCCESSFUL EXCLUSIVE BREASTFEEDING • M. Miñambres Rodríguez, L.C. Bermúdez Barrezueta, A. Pino Vázquez, M.C. Fernández García-Abril, M. Palomares Cardador, V. MatíasABS 10. THE INFLUENCE OF MOTHER’S ATTITUDE AND MEDICAL STAFF’S ACTIONS ON THE RATES OF BREASTFEEDING OF PRETERM INFANTS • J. Ribeliene, D. Stoniene, N. Skorobogatova, E. Meškelevičiūtė, R. Penkauskaitė, R. TamelieneABS 11. DONOR HUMAN MILK OFFERS PROTECTION AGAINST LIPID OXIDATIVE STRESS IN PRETERM INFANTS < 32 WEEKS OF GESTATIONAL AGE • J. Kuligowski, A. Parra-Llorca, Á. Sánchez-Illana, M

  16. Preparation of emergency care centre exercises

    International Nuclear Information System (INIS)

    Schnadt, H.; Miska, H.

    2011-01-01

    Setup and operation of emergency care centres (sometimes also addressed as emergency reception centres) are part of emergency response in the environs of nuclear power plants. The preparation of an exercise scenario for such a centre is very demanding on the responsible agency. Therefore, a computer code has been developed which helps to translate the exercise objectives into instructions for figurants which simulate the affected population. These instructions are intended to steer a determined flow of people through the emergency care centre by providing fictitious radiological readings and by injecting the demand for additional actions of response personnel by statements and questions. (orig.)

  17. Factors influencing subjective perceptions of everyday occupations: comparing day centre attendees with non-attendees.

    Science.gov (United States)

    Argentzell, Elisabeth; Leufstadius, Christel; Eklund, Mona

    2012-01-01

    Subjective perceptions of everyday occupations are important for the well-being of people with psychiatric disabilities (PD) and are likely to vary with factors such as attending a day centre or not, activity level, self-mastery, sociodemographic and clinical factors. To explore differences in subjective perceptions of occupation and activity level between day centre attendees and non-attendees, and to investigate factors of importance for the subjective perceptions of occupations. The study groups comprised 175 participants: 93 day centre attendees and 82 non-attendees. Data were collected with instruments concerning; subjective perceptions of everyday occupations, activity level, self-mastery, and sociodemographic and clinical factors. Day centre attendees perceived higher levels of occupational value and activity level, while the groups perceived a similar level of satisfaction with daily occupations. For the total sample, self-mastery influenced both valued and satisfying everyday occupations while only value was affected by activity level. Satisfaction with daily occupation increased with age and both value and satisfaction increased with lower levels of psychiatric symptoms. Day centres provide perceptions of occupational value and stimulate activity. Non-differences between the groups regarding satisfaction with everyday occupations implied, however, that day centres might not cover all relevant occupational needs.

  18. South African Gastroenterology Review

    African Journals Online (AJOL)

    Fees for medical services: money and medicine. Carl Schulenburg. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Article Metrics. Metrics Loading ... Metrics powered by PLOS ALM · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians ...

  19. South African Gastroenterology Review

    African Journals Online (AJOL)

    IBS - the beginning and the end: clinical review. Keith Pettengell. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Article Metrics. Metrics Loading ... Metrics powered by PLOS ALM · http://dx.doi.org/10.4314/sagr.v1i1.30693 · AJOL African Journals Online. HOW TO USE ...

  20. American College of Gastroenterology

    Science.gov (United States)

    ... journal published to provide an opportunity to share interesting case reports. Edited by GI fellows, it is ... AmCollegeGastro Events November 9 Advances in Inflammatory Bowel Diseases – AIBD 2017 November 9 - 11, 2017 Walt Disney ...

  1. EVALUATION OF ENVIRONMENTAL EDUCATION CENTRES- A ...

    African Journals Online (AJOL)

    centres in South Africa revealed that some field .... psychomotor goals suitable for each age group? * Did the officer have a proper ..... education centres, spending two to four weeks at a ... you must be willing to suspend judgement, to hold in ...

  2. Australian International Food Security Research Centre | IDRC ...

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

    Australian International Food Security Research Centre. Australian International Food Security Research Centre. http://aciar.gov.au/AIFSC. Cultivate Africa's Future. The Cultivate Africa's Future research partnership is designed to support applied research to combat hunger in sub-Saharan Africa by harnessing the potential ...

  3. Communications strategy for the Chernobyl Centre

    International Nuclear Information System (INIS)

    Kurilchik, Mykola; Green, Len

    2000-01-01

    This Communications Strategy was developed for the International Chernobyl Centre (ICC) as part of a joint UK/Ukraine project, sponsored by the Department of Trade and Industry and NNC Limited. The Plan was developed during four weeks of workshop discussions in the UK between staff from the centre and experienced PR Professionals from NNC Limited. The requirements for a sustained communications activity at the ICC go much further than simply enhancing or promoting the Centre's scientific and technical activities. Raising sufficient awareness of the Centre among potential funding agents and commercial partners is critical to its future development as a major centre for international co-operation and research. It is only through establishing and developing effective communications that the Centre will become well enough known and understood both within the Ukraine, and internationally, to secure its long term future. However, as the workshop programme unfolded, it also became clear that communications was in itself a legitimate and necessary function of the Centre, and part of the foundations of its existence. The Centre has a fundamental role as an 'information exchange', collecting and communicating information from within the Ukraine to the rest of the world, and interpreting world interest and attitudes to the Ukraine Government and nuclear industry. As such compliments the efforts of individual power plant and corporate PR functions within the Ukraine nuclear energy sector

  4. Skookum Jim Friendship Centre retrofit training

    Energy Technology Data Exchange (ETDEWEB)

    1984-08-01

    The retrofit/renovation of the Skookum Jim Friendship Centre in Whitehorse, Yukon, provided an ideal opportunity to train ten carpenters as specialists in energy conserving construction at the community level throughout the Yukon. Through this project, the trainees have gained special skills through hands-on experience with many energy conserving materials and techniques. As well, the training sessions provided extensive information on applicable thermodynamic principles and building science technology. The crew of two instructors, ten trainees, and the foreman covered all aspects of residential/light commercial construction which apply to retrofit work. Training sessions included information on site-safety, and interpreting the National Building Code, as well as special attention to the air tightness and insulation levels in the building. In observing the operation of the new building during the first heating season, it was noted that the heat provided by the lighting in the building supplied the majority of space heating requirements. Back-up electrical heating was required only at temperatures approaching design temperature for the building. 6 Figs.

  5. Centre for urban ecotechnology in ``Oeksnehallen``

    Energy Technology Data Exchange (ETDEWEB)

    1992-03-01

    The Lord Mayor`s Department of the municipality of Copenhagen, Denmark, has with support from this project made a proposal for the establishment of the Centre for Urban Ecotechnology in ``Oeksnehallen``, located in the Vesterbro area of the city. The centre should contribute to the dissemination of knowledge on ecological techniques (regarding passive solar energy etc.) to the inhabitants of Vesterbro and other citizens of Copenhagen, and also serve as a centre in an European context. The ecological demonstration centre will cover an area of two thousand square meters and will also include a cafe, a room for showing coloured slides, facilities for exhibitions created by the center and interested firms etc. The centre should play an important role as part of the ecological concept of urban renewal in Vesterbro. (author).

  6. The role of the sexual assault centre.

    LENUS (Irish Health Repository)

    Eogan, Maeve

    2013-02-01

    Sexual Assault Centres provide multidisciplinary care for men and women who have experienced sexual crime. These centres enable provision of medical, forensic, psychological support and follow-up care, even if patients chose not to report the incident to the police service. Sexual Support Centres need to provide a ring-fenced, forensically clean environment. They need to be appropriately staffed and available 24 hours a day, 7 days a week to allow prompt provision of medical and supportive care and collection of forensic evidence. Sexual Assault Centres work best within the context of a core agreed model of care, which includes defined multi-agency guidelines and care pathways, close links with forensic science and police services, and designated and sustainable funding arrangements. Additionally, Sexual Assault Centres also participate in patient, staff and community education and risk reduction. Furthermore, they contribute to the development, evaluation and implementation of national strategies on domestic, sexual and gender-based violence.

  7. Laparoscopic adrenalectomy: Single centre experience.

    LENUS (Irish Health Repository)

    O'Farrell, N J

    2012-02-01

    BACKGROUND: Laparoscopic adrenalectomy is an attractive alternative to the traditional open approach in the surgical excision of an adrenal gland. It has replaced open adrenalectomy in our institution and we review our experience to date. METHODS: All cases of laparoscopic adrenalectomies in our hospital over eight years (from 2001 to May 2009) were retrospectively reviewed. Patient demographics, diagnosis, length of hospital stay, histology and all operative and post-operative details were evaluated. RESULTS: Fifty-five laparoscopic adrenalectomies (LA) were performed on 51 patients over eight years. The mean age was 48 years (Range 16-86 years) with the male: female ratio 1:2. Twenty-three cases had a right adrenalectomy, 24 had a left adrenalectomy and the remaining four patients had bilateral adrenalectomies. 91% were successfully completed laparoscopically with five converted to an open approach. Adenomas (functional and non functional) were the leading indication for LA, followed by phaeochromocytomas. Other indications for LA included Cushing\\'s disease, adrenal malignancies and rarer pathologies. There was one mortality from necrotising pancreatitis following a left adrenalectomy for severe Cushing\\'s disease, with subsequent death 10 days later. CONCLUSION: Laparoscopic adrenalectomy is effective for the treatment of adrenal tumours, fulfilling the criteria for the ideal minimally invasive procedure. It has replaced the traditional open approach in our centre and is a safe and effective alternative. However, in the case of severe Cushing\\'s disease, laparoscopic adrenalectomy has the potential for significant adverse outcomes and mortality.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  9. Birth centre confinement at the Queen Victoria Medical Centre. I. Obstetric and neonatal outcome.

    Science.gov (United States)

    Campbell, J; Hudson, H; Lumley, J; Morris, N; Rao, J; Spensley, J

    1981-10-03

    A review of hte first 175 confinements at the Queen Victoria Medical Centre Birth Centre is presented. The design, structure and function of hte Birth Centre is described and the safety of the programme demonstrated. Seventy-four pregnancies (42%) accepted for Birth Centre confinement required transfer because of antepartum or intrapartum complications. There were satisfactory obstetric and neonatal outcomes in all pregnancies. The first year's experience has allowed a reassessment of the risk factors, which will permit greater use of the Birth Centre without any increases risk to mothers or babies.

  10. Big Surveys, Big Data Centres

    Science.gov (United States)

    Schade, D.

    2016-06-01

    Well-designed astronomical surveys are powerful and have consistently been keystones of scientific progress. The Byurakan Surveys using a Schmidt telescope with an objective prism produced a list of about 3000 UV-excess Markarian galaxies but these objects have stimulated an enormous amount of further study and appear in over 16,000 publications. The CFHT Legacy Surveys used a wide-field imager to cover thousands of square degrees and those surveys are mentioned in over 1100 publications since 2002. Both ground and space-based astronomy have been increasing their investments in survey work. Survey instrumentation strives toward fair samples and large sky coverage and therefore strives to produce massive datasets. Thus we are faced with the "big data" problem in astronomy. Survey datasets require specialized approaches to data management. Big data places additional challenging requirements for data management. If the term "big data" is defined as data collections that are too large to move then there are profound implications for the infrastructure that supports big data science. The current model of data centres is obsolete. In the era of big data the central problem is how to create architectures that effectively manage the relationship between data collections, networks, processing capabilities, and software, given the science requirements of the projects that need to be executed. A stand alone data silo cannot support big data science. I'll describe the current efforts of the Canadian community to deal with this situation and our successes and failures. I'll talk about how we are planning in the next decade to try to create a workable and adaptable solution to support big data science.

  11. The Canadian Astronomy Data Centre

    Science.gov (United States)

    Ball, Nicholas M.; Schade, D.; Astronomy Data Centre, Canadian

    2011-01-01

    The Canadian Astronomy Data Centre (CADC) is the world's largest astronomical data center, holding over 0.5 Petabytes of information, and serving nearly 3000 astronomers worldwide. Its current data collections include BLAST, CFHT, CGPS, FUSE, Gemini, HST, JCMT, MACHO, MOST, and numerous other archives and services. It provides extensive data archiving, curation, and processing expertise, via projects such as MegaPipe, and enables substantial day-to-day collaboration between resident astronomers and computer specialists. It is a stable, powerful, persistent, and properly supported environment for the storage and processing of large volumes of data, a condition that is now absolutely vital for their science potential to be exploited by the community. Through initiatives such as the Common Archive Observation Model (CAOM), the Canadian Virtual Observatory (CVO), and the Canadian Advanced Network for Astronomical Research (CANFAR), the CADC is at the global forefront of advancing astronomical research through improved data services. The CAOM aims to provide homogeneous data access, and hence viable interoperability between a potentially unlimited number of different data collections, at many wavelengths. It is active in the definition of numerous emerging standards within the International Virtual Observatory, and several datasets are already available. The CANFAR project is an initiative to make cloud computing for storage and data-intensive processing available to the community. It does this via a Virtual Machine environment that is equivalent to managing a local desktop. Several groups are already processing science data. CADC is also at the forefront of advanced astronomical data analysis, driven by the science requirements of astronomers both locally and further afield. The emergence of 'Astroinformatics' promises to provide not only utility items like object classifications, but to directly enable new science by accessing previously undiscovered or intractable

  12. Relationships between the school-level and classroom-level ...

    African Journals Online (AJOL)

    education; school-level environment; science education; South Africa. Introduction .... instrument to the primary school students (N = 1,077) of 31 distance-education primary school teachers ..... Centre for Curriculum, Transfer and Technology.

  13. A risk scoring model based on vital signs and laboratory data predicting transfer to the intensive care unit of patients admitted to gastroenterology wards.

    Science.gov (United States)

    Kim, Won-Young; Lee, Jinmi; Lee, Ju-Ry; Jung, Youn Kyung; Kim, Hwa Jung; Huh, Jin Won; Lim, Chae-Man; Koh, Younsuck; Hong, Sang-Bum

    2017-08-01

    To compare the ability of a score based on vital signs and laboratory data with that of the modified early warning score (MEWS) to predict ICU transfer of patients with gastrointestinal disorders. Consecutive events triggering medical emergency team activation in adult patients admitted to the gastroenterology wards of the Asan Medical Center were reviewed. Binary logistic regression was used to identify factors predicting transfer to the ICU. Gastrointestinal early warning score (EWS-GI) was calculated as the sum of simplified regression weights (SRW). Of the 1219 included patients, 468 (38%) were transferred to the ICU. Multivariate analysis identified heart rate≥105bpm (SRW 1), respiratory rate≥26bpm (SRW 2), ACDU (Alert, Confused, Drowsy, Unresponsive) score≥1 (SRW 2), SpO 2 /FiO 2 ratiogastroenterology wards. The EWS-GI should be prospectively validated. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Quality indicators for the management of Barrett's esophagus, dysplasia, and esophageal adenocarcinoma: international consensus recommendations from the American Gastroenterological Association Symposium.

    Science.gov (United States)

    Sharma, Prateek; Katzka, David A; Gupta, Neil; Ajani, Jaffer; Buttar, Navtej; Chak, Amitabh; Corley, Douglas; El-Serag, Hashem; Falk, Gary W; Fitzgerald, Rebecca; Goldblum, John; Gress, Frank; Ilson, David H; Inadomi, John M; Kuipers, Ernest J; Lynch, John P; McKeon, Frank; Metz, David; Pasricha, Pankaj J; Pech, Oliver; Peek, Richard; Peters, Jeffrey H; Repici, Alessandro; Seewald, Stefan; Shaheen, Nicholas J; Souza, Rhonda F; Spechler, Stuart J; Vennalaganti, Prashanth; Wang, Kenneth

    2015-11-01

    The development of and adherence to quality indicators in gastroenterology, as in all of medicine, is increasing in importance to ensure that patients receive consistent high-quality care. In addition, government-based and private insurers will be expecting documentation of the parameters by which we measure quality, which will likely affect reimbursements. Barrett's esophagus remains a particularly important disease entity for which we should maintain up-to-date guidelines, given its commonality, potentially lethal outcomes, and controversies regarding screening and surveillance. To achieve this goal, a relatively large group of international experts was assembled and, using the modified Delphi method, evaluated the validity of multiple candidate quality indicators for the diagnosis and management of Barrett's esophagus. Several candidate quality indicators achieved >80% agreement. These statements are intended to serve as a consensus on candidate quality indicators for those who treat patients with Barrett's esophagus. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

  15. The politics of patient-centred care.

    Science.gov (United States)

    Kreindler, Sara A

    2015-10-01

    Despite widespread belief in the importance of patient-centred care, it remains difficult to create a system in which all groups work together for the good of the patient. Part of the problem may be that the issue of patient-centred care itself can be used to prosecute intergroup conflict. This qualitative study of texts examined the presence and nature of intergroup language within the discourse on patient-centred care. A systematic SCOPUS and Google search identified 85 peer-reviewed and grey literature reports that engaged with the concept of patient-centred care. Discourse analysis, informed by the social identity approach, examined how writers defined and portrayed various groups. Managers, physicians and nurses all used the discourse of patient-centred care to imply that their own group was patient centred while other group(s) were not. Patient organizations tended to downplay or even deny the role of managers and providers in promoting patient centredness, and some used the concept to advocate for controversial health policies. Intergroup themes were even more obvious in the rhetoric of political groups across the ideological spectrum. In contrast to accounts that juxtaposed in-groups and out-groups, those from reportedly patient-centred organizations defined a 'mosaic' in-group that encompassed managers, providers and patients. The seemingly benign concept of patient-centred care can easily become a weapon on an intergroup battlefield. Understanding this dimension may help organizations resolve the intergroup tensions that prevent collective achievement of a patient-centred system. © 2013 John Wiley & Sons Ltd.

  16. Development of the Advanced CANDU Reactor control centre

    International Nuclear Information System (INIS)

    Malcolm, S.; Leger, R.

    2004-01-01

    The next generation CANDU control centre is being designed for the Advanced CANDU Reactor (ACR) station. The design is based upon the recent Qinshan control room with further upgrades to meet customer needs with respect to high capacity factor with low Operation, Maintenance and Administration (OM and A) costs. This evolutionary design includes the long proven functionality at several existing CANDU control centres such as the 4-unit station at Darlington, with advanced features made possible by new control and display technology. Additionally, ACR control centres address characteristics resulting from Human Factors Engineering (HFE) analysis of control centre operations in order to further enhance personnel awareness of system and plant status. Statistics show that up to 70% of plant significant events, which have caused plant outages, have a root cause attributable to the human from such sources as complex interfaces, procedures, maintenance and management practices. Consequently, special attention is made for the application of HFE throughout the ACR design process. The design process follows a systematic analytical approach to define operations staff information and information presentation requirements. The resultant human-system interfaces (HSI) such as those for monitoring, annunciation and control information are then verified and validated against the system design requirements to provide a high confidence level that adequate and correct information is being provided in a timely manner to support the necessary operational tasks. The ACR control centre provides plant staff with an improved operability capability due to the combination of systematic design and enhanced operating features. Significant design processes (i.e. development) or design features which contribute to this improved operability, include: Design Process: Project HFE Program Plan - intent, scope, timeliness and interfacing; HFE aspects of design process - procedures and instructions

  17. Development of the advanced CANDU reactor control centre

    International Nuclear Information System (INIS)

    Malcolm, S.; Leger, R.

    2004-01-01

    The next generation CANDU control centre is being designed for the Advanced CANDU Reactor (ACR) station. The design is based upon the recent Qinshan control room with further upgrades to meet customer needs with respect to high capacity factor with low Operation, Maintenance and Administration (OM and A) costs. This evolutionary design includes the long proven functionality at several existing CANDU control centres such as the 4-unit station at Darlington, with advanced features made possible by new control and display technology. Additionally, ACR control centres address characteristics resulting from Human Factors Engineering (HFE) analysis of control centre operations in order to further enhance personnel awareness of system and plant status. Statistics show that up to 70% of plant significant events, which have caused plant outages, have a root cause attributable to the human from such sources as complex interfaces, procedures, maintenance and management practices. Consequently, special attention is made for the application of HFE throughout the ACR design process. The design process follows a systematic analytical approach to define operations staff information and information presentation requirements. The resultant human-system interfaces (HSI) such as those for monitoring, annunciation and control information are then verified and validated against the system design requirements to provide a high confidence level that adequate and correct information is being provided in a timely manner to support the necessary operational tasks. The ACR control centre provides plant staff with an improved operability capability due to the combination of systematic design and enhanced operating features. Significant design processes (i.e. development) or design features which contribute to this improved operability, include: Design Process: Project HFE Program Plan - intent, scope, timeliness and interfacing; HFE aspects of design process - procedures and instructions

  18. A 25-year analysis of the American College of Gastroenterology research grant program: factors associated with publication and advancement in academics.

    Science.gov (United States)

    Crockett, Seth D; Dellon, Evan S; Bright, Stephanie D; Shaheen, Nicholas J

    2009-05-01

    The American College of Gastroenterology (ACG) has awarded research grants for 25 years. We assessed the characteristics of grant recipients, their current academic status, and the likelihood of publication resulting from the grant. Demographic data, the year and amount of award, title of project, and recipient's institution were extracted from ACG databases. Using ACG reports and medical literature search engines, we assessed publication based on grant-funded research, as well as career publication record. We also determined the current position of awardees. A similar analysis was performed for recipients of junior investigator awards. A total of 396 clinical research awards totaling $5,374,497 ($6,867,937 in 2008 dollars) were awarded to 341 recipients in the 25 years between 1983 and 2008. The most commonly funded areas of research were endoscopy (22% of awards) and motility/functional disorders (21%). At least one peer-reviewed publication based on grant-funded research occurred with 255 of the 368 awards (69%) for 1983-2006 [corrected]. Higher award value was associated with subsequent publication. Of the 313 awardees over the same period, 195 (62%) are currently in academic positions [corrected]. Factors associated with staying in academics included higher award value (P academics. Overall, the mean cost in grant dollars per published paper based on the research was $14,875. The majority of ACG grant recipients published the results of their research and remained in academics. Higher amount of award, holding an advanced degree, and publication were associated with careers in academics. The ACG research grant award program is an important engine of investigation, publication, and academic career development in the field of gastroenterology.

  19. European Society for Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for the Evaluation and Treatment of Gastrointestinal and Nutritional Complications in Children With Neurological Impairment.

    Science.gov (United States)

    Romano, Claudio; van Wynckel, Myriam; Hulst, Jessie; Broekaert, Ilse; Bronsky, Jiri; Dall'Oglio, Luigi; Mis, Nataša F; Hojsak, Iva; Orel, Rok; Papadopoulou, Alexandra; Schaeppi, Michela; Thapar, Nikhil; Wilschanski, Michael; Sullivan, Peter; Gottrand, Frédéric

    2017-08-01

    Feeding difficulties are frequent in children with neurological impairments and can be associated with undernutrition, growth failure, micronutrients deficiencies, osteopenia, and nutritional comorbidities. Gastrointestinal problems including gastroesophageal reflux disease, constipation, and dysphagia are also frequent in this population and affect quality of life and nutritional status. There is currently a lack of a systematic approach to the care of these patients. With this report, European Society of Gastroenterology, Hepatology and Nutrition aims to develop uniform guidelines for the management of the gastroenterological and nutritional problems in children with neurological impairment. Thirty-one clinical questions addressing the diagnosis, treatment, and prognosis of common gastrointestinal and nutritional problems in neurological impaired children were formulated. Questions aimed to assess the nutritional management including nutritional status, identifying undernutrition, monitoring nutritional status, and defining nutritional requirements; to classify gastrointestinal issues including oropharyngeal dysfunctions, motor and sensory function, gastroesophageal reflux disease, and constipation; to evaluate the indications for nutritional rehabilitation including enteral feeding and percutaneous gastrostomy/jejunostomy; to define indications for surgical interventions (eg, Nissen Fundoplication, esophagogastric disconnection); and finally to consider ethical issues related to digestive and nutritional problems in the severely neurologically impaired children. A systematic literature search was performed from 1980 to October 2015 using MEDLINE. The approach of the Grading of Recommendations Assessment, Development, and Evaluation was applied to evaluate the outcomes. During 2 consensus meetings, all recommendations were discussed and finalized. The group members voted on each recommendation using the nominal voting technique. Expert opinion was applied to

  20. Review of CERN Data Centre Infrastructure

    International Nuclear Information System (INIS)

    Andrade, P; Bell, T; Van Eldik, J; McCance, G; Panzer-Steindel, B; Coelho dos Santos, M; Traylen and, S; Schwickerath, U

    2012-01-01

    The CERN Data Centre is reviewing strategies for optimizing the use of the existing infrastructure and expanding to a new data centre by studying how other large sites are being operated. Over the past six months, CERN has been investigating modern and widely-used tools and procedures used for virtualisation, clouds and fabric management in order to reduce operational effort, increase agility and support unattended remote data centres. This paper gives the details on the project's motivations, current status and areas for future investigation.

  1. Attitude of Farmers towards Kisan Call Centres

    Directory of Open Access Journals (Sweden)

    Shely Mary Koshy

    2017-09-01

    Full Text Available The present study was conducted to measure the attitude of farmers in Kerala, India towards Kisan Call Centre (KCC. Kisan Call Centre provides free agricultural advisory services to every citizen involved in agriculture through a toll free number. One hundred and fifty farmers who have utilized the Kisan Call Centre service were selected from the database of KCC. The results showed that the respondents had moderately favourable attitude towards KCC followed by highly favourable attitude. The variables digital divide, temporal awareness on KCC, satisfaction towards KCC and utilization of KCC were found to have a positive correlation with the attitude of respondents towards KCC.

  2. Associating science and development - the Trieste Centre

    International Nuclear Information System (INIS)

    Hamende, A.

    1982-01-01

    The International Centre for Theoretical Physics, located in Trieste, Italy, is supported by income from the Italian Government, from UNESCO and from the IAEA. The Centre organizes research sessions, workshops and extended courses on advanced topics in the physical and mathematical sciences and encourages scientists, especially from developing countries, to visit the ICTP for extended periods. With the aim of facilitating the transfer of knowledge to scientists from developing countries, the Centre's current scientific programme is divided up into five major disciplines: physics and energy; physics and frontiers of knowledge; physics and technology; physics and the environment and natural resources; applicable mathematics

  3. International Network of Nuclear Reaction Data Centres

    International Nuclear Information System (INIS)

    Otsuka, Naohiko; Dunaeva, Svetlana

    2010-11-01

    The activities of fourteen nuclear data centres are summarized, and their cooperation under the auspices of the International Atomic Energy Agency is described. Each of the centres provides coverage for different geographical zones and/or specific types of nuclear data, thus together providing a complete service for users worldwide. The International Network of Nuclear Reaction Data Centres (NRDC) was established with the objective of providing nuclear physics databases that are required for nuclear technology (encompassing energy and non-energy applications) by coordinating the collection, compilation and dissemination of nuclear data on an international scale. (author)

  4. The Manche Storage Centre: 2009 annual report

    International Nuclear Information System (INIS)

    2010-01-01

    After a brief presentation of the ANDRA (the French national agency for the management of radioactive wastes), this report presents the CSM installations (CSM stands for Centre de Stockage de la Manche, the Manche storage centre), recalls results and actions in the field of nuclear safety and in the field of radioprotection. It indicates incidents and accidents which occurred in the installations, presents data about the Centre's releases. It presents the waste management and evokes other pollution. It indicates the various actions undertaken for information transparency

  5. Review of CERN Data Centre Infrastructure

    CERN Document Server

    Andrade, P; van Eldik, J; McCance, G; Panzer-Steindel, B; Coelho dos Santos, M; Traylen, S; Schwickerath, U

    2012-01-01

    The CERN Data Centre is reviewing strategies for optimizing the use of the existing infrastructure and expanding to a new data centre by studying how other large sites are being operated. Over the past six months, CERN has been investigating modern and widely-used tools and procedures used for virtualisation, clouds and fabric management in order to reduce operational effort, increase agility and support unattended remote data centres. This paper gives the details on the project’s motivations, current status and areas for future investigation.

  6. Visitor centres at nuclear facility sites

    International Nuclear Information System (INIS)

    1993-01-01

    Communications strategies in the nuclear field are often based on the creation of visitor centres at nuclear facility sites. Today, the design, as well as the realization and management of such centres has become a specialized function, and its role is very complementary to the nuclear operator's. It also uses the latest technology in the field of audio-visual, experiment and interactivity. This publication contains the proceedings of an international seminar organized by the OECD Nuclear Energy Agency on the role of visitor centres at nuclear facility sites. It includes the main papers presented at this Seminar

  7. Human-centred automation: an explorative study

    International Nuclear Information System (INIS)

    Hollnagel, Erik; Miberg, Ann Britt

    1999-05-01

    The purpose of the programme activity on human-centred automation at the HRP is to develop knowledge (in the form of models and theories) and tools (in the form of techniques and simulators) to support design of automation that ensures effective human performance and comprehension. This report presents the work done on both the analytical and experimental side of this project. The analytical work has surveyed common definitions of automation and traditional design principles. A general finding is that human-centred automation usually is defined in terms of what it is not. This is partly due to a lack of adequate models and of human-automation interaction. Another result is a clarification of the consequences of automation, in particular with regard to situation awareness and workload. The experimental work has taken place as an explorative experiment in HAMMLAB in collaboration with IPSN (France). The purpose of this experiment was to increase the understanding of how automation influences operator performance in NPP control rooms. Two different types of automation (extensive and limited) were considered in scenarios having two different degrees of complexity (high and low), and involving diagnostic and procedural tasks. Six licensed NPP crews from the NPP at Loviisa, Finland, participated in the experiment. The dependent variables applied were plant performance, operator performance, self-rated crew performance, situation awareness, workload, and operator trust in the automation. The results from the diagnostic scenarios indicated that operators' judgement of crew efficiency was related to their level of trust in the automation, and further that operators trusted automation least and rated crew performance lowest in situations where crew performance was efficient and vice versa. The results from procedural scenarios indicated that extensive automation efficiently supported operators' performance, and further that operator' judgement of crew performance efficiency

  8. Addiction research centres and the nurturing of creativity: National Drug Dependence Treatment Centre, India--a profile.

    Science.gov (United States)

    Ray, Rajat; Dhawan, Anju; Chopra, Anita

    2013-10-01

    The National Drug Dependence Treatment Centre (NDDTC) is a part of the All India Institute of Medical Sciences, a premier autonomous medical university in India. This article provides an account of its origin and its contribution to the field of substance use disorder at the national and international levels. Since its establishment, the NDDTC has played a major role in the development of various replicable models of care, the training of post-graduate students of psychiatry, research, policy development and planning. An assessment of the magnitude of drug abuse in India began in the early 1990s and this was followed by a National Survey on Extent, Patterns and Trends of Drug Abuse in 2004. Several models of clinical care have been developed for population subgroups in diverse settings. The centre played an important role in producing data and resource material which helped to scale up opioid substitution treatment in India. A nationwide database on the profile of patients seeking treatment (Drug Abuse Monitoring System) at government drug treatment centres has also been created. The centre has provided valuable inputs for the Government of India's programme planning. Besides clinical studies, research has also focused on pre-clinical studies. Capacity-building is an important priority, with training curricula and resource material being developed for doctors and paramedical staff. Many of these training programmes are conducted in collaboration with other institutions in the country. The NDDTC has received funding from several national and international organizations for research and scientific meetings, and, most recently (2012), it has been designated as a World Health Organization Collaborating Centre on Substance Abuse. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

  9. Nganyi Community Resource Centre: Community radio station ...

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

    2016-05-04

    May 4, 2016 ... To mark World Meteorological Day on March 23, 2015, the Kenya Meteorological Services (KMS) launched a resource centre and radio station in western Kenya to disseminate weather and climate information.

  10. Social innovation for People-Centred Development

    DEFF Research Database (Denmark)

    Hulgård, Lars; P.K., Shajahan

    2013-01-01

    Social innovation is closely related to the people-centred development (PCD) framework of knowledge production. The discussion of PCD in this chapter particularly expands on the feature of empowerment and socio-political mobilization of people in social innovation...

  11. The nuclear research centre at Bariloche, Argentina

    International Nuclear Information System (INIS)

    Abriata, J.P.

    2001-01-01

    The nuclear research centre at Bariloche (CAB) is one of the four centres under the Atomic Energy Commission of Argentina (CNEA). The research programme of CAB addresses various issues like nuclear reactor development, nuclear fuel and fuel cycle, applications of radioisotopes and radiation, and waste management. There is also a basic nuclear science component. The human resource development in the areas of physics and nuclear engineering is done in an associated Balseiro Institute which has undergraduate and graduate programmes as well as doctoral and postdoctoral research. The Centre interacts well with the society and provides services in the nuclear area. It has a close interaction with the nuclear sector of Argentina as also with many international organisations. Regulatory control over the Centre is carried out by the Nuclear Regulatory Authority of Argentina. (author)

  12. International Development Research Centre Governor Travel Policy

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

    André Lavoie

    business. Governors are required to travel to conduct IDRC business, attend ... of Governors, liaise with Centre management, and perform specific representational functions on ..... Travel between Points of Origin and Destination - Air Travel.

  13. Haiti | IDRC - International Development Research Centre

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

    ... for the environment, reduced spending on food, increased self-esteem, and stronger ... The consortium acts as a knowledge centre and explores communication ... train teachers and researchers in high-quality science and technology skills ...

  14. Bulletin #112 | IDRC - International Development Research Centre

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

    ... to support training of African mathematical scientists on climate change solutions ... significant support following UN meeting on refugees and migrants ... for Urban Equity at India's Centre for Environmental Planning and Technology, this ...

  15. President | IDRC - International Development Research Centre

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

    International Development Research Centre Selection Criteria Education A ... or an acceptable combination of education, job-related training and/or experience. ... Knowledge of current corporate governance and human resource issues; ...

  16. Potential of Natural Ventilation in Shopping Centres

    DEFF Research Database (Denmark)

    Diederichsen, Alice; Friis, Kristina; Brohus, Henrik

    2008-01-01

    The indoor environmental quality (IEQ) is a fundamental requirement for a well performing shopping centre. This paper contains a pilot study of the potential of using hybrid ventilation (a combination of automatically controlled natural and mechanical ventilation - respectively NV and MV) in shop......The indoor environmental quality (IEQ) is a fundamental requirement for a well performing shopping centre. This paper contains a pilot study of the potential of using hybrid ventilation (a combination of automatically controlled natural and mechanical ventilation - respectively NV and MV......) in shopping centres with focus on both the achieved IEQ and energy consumptions for air movement. By thermal building simulations it is found that there exists an interesting potential for hybrid ventilation of shopping centres, which can lead to great savings in the electrical energy consumptions...

  17. Product Lifecycle Management Centre of Technology

    CSIR Research Space (South Africa)

    Barnard, Rentia

    2017-10-01

    Full Text Available - Rentia Barnard.pdf.txt Content-Type text/plain; charset=UTF-8 1 Interactive activities Contents Product Lifecycle Management Centre of Technology Rentia Barnard National Industrialisation Support Initiative (NISI) 3 Initiative (NISI...

  18. Towards Human-Centred Design

    Science.gov (United States)

    Bannon, Liam J.

    The field of HCI has evolved and expanded dramatically since its origin in the early 1980’s. The HCI community embraces a large community of researchers and practitioners around the world, from a variety of disciplinary backgrounds in the human and social sciences, engineering and informatics, and more recently, the arts and design disciplines. This kaleidoscope of cultures and disciplines as seen at INTERACT Conferences provides a rich pool of resources for examining our field. Applications are increasingly exploring our full range of sensory modalities, and merging the digital and physical worlds. WiFi has opened up a huge design space for mobile applications. A focus on usability of products and services has been complemented by an emphasis on engagement, enjoyment and experience. With the advent of ubiquitous computing, and the emergence of “The Internet of Things”, new kinds of more open infrastructures make possible radically new kinds of applications. The sources of innovation have also broadened, to include human and social actors outside of the computing and design organizations. The question is to what extent is our mainstream thinking in the HCI field ready for the challenges of this Brave New World? Do the technological and social innovations that we see emerging require us to re-shape, or even, re-create, our field, or is it a case of a more gradual evolution and development of that which we already know? In this closing Keynote, I will provide a perspective on the evolution and development of the HCI field, looking backwards as well as forwards, in order to determine what are some of the changes of significance in the field. This “broad-brush” approach to what I term “ human-centred design” will be complemented by the examination of specific projects and applications, to help anchor some of the discussion. Areas such as user-centred design, participatory design, computer-supported cooperative work and learning, and interaction design, in

  19. Does professional-centred training improve consultation outcomes?

    DEFF Research Database (Denmark)

    Parkin, Tracey; Barnard, K.; Cradock, S.

    2006-01-01

    discussed and decisions made. Patients also completed the Health Care Climate Questionnaire (HCCQ). Pre-training results were fed back to the professionals to provide an objective measure of current practice. Training day one comprised 10 minutes' observation of videoed consultations of each professional......This study aimed to examine whether professional-centred training improves consultation outcomes. Using a pre- and post-data collection design. Immediately after consultations, professionals and patients completed a consultation review sheet which was coded for the level of agreement on issues...... in order to identify strengths and training needs. Each professional identified key areas of their consultation that they felt needed further development. Training day two centred on goal setting and negotiating agendas as these were identified as priority areas requiring more skills. Data from 110...

  20. White-centred retinal haemorrhages (Roth spots).

    OpenAIRE

    Ling, R.; James, B.

    1998-01-01

    Roth spots (white-centred retinal haemorrhages) were classically described as septic emboli lodged in the retina of patients with subacute bacterial endocarditis. Indeed many have considered Roth spots pathognomonic for this condition. More recent histological evidence suggests, however, that they are not foci of bacterial abscess. Instead, they are nonspecific and may be found in many other diseases. A review of the histology and the pathogenesis of these white-centred haemorrhages will be p...

  1. Karlsruhe Nuclear Research Centre. Programme budget 1988

    International Nuclear Information System (INIS)

    1987-01-01

    Following a general survey of tasks, planned activities and developmental trends of the nuclear research centre, the report gives an account of the activities to be performed in the subject fields of main interest, showing the budgeting figures for annual expenditure (for personnel, investments, operating costs) up to the year 1991. Further information explains the infrastructure of the centre and the distribution of overall expenditure as well as the budgetary planning. (UA) [de

  2. The CSN's Information Centre: a necessary venture

    International Nuclear Information System (INIS)

    Calvo, A.

    1999-01-01

    Every year, around 10,000 pupils will visit the CSN's Information Centre, an exposition area which was created with the intention of explaining simply but strictly, what radiations are, for what they are used, what risks they hold and how they are controlled. Opened in October, 1998, encouraged by Parliamentary urging, the Centre is a path to CSN Information for citizens to use. (Author)

  3. User-Centred BCI Videogame Design

    OpenAIRE

    Loup-Escande , Emilie; Lotte , Fabien; Loup , Guillaume; Lécuyer , Anatole

    2015-01-01

    International audience; This chapter aims to offer a user-centred methodological framework to guide the design and evaluation of Brain-Computer Interface videogames. This framework is based on the contributions of ergonomics to ensure these games are well suited for their users (i.e., players). It provides methods, criteria and metrics to complete the different phases required by ae human-centred design process. This aims to understand the context of use, specify the user needs and evaluate t...

  4. Joint Research Centre. Ispra establishment-Italy

    International Nuclear Information System (INIS)

    Angelini, Antonio

    1976-01-01

    A comprehensive review of the work carried out during 1974 and 1975 in the Ispra establishment of the Joint Research Centre is presented. A description of the activity carried out within the context of the running programmes is given. Some of the most relevant scientific and technical achievement are described from the viewpoints of the Scientific Departments of the Centre. The technical and administrative support activities are also presented. A list of publications issued by the Ispra Scientific staff is given

  5. Automatic centring and bonding of lenses

    Science.gov (United States)

    Krey, Stefan; Heinisch, J.; Dumitrescu, E.

    2007-05-01

    We present an automatic bonding station which is able to center and bond individual lenses or doublets to a barrel with sub micron centring accuracy. The complete manufacturing cycle includes the glue dispensing and UV curing. During the process the state of centring is continuously controlled by the vision software, and the final result is recorded to a file for process statistics. Simple pass or fail results are displayed to the operator at the end of the process.

  6. Building an applied activation analysis centre

    International Nuclear Information System (INIS)

    Bartosek, J.; Kasparec, I.; Masek, J.

    1972-01-01

    Requirements are defined and all available background material is reported and discussed for the building up of a centre of applied activation analysis in Czechoslovakia. A detailed analysis of potential users and the centre's envisaged availability is also presented as part of the submitted study. A brief economic analysis is annexed. The study covers the situation up to the end of 1972. (J.K.)

  7. CLINICAL SPECTRUM OF HYPONATRAEMIA IN TERTIARY CENTRE

    Directory of Open Access Journals (Sweden)

    Suresh Chincholi

    2017-02-01

    Full Text Available BACKGROUND Hyponatraemia is defined as a serum sodium level less than 135 mEq/L. High mortality among the patients of hyponatraemia is secondary to the underlying medical condition. Frequency is high in elderly patients. MATERIALS AND METHODS The study was conducted at a tertiary care centre (Basaveshwar Teaching and General Hospital, Gulbarga, from the period September 2014 to August 2016. These patients were evaluated for the underlying cause of hyponatraemia, which included detailed history and physical examination followed by appropriate laboratory investigations. Patients were followed up till the hyponatraemia was treated or patients were discharged from the hospital. RESULTS 100 patients of hyponatraemia were included in the study. 46% of the patients were asymptomatic. 33% patients had lethargy, 28% patients had postural dizziness and 19% had abnormal behaviour. Overall incidence of hyponatraemia was 4.58% in the hospitalised population, whereas its incidence in ICU patients was 22.4%. Twelve patients of symptomatic severe hyponatraemia were treated with hypertonic saline infusion, 25% patients were given loop diuretics with oral supplementation of sodium chloride for free water excretion in SIADH cases and in patients with hypervolaemia, hyponatraemia, fluid restriction was advised to 44 patients, oral supplementation of sodium chloride was given in 36 patients and 64 patients received normal saline. 9 patients included in the study died, 5 of which had advanced cirrhosis of liver as underlying cause. One patient developed Osmotic Demyelination Syndrome (ODS. CONCLUSION The possible cause of hyponatraemia should always be sought as outcome in severe hyponatraemia is governed by aetiology, and not by the serum sodium level. Treatment of severe symptomatic hyponatraemia with hypertonic saline is safe if recommendation for the rate of correction of hyponatraemia is strictly followed.

  8. The Imperial College Thermophysical Properties Data Centre

    Science.gov (United States)

    Angus, S.; Cole, W. A.; Craven, R.; de Reuck, K. M.; Trengove, R. D.; Wakeham, W. A.

    1986-07-01

    The IUPAC Thermodynamic Tables Project Centre in London has at its disposal considerable expertise on the production and utilization of high-accuracy equations of state which represent the thermodynamic properties of substances. For some years they have been content to propagate this information by the traditional method of book production, but the increasing use of the computer in industry for process design has shown that an additional method was needed. The setting up of the IUPAC Transport Properties Project Centre, also at Imperial College, whose products would also be in demand by industry, afforded the occasion for a new look at the problem. The solution has been to set up the Imperial College Thermophysical Properties Data Centre, which embraces the two IUPAC Project Centres, and for it to establish a link with the existing Physical Properties Data Service of the Institution of Chemical Engineers, thus providing for the dissemination of the available information without involving the Centres in problems such as those of marketing and advertising. This paper outlines the activities of the Centres and discusses the problems in bringing their products to the attention of industry in suitable form.

  9. Underpricing and Firm’s Distance from Financial Centre: Evidence from three European Countries

    OpenAIRE

    Antonio Acconcia; Alfredo Del Monte; Luca Pennacchio

    2011-01-01

    We provide international evidence on the relationship between the extent of underpricing related to initial public offerings (IPOs) and the distance of the issuing firm from the financial centre of a country: for France, Germany and Italy, the higher the distance, the higher the level of underpricing. Under the maintained assumption that headquarters of institutional investors and underwriters are part of a financial centre, our evidence is consistent with the hypothesis that ex ante uncertai...

  10. Interaction systems design and the protocol- and middleware-centred paradigms in distributed application development

    OpenAIRE

    Andrade Almeida, João; van Sinderen, Marten J.; Quartel, Dick; Ferreira Pires, Luis

    2003-01-01

    This paper aims at demonstrating the benefits and importance of interaction systems design in the development of distributed applications. We position interaction systems design with respect to two paradigms that have influenced the design of distributed applications: the middleware-centred and the protocol-centred paradigm. We argue that interaction systems that support application-level interactions should be explicitly designed, using the externally observable behaviour of the interaction ...

  11. Lead and polycyclic aromatic hydrocarbons (PAHs) in surface soil from day care centres in the city of Bergen, Norway

    International Nuclear Information System (INIS)

    Haugland, Toril; Ottesen, Rolf Tore; Volden, Tore

    2008-01-01

    Surface soil (0-2 cm) quality in 87 day care centres in the city of Bergen, Norway has been studied. Approximately 45% of the day care centres contained Pb and PAH values above recommended action levels. There are clear variations between different areas of the city. The old central part of the city hosts most of the contaminated day care centres. In suburban areas most of the day care centres have Pb and PAH concentrations below action levels. City fires, gas work emission, lead-based paint, and traffic are probably important anthropogenic contamination sources, together with uncontrolled transportation of soil from contaminated to clean areas. Geological or other natural sources are probably not an important contributor to the high levels of lead and PAH. - Surface soil in 45% of the studied day care centres was contaminated by lead and PAH

  12. Nurse middle managers contributions to patient-centred care: A 'managerial work' analysis.

    Science.gov (United States)

    Lalleman, Pcb; Smid, Gac; Dikken, J; Lagerwey, M D; Schuurmans, M J

    2017-10-01

    Nurse middle managers are in an ideal position to facilitate patient-centred care. However, their contribution is underexposed in literature due to difficulties to articulate this in practice. This paper explores how nurse middle managers contribute to patient-centred care in hospitals. A combination of time-use analysis and ethnographic work was used to disclose their contribution to patient-centred care at a micro level. Sixteen nurse managers were shadowed for over 560 hours in four hospitals. Some nurse middle managers seldom contribute to patient-centred care. Others are involved in direct patient care, but this does not result in patient-centred practices. At one hospital, the nurse middle managers did contribute to patient-centred care. Here balancing between "organizing work" and "caring work" is seen as a precondition for their patient-centeredness. Other important themes are feedback mechanisms; place matters; with whom to talk and how to frame the issues at stake; and behavioral style. Both "hands-on" and "heads-on" caring work of nurse middle managers enhances their patient-centeredness. This study is the first of its kind to obtain insight in the often difficult to articulate "doings" of nurse middle managers with regard to patient-centred care through combining time-use analysis with ethnographic work. © 2017 John Wiley & Sons Ltd.

  13. Aube storage centres - 2007 review

    International Nuclear Information System (INIS)

    2008-10-01

    The National Radioactive Waste Management Agency (Andra), was established by the December 1991 Waste Act as a public body in charge of the long-term management of all radioactive waste, under the supervision of the Ministry of Ecology, Energy, Sustainable Development and the Sea (formerly the Ministry of Industry and the Ministry of Environment), and the Ministry of Research. The Andra operates two storage centers in the Aube region (France): the center for short-lived low- and intermediate-level wastes, and the center for very-low-level radioactive wastes. This report presents a review of the activities of both centers for 2007: deliveries, storage and processing, maintenance, incidents, personnel security, installations and environmental monitoring, effluents, budget and revenues, personnel, taxes, public information and actions of communication

  14. Aube storage centres - 2005 review

    International Nuclear Information System (INIS)

    2006-07-01

    The National Radioactive Waste Management Agency (Andra), was established by the December 1991 Waste Act as a public body in charge of the long-term management of all radioactive waste, under the supervision of the Ministry of Ecology, Energy, Sustainable Development and the Sea (formerly the Ministry of Industry and the Ministry of Environment), and the Ministry of Research. The Andra operates two storage centers in the Aube region (France): the center for short-lived low- and intermediate-level wastes, and the center for very-low-level radioactive wastes. This report presents a review of the activities of both centers for 2005: deliveries, storage and processing, maintenance, incidents, personnel security, installations and environmental monitoring, effluents, budget and revenues, personnel, taxes, public information and actions of communication

  15. Closing the gender leadership gap: a multi-centre cross-country comparison of women in management and leadership in academic health centres in the European Union.

    Science.gov (United States)

    Kuhlmann, Ellen; Ovseiko, Pavel V; Kurmeyer, Christine; Gutiérrez-Lobos, Karin; Steinböck, Sandra; von Knorring, Mia; Buchan, Alastair M; Brommels, Mats

    2017-01-06

    Women's participation in medicine and the need for gender equality in healthcare are increasingly recognised, yet little attention is paid to leadership and management positions in large publicly funded academic health centres. This study illustrates such a need, taking the case of four large European centres: Charité - Universitätsmedizin Berlin (Germany), Karolinska Institutet (Sweden), Medizinische Universität Wien (Austria), and Oxford Academic Health Science Centre (United Kingdom). The percentage of female medical students and doctors in all four countries is now well within the 40-60% gender balance zone. Women are less well represented among specialists and remain significantly under-represented among senior doctors and full professors. All four centres have made progress in closing the gender leadership gap on boards and other top-level decision-making bodies, but a gender leadership gap remains relevant. The level of achieved gender balance varies significantly between the centres and largely mirrors country-specific welfare state models, with more equal gender relations in Sweden than in the other countries. Notably, there are also similar trends across countries and centres: gender inequality is stronger within academic enterprises than within hospital enterprises and stronger in middle management than at the top level. These novel findings reveal fissures in the 'glass ceiling' effects at top-level management, while the barriers for women shift to middle-level management and remain strong in academic positions. The uneven shifts in the leadership gap are highly relevant and have policy implications. Setting gender balance objectives exclusively for top-level decision-making bodies may not effectively promote a wider goal of gender equality. Academic health centres should pay greater attention to gender equality as an issue of organisational performance and good leadership at all levels of management, with particular attention to academic enterprises

  16. Service quality perceptions in primary health care centres in Greece

    Science.gov (United States)

    Papanikolaou, Vicky; Zygiaris, Sotiris

    2012-01-01

    Abstract Context  The paper refers to the increased competition between health care providers and the need for patient‐centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. Objective  To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. Strategy  SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. Results  The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients’ perceptions rather than expectations. Discussion and conclusions  This paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations–perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services. PMID:22296402

  17. Service quality perceptions in primary health care centres in Greece.

    Science.gov (United States)

    Papanikolaou, Vicky; Zygiaris, Sotiris

    2014-04-01

    The paper refers to the increased competition between health care providers and the need for patient-centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients' perceptions rather than expectations. THIS paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations-perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services. © 2012 John Wiley & Sons Ltd.

  18. Strategic management in company information centre

    International Nuclear Information System (INIS)

    Judita Kopacikova, J.

    2004-01-01

    The article deals with the necessity of strategic management in libraries and information centres, with the process of creation, realization and regulation of settlement of strategic objectives and plans. It analyzes two levels of strategic management - information support of strategic management towards the superior body, provider, top management of the enterprise and organisation and proper strategic management of the information workplace. Marginally it also interferes with the problems of the so-called functional strategies - personal, technical provision and marketing. The current political, economical, social and for librarians and informative workers even information environs are subject to review of continual changes and show the organisations, institutions, enterprises and libraries how to compete successfully in competition. Changes, which are typical for the current period, will continue constantly. Consequently we must try to get them under the control, respond to them elastically, to be ready for them and to expect and predict them. For their managing we keep the modern management tools and methods at disposal - strategic management, TQM, knowledge management, management of human sources, etc. Increasing intensity and change ranges in the environs around us effect exceeding of strategic management demand - strategy. The higher uncertainty of the future development and the more solution alternatives are, the more important demand for strategic thinking and strategic proceeding is. By the strategic management the strategic thinking is the supposition of success and increasing of the effectiveness, performance and quality of products and services are the target. The final outcome is a satisfied customer, reader, user and its purpose is a long-term success in the activity or in the business. (author)

  19. Strategic management in company information centre

    International Nuclear Information System (INIS)

    Judita Kopacikova, J.

    2004-01-01

    The presentation deals with the necessity of strategic management in libraries and information centres, with the process of creation, realization and regulation of settlement of strategic objectives and plans. It analyzes two levels of strategic management - information support of strategic management towards the superior body, provider, top management of the enterprise and organisation and proper strategic management of the information workplace. Marginally it also interferes with the problems of the so-called functional strategies - personal, technical provision and marketing. The current political, economical, social and for librarians and informative workers even information environs are subject to review of continual changes and show the organisations, institutions, enterprises and libraries how to compete successfully in competition. Changes, which are typical for the current period, will continue constantly. Consequently we must try to get them under the control, respond to them elastically, to be ready for them and to expect and predict them. For their managing we keep the modern management tools and methods at disposal - strategic management, TQM, knowledge management, management of human sources, etc. Increasing intensity and change ranges in the environs around us effect exceeding of strategic management demand - strategy. The higher uncertainty of the future development and the more solution alternatives are, the more important demand for strategic thinking and strategic proceeding is. By the strategic management the strategic thinking is the supposition of success and increasing of the effectiveness, performance and quality of products and services are the target. The final outcome is a satisfied customer, reader, user and its purpose is a long-term success in the activity or in the business. (author)

  20. Scavenger hunt in the CERN Computing Centre

    CERN Multimedia

    CERN Bulletin

    2013-01-01

    Hidden among the racks of servers and disks in the CERN Computing Centre, you’ll find Hawaiian dancers, space aliens, gorillas… all LEGO® figurines! These characters were placed about the Centre for the arrival of Google’s Street View team for the world to discover.   PLEASE NOTE THAT THE COMPETITION IS OVER. ONLY FOR REFERENCE, HERE IS THE ORIGINAL ARTICLE. We’re pleased to announce our first global scavenger hunt! Spot three LEGO® figurines using Google’s Street View and you’ll be entered to win a gift of your choice from our CERN Gift Guide. A LEGO® figurine in the CERN Computing Centre, as seen on Google Street View. Here are the details: Find at least three LEGO® figurines hidden around the CERN Computing Centre using Google Street View.   Take screencaps of the figurines and e-mail the pictures to TreasureHunt-ComputingCentre@cern.ch. This email is no longer active.   The...